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Native Communities: Alcohol Intervention Review (NativeAIR)

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Description of Intervention Variables

Outcomes

Description: Estimates of changes or differences in alcohol-related problems and the stability of those changes or differences.

For example:

  • Changes or differences in the quantity, frequency, trajectory, or intensity of alcohol use
  • Changes or differences in the direction of healthy attitudes toward alcohol use
  • Stability of any observed changes or differences across follow-up assessments

Terms:

  • Negative Change: The measures of alcohol-related problems got worse.
  • No Change: No change or difference at all
  • Low Level of Change: Little change or difference and unstable
  • Medium/Mixed Level of Change: Moderate change or difference, relatively stable, across one to two post-intervention follow-ups, OR if the expert reviewers provided mixed ratings, (e.g., one high and one low)
  • High Level of Change: Moderate to higher change or difference that holds up after two follow‑ups
  • N/A: Not Applicable

Costs

Description: Two domains estimating start-up and ongoing expenses

Best estimate of costs of implementing and maintaining the intervention. Major determinants of costs are number and credentials of staff and salaries, training and supervision requirements, number of sessions, manuals and other materials, and whether or not there is infrastructure upon which to build (e.g., existing health clinic).

Start-Up Costs: Estimates of initial expenses to set up the intervention. This includes infrastructure (e.g., number, credentials, and training of staff and community advisory boards, renting or purchasing of facilities, developing and dissemination of recruitment materials, acquiring research materials and/or constructing culturally based components such as sweat lodges, beads, drums).

Ongoing Costs: Estimates of ongoing expenditures to deliver the intervention. Outlays for maintaining the intervention (e.g., paying staff salaries, rent for facilities, replenishing materials, medications, prizes or reimbursement for participation, number of sessions required).

Terms:

Low ($)

  • Minimal infrastructure required
  • Few personnel and they require little training
  • Little expenditure for materials
  • Limited number of intervention sessions

Medium ($$)

  • Moderate need for infrastructure (e.g., using classrooms after-school program)
  • Some moderately trained and paid personnel
  • Moderate number of intervention sessions
  • Moderate expenditures for materials (e.g., manuals, workbooks)

High ($$$)

  • Requires considerable infrastructure (e.g., telephones, use of clinic rooms)
  • Highly qualified and paid personnel (e.g., Ph.D., M.D.)
  • Extensive costs for materials (e.g., manuals) or software
  • Salary costs for large number of intervention sessions and/or supervision or booster sessions

Insufficient data to assess: Cannot draw strong conclusions

N/A: Not Applicable

Cultural Engagement

Description: Two indicators of cultural and Tribal/community contributions:

Cultural Inclusion: Use of culturally based elements, beliefs and practices of the participating community (e.g., traditional ceremonies, language, icons/symbols, sweat lodges, talking circles, drumming, storytelling), higher-order concepts (e.g., cultural identity, spirituality). Incorporation of historical loss/trauma as a component of the intervention.

Tribal Inclusion: Degree of input from community or Tribe in any and all stages of the research.

Terms:

Cultural Inclusion

  • None Reported
  • Low
  • Medium
  • High

Tribal Inclusion

  • None Reported
  • Low
  • Medium
  • High

Setting

Description: Place(s) in which this intervention was conducted

Terms:

  • Community Center
  • School
  • Clinic/Health Care Setting
  • Social Services Setting
  • Community-Wide
  • Home
  • Rural
  • Urban
  • Reservation
  • Other
  • Insufficient data to assess: Cannot draw strong conclusions
  • N/A: Not Applicable

Participants

Description: Demographic description of the people who participated in the research study. This does not include others mentioned in the article(s) if they did not provide data.

Terms:

Age

  • Fetus (conception to birth)
  • Child (0-12 years old)
  • Adolescent (13−17 years old)
  • Young Adult (18−25 years old)
  • Adult (26−59 years old)
  • Senior (60 years and older) Insufficient data to assess
  • N/A: Not Applicable

Native Status

  • Native
  • Non-Native
  • Insufficient data to assess
  • N/A: Not Applicable

Sex

  • Male
  • Female
  • Both
  • Insufficient data to assess
  • N/A: Not Applicable

Intervention Delivery

Description: Method through which the intervention was delivered to participants in the study. Was the intervention delivered to individuals, small groups (e.g., couples, families), medium groups (e.g., extended families or a single classroom), or larger groups (e.g., entire schools or community)? Or was it delivered on multiple levels (e.g., community-wide, individual sessions, medium groups)? This element also includes method of delivery, such as face-to-face, telephone conversation, or platforms for eHealth (the use of information and communication technologies for health) or mHealth (medical and public health practice supported by mobile devices), including web-based or text-messaging apps.  

Terms:

  • Individual
  • Small Group (0–10)
  • Medium Group (10–50)
  • Large Group (50 or more)
  • Multi-level
  • Insufficient data to assess: Cannot draw strong conclusions
  • N/A: Not Applicable
  • Face-to-face Delivery
  • Telephone Call Delivery
  • eHealth or mHealth Delivery

Staffing Needs

Description: Credentials and/or background of personnel who delivered the intervention.

Terms:

Credentials

  • Advanced Degree (post B.A.) Professional: Advanced academic credentials such as Ph.D., M.D., M.S.W., or R.N.
  • Certified Professional: Credentials or certifications that do not require a B.A. degree (e.g., licensed alcohol and drug counselors, certified alcohol and drug counselors), community health coaches/aides, addiction counselors
  • Not specified
  • N/A: Not Applicable

Background

  • Educator: Classroom teacher/educator, teacher’s aide
  • Community Leader: Influential in community such as a Tribal leader, community expert, Elder, traditional healer
  • Community Member: Parent, extended or nuclear family members, other non-related adults, peers
  • Not specified
  • N/A: Not Applicable

Research Design

Description: Methods employed to gather research data.

  • Focus on essential elements of the research design
  • Collection of pre- and post-intervention data
  • Presence or absence of comparison groups
  • Random assignment to condition

Terms:

  • No pre-intervention data: No data collected prior to intervention, and only post­intervention data reported and compared to a non-equivalent comparison group
  • Pre-/post-intervention data: Data collected prior to and after intervention, with no comparison group (e.g., program evaluation)
  • Quasi-experimental design: Data collected prior to and after intervention, compared with a non-random comparison group (e.g., multiple time series design, interrupted time series design, nonequivalent comparison group design)
  • Randomized controlled experimental design, or randomized controlled trial (RCT): Data collected prior to and after intervention, random assignment to intervention and control group (e.g., step wedge design, wait-list control design)
  • Insufficient data to assess: Cannot draw strong conclusions
  • N/A: Not Applicable

Developmental Stage of Research

Description: Stage of development of the evidence supporting this intervention. Can strong conclusions be drawn from the existing research-based evidence, including earlier related studies that contributed to the present intervention?

Terms:

  • Early-Stage Suggestive Research: Feasibility demonstrated but limited ability to draw strong conclusions, and preliminary evidence in research with one or more significant limitations in group equivalence and the control of extraneous and confounding variables
  • Mid-Stage Promising Research Practice: Moderate ability to draw strong conclusions based on research that adequately addresses group equivalence and control of extraneous and confounding variables
  • Mature-Stage Demonstrated Efficacy: High ability to draw strong conclusions based on well-designed research that effectively addresses group equivalence and control over extraneous and confounding variables
  • Insufficient data to assess: Cannot draw strong conclusions
  • N/A: Not Applicable

Potential

Narrative offered by expert reviewers providing overall comments or evaluations about the intervention. These include:

  • What worked well?
  • What did not work well?
  • How could difficulties be resolved?
  • Would further implementation be feasible given local resources and cultural acceptability?
  • Is the intervention transportable, i.e., sufficiently flexible to allow for further cultural adaption?
  • Outside of a carefully controlled research setting, would the intervention show promise to guide practice in Native communities?
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