PROJECT SUMMARY
Inequities in substance use disorders (SUDs) among American Indian (AI) populations persist despite decades
of awareness and research. Advancements in heretofore separate areas of SUD research have (1)
underscored the importance of community based and culturally grounded research approaches in AI
populations and (2) shown the promise of clinical neuroscience's role in addressing SUD. Merging these
approaches through clinical-cultural neuroscience is a missing link in the field which holds large promise for
advancing both SUD disparities research in AIs and underserved populations, and the neuroscientific
understanding of SUD and recovery more broadly. This proposal integrates Community Based Participatory
Research (CBPR) and clinical-neuroscience approaches to better delineate the brain processes that are
important for SUD and that are impacted by traditional cultural engagement (TCE). The study aims to leverage
the large promise of multimodal neuroimaging techniques as a method for probing TCE using objective
markers of brain structure and function. Conceptualization of TCE will be done in collaboration with partners
from the Shawnee Tribe (ST). This partnership is critical to the current project as culture comprises a broad
category of human experiences common to a group of people and is often conflated with race, ethnicity,
geographic distribution, and religion. This complexity has made it difficult to parse the influence of cultural
factors and meaningfully incorporate TCE into disease and treatment models. Recently, advances in health
disparities research among AI communities have conceptualized features of TCE under the framework of
social determinants of health (SDH) to delineate specific risk and resilience factors for SUD. Furthermore, TCE
has been supported as protective against and as treatment for SUD.
The ST recognizes the impact of historical loss and degradation of cultural practices as a key factor in the
prevalence of SUD and is committed to centering community engagement in developing evidence-based
intervention and prevention efforts informed by and integrating traditional cultural knowledge and practices.
Kipiyeecipsakiciipe “coming home” is a Shawnee word chosen by the ST partners to represent the effort of
advancing the science of TCE in mitigating SUD disparities. A community advisory board of Shawnee adults
will oversee the design, implementation, and interpretation of the study. A three phased approach will be used
to provide a multi-level understanding of TCE as a protective SDH. Phase 1 will consist of focus groups aimed
at refining a conceptualization of TCE specific to the ST to provide deep conceptual validity for behavioral
probes and stimuli for neural probes of TCE. Phase 2 will examine neural probes of TCE and neurobehavioral
and cognitive risk factors for SUD across individuals with varying degrees of TCE as defined by the CAB.
Phase 3 will extend results to a sample of individual with SUD and healthy controls. This study will provide a
framework for studying analogous cultural factor across other racial minority groups to advance health equity.
