A COMMUNITY-BASED APPROACH TO PREVENTING ALCOHOL-USE AMONG ADOLESCENTS ON AN AMERICAN-INDIAN RESERVATION

This paper examines the effectiveness of a 5-year community-based heal th promotion program to reduce the rate of substance use, particularly alcohol, by adolescents on a Plains State American Indian reservation . The program was part of the Kaiser Family Foundation Community Healt h Promotion Grants Program. Since a reservation control group was not available, adolescents sewing as control groups far other Community He alth Promotion Grants Program communities, including a small sample of rural American Indians, were used as a basis for comparison. School-b ased surveys of 9th and 12th graders were carried out on the reservati on and in five relevant California control communities-two suburban, t hree rural-in 1988, 1990, and 1992. The results showed that the use of both alcohol and marijuana declined substantially among American Indi an adolescents living on the reservation. Binge drinking (five or more drinks on an occasion) declined from 46 percent to 30 percent, and ma rijuana use (in the past month) declined from 46 percent to 29 percent over the 4-year period. However, there were similar, if smaller decli nes in alcohol use in the comparison groups. Since there was no eviden ce of a relative increase in exposure to alcohol and drug programs on the reservation, the authors are cautious in attributing the significa nt and heartening declines in substance use among adolescents on the r eservation to the community-based program.