Journal of Community Engagement and Scholarship

Volume 9 | Issue 1 Article 9

May 2016 A Community-University Approach to Substance Abuse Prevention Lola Baydala University of

Fay Fletcher University of Alberta

Melissa Tremblay University of Alberta

Natasha Rabbit Nehiyaw Kakeskewina Learning Society

Jennilee Louis Nehiyaw Kakeskewina Learning Society

See next page for additional authors

Follow this and additional works at: https://digitalcommons.northgeorgia.edu/jces

Recommended Citation Baydala, Lola; Fletcher, Fay; Tremblay, Melissa; Rabbit, Natasha; Louis, Jennilee; Ksay-yin, Kisikaw; and Sinclair, Caitlin (2016) "A Community-University Approach to Substance Abuse Prevention," Journal of Community Engagement and Scholarship: Vol. 9 : Iss. 1 , Article 9. Available at: https://digitalcommons.northgeorgia.edu/jces/vol9/iss1/9

This Article is brought to you for free and open access by Nighthawks Open Institutional Repository. It has been accepted for inclusion in Journal of Community Engagement and Scholarship by an authorized editor of Nighthawks Open Institutional Repository. A Community-University Approach to Substance Abuse Prevention

Authors Lola Baydala, Fay Fletcher, Melissa Tremblay, Natasha Rabbit, Jennilee Louis, Kisikaw Ksay-yin, and Caitlin Sinclair

This article is available in Journal of Community Engagement and Scholarship: https://digitalcommons.northgeorgia.edu/jces/vol9/ iss1/9 Baydala et al.: A Community-University Approach to Substance Abuse Prevention A Community-University Approach to Substance Abuse Prevention

Lola Baydala, Fay Fletcher, Melissa Tremblay, Natasha Rabbit, Jennilee Louis, Kisikaw Ksay-yin, and Caitlin Sinclair

Abstract In response to high rates of substance abuse in their communities, members of the Maskwacis four Nations invited university researchers to partner in culturally adapting, implementing, and evaluating an evidence-based substance abuse and violence prevention program, the Life Skills Training program (Botvin & Griffin, 2014). This project used a community-based participatory research (Israel, Schulz, Parker, & Becker, 1998; Minkler & Wallerstein, 2003) approach, and was carried out by university and First Nation community partners. To evaluate the impact of the adapted program, students completed pre and post questionnaires, and community members participated in focus groups. The adapted Maskwacis Life Skills Training program was delivered in schools for three years. Students’ knowledge increased significantly during program delivery, and strong support was documented from community members. This project demonstrates the impact that can be facilitated by culturally adapting and delivering a prevention program, and by forming a community-university partnership.

Introduction Project Initiation The Maskwacis , located in central The current project stemmed from a previ- Alberta, , include four communities: ous pilot project led by a partnership between LouisBull, Montana, Samson, and Ermineskin. university researchers and Alexis Nakota Sioux These neighboring Plains Nations have a Nation members (Baydala, Fletcher, Worrell, combined population of approximately 15,000 Kajner, Letendre, & Rasmussen, 2014). Alexis with roughly 53% of the population aged 17 or community members sought to address the root under (Grekul & Sanderson, 2011). The causes of fetal alcohol spectrum disorder, and Nations are governed by independent chief and invited university researchers to partner with them councils, and have separate education directors in working toward substance abuse prevention. and schools. This pilot project involved the cultural adaptation, National media attention has focused on high delivery, and evaluation of a substance abuse and rates of crime and gang violence in Maskwacis, violence prevention program in the Alexis com- largely ignoring the rich and vibrant Cree culture munity. The Botvin Life Skills Training (LST) pro- that threads the four Nations together. In Maskwa- gram (Botvin, Baker, Renick, Filazzola, & Botvin, cis, Cree history, culture, and language are featured 1984; Botvin & Griffin, 2014) was chosen for the prominently in traditional community ceremonies project, based on the results of a literature review and cultural events that regularly take place. Com- that identified the program as having extensive, munity Elders view their culture and language as high-quality evidence to support its effective- a means to combat the social and public health ness, including multiple randomized control trials problems that face Maskwacis community (National Registry of Evidence-based Programs members as a result of the destructive impact of and Practices, 2008). The three-year LST program colonization, residential schools, and forced has three levels, each including between 8 and 14 assimilation. Research evidence supports this one-hour modules, and begins in either elementary perspective, demonstrating that a positive cultural or junior high school (see Table 1). identity can be a protective factor against In 2010, a Maskwacis community member substance abuse and violence for Indigenous attended a presentation delivered by university children and youth (French, Kim, & Pillado, researchers and Alexis community members. Fol- 2006; Gazis, Connor, & Ho, 2009; Kulis, Napoli, lowing this presentation, Maskwacis community & Marsiglia, 2002). members invited university researchers to partner in introducing and adapting the LST program in their own community.

Published by NighthawksVol. 9, No. Open 1 ­—JOURNALInstitutional Repository, OF COMMUNITY 2016 ENGAGEMENT AND SCHOLARSHIP—Page 68 1 Journal of Community Engagement and Scholarship, Vol. 9, Iss. 1 [2016], Art. 9 Table 1. Life Skills Training Levels Life Skills Training (MLST) program, began in the Level Grade Modules first year of the project. Elementary School Program During the first year, a six-member adaptation I committee was formed consisting of Elders from II boosters

III boosters each of the Maskwacis four Nations. This commit-

Junior High School Program tee met weekly to complete adaptations to the first I level of manuals. Adaptations to the second and II boosters

III boosters third levels were completed by a rotating group of Elders. During adaptation meetings, over 30 dif- ferent Elders from all four communities reviewed Project Objectives the original LST curriculum and provided recom- The partners identified three broad objectives mendations for adaptations, consisting of Cree lan- for the current project: (1) culturally adapt the LST guage and syllabics, Elders’ teachings, and personal program to reflect the language, culture, and visual life stories. Following committee meetings, com- images of the Maskwacis community; (2) deliver munity and university partners worked together the adapted program in Maskwacis schools; and to adapt the manuals. Additionally, a community (3) evaluate the impact of the adapted program. member created visual images for the manuals that Given the established effectiveness of the LST pro- reflected the Maskwacis culture and community. gram in reducing substance abuse and violence After adaptations were completed, Elders reviewed and increasing skills related to prevention, the aim and provided approval for the adapted manuals. of the current project was to deliver the culturally Throughout the adaptation process, Elders adapted program with fidelity to the original were instrumental in ensuring that the adapted curriculum, and to document the impact of the program accurately reflected the Cree culture. adapted program. For example, one of the modules in the original LST curriculum focused on the harmful effects of Program Adaptations tobacco use. However, Elders shared the impor- Research has demonstrated the importance tance of distinguishing between “poison tobacco” of programming for Indigenous children to reflect and “sacred tobacco” (i.e., kistemaw). In Mask- Indigenous worldviews and culture (Hare, 2011). wacis, kistemaw has important spiritual, cultural, Further, the cultural content of programming has and ceremonial purposes, such as being offered to been correlated with enhanced learning for Indige- communicate gratitude in advance of a request. nous children (Tsethlikai & Rogoff, 2013). A recent Accordingly, the original LST module on smoking policy report also declared that the representation was adapted to focus on both the detrimental of Indigenous cultures, languages, and traditions effects of poison tobacco as well as the healthy in school classrooms is essential for promoting the traditional use of kistemaw. Additionally, in or- academic success of Canadian Indigenous children der to reinforce program adaptations, MLST staff and youth (Toulouse, 2008). For minority popula- created digital stories to accompany each program tions in general, culturally adapted evidence-based module; these were guided and narrated by programs have been shown to be more effective community Elders. than standard programs (Kumpfer, Magalhaes, & As Figure 1 shows, the adaptation process Xie, 2012). resulted in a program that incorporated both The LST program is a generic program prov- Western and Indigenous foundations of substance en highly effective with students from different abuse and violence prevention. Rather than infus- geographic regions, socioeconomic circum- ing Indigenous pillars of effective substance abuse stances, and racial-ethnic backgrounds (Botvin, prevention into an existing Western framework, Griffin, Diaz, & Ifill-Williams, 2001). However, the integrity of the lessons from each worldview because the LST program does not incorporate Cree was maintained. values, language, culture, and identity, Maskwacis community members and Elders decided to Methods culturally adapt the program. In keeping with the Community-Based Participatory Research principles of knowledge to action research (Gra- This project used a community-based partic- ham, Logan, Harrison, Straus, Tetroe, Caswell, & ipatory research (CBPR) approach (Israel, Schulz, Robinson, 2006), adaptations to the LST program, Parker, & Becker, 1998; Minkler & Wallerstein, and the corresponding creation of the Maskwacis 2003). With an emphasis on tangible benefits for https://digitalcommons.northgeorgia.edu/jces/vol9/iss1/9Vol. 9, No. 1­—JOURNAL OF COMMUNITY ENGAGEMENT AND SCHOLARSHIP—Page 69 2 Baydala et al.: A Community-University Approach to Substance Abuse Prevention Figure 1. Model Incorporating Abuse and Violence Prevention Ideas from Both Western and Indigenous Traditions

Culture

nolege Social Sills

entity istory

eusal Sills Sel anagement

anguage

communities, co-learning, equitable involvement, program evaluation was participatory, with input and respect for multiple forms of knowledge, and guidance from all partners; and all reports and CBPR can contribute to leveling power imbalances program materials were created collaboratively between community and university partners. and approved by all partners. The project was Because Indigenous peoples are calling for approved by the research ethics board at the part- research to be done with and for Indigenous com- ner university and by the Maskwacis First Nations munities rather than on Indigenous communities, through a Band Council Resolution (the authori- CBPR has been recognized as particularly suitable ty mechanism by which elected representatives in for research involving Indigenous peoples (Cas- First Nation communities support and authorize tleden, Morgan, & Lamb, 2012; Koster, Baccar, & an action). Lemelin, 2012; Smith,1999). The partners in this project applied the principles of CBPR in multiple Focus Groups ways. In particular, academic team members trav- A total of 25 focus groups were held over the eled to the community each week to engage in team course of the three-year project with 42 school meetings; meetings began with smudging and personnel, 102 students, 18 Elders, four parents, a prayer conducted in the local ; a and 12 MLST facilitators. With the exception of consensus-based decision-making model was fol- student focus groups, which were held with classes lowed with contributions from all team members; of approximately 20 students, focus groups includ-

Published by NighthawksVol. 9, No. Open 1 ­—JOURNALInstitutional Repository, OF COMMUNITY 2016 ENGAGEMENT AND SCHOLARSHIP—Page 70 3 Journal of Community Engagement and Scholarship, Vol. 9, Iss. 1 [2016], Art. 9 Table 2. Number of Students Who Completed Questionnaires

Year Pre Year Post Year 2 Pre Year 2 Post Year Pre Year Post 2

ed between six and eight participants to enable Questionnaires effective information sharing (Kreuger & Casey, To evaluate learning of program content, ques- 2015). Focus groups took place at the end of each tionnaires were distributed to students before and of the three program years, and were held sepa- after each year of program delivery. The LST ques- rately with school personnel from each school, tionnaire (National Health Promotion Associates, students from each school, Elders, parents, and 2011a; 2011b) and Piers-Harris Self-Concept Scale, facilitators. The length of focus groups was Second Edition (Piers & Herzberg, 2002) were between one and two hours. distributed to students. The wording of LST ques- Using purposive sampling, university partners tionnaires was adjusted to accommodate students’ recruited MLST facilitators, school personnel, reading levels. The elementary school version of and students to participate in focus groups, while the LST questionnaire included items regarding community partners recruited Elders and parents. knowledge and attitudes toward smoking and Community and university partners worked drinking, as well as social and personal self-man- together to gather consent for participation. agement skills. The junior high version of the LST Although university partners facilitated all focus questionnaire included similar content with an groups, community partners were present during added focus on drug refusal skills. Additionally, Elder focus groups to translate from Cree to LST questionnaires were adapted to include a cul- English where necessary. University research tural knowledge scale consisting of items created team members who conducted focus groups had by community members and Elders. From the ini- graduate-level training in research methods tial stages of the project, community partners em- and focus group facilitation as well as specific phasized the importance of using a strengths-based experience working with Indigenous communities. approach. Accordingly, questionnaire items that Different focus group guides were developed directly questioned frequency of substance use for school personnel, students, Elders, parents, and were eliminated. Instead, questionnaire items MLST facilitators. Questions focused on partic- focused on constructs that are highly related to ipants’ experiences with the program adaptation decreased substance use (i.e., knowledge, attitudes, and delivery, program impact on students, schools, self-management, refusal, and social skills). and the community, unanticipated successes and Children who provided verbal assent and challenges, and suggestions for improvement. whose parents provided written consent for partic- Focus groups were conducted using a conversa- ipation completed questionnaires before and after tional style whereby participants were invited to each year of program delivery (see Table 2). Where speak to one another rather than directly to the assent and/ or consent was not provided, children facilitator, disagreements were encouraged, and still received the MLST program but did not com- participants were guided to express their thoughts plete questionnaires. in their own words and on their own terms A sequential longitudinal cohort design was (Kitzinger, 2005). used, and a linear mixed model was used to analyze With participants’ permission, focus groups the questionnaire data. The linear mixed model has were audio recorded and transcribed verbatim. advantages over repeated measures ANOVA for Data were managed with ATLAS.ti software, and working with repeated measures data (Kreuger & analyses were completed using content analysis. Tian, 2004). Primarily, a linear mixed model gives Data were grouped according to common content, structure to the error term by adding additional and a preliminary coding scheme was developed. random-effect terms. This is important to properly The coding scheme was refined during discussions account for error that can arise due to correlations among partners, and themes were subsequently between data points within the same subject identified. Transcripts and preliminary data anal- (intra-subject correlation). Also, the linear mixed yses were presented to participants as a means of effects model can accommodate missing data member checking. points, and is less likely to lead to spurious results (both Type I and Type II error) with categorical data. https://digitalcommons.northgeorgia.edu/jces/vol9/iss1/9Vol. 9, No. 1­—JOURNAL OF COMMUNITY ENGAGEMENT AND SCHOLARSHIP—Page 71 4 Baydala et al.: A Community-University Approach to Substance Abuse Prevention Results gets to have a bulk of what I teach.” Additionally, Focus Groups facilitators were impacted by the opportunity to Focus group findings were grouped into three build strong relationships with Elders, and also overarching themes, consisting of (i) program described feeling proud to make a difference in impact; (ii) factors that contributed to the program’s their community. success; and (iii) suggestions for improvement. Factors contributing to program success. Program impact. Focus group participants Among the multiple contributors to the MLST described the impact of the MLST program in a program’s success, participants described the number of areas. School impact was a particular focus on cultural teachings as paramount. Accord- area of focus. Participants described how the ing to participants, it was critical for facilitators program allowed for traditional Elders’ teachings and Elders to teach students about the impor- to be brought in to the schools; that the program tance of respect, honoring the Creator, speaking facilitated both student and teacher learning about Cree, learning Maskwacis history, and developing Cree culture and the Maskwacis community; and cultural pride. These teachings were fundamental how the program had resulted in positive class- to student engagement and overall program room changes. As one teacher commented, “there’s acceptability. One teacher described how, a more positive environment in the classroom... we’re all communicating and we’re talking and This content would not have worked there’s no yelling.” had it not been presented culturally… Student impact was also described. Partici- we prayed before every class, we burned pants not only discussed how students had demon- sweet grass…and the Elder led them in strated learning of program content; they also prayer and that just locked them in, they described how the program had contributed to knew they were home once they did that. elevating students’ self-esteem, respectful attitudes, In order to enrich the program’s cultural con- and listening skills. According to one student, “I tent, Elder involvement was also critical. Facilita- learned to like myself for who I am.” Similarly, tors felt that Elders’ guidance and knowledge made as a school staff member stated, “I noticed their program adaptations successful, while students, self-esteem was brought up...I noticed with their facilitators, and school personnel appreciated attitudes, they’ve been more respectful...to the class Elders’ presence in the classroom. As one facilitator teacher and they’ve learned to respect themselves described, “it seems like the more we bring the and their fellow peers...” Additionally, focus group Elders in, the more the children benefit.” participants reported that the MLST program had contributed to students’ enhanced sense of pride Table 3. Mean Pre and Post Scores on LST in their identity. One teacher described how the Questionnaire Expressed as Percentages program had “opened up a lot of doors for them Elementary Students to try and realize that being who they are is okay.” Variable Baseline Year Post p value Similarly, Elders reported an increase in youth Overall knowledge 2. . . Anti-smoking knowledge . . . attendance at cultural events in the community. Life skills knowledge . . . Focus group participants also described Elder Cultural knowledge . . . Attitude . . . impact. Elders recounted how the program had Anti-smoking attitudes .2 . . facilitated their own learning by reminding them Anti-drinking attitudes . . .2 Life skills .2 . . about ancestral teachings shared by other Elders. Elders also felt that their participation in the pro- Table 4. Mean Pre and Post Scores on LST gram allowed them to contribute to their com- Expressed as Percentages munity in meaningful ways, resulting in positive } Junior High Students personal impact. As one Elder described, “it Variable Baseline Year Post p value warmed my heart to make me feel wanted.” Overall knowledge . Anti-drinking knowledge .22 Similarly, facilitator impact was described. Life skills knowledge 2 . Facilitators felt that they had benefited from Cultural knowledge . Attitude . being immersed in cultural teachings, and Anti-smoking attitudes . described bringing traditional teachings into their Anti-drinking attitudes . Life skills . own homes for their children and grandchildren to Drug refusal skills . learn: “I had pride in what I was teaching. And for Assertiveness skills . Relaxation skills . my personal life...I’m raising my grandson, and he Self-control skills .

Published by NighthawksVol. 9, No. Open 1 ­—JOURNALInstitutional Repository, OF COMMUNITY 2016 ENGAGEMENT AND SCHOLARSHIP—Page 72 5 Journal of Community Engagement and Scholarship, Vol. 9, Iss. 1 [2016], Art. 9 Additionally, focus group participants com- Table 5. Total Pre and Post Scores on Piers-Harris Chil- mended the program’s community relevance. dren’s Self-Concept Scale-2 Expressed as Mean T Scores Because the program was adapted specifically for Elementary Students the Maskwacis community by Maskwacis Elders Variable Baseline Year Post p value Total score elementary .2 and community members, the program incor- Total score unior high . porated community relevant language and visual images as well as local knowledge. Additionally, Suggestions for improvement. Focus group because MLST facilitators were community participants made a number of suggestions for members, they were familiar to many students; program improvement related to program delivery. even where facilitators and students did not have In the first year of implementation, it was strongly pre-existing relationships, focus group participants suggested that facilitators take part in additional reported that students could easily identify with training to enhance their teaching and classroom facilitators from their own community. management skills. This was addressed during Facilitator skills were also important for the the second and third years of implementation. In program’s success. Equipping facilitators with the addition, focus group participants communicated necessary skills was a challenge in the first year of that the program should be delivered for the full the program, with school personnel noting steady school year rather than for only four months of improvements in the second year of implementa- the year. One teacher felt that, “In order to really tion, and providing exclusively positive feedback in get the full benefit of the program, it needs to be the third year. The most important facilitator skills reinforced all year long…so they are always described by focus group participants were sincer- reminded and supported.” ity, confidence, the ability to engage students, the Suggestions for improvement were also made flexibility to accommodate students’ learning and related to program content. During the first year reading levels, and classroom management compe- of implementation, a recommendation was made tence. One teacher noted that, “it was really great to increase the involvement of Elders in program that [the facilitator] was so enthusiastic about the delivery, to incorporate more cultural teachings, program…it got the kids engaged, and they could and to improve the readability of manuals. Each sense that she really cared.” of these suggestions were addressed by setting Although it was important for facilitators to a goal to bring Elders into each MLST class, and possess skills in leading students through program by adapting manuals to include stronger cultural teachings and activities, teacher involvement was elements and lower reading levels. Suggestions also described as essential. Facilitators noted that were also made to add modules related to grieving when teachers supported and contributed to MLST and gender roles, as well as to implement a par- classes, students demonstrated increased engage- ent component. Finally, focus group participants ment. It was helpful for teachers to assist with strongly suggested that the program include more classroom management, to provide feedback to hands-on activities: “When we would do activities, facilitators, and to supplement facilitators’ teachings it was amazing, it was the most interaction I would with their own knowledge and experience. By the get out of my kids all year.” third year of implementation, all facilitators and school personnel reported strong relationships. Questionnaires Finally, it was important for the MLST pro- Questionnaire results are summarized below, gram to demonstrate compatibility with the with scores at baseline and at the final data school’s core curriculum. According to school collection point (i.e., year 3 post) depicted. personnel, the MLST program complemented Tables 3 and 4 show LST questionnaire scores for students’ regular social studies curriculum, and elementary and junior high students respectively. was a suitable replacement for regularly scheduled Analyses demonstrated statistically significant health classes. This simplified the task of fitting increases in scores for elementary students on all MLST classes into busy classroom schedules. Even LST questionnaire scales. For elementary students, when classroom schedules were hectic, however, the Overall Knowledge scale included items rele- teachers were willing to prioritize the program: vant to anti-smoking knowledge (i.e., the harmful “They’re life skills, they’re things that are literally effects of smoking) and life skills knowledge (i.e., going to get them into their adulthood, so maybe communication, decision-making, advertising, math can wait a little while.” self-esteem, dealing with stress, and assertiveness). Items relevant to cultural content (e.g., Cree words https://digitalcommons.northgeorgia.edu/jces/vol9/iss1/9Vol. 9, No. 1­—JOURNAL OF COMMUNITY ENGAGEMENT AND SCHOLARSHIP—Page 73 6 Baydala et al.: A Community-University Approach to Substance Abuse Prevention and cultural protocol) were included in the Cul- like other social-emotional measurement tools, the tural Knowledge scale. The Attitude scale included Piers-Harris-2 was validated using a U.S. sample of items relevant to anti-smoking and anti-drinking primarily Caucasian children (Piers & Herzberg, attitudes. Finally, the Life Skills scale included the 2002), and its applicability to Indigenous children same content as the life skills knowledge items, but has not been established. Moving forward, it will inquired about behaviors related to these content be important to establish and utilize pre and post areas rather than inquiring about knowledge. measurement tools that reflect the unique realities Statistically significant differences between of Indigenous children. baseline and the end of year 3 were also demon- In addition to pre and post questionnaires, strated for junior high students on all LST ques- focus groups were implemented to provide insight tionnaire scales with the exception of relaxation regarding program impact, factors contributing skills. For junior high students, Overall Knowledge to program success, and suggestions for improve- included anti-drinking knowledge and life skills ment. Conducting focus groups after each year of knowledge. The Cultural Knowledge scale includ- program delivery allowed for suggestions to be ed items with the same content as that of the ele- addressed continually, contributing to growing mentary questionnaire. Also similar to elementary community support. Overall, focus group students, the Attitude scale included anti-smoking participants communicated strong support for and and anti-drinking attitude content. Finally, the Life investment in the program as a promising means to Skills scale included items relevant to drug refusal address substance abuse and violence and to skills, assertiveness skills, relaxation skills, and enhance traditional culture in Maskwacis. Focus self-control skills. groups provided information regarding the wide- Table 5 depicts elementary and junior high spread impact of the program on schools, Elders, students’ scores for the Piers-Harris Children’s facilitators, and students. Self-Concept Scale-2. There were no statistically Key to program impact was the utilization of significant differences between baseline and a community-based participatory approach that the end of year 3 for elementary or junior high incorporated Western and Indigenous pillars of students on the Piers-Harris-2. knowledge. In this way, the MLST program hon- ored the concept of “two-eyed seeing” (Figure 2), Discussion developed by Mi’kmaw Elders Albert and Mudena The current project demonstrates the mean- Marshall. “Two-eyed seeing” recognizes multiple ingful impact that can be achieved by culturally diverse perspectives as valid without privileging adapting and delivering an evidence-based pre- one viewpoint over another. Enacting this principle vention program in a First Nations community. also means acknowledging that multiple perspec- Quantitative results obtained from pre and post tives can lead to a richer understanding of health LST questionnaires showed significant positive issues than one perspective alone. By acknowledg- increases in knowledge, skills, and attitudes ing the value of Western and Indigenous substance between baseline and the end of year three. Find- abuse prevention models, our community-univer- ings reflect that students not only retained the sity partnership provided an example of how Indig- knowledge communicated to them through the enous and Western research paradigms can co-ex- MLST program, but that students learned progres- ist in a space that honors both worldviews. Focus sively more from the program each year. Further, groups revealed that this was critical to the success because students’ scores increased related to both Figure 2. “Two-Eyed Seeing” Perspectives original program content and additional cultural content, these results demonstrate that students improved their knowledge, skills, and attitudes re- lated to substance abuse from both Euro-Western and Indigenous perspectives. With regard to the Piers-Harris questionnaire, there were no statistically significant differences between scores at baseline and the end of year three. This may be due in part to students’ scores being average at baseline (i.e., t scores approximated 50). It may not be realistic to expect mean self-concept scores to increase beyond an average range. Further,

Published by NighthawksVol. 9, No. Open 1 ­—JOURNALInstitutional Repository, OF COMMUNITY 2016 ENGAGEMENT AND SCHOLARSHIP—Page 74 7 Journal of Community Engagement and Scholarship, Vol. 9, Iss. 1 [2016], Art. 9 of the project. In particular, schools and commu- necessary to once again prove the effectiveness of nity members identified the central importance of the program; rather the aim of this project was to cultural adaptations to the program’s acceptance deliver the culturally adapted program with fidelity by students, schools, and the wider community. to the original curriculum, and to document the Focus group participants also reported that adapta- impact of the adapted program. tions elevated the program’s potential to reach and engage students by presenting content in a way that Conclusion was relevant to their community and cultural con- Maskwacis community members and Elders text. Similarly, adaptation of MLST questionnaires established a partnership with University of was important to honor community partners’ per- Alberta researchers to culturally adapt, implement, spectives regarding the importance of capturing the and evaluate an evidence-based substance abuse program’s impact on students’ cultural knowledge. and violence prevention program. Students’ The current project also suggests that CBPR overall knowledge increased significantly during can act as a catalyst for community change. How- the three years of program implementation, and ever, although pre and post questionnaires and strong support was documented from schools, focus groups provided the opportunity to obtain Elders, students, and other community members. important community feedback on the MLST This project demonstrates the considerable impact program, our research team identified a number that can be facilitated by culturally adapting and of unanticipated and peripheral community delivering a prevention program, and by forming impacts that were not accounted for by the use of our and maintaining a strong community-university conventional evaluation methods. For example, partnership. community partners took on leadership roles in the program and formed a non-profit society to References sustain the MLST program beyond the terms of Baydala, L., Fletcher, F., Worrell, S., Kajner, T., our original research grant. In order to more fully Letendre, S., Letendre, L., & Rasmussen, C. (2014). understand these additional impacts, we supple- Partnership, knowledge translation, and substance mented the current evaluation methods with Out- abuse prevention with a First Nations community. come Mapping (Earl, Carden, & Smutylo, 2001; Progress in Community Health Partnerships, 8(2), Tremblay, Baydala, Rabbit, Louis, & Ksay-yin, 145–155. submitted for publication). Outcome Mapping is Botvin, G.J., Baker, E., Renick, N.L., Filazzola, a tool that is sensitive to community change and A. D., & Botvin, E.M. (1984). A cognitive-behav- development, and that emphasizes the significant ioral approach to substance abuse prevention. Ad- process of culturally adapting and implementing dictive Behaviors, 9(2), 137–147. programs in the context of a CBPR partnership. Botvin, G.J., Griffin, K.W., Diaz, T., & Ifill-Wil- Finally, a potential limitation of this study liams, M. (2001). Drug abuse prevention among should be acknowledged; namely, the current study minority adolescents: Posttest and one-year fol- does not include a control group. In order to engage low-up of a school-based prevention intervention. all four Nations in this project, it was necessary to Prevention Science, 2(1), 1–13. deliver the MLST program in all Maskwacis schools. Botvin, G.J., & Griffin, K.W. (2014). Life Skills An intervention group and control group were ini- Training: Preventing substance misuse by enhanc- tially defined; however, because these groups came ing individual and social competence. New Direc- from the same schools, it was not possible to main- tions for Youth Development, 2014(141), 57–65. tain the integrity of the control group. In particular, Castleden, H., Morgan, V. S., & Lamb, C. students often switched back and forth between (2012). “I spent the first year drinking tea”: Explor- control group and intervention group classrooms, ing Canadian university researchers’ perspectives and teachers indicated that students were sharing on community-based participatory research in- MLST teachings with students in the control group. volving Indigenous peoples. The Canadian Geog- Consistent with our experience, recent literature rapher, 56(2), 160–179. indicates that treating complex community change French, S.E., Kim, T.E., & Pillado, O. (2006). initiatives as controlled experiments may be inap- Ethnic identity, social group membership, and propriate, particularly in the context of CBPR (Kel- youth violence. In N. G. Guerra & E. P. Smith ly, 2010). In addition, we intentionally selected an (Eds.), Preventing youth violence in a multicultural evidence-based program with extensive research society (pp. 47–73). Washington, DC: APA Books. to support its effectiveness. As a result, it was not Gazis, N., Connor, J.P., & Ho, R. (2009). Cul- https://digitalcommons.northgeorgia.edu/jces/vol9/iss1/9Vol. 9, No. 1­—JOURNAL OF COMMUNITY ENGAGEMENT AND SCHOLARSHIP—Page 75 8 Baydala et al.: A Community-University Approach to Substance Abuse Prevention tural identity and peer influence as predictors of San Francisco, CA: Jossey-Bass. substance use among culturally diverse Australian National Health Promotion Associates, Inc. adolescents. Journal of Early Adolescence, 30(3), (2011a). Life skills training questionnaire: Elementary 345–368. school version. Retrieved from www.lifeskillstrain- Graham, I.D., Logan, J., Harrison, M.B., ing.com. Straus, S.E., Tetroe, J., Caswell, W., & Robinson, N. National Health Promotion Associates, Inc. (2006). Lost in translation: Time for a map? Jour- (2011b). Life skills training questionnaire: Middle nal of Continuing Education in the Health Profes- school version. 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Fay Fletcher is professor and associate ing group dynamics to explore perceptions, expe- dean academic, Faculty of Extension, the Uni- riences, and understandings. In I. Hollway (ed.), versity of Alberta. Melissa Tremblay is a program Qualitative research in health care (pp. 56–70). evaluator in the Department of Pediatrics at the Maidenhead: Open University Press. University of Alberta. Natasha Rabbit is the exec- Kreuger, R.A., & Casey, M. (2015). Focus utive director of the Nehiyaw Kakeskewina Learn- groups: A practical guide for applied research (5th ing Society in Maskwacis, Alberta. Jennilee Louis is ed.). Thousand Oaks, CA: Sage Publications. a research assistant for the Nehiyaw Kakeskewina Kreuger, C., & Tian, L. (2004). A comparison of Learning Society in Maskwacis, Alberta. Kisikaw the general linear mixed model and repeated mea- Ksay-yin is an Elder in the Nehiyaw Kakeskewi- sures ANOVA using a dataset with multiple missing na Learning Society, Maskwacis, Alberta. 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