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Native Voices
Native Voices promoted HIV/AIDS, hepatitis, and substance use prevention at a Gathering of Native Americans (GONA).
The health behavior targets for Native Voices intervention were developed based on a comprehensive community-wide needs assessment. The curriculum of the 4-day community-sponsored GONA event teaches skills and knowledge based in Native values and focuses on themes of belonging, mastery, interdependence, and generosity.
Outcomes
Outcomes limited to perceptions of risky behavior, but no behavioral changes.
Behavior did not significantly change, but participants perceived a significantly greater risk of harm in consuming 5 or more alcohol drinks once or twice a week at follow-up. There were similarly significant changes in perceived risk associated with cigarette smoking and marijuana use and improvements in health risk knowledge before and after the intervention.
Costs
Mid-range costs for training and honoraria for personnel to deliver intervention plus implementation costs.
Assuming access to a community center-based infrastructure, start-up and ongoing costs would be mid-range. Costs include staff training, materials for activities, outreach advertising, door prizes, and honoraria for Elders, spiritual leaders, or local performers.
Cultural Engagment
Local community was involved in determining the intervention focus of the GONA, which is highly culturally grounded.
The GONA curriculum, a widely available program developed by Tribal leaders and Indigenous people (see recommended references), is grounded in Indigenous cultural values and knowledge. Students engage in empowering Native activities, including traditional healing ceremonies provided by community members. The curriculum addresses historical trauma and loss.
Participants
Adolescent, Young Adult; Native, Non-Native; Female, Male
Setting
Community Center, Urban
Delivery
Large Group, Face-to-Face
Participating Native American urban agencies carefully selected youth to participate.
San Francisco Bay Area Native youth (n = 186, ages 13–18 years), selected and recruited from area agencies based on established rapport with staff, completed self-report pre-event questionnaires. Of these, 100 completed post-event questionnaires 4 to 6 months following the event, which was held at the Native American Health Center in the San Francisco Bay Area.
Staffing Needs
Community Member
Community members are involved in the focus of and implementation of the GONA.
Community members serve as facilitators.
Research Design
Pre-/post-intervention data
Developmental stage of research
Native Voices demonstrated that GONA may be associated with modest improvements in health knowledge and risk perceptions.
In the present study, the intervention demonstrated modest association with increasing knowledge and risk perception, but did not appear to influence risky behaviors. Results may have been affected by the high loss to follow-up. Furthermore, participants may have been from lower risk groups (i.e., those already connected to culture), which may limit potential for behavior change. These limitations plus lack of a control group prevent attributing changes to participation in the program.
Potential
GONA shows promise to be transportable to different Tribal communities, but the impact on health behaviors is not clear.
The core constructs embedded in the GONA curriculum were designed to be transferable to diverse Tribal contexts. The intervention appears acceptable and easily implemented, but more studies are needed to test its impact on behavior change and substance use prevention.
References
Nelson K, Tom N. Evaluation of a substance abuse, HIV and hepatitis prevention initiative for urban Native Americans: The Native Voices Program. J Psychoactive Drugs. 2011;43(4):349-354. https://pubmed.ncbi.nlm.nih.gov/22400468. https://doi.org/10.1080/02791072.2011.629158.
Aguilera S, Plasencia AV. Culturally appropriate HIV/AIDS and substance abuse prevention programs for urban Native youth. J Psychoactive Drugs. 2005;37(3):299-304. https://pubmed.ncbi.nlm.nih.gov/16295013. https://doi.org/10.1080/02791072.2005.10400523.
Substance Abuse and Mental Health Services Administration (SAMHSA), SAMHSA Tribal Training and Technical Assistance Center. Gathering of Native Americans/Gathering of Alaska Natives (GONA/GOAN) Curriculum and Facilitator Guide Toolkit. Rockville, MD: U.S. Department of Health and Human Services; July 2015. https://www.samhsa.gov/sites/default/files/gona-goan-toolkit.pdf.
Substance Abuse and Mental Health Services Administration (SAMHSA), SAMHSA Tribal Training and Technical Assistance Center. GONA/GOAN Curriculum and Facilitator Guide. Rockville, MD: U.S. Department of Health and Human Services; July 2015. https://www.samhsa.gov/sites/default/files/gona-goan-curriculum-facilitator-guide.pdf.
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