178: Substance Abuse Prevention in the Maskwacis Four Nations: A Community-Based Participatory Research Partnership

Many Canadian pediatric health care providers participate in the conduct and dissemination of research involving Aboriginal children. Even if they are not directly involved in research, front-line clinicians have insight into issues, both medical and sociopolitical, affecting the health of Aboriginal patients, and are uniquely positioned to highlight areas where thoughtfully conducted research could improve the health status of Aboriginal children. A community-based participatory research approach (CBPR; Minkler & Wallerstein, 2003) can identify and address the social determinants of health that impact Aboriginal children and their communities. The current presentation describes a CBPR project carried out by university and First Nation community partners. In response to high rates of substance abuse in their communities, members of a First Nation community invited university researchers to form a partnership to culturally adapt, implement, and evaluate an evidence-based substance abuse and violence prevention program. The objectives of the current presentation are to (1) share evaluation findings from three years of program implementation in community schools; (2) describe how CBPR can address the social determinants of health and build the capacity of university and community partners to address important health issues; and (3) demonstrate how different research paradigms can co-exist in an ethical space that honors multiple worldviews. Evaluation of the culturally adapted program utilized a mixed method approach. Outcome Mapping (Earl, Carden, & Smutylo, 2001), a unique participatory evaluation tool, documented changes in behaviors, relationships, actions, and activities of program stakeholders. Additionally, pre- and post- program questionnaires were distributed to students, and a linear mixed model was used to evaluate learning of program content. Finally, focus groups were conducted with community members to obtain program feedback. Outcome Mapping documented how the process of culturally adapting, implementing, and evaluating the prevention program (1) acted as a catalyst for community development, and (2) built community and academic capacity to facilitate community change. The results of pre- and post-program questionnaires indicated statistically significant improvements in student knowledge, skills, and attitudes related to substance abuse, and focus groups captured the critical importance of the program's cultural content. The process of forming and maintaining a community-university partnership, as well as culturally adapting, implementing, and evaluating the effectiveness of an evidence based substance abuse and violence prevention program led to meaningful individual and community change. Implications relevant to research and practice will be discussed, and findings will be presented from the perspectives of both community and university partners.