Conducting culturally relevant, sustainable prevention in Indian country

PURPOSE:  To test a broadly used community diagnostic and outcome instrument, the Communities that Care (CTC) Youth Survey for use with Native American youth.  HYPOTHESIS: The CTC survey measures, developed and normed on a nationally representative sample will not be reliable or valid for Native American youths. METHODS: The study uses the SAMHSA normative CTC survey database consisting of 310,171 adolescents (ages 10-19; grades 6-12), and a range of residences (from farms to cities). In this database 5912 youth self-identified as Native American.  Chronbach alpha reliabilities were computed for each of the 32 CTC scales for the Native American youth and compared to the National Database as a whole. Logistic regression was used to predict daily smoking, frequent drinking, past month marijuana use from the CTC scales.  RESULTS:  Reliabilities of all CTC scales for Native American youths were comparable to those for the National database.  Validity analyses within the Native American sample indicated that the scales predicted smoking, drinking and marijuana use comparably to the National Database.  CONCLUSIONS/DISCUSSION: The CTC scales, as they currently exist are reliable and valid measures for Native American youths. However, we also describe efforts currently underway to improve the CTC Youth Survey by adding potential culturally specific risk and protection indicators and by augmenting the survey to include HIV risk behaviors, an important but little studied outcome among Indian youth.  Combined with the existing CTC survey, these efforts will help researchers and community members to conduct culturally relevant, sustainable prevention in Indian country.