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The Ehlers Laboratory

Principal Investigator: Cindy L. Ehlers, PhD
Preventing Underage Drinking by Southwest California Indians: Building Capacity 
Grant #: NIAAA U01016479

Underage drinking has significant negative consequences including family problems, poor school performance, major injury and mortality from automobile accidents, and increased risk for the development of alcohol addiction as an adult. A national epidemiologic study found that the risk for developing alcohol addiction as an adult was about 40% in youth who begin drinking before 13 years of age. In youth who waited to start drinking until they were 21 years old, only 10% developed alcohol addiction.

The prevalence of heavy drinking by youth is distributed unequally in the U.S. population. Specifically, drinking heavily is more common among rural than urban underage populations and more likely among Native Americans than in other ethnic groups, with rural American Indians drinking more than their urban counterparts. Despite a great deal of research focusing on the nature of underage drinking in rural and American Indian populations, insufficient progress has been made toward preventing drinking problems in these important groups of people.

This study is a joint project of three institutions, the Indian Health Council (IHC), which serves as the primary healthcare facility for the nine north San Diego County reservations, the Pacific Institute for Research and Evaluation's Prevention Research Center (PRC), and The Scripps Research Institute (TSRI) in La Jolla. The study is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Office of Minority Health and Health Disparities. The study's primary goal is to develop and enrich the capacity of the IHC and community coalition members to address the problem of underage drinking in their communities.

The specific aims of this project are:

1. To evaluate and enhance the capacity of Indian Health Council to assess the extent of underage drinking in the areas that it serves. This aim will be implemented by:

a. Training IHC and community coalition members in techniques of quantitative survey design, data collection and analysis in order to develop in-clinic capacity to implement brief surveys to assess the extent of underage drinking on the reservations.

b. Training IHC and community coalition members in techniques of qualitative data collection and analysis in order to investigate the nature of underage alcohol consumption on the reservations and better understand its consequences, including where and how reservation youth obtain the alcohol they consume.

2. To evaluate and strengthen the capacity of Indian Health Council and community coalition members to intervene to reduce underage drinking. To accomplish this PRC and TSRI staff will:

a. Conduct a series of seminars, workshops and training sessions for coalition members, reservation leaders, and interested community members on techniques for environmental prevention of alcohol problems.

b. Conduct a series of seminars, workshops, and training sessions for IHC physicians and staff on Motivational Intervention as a brief intervention technique with youth entering the clinic for treatment of alcohol and related problems.

c. Conduct a process evaluation to document the actions taken by the IHC, community coalitions, and reservation leadership with respect to the treatment and prevention of underage drinking.

3. To mobilize specific sectors of the community to partner with Indian Health Council in preparation for implementation and evaluation of preventive interventions designed to reduce underage drinking in this population. A series of programs will be developed to:

a. Aid IHC in developing an education and outreach program to the community to translate their goals to important community members and enlist their support.

b. Evaluate the program's ability to mobilize IHC physicians and other staff, coalition members, community leaders and other interested reservation residents on their capacity to conduct alcohol research and interventions.