Damian Chase-Begay, PhD, MS, is a cultural epidemiologist with a background in Indigenous health whose research largely focuses on reducing the burden of problem substance use in urban, multi-tribal communities. The study he proposes, entitled “Reducing opioid misuse among urban Indigenous young adults in Montana using a culturally centered intervention,” combines rigorous implementation science with cultural adaptation of an existing evidence- based practice (EBP). Candidate: Dr. Chase-Begay is an associate research professor in the University of Montana Center for Population Health Research (CPHR), housed within the School of Public and Community Health Sciences in the College of Health. He completed a Master of Science degree in Healthcare Administration and Interprofessional Leadership at the University of California, San Francisco, and a PhD in Public Health at the University of Montana. His previous work has explored the potential for traditional ceremonial practices (TCPs) to be incorporated into the delivery systems of urban Indigenous health organizations (UIHOs) for a number of physical, behavioral, and health promotion practices. Mentoring Committee: Dr. Chase-Begay and his primary mentor, Dr. Annie Belcourt, who holds dual appointments as professor of public health and chair of Native American studies, have assembled a strong team of mentors to guide the proposed training, research, and career development activities. Dr. Curtis Noonan is a professor of epidemiology, and director of CPHR, and will serve as co-mentor for the award. Dr. Bonnie Duran is professor emerita at the University of Washington School of Social Work, Dr. Daniel Dickerson is an associate professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and Dr. Shannon Wiltsey Stirman is an associate professor in the Stanford University Department of Psychiatry and Behavioral Sciences. Research: The proposed study seeks to rigorously adapt an evidence-based substance abuse prevention intervention to incorporate TCPs and then test this invention with urban Indigenous young adults in Montana. Aim 1 will seek to obtain community-informed guidance on the selection and adaptation of an evidence-based substance use prevention intervention, and incorporation of TCPs, through a sequential mixed-methods process. Aim 2 will seek to test the effectiveness and sustainability of the adapted EBP at five UIHO sites throughout Montana via a hybrid type 2 implementation-effectiveness trial.

NARRATIVE Problem substance use is a significant issue for many contemporary Indigenous communities, both reservation-based and urban, and opioid misuse is especially disproportionate among Indigenous young adults (ages 18-29) throughout the state of Montana, despite the fact that Indigenous communities hold traditional knowledge and tools, including traditional ceremonial practices (TCPs), that could be wielded to stem the tide of problem substance use. By obtaining community guidance on the rigorous adaptation of an existing evidence-based substance abuse prevention intervention to incorporate TCPs we can develop an effective, sustainable, and culturally centered approach aimed at reducing opioid misuse among urban Indigenous young adults. Once obtained, evidence of effectiveness of this approach can be used to more broadly inform public policy and, especially, expand reimbursement for these services by public and private payors to enhance their sustainability.