Indigenous theoretical perspectives: Cultural elements for American Indian and Alaska Native substance abuse prevention programs and direction for future policies

The majority of current theories guiding substance abuse prevention programs stem from a Western ideology and typically lack Indigenous perspectives. There is a paucity of research on theoretical underpinnings of Indigenous perspectives in American Indian/Alaska Native (AI/AN) communities and their potential role in substance abuse prevention programming. It is well known that when programs are theoretically connected to the communities in which they are implemented, they are more likely to be accepted, accurately measured, and sustained for longer periods of time. This study assessed perceptions on the role of theory in substance abuse prevention in AI/AN communities, with a primary focus on Indigenous perspectives in programming and potential future policy implications. A total of N = 22 in-depth interviews were conducted with key researchers in the field of substance abuse prevention in AI/AN communities, followed by N = 6  brief member check interviews to validate findings. Results provided evidence of a complex ideas characteristically not discussed in reference to substance abuse prevention programs and policy development. The study identified components of Indigenous theoretical perspectives that may guide current and future culturally appropriate and relevant substance abuse prevention programs in AI/AN communities. Cultural elements such as balance, holistic, social cohesion, and belonging were found to be particularly important and currently absent from many substance abuse prevention programs for AI/AN. Implications for future policies show a need for integration of Indigenous perspectives into substance abuse prevention programs for AI/AN communities.