Youth Running Strong CARA Program to reduce youth methamphetamines and opioids in souther navajo county communities - CareAz, serving as the fiscal agent for the Youth Running Strong Coalition, proposes to implement a comprehensive community-based substance use prevention initiative in the Navajo Nation (Diné) communities of Nahata' Dziil, Houck, Wide Ruins, Sanders, and Lupton in southern Apache County, Arizona. The project is designed to prevent and reduce youth opioid, fentanyl, methamphetamine, and prescription drug misuse while changing the culture and context regarding the acceptability of youth substance use through sustainable community-level environmental strategies. Apache County faces one of the most severe substance use challenges in Arizona. According to the Arizona Department of Health Services, Apache County experienced the highest opioid overdose fatality rate in Arizona in 2023 at 46.3 deaths per 100,000 population. Youth fentanyl exposure continues to increase, with the percentage of youth reporting lifetime fentanyl use rising nearly 44 percent between 2022 and 2024. The service area is approximately 99 percent Navajo (Diné) and is characterized by significant geographic isolation, high poverty rates, limited transportation infrastructure, behavioral health workforce shortages, and restricted access to prevention and early intervention services. The proposed project will serve youth, families, schools, healthcare providers, Chapter Houses, tribal programs, and community organizations within the Sanders Unified School District service area. The project builds upon the coalition’s existing Drug-Free Communities (DFC) infrastructure and utilizes the Strategic Prevention Framework and the Seven Strategies for Community-Level Change to create lasting systems and environmental change. The project has two primary goals: (1) prevent and reduce youth opioid, fentanyl, methamphetamine, and prescription drug misuse by strengthening community conditions that support healthy youth development and reducing youth access to substances; and (2) change the culture and context regarding the acceptability of youth substance misuse by strengthening community norms, policies, practices, and environmental supports that promote substance-free lifestyles. Key initiatives include the Diné Safe Medicine Homes Initiative, the Chapter House Youth Protection and Drug-Free Spaces Resolution, the Diné Youth Early Identification and Support (YES) Protocol, the Diné Community Access Reduction and Environmental Assessment (CARE) Initiative, the Diné Youth Protection and Healthy Futures Resolution, the Diné Safe Spaces for Youth Initiative, and community-wide prevention visibility campaigns. The coalition will also implement the evidence-based Too Good for Drugs curriculum and strengthen referral systems that connect youth and families to prevention, behavioral health, and support services. Expected outcomes include increased adoption of prevention-supportive policies and practices by community organizations, increased youth participation in prevention activities, expanded community referral networks, reduced youth access to opioids and other substances, strengthened community norms supporting substance-free lifestyles, and improved prevention infrastructure across participating communities. Over time, the project will contribute to reductions in youth opioid, fentanyl, methamphetamine, and prescription drug misuse while creating sustainable community-level systems and environmental changes that support healthy youth development throughout the Navajo Nation communities of southern Apache County.
