Abstract
We examined the effectiveness of the Qungasvik (Tools for Life) intervention in enhancing protective factors as a universal suicide and alcohol prevention strategy for young people ages 12−18 living in highly affected rural Alaska Native communities. Four communities were assigned to immediate intervention or to a dynamic wait list. Outcomes were analyzed for 239 young people at four time points over two years of community intervention. Outcomes assessed two ultimate variable protective factors buffering suicide and alcohol risk, and three intermediate variable protective factors at the individual, family, and community level. Dose dependent intervention effects were associated with growth in ultimate but not intermediate variables. This evaluation of the Qungasvik intervention provides support for the effectiveness of its Indigenous strategies for suicide and alcohol misuse prevention in this rural Alaska Native setting. Though findings did not provide support for a theory of change where growth in ultimate variables is occasioned through effects on intermediate variables, research designs focused on young people who enter intervention at lower levels of preexisting protection hold promise for better understanding of intervention change processes. The Qungasvik intervention is responsive to an acute public health need for effective rural Alaska Native suicide and alcohol risk prevention strategies.
Original language | English (US) |
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Pages (from-to) | 184-197 |
Number of pages | 14 |
Journal | American Journal of Community Psychology |
Volume | 71 |
Issue number | 1-2 |
DOIs | |
State | Published - Mar 2023 |
Externally published | Yes |
Bibliographical note
Funding Information:This research was possible only through the contributions of numerous individuals, councils, groups, and past project staff. These include the Yupiucimta Asvairtuumallerkaa Council, the Ellangneq Council, the Yuuyaraq Council, the Regional Coordinating Council, the Ellangneq Advisory Group, and the Ellangneq, Yupiucimta Asvairtuumallerkaa, and Cuqyun Project Staff. The Yupiucimta Asvairtuumallerkaa Council included Sophie Agimuk, Harry Asuluk, Thomas Asuluk, T. J. Bentley, John Carl, Mary Carl, Emily Chagluk, James Charlie, Sr., Lizzie Chimiugak, Ruth Jimmie, Jolene John, Paul John, Simeon John, Aaron Moses, Phillip Moses, Harry Tulik, and Cecelia White. The Ellangneq Council included Catherine Agayar, Fred Augustine, Mary Augustine, Paula Ayunerak, Theresa Damian, Lawrence Edmund, Sr., Barbara Joe, Lucy Joseph, Joe Joseph, Placide Joseph, Zacheus Paul, Charlotte Phillip, Henry Phillip, Joe Phillip, Penny Alstrom, Fred Augustine, Mary Augustine, Paula Ayunerak, Theresa Damian, Shelby Edmund, Flora Patrick, Dennis Sheldon, Isidore Shelton, Catherine Agayar, Theresa Damian, Freddie Edmund, Shelby Edmund, Josie Edmund, and Flora Patrick. The Yuuyaraq Council included the elders Ben Tucker, Phillip Yupanik, Andrew Kelly, Matrona Yupanik, Mike Andrews, Sr., Maryann Andrews, Evan Hamilton, Jr., Nick Tucker, Paul Crane, Clara Andrews, Bernice Redfox, Margaret Charles, Cecilia Redfox, Ray Waska, Sr., Peter Moore, and Martin Moore, Sr., and community members Ronald Trader, Fredrick Joseph, Marvin Kelly, Stephen Levi, Leandra Andrews, Malora Hunt, Dominic Hunt, Patrick Tam, Yolanda Kelly, Emily Crane, Grace Charles, Roberta Murphy, Ray Waska, Jr., Doug Redfox, Evan Charles, Mark Tucker, Greg Fratis, and Wilbur Hootch. The Regional Coordinating Council included Martha Simon, Moses Tulim, Ed Adams, Tammy Aguchak, Paula Ayunerak, Sebastian Cowboy, Lawrence Edmund, Margaret Harpak, Charles Moses, and Raymond Oney. The Ellangneq Advisory Group included Walkie Charles, Richard Katz, Mary Sexton, Lisa Rey Thomas, Beti Thompson, and Edison Trickett. Past members of the Qungasvik Project Staff included Debbie Alstrom, Carl Blackhurst, Rebekah Burkett, Diana Campbell, Arthur Chikigak, Gunnar Ebbesson, Aaron Fortner, John Gonzalez, Scarlett Hopkins, Nick Hubalik, Charles Moses, Dora Nicholai, Eliza Orr, Marvin Paul, Michelle Dondanville, Jonghan Kim, Rebecca Koskela, Johanna Herron, Roy Bell, Sam Joe, and Dhara Shah. Previous investigators who lead this project include our originating PI, Gerald Mohatt and our original lead analyst, David Henry. The Qungasvik External Advisory Committee includes Joseph Trimble, Arthur Blume, Edison Trickett, and Kirk Dumbrowski. We wish to highight the notable intellectual, logistic, and spiritual contributions of Elders to this work, including those of Paula Ayunerak, Lawrence Edmund, Fred Augustine, Placid Joseph, Joe Phillip, Barbara Joe, Lucy Joseph, Joe Joseph, Mary Teresa Augustine, Paul John, Andrew Kelly, Mike and Maryann Andrews, and Paul Nukusuk. The Yukon Kuskowkim Health Corporation has been a consistent support of this research for over 25 years. This study was funded by the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Mental Health, the National Institute for Minority Health and Health Disparities, and the National Institute of General Medical Sciences (R01AA023754, R21AA016098, U19MH113138, R24MD001626, P20RR061430, R01AA023754). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the NIH or its Institutes. Finally, we wish to acknowledge immense contributions of the late Edison Trickett throughout a long research relationship with our team, and we thank all the participating communities. Yup'ik Yup'ik Yup'ik
Publisher Copyright:
© 2022 The Authors. American Journal of Community Psychology published by Wiley Periodicals LLC on behalf of Society for Community Research and Action.
Keywords
- American Indian/Alaska Native
- alcohol
- community based participatory research
- multilevel community intervention
- suicide