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Table 1 A summary of the articles that were included in the scoping review

From: A scoping review of school-based indigenous substance use prevention in preteens (7–13 years)

S.No Author Country Objectives Target grades Intervention Cultural tailoring
1. Asdigian et al. (2018) [46] United States To evaluate the Effectiveness of the Circle of Life (CoL) program in reducing marijuana use among Alaskan Native (AN) youth. Grade 7–8 The Circle of Life (CoL) program is a 30-h health education and youth development curriculum that integrates theories of behaviour change and cultural knowledge, values, stories, illustrations, historical practices and teachings. The Circle of life was developed by Alaskan Native educators and reviewed by parents, education specialists, and health experts from a wide range of AN communities and organizations.
2. Baydala et al. (2009; 2014) [47, 48] Canada a) To describe the collaboration between the Alexis Nakota Sioux Nation and the University of Alberta to adapt, deliver and evaluate the first year of Life Skills Training program.
b) To outline the process of culturally adapting, delivering and evaluating a substance abuse prevention program for school-aged children in the Alexis Nakota Sioux Nation.
Grade 3–9 The Life Skills Training (L.S.T.) program includes three levels, with each level consisting of between 8 and 14 one-hour lessons delivered to students. It consists of three modules, that consist of between 8 and 14 one-hour sessions delivered over the course of 3 years In the first phase, school personnel, community stakeholders evaluated the program to make sure it reflected the traditional ways of knowing. In the second phase of the project, cultural adaptation of the L.S.T. program was achieved by a) establishment of an Adaptation Committee; b) incorporating traditional knowledge offered by the elders including cultural terms and cultural practices.
3. Baydala et al. (2016) [49] Canada a) To culturally adapt Life Skills Training program to reflect the language, culture and visual images of Maskwasis community
b) To deliver the adapted program in Maskwasis schools
c) Evaluate the impact of the adapted program
Grade 3–8 The Life skills training is an 8-module program offered at three levels at elementary and junior high. It consists of 8 modules delivered as an initial lesson in the first year and booster sessions in the subsequent years. The intervention entails the incorporation of Indigenous and western foundations of substance use prevention. Community elders were involved in adaptation of the original LST program which entailed incorporation of Cree language and syllabics, elders teaching, and personal life stories. Community members created visual images for manuals that reflect the Maskwasis culture and community.
4. Hodder (2017) [50] Australia To examine the Effectiveness of a school-based resilience intervention in reducing the use of tobacco, alcohol and illicit substance use, and increasing individual and environmental protective factors among secondary high school students. Grades 7–10 Each intervention school chose 16 broad strategies seeking to build protective factors across three domains: 1) curriculum, teaching and learning, 2) ethos and environment, 3) Partnerships and services. Not applicable
5. Johnson et al. (2009) [51] United States To examine the efficacy of the Think Smart school-based drug prevention curriculum among elementary school students Grades 5–6 Think Smart is an adaptation of the Personal Intervention Curriculum for Native American adolescents that focusses on teaching a) drug refusal skills, b) anti-drug norms, c) personal self-management skills, and, d) general social skills to resist drug offers. Researchers, and Alaskan natives and other Alaskan consultants were involved in the curriculum adaptation at three levels- surface, deep, and evidential levels. Surface adaptations included Alaksa-specific visuals and examples, deep adaptations involved integrating the values of Alaskan curricula, and evidential adaptations provided more Alaskan-specific statistics. Findings from a feasibility study also informed cultural adaptations.
6. Kulis et al. (2017) [52] United States To describe a small efficacy trial of the Living in 2 Worlds prevention curriculum Grades 7–8 Living in 2 Worlds (L2W) is a culturally adapted version of keepin’ it REAL (KiR) that teaches youth skills to resist drug offers, conduct risk assessments, improve decision making and develop other life skills. The L2W was adapted using a community-based participatory research approach that employed expert knowledge of urban American Indian youth, parents, professional, and prevention curriculum specialists.
7. Lowe et al. (2012) [53] United States To evaluate an innovative school-based cultural intervention targeting substance use among a Native American adolescent population. Not specified The Cherokee Talking Circle (C.T.C.) is a 10-session manual-based intervention where students engage in a 45-min talking circle led by a counselor and cultural expert, once a week over a 10-week period. The research team established partnerships, steering committee which reviewed the intervention manual and selected the most culturally appropriate measures for substance a abuse. Adolescents provided feedback and recommendations that were addressed by the steering committee.
8. Helm & Okamoto. (2013) [54]; Okamoto et al. (2012) [55];
Okamoto et al. (2016) [56];
Okamoto et al. (2019) [57]
United States a) To outline collaboration among Hawai’ian Island communities and a university-based research term to develop, implement and evaluate the Ho’ouna Pono substance use prevention curriculum.
b) To adapt and validate narrative scripts to be used for the video components of a culturally grounded drug prevention program for rural native Hawaiian youth.
c) To examine the Effectiveness of the Ho’ouna Pono curriculum in reducing substance use, increasing the use of drug resistant strategies and improving psychosocial risk factors among middle, intermediate or multi-level school students
d) To outline the drug use outcomes in an efficacy trial of a culturally grounded, school-based substance use prevention curriculum in rural Hawai’i
Grades 6–8 Ho’ouna Pono curriculum is a video enhanced curriculum is delivered once per week for 7 weeks. For each lesson, a video is shown depicting a drug offer, and three possible drug refusal options. Critical thinking skills and practical activities are included in the intervention. Scripts were based on a multiyear study examining the most frequently experienced and challenging problem drug situations reported by rural Hawaiian youth. Youth identified the types of situations where drugs were offered, and the types of drug refusal strategies used. Scripts were based on the seven most frequently experienced and challenging problem drug situations reported by rural Hawaiian youth.
9. Stanley et al. (2018) [58] United States To present research findings being used to adapt an existing substance use prevention media campign for American Indian youth. Grade 7 and 11 The Be Your Own Influence (B.U.Y.O.I) is a media-based substance use prevention campaign that target middle school youth to reframe substance use that is inconsistent with personal autonomy and aspirations. It emphasizes the prosocial influence of older peers at a time when students begin to make decision and substance use. Focus groups were carried out with 7th graders, and photovoice was carried out with 11th grades to guide cultural adaptations.
10. Usera et al. (2017) [59] United States To examine the Effectiveness of the Lakota Circles of Health (L.C. H) in improving healthy decision making on substance use, conflict resolution, communication, self-identity and cultural competence among elementary school students in four American Indian reserves. Grades 4–5 The Lakota Circles of Hope (L.C. H) is a substance use prevention program delivered through grades 2 to 5. It consists of 10 lessons per school year that is based on making healthy decisions within the context of Lakota traditions and values. The L.C.H. was adopted by a team of Lakota educators and was based on four Lakota values: generosity, courage, wisdom and respect. Educators identified instructional patterns, strategies and performance outcomes for the delivery of lessons and activities. Each lesson was adapted to incorporate Lakota ways of knowing and being.
11. Wexler et al. (2017) [60] United States To describe the process and outcome evaluation of the Youth Leadership Program in rural Alaskan schools. Grade 3–12 The Youth Leadership program was adapted from the Health Education Foundation’s Natural Helper curriculum. It uses helpers and peer leaders to increase protective factors and to reduce risk factors associated with drug use, alcohol use, violence and bullying. The curriculum was previously adapted to reflect the realities of the school district and the cultural norms of Alaskan native youth. It incorporates Inupiaq cultural values such as respect for others, cooperation, hard work, responsibility to the tribe, and sharing.