Parenting in 2 Worlds: A Parenting Intervention for Urban American Indians That Strengthens Families through Cultural Engagement

Purpose: Maintaining and re-engaging with traditional cultural heritage is often cited as a potent factor in improving the wellbeing of American Indian (AI) communities. However, culturally appropriate, evidence-based prevention programs are often unavailable to the growing majority of AIs who live in cities. Parenting in 2 Worlds (P2W), a culturally grounded parenting intervention, was created to strengthen protective factors among urban AI families and reduce adolescent substance use and sexual health risks. Employing community-based participatory research in urban AI communities with diverse tribal backgrounds, a multi-stage cultural program adaptation process uncovered and systematically incorporated common AI cultural values and parenting practices into the P2W curriculum. This presentation reports on several measures of the cultural engagement of the P2W participants as an outcome of the intervention and as a moderator of its effects on parenting skills and family functioning.

 Methods: Data come from 575 parents of AI children (ages 10-17) in a randomized controlled trial in three Arizona cities, each with AI migration histories and tribal compositions. Parents were recruited through urban Indian centers and randomized to P2W or to an informational family health program, Healthy Families in 2 Worlds (HF2W). Both P2W and HF2W consisted of 10 workshops delivered weekly by AI community facilitators who were trained by the research team. Parents received incentives for participating in each workshop ($15), 98% consented to complete self-administered questionnaires. Participants could make-up workshops they had missed, and they attended or made-up an average of 8 workshops. Pretests occurred at the first workshop and posttests (over 60% completion) at the last workshop, measuring parenting skills, family functioning, youth and parent risk behaviors, and identification/engagement with traditional AI heritage/culture. The measures of cultural engagement included (1) Phinney’s (1992) Multigroup Ethnic Identity Measure and its Attachment and Exploration subscales;  (2) Bicultural Ethnic Identity Scale (Moran et al., 1999), with  subscales for cultural orientations toward the “AI Way” and “White Way” based on cultural traditions, beliefs, and tribal language; (3) an AI Traditions scale gauging involvement in eleven spiritual and cultural practices; and (4) AI Spirituality, assessing level of involvement in AI spiritual practices and their perceived importance. Tests of the efficacy of P2W versus HF2W were analyzed through baseline adjusted regression models in Mplus using FIML estimation to adjust for attrition, including random effects (site, facilitator), and controlling dosage (# workshops attended). Moderated treatment effects of pretest cultural engagement were tested with mean centered interactions.

 Results: Compared to parents in HF2W, those in P2W reported significantly larger pretest to posttest increases in AI ethnic identity, positive bicultural identification, and AI spirituality. In tests of moderation, these increases in cultural engagement were significantly larger for P2W participants who were less culturally engaged at pretest. In addition, P2W parents with lower baseline AI ethnic identity reported significantly larger desired intervention effects on their child’s antisocial behavior, their own substance use, and parent-child communication about sex.

 Conclusions: Culturally adapted parenting interventions like P2W can effectively build on indigenous cultural heritage to promote well-being of AI parents and their children.