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Seventh Generation
After-school prevention program blending skills training with cultural values and content.
Seventh Generation is an after-school intervention program that blends personal and social skills intervention with a strong focus on American Indian (AI) values and identity, decision-making and problem-solving, alcohol use resistance skills, enhancement of self-esteem, strategies to cope with stress and anxiety, and general social skills. The intervention was delivered in weekly 2-hour sessions over 13 weeks; there was a non-equivalent comparison group from a nearby urban setting. Six months after completion, a series of six booster sessions were offered to youth in the intervention group.
Outcomes
Improvement in alcohol beliefs in Seventh Generation compared toa non-equivalent comparison group.
Outcome measures were limited to mediators of alcohol use after piloting of direct questions about drinking (see Moran 1999) found them to be unreliable. The intervention group, when contrasted to the comparison group, showed significant beneficial changes in alcohol beliefs and improved locus of control, depression, and social support at 1-year follow-up (but not immediately after the intervention). While scores for the intervention and comparison groups on these mediators were similar immediately after the intervention, the scores for intervention participants continued to improve at 1-year follow-up.
Costs
Mid-range costs consisting of expenditures for staffing, training, and transportation.
Training and employment of AI community members as well as participant transportation to and from the intervention sites suggest moderate start-up and ongoing costs. Materials needed to modify and deliver the 13 weeks of intervention plus booster sessions could be in the mid-range of costs.
Cultural Engagment
Community extensively involved in identifying core American Indian values to be included in the intervention.
The conceptualization of the program was guided by expertise from the local AI community. The community was involved in finding a unifying theme and name for the intervention. A community group identified the core “trans-Indian” values of the intervention: harmony, respect, generosity, courage, wisdom, humility, and honesty. The program ended with a culturally based “staking ceremony” at which Elders, family, and friends watched participants demonstrate their commitment to avoid alcohol. The level of the American Indian community’s involvement in the research process is unclear.
Participants
Child; Native; Female, Male
Setting
Urban
Delivery
Face-to-Face
American Indian children recruited from schools in two urban centers; intervention conducted at centrally located sites after school.
At baseline, participants were a gender-balanced sample of 378 AI students in 4th through 7th grades with mean ages of 10.3 to 10.8 years. The analysis was limited to 168 students who had 1-year follow-up data. Additionally, to be included in the analysis, youth in the intervention group must have attended 10 or more sessions. The intervention and data collection were conducted in centrally located sites to which the participants were transported after school. Data were collected on a one-on-one basis in the homes of comparison group participants.
Staffing Needs
Community Member
No information on credentials of AI community members who conducted the intervention.
The intervention was delivered by trained local AI community members.
Research Design
Quasi experimental design
Promising initial results yielded information about mediators of alcohol use.
The study showed promising results employing a quasi-experimental -equivalent comparison group. Preliminary work informed the main trial. Some measures had not been validated in the population. Although the study started with a large sample, more than half of participants were lost to follow-up. A major limitation of the intervention was that data were collected differently for the treatment groups and for the comparison group.
Developmental stage of research
Promising initial results yielded information about mediators of alcohol use.
The study showed promising results employing a quasi-experimental treatment/non-equivalent comparison group. Preliminary work informed the main trial. Some measures had not been validated in the population. Although the study started with a large sample, more than half of participants were lost to follow-up. A major limitation of the intervention was that data were collected differently for the treatment groups and for the comparison group.
Potential
Intervention shows promise to be employed in similar AI/AN urban settings.
The Seventh Generation program reflected the beliefs of the participating urban AI communities. Indications are that it may be similarly adapted for use in other AI communities. Because the intervention was not described in detail, the feasibility of replication is difficult to assess.
References
Moran JR, Bussey M. Results of an alcohol prevention program with urban American Indian youth. Child Adolesc Social Work J. 2007;24(1):1-21. https://link.springer.com/article/10.1007/s10560-006-0049-6. https://doi.org/10.1007/s10560-006-0049-6.
Moran JR. Preventing alcohol use among urban American Indian youth: The Seventh Generation Program. J Human Behav Soc Environ. 1999;2(1-2):51-67. https://www.tandfonline.com/doi/abs/10.1300/J137v02n01_05. https://doi.org/10.1300/J137v02n01_05.
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