PROJECT SUMMARY
The overall long-term objectives for this K01 proposal are to (1) develop and evaluate a nature-based culturally
grounded (NBCG) substance misuse intervention tailored to Native American teenage mothers and their young
children that live in a tribal community (2) while also advancing my research and professional capacity to
become an independent research investigator.
Although Native Americans (NA) demonstrate high abstinence rates from alcohol, the generations of trauma
and oppression, ongoing discrimination, COVID-19 pandemic-related consequences, and drug companies
disproportionately targeting Black, Indigenous, people of color (BIPOC) communities have contributed to NAs
experiencing the highest mortality rates from overdose, suicide and alcoholic liver disease (deaths of despair)
as of 2020. NA young women experience heightened risk of interpersonal violence that places them at risk for
substance use disorder (SUD) and other risk-taking behaviors, which can result in unplanned pregnancies.
Their children are then placed in the cycle of addiction as these children are at heightened risk for early
problem emotional and behavioral development, partly due to impaired sleeping, which has demonstrated
increased risk for later substance misuse. These alarming statistics warrant investigation of a promising
culturally grounded substance misuse intervention that targets both young mothers and their children with the
goal of breaking the cycle of addiction by way of restoring our traditional and ceremonial knowledges and
practices with the land. To do this work, we need Indigenous frameworks. The traditional ecological knowledge
(TEK) framework is the theoretical underpinning for the proposed study. Due to the close relational ties NAs
and other Indigenous people have to our land and water, TEK posits additional cultural and spiritual
mechanisms between the natural environment and human health and wellbeing.
The proposed specific aims of this study are to: 1) develop NBCG programming to enhance an evidence-
based home-visiting model to fit the needs of the local context; 2) test the NBCG intervention to determine
feasibility and acceptability; and, 3) evaluate the NBCG intervention for effectiveness and efficiency and refine
modules to maximize fit to the local context to set the stage for a future R01 fully powered Hybrid Type II trial
examining implementation and program effectiveness against maternal substance misuse and child negative
child emotional and behavioral development, risk factors for later substance misuse. This K01 incorporates a
community-engaged exploratory mixed methods sequential study design to inform, evaluate and refine the
NBCG intervention. This study will shed light on proposed theoretical mechanisms (e.g., sleep quality, sense of
connectedness) between nature-based culturally grounded experiential learning (i.e., NBCG intervention) and
resilience and resistance against addiction (NIDA Objective 2.1).
