Affiliation:
1. Department of Nursing and Systems Science Washington State University Spokane Washington USA
2. Native Lifeway Phoenix Arizona USA
3. Seattle Washington USA
4. Northwest Portland Area Indian Health Board Portland Oregon USA
5. University of Washington School of Medicine Seattle Washington USA
6. Portland Oregon USA
7. School of Nursing University of Texas at Austin Austin Texas USA
Abstract
AbstractPrior research suggests that culturally aligned, accessible and lower‐barrier interventions are well‐placed to align with the needs of American Indian and Alaska Native (AI/AN) people with alcohol use disorder (AUD). Taking into account community members' suggestions and the need for physical distancing during the COVID‐19 pandemic, our team developed a protocol for virtual Harm Reduction Talking Circles (HaRTC) to incorporate these points. The aims of this 8‐week, single‐arm pilot were to initially document feasibility, acceptability, and outcomes associated with attendance at virtual HaRTC, which integrates the accessibility of virtual connection, a lower‐barrier harm‐reduction approach, and a culturally aligned intervention. Participants (N = 51) were AI/AN people with AUD (current or in remission) across 41 Tribal affiliations and 25 US states. After a baseline interview, participants were invited to attend 8, weekly virtual HaRTC sessions. At the baseline, midpoint and post‐test assessments, we collected data on virtual HaRTC acceptability, cultural connectedness, quality of life, and alcohol outcomes. Of the 123 people approached, 63% were interested in and consented to participation. Participants attended an average of 2.1 (SD = 2.02) virtual HaRTC sessions, with 64% of participants attending at least one. On a scale from 1 to 10, participants rated the virtual HaRTC as highly acceptable (M = 9.3, SD = 1.9), effective (M = 8.4, SD = 2.9), culturally aligned (M = 9.2, SD = 1.5), helpful (M = 8.8, SD = 1.9), and conducted in a good way (M = 9.8, SD = 0.5). Although the single‐arm study design precludes causal inferences, participants evinced statistically significant decreases in days of alcohol use and alcohol‐related harm over the three timepoints. Additionally, both sense of spirituality, which is a factor of cultural connectedness, and health‐related quality of life increased over time as a function of the number of HaRTC sessions attended. Virtual HaRTC shows initial feasibility and acceptability as a culturally aligned intervention for AI/AN people with AUD. Future randomized controlled trials will provide a test of the efficacy of this approach.