Culture is Prevention: Combining frameworks to create an innovative strength-based inter-Tribal strategic plan

In September 2011, Great Lakes Inter-Tribal Council (GLITC) received a one year Substance Abuse and Mental Health Services Administration (SAMHSA) grant to develop an inter-Tribal five-year system level prevention strategic plan to promote behavioral health, prevent alcohol tobacco and other drug abuse (including prescription drugs), and suicide.  This innovate plan is based upon the growing recognition and evidence from prevention science, nationally that, “Culture is Prevention.” 

A multi-disciplinary team, and policy consortium including representatives from six of the 12 GLITC Tribes and the state of Wisconsin, utilized SAMHSA’s Strategic Prevention Framework, in conjunction with traditional cultural beliefs/approaches and strength-based medicine wheel logic models.  Core components of the plan include: data collection, analysis and reporting; coordination of services; technical assistance and training; and performance/evaluation.  In addition, 66.7 percent of key stakeholders at Tribes (n=44) completed a survey on these topics which further informed the plan.  

Additionally the plan distinguishes between evidence-based practices (EBP) and practice-based evidence (PBE), as Tribes often face challenges implementing EBPs which, although they have undergone rigorous study with the mainstream population, are often not designed nor tested for reliability with American Indian populations.  Conversely, many PBEs have stood the test of time in many Tribal communities but are not validated by many funders who require the use of EBPs.  The plan advocates for the creation of a system to identify effective PBEs and the development of policies to validate effective PBEs.  All components are interrelated; and each section includes considerations for recommendations, relevant goals, and action steps.