Pathways to Prevention - The Indian Health Center of Santa Clara Valley's (IHC) Urban AI/AN Youth Substance Use and Overdose Prevention Initiative will implement evidence-based and locally tailored strategies to build community-driven prevention systems in Santa Clara County, California. This project will strengthen protective factors, reduce risk factors, and expand sustainable workforce and infrastructure capacity to prevent substance use initiation and reduce accidental overdoses among urban American Indian and Alaska Native (AI/AN) youth and young adults from birth through age 24. This program is based in Santa Clara County, California, focusing heavily on San Jose and the county's more rural central and southeast regions where the majority of IHC's patients reside and work. The primary population of focus consists of nearly 8,000 urban AI/AN youth and transition-age youth up to age 24 who navigate severe systemic vulnerabilities and experience disproportionate rates of complex trauma, major depression, and co-occurring substance use disorders, heavily exacerbated by intergenerational trauma, historic culture loss, and an extreme local deficit in culturally integrated care. Urban Native youth in this catchment area face significant socioeconomic inequities, including a 44% chronic absenteeism rate and a 91.3% household poverty rate among IHC participants. The target population demonstrates an acute need for a coordinated network that addresses substance use prevention and mental health. The project will implement highly structured infrastructure and workforce enhancements. IHC will establish an internal, data-driven entry point to services map to streamline coordination across prevention, treatment, and recovery systems. Capacity building will be further reinforced by delivering a Train-the-Trainer curriculum to at least 10 core staff and creating a formalized, annual Overdose Response Protocol that establishes explicit steps for emergency response and naloxone administration. The overarching goals of the project are to establish community-driven prevention and strategic planning systems, increase IHC’s organizational capacity to deliver resilient, community-based services, and expand locally tailored educational and cultural programming. The project aims to achieve specific, time-bound objectives aligned directly with SAMHSA’s Strategic Priorities. Key milestones include completing a comprehensive Community Needs Assessment and a written Strategic Plan in Year 1, hosting regular collaborative community Town Halls, and launching a large-scale social media education campaign designed to engage at least 300 individuals annually. On the ground, the initiative will deliver evidence-based overdose recognition and Narcan training to at least 40 youth, family, and community members annually. Concurrently, frontline staff will deliver 4 quarterly Youth Empowerment Groups and traditional cultural wellness services-including mini Powwows, Round Dances, and Talking Circles—to a minimum of 20 youth and their families each year to build lasting cross-cultural protective factors. Through these direct selective and indicated prevention workflows, the project will serve an unduplicated total of 40 individuals each year, reaching a total of 200 unique participants over the 5-year grant cycle.
