A review of tribal best practices in substance abuse prevention

American Indian youth experience higher rates of substance use than non-American Indian youth. Researchers, clinicians, and treatment programs embrace evidence-based practices (EBPs) and practice based evidence (PBE) as a primary method for addressing substance abuse and advancing behavioral health. However, less is known about the use of tribal best practices (TBPs) and how they are implemented in American Indian substance use prevention contexts. Objective: The main objective of this systematic review was to determine how TBPs are implemented and shared in the context of tribal substance use prevention. The second objective was to document TBP examples from three tribal communities involved in a 5-year substance use prevention initiative. Methods: A systematic review of published and grey literature was conducted using funding agencies websites, EBSCO Host and national registries. Three tribal communities involved in the initiative documented current TBPs to highlight characteristics of TBPs, costs, and approval processes. Results: TBPs are very limited in the literature. Despite tribal use for thousands of years, TBPs are underrepresented and misunderstood. This review found that the terminology used to describe TBPs is not consistent across agencies, publications, websites, or reports. There is also variation in how TBPs originate in substance use prevention contexts and there is not a primary resource or protocol for sharing TBPs. Continued efforts are needed to support the use and dissemination of TBPs in substance use prevention.