Using a Community-Based Participatory Research (CBPR) approach, the investigators will
work with community partners to develop a culturally grounded, trauma-informed alcohol
intervention. The investigators will collaborate with community partners to design,
implement, and evaluate this intervention program. A strength of this approach is that in
using existing structures, settings, and resources, this intervention will be able to be
more easily sustained over time. This work will occur in two stages. Stage 1a, will occur
in two phases; first, talking circles will be used to develop the intervention/manual. In
this stage, the investigators will explore their place in the community, identifying
important stakeholders, recognizing strengths and resources at the local level,
pinpointing settings in the community where research and intervention can potentially or
already is taking place, and developing a strong communication and collaboration plan
that involves community members and researchers to allow for an exchange of knowledge
that is bi-directional. Talking circles will identify Indigenous knowledge and practices
related to historical trauma and alcohol use. Benchmark: The end of this first phase will
yield a manual. Results from the talking circle will provide important knowledge on the
targets, techniques, and mechanisms of change for the intervention, as well as the
structure of the intervention, including number and length of sessions, treatment
setting, and format (group or individual). Second, the investigators will conduct an open
pilot trail that will provide information on the manual, delivery of the intervention,
and acceptability of participants. Community members (n = 5) will be recruited to go
through the intervention and provide qualitative feedback after each session that will be
used to further refine intervention components. Benchmark: Open pilot participants will
help further refine the manual for delivery in the randomized pilot trial. During Stage
1b (pilot randomized trial), the investigators will test the feasibility, acceptability,
and potential efficacy of the program in a randomized, 2-group pilot clinical trial.
Participants (N=60) will be randomized to either a wait-list-control (WLC) group (n=30)
or to the culturally grounded, trauma-informed alcohol intervention (n=30). Alcohol
outcomes will be assessed at baseline, completion, and 3 and 6 months post-completion.
The investigators will evaluate whether the program shows promise relative to the WLC
group in terms of alcohol consumption, historical losses and response, well-being, and
community connectedness. Benchmarks: Major intermediate objectives are: 1) adequate
recruitment volume, 2) achievement of targeted enrollment goals, and 3) follow-up rates
>= 85% in Stage 1b pilot trial. In the unlikely scenario that recruitment lags, the
investigators will first increase field efforts at flyering and following up recruitment
letters. If recruitment continues to lag, the investigators have existing relationships
with other Indigenous communities in the nearby area that share the same cultural
heritage and language. If follow-up rates lag, telephone follow-ups will be intensified
and follow-up incentives will be increased as allowed by budgetary constraints. The
investigators will also consider truncating 6-month follow-ups to include only those
items necessary for alcohol use.