Youth as Preventionists: The Twofold Impact of Having High Risk Youth Culturally Adapt Substance Abuse Prevention Programs

Purpose: This research (1 K01 DA017276-05) investigated the twofold benefits of having high risk youth in community settings systematically make cultural adaptations to an evidence based curriculum (i.e., benefits to the curricula and benefits to the youth doing the adaptation process). Older youth (N=202) who have already initiated their drug use utilized their personal experiences in the re-creation of scenarios and videos in order to have a better “fit” with their communities. Methods: Utilizing instruction manuals and guidance, groups of youth made systematic changes to the curriculum and recreated videos in order to more appropriately fit their peer culture. Focus Groups and surveys were administered before and after adaptation processes. Results: Youth who adapt are easily engaged; animatedly discussing the payoffs and downsides of drugs and alcohol, but also that the groups that received the culturally adapted versions had better outcomes than those that received the original curricula or no intervention (Holleran Steiker, 2008). During the adaptation phase, it was clear that there was a two-fold impact on the youth; that the curriculum they created resulted in improved outcomes for their peers (only the adapted group displayed consistent decreases in acceptance across all three time points) and that the actual participation in the adaptation process resulted in attitude and behavior changes in the youth. Due to the sample size and consistently high rates of use of participants, there were no statistically significant effects found for the Phase I youth. However, qualitative data suggest that the youth that participated in the adaptation process became more aware of their own use and rates of use, experienced some cognitive dissonance between their use and their role as “Preventionist,” and increased their perceptions of the consequences of substance use, which they clearly depicted in the adapted scenarios and videos. Some participants were not only receptive to the new curriculum, but made comments asserting the self-realization of their past history and decisions. More than one youth made comments during the survey administration, stating, “I had no idea how much I was using until you came.” In addition, one focus group participant suggested that, “It helps you think about what you've done and what you want to do and stuff like that. So you help yourself through helping others… I don't know, like makes you think different than you do now.” Several became very emotional when describing the drug risks that their younger siblings and/or cousins face and their desire to help them resist consequences they themselves have experienced. The participant “experts” in the adaptation process, recognized the implications and consequences for both themselves and their younger peers by discussion their past decisions and future plans. Conclusions: Working with high risk youth in community settings to create more culturally grounded curriculum has an impact on both the youth who create it, and the peers they intend it for. The youth engaged in the adaptation process reported changes in their attitudes towards drugs and alcohol use, as well as a decrease in acceptance.