TACUNA (Traditions and Connections for Urban Native Americans)

NCT04617938 | Completed Results DMC

• 1 other identifier: 4UH3DA050235
• Study Type: interventional
• Target: 541
• Locations: 1 country
• Sites: 3

Brief Summary

This study responds to Request For Application-DA-19-035, HEAL (Helping End Addiction Long Term) initiative: Preventing OUD in Older Adolescents and Young Adults (ages 16-30) by developing and implementing a culturally centered intervention to address opioid use among urban AI/AN emerging adults in California. The primary goal of this study is to compare AI/AN emerging adults who receive TACUNA plus a Wellness Circle (WC) to those AI/AN emerging adults who receive an opioid education workshop on outcomes (e.g., opioid misuse and alcohol and other drug use) over a period of 12 months. TACUNA will be a motivational interviewing group intervention that incorporates traditional practices and discussion of how to cultivate healthy social networks and cultural worlds. The Wellness gathering will be for emerging adults and people in their social network, and will focus on how social networks and cultural connectedness influence healthy behaviors. Opioid education will focus on discussion of opioid misuse within the AI/AN urban community and ways to reduce use in a culturally appropriate manner. Investigators expect those who receive TACUNA + WG will report less opioid and AOD (alcohol and other drug) use frequency, fewer consequences, less time spent around peers who use opioids and AOD, and less perceived prevalence of peer use compared to opioid education over a period of 12 months. Also, investigators will evaluate the intervention's effects on secondary outcomes of social networks and cultural connectedness. Survey data is collected at baseline, 3-months, 6-months and 12-months. Longitudinal analyses will compare intervention participant and control participants on primary and secondary outcomes.

Conditions

Alcohol Drinking; Marijuana Use; Opioid Use

Keywords

American Indian/Alaska Native young adults; Cultural intervention; Motivational interviewing

Outcome Measures

Primary Outcomes (5)

• Alcohol Use Past 3 Months

  Survey asks number of times had "At least one drink of alcohol." Response was on a scale with options 0=none, 1=1 time, 2=2 times, 3=3-5 times, 4=6-9 times, 5=10-19 times, 6=20-30 times, and 7=31+ times. Responses were translated to actual number of times by taking the midpoints of intervals, e.g. response 3 ("3-5 times") coded as 4 times. To be conservative values were rounded down when the midpoint was not an integer, e.g. response 4 ("6-9 times") coded as 7 times. Response 7 ("31+ times") was coded as 31 times.

  3, 6, and 12 months post-baseline

• Cannabis Use Past 3 Months

  Survey asks how many times participant used "Marijuana (cannabis, pot, weed, hash)." Response was on a scale with options 0=none, 1=1 time, 2=2 times, 3=3-5 times, 4=6-9 times, 5=10-19 times, 6=20-30 times, and 7=31+ times. Responses were translated to actual number of times by taking the midpoints of intervals, e.g. response 3 ("3-5 times") coded as 4 times. To be conservative values were rounded down when the midpoint was not an integer, e.g. response 4 ("6-9 times") coded as 7 times. Response 7 ("31+ times") was coded as 31 times.

  3, 6, and 12 months post-baseline

• Most Drinks in One Day During the Past Month

  If participant reports any drinks in past month, survey asks "What is the largest number of drinks you had on any day in the PAST MONTH (30 DAYS)?" Response options range from 1 (a few sips) to 17 (15 or more drinks)

  3, 6, and 12 months post-baseline

• Amount of Cannabis Used Per Day When Using

  Participants reporting lifetime marijuana use were asked "On the days you use marijuana, about how much marijuana flower/bud do you personally consume?" with response options ranging from 1="less than 0.25g" to 10="more than 5g."

  3, 6, and 12 months post-baseline

• Opioid Use Past 3 Months

  Measure Description: Survey asks number of times used "Prescription opioid." Response was on a scale with options 0=none, 1=1 time, 2=2 times, 3=3-5 times, 4=6-9 times, 5=10-19 times, 6=20-30 times, and 7=31+ times. Responses were translated to actual number of times by taking the midpoints of intervals, e.g. response 3 ("3-5 times") coded as 4 times. To be conservative values were rounded down when the midpoint was not an integer, e.g. response 4 ("6-9 times") coded as 7 times. Response 7 ("31+ times") was coded as 31 times.

  3, 6, and 12 months post-baseline

Secondary Outcomes (1)

• Cultural Connectedness

  3, 6, and 12 months post-baseline

Study Arms (2)

TACUNA

EXPERIMENTAL

Randomized participants will attend 3 virtual TACUNA workshops, focused on behavioral, physical, and spiritual domains, and designed to guide AI/AN youth to make healthy choices surrounding opioid and AOD use. They will also attend a Wellness Circle, focused on healthy social networks and engaging in traditional practices.

Behavioral: TACUNA plus Wellness Circle

Opioid education

ACTIVE COMPARATOR

Randomized participants will attend 1 virtual opioid education workshop, focused on behavioral and physical domains, and designed to guide AI/AN youth to make healthy choices surrounding opioid and AOD use.

Behavioral: Opioid Education Workshop

Interventions

TACUNA plus Wellness Circle BEHAVIORAL

TACUNA provides three virtual workshops (one hour each) that use motivational interviewing and a virtual Wellness Circle (WC). The workshops combine a 30-minute discussion of opioid, alcohol and marijuana use, and social networks with another 30 minutes focused on three different traditional practices (one per workshop). TACUNA was adapted from our three-session workshop, MICUNAY (Motivational Interviewing and Culture for Urban Native American Youth) protocol, which was developed and tested for urban AI/AN adolescents and from focus groups conducted in Year 1. For the Wellness Circle, youth will have members of their social network virtually attend these once-a-month gatherings. The WC will bring people together to celebrate health and wellness and tradition. The WC will focus on the importance of social networks in making healthy choices, and provide discussion on the role that AOD use and engagement in traditional practices among members of their social networks affect their choices.

TACUNA

Opioid Education Workshop BEHAVIORAL

The virtual opioid education workshop draws from prevention and education materials supplied and recommended by the National AI/AN Technology and Transfer Center, which is funded by SAMHSA. Materials are culturally relevant educational packages addressing opioid use through recorded webinars, toolkits, and other resources.

Opioid education

Eligibility Criteria

• Age: 18 Years - 25 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• must self-identify as American Indian/Alaska Native (AI/AN)
• be in the age range of 18-25
• not be in need of substance treatment

You may not qualify if:

• If substance treatment need is indicated

Sponsors & Collaborators

• RAND: lead
• University of California, Los Angeles: collaborator
• Sacred Path Indigenous Wellness Center: collaborator

Study Sites (3)

United American Indian Involvement, Inc

Los Angeles, California, 90017, United States

Location

UCLA

Los Angeles, California, 90095, United States

Location

RAND Corporation

Santa Monica, California, 90401, United States

Location

Related Publications (4)

• Kuklinski MR, Gibbons BJ, Bowser DM, McCollister KE, Smart R, Dunlap LJ, Shenkar E, Bonar EE, Boomer T, Campbell M, Fiellin LE, Hutton DW, Rao V, Saldana L, Su K, Walton MA, Yilmazer T. Investing in Interventions to Prevent Opioid Use Disorder in Adolescents and Young Adults: Start-up Costs from NIDA's HEAL Prevention Initiative. Prev Sci. 2025 Nov;26(7):1045-1055. doi: 10.1007/s11121-025-01835-6. Epub 2025 Oct 14.

  PMID: 41085955 DERIVED

• D'Amico EJ, Kennedy DP, Malika N, Klein DJ, Brown RA, Rodriguez A, Johnson CL, Schweigman K, Arvizu-Sanchez V, Etz K, Dickerson DL. Risk and protective factors of social networks on alcohol, cannabis, and opioid use among urban American Indian/Alaska Native emerging adults. Psychol Addict Behav. 2023 Aug;37(5):657-669. doi: 10.1037/adb0000918. Epub 2023 Apr 6.

  PMID: 37023284 DERIVED

• Kennedy DP, D'Amico EJ, Brown RA, Palimaru AI, Dickerson DL, Johnson CL, Lopez A. Feasibility and acceptability of incorporating social network visualizations into a culturally centered motivational network intervention to prevent substance use among urban Native American emerging adults: a qualitative study. Addict Sci Clin Pract. 2022 Sep 30;17(1):53. doi: 10.1186/s13722-022-00334-1.

  PMID: 36180896 DERIVED

• D'Amico EJ, Dickerson DL, Rodriguez A, Brown RA, Kennedy DP, Palimaru AI, Johnson C, Smart R, Klein DJ, Parker J, McDonald K, Woodward MJ, Gudgell N. Integrating traditional practices and social network visualization to prevent substance use: study protocol for a randomized controlled trial among urban Native American emerging adults. Addict Sci Clin Pract. 2021 Sep 26;16(1):56. doi: 10.1186/s13722-021-00265-3.

  PMID: 34565444 DERIVED

MeSH Terms

Conditions

Alcohol Drinking; Marijuana Use

Condition Hierarchy (Ancestors)

Drinking Behavior; Behavior; Substance-Related Disorders; Mental Disorders

Limitations and Caveats

All AEs endorsed suicidal ideation in the PHQ. Those endorsing a 1 (several days) were reported to the IRB and PO quarterly. Those with a 2 or a 3 (more than half the days; nearly every day) were reported w/in 1 business day. Phase 1 (P1) informed Phase 2 (CT phase) via focus groups that included participants not part of Phase 2. Parents \& providers--all lacking eligibility in the CT--were also part of Phase 1. No NCT# for P1 as it was not an RCT. P1 was funded under a separate NIH award number.

Results Point of Contact

• Title: Elizabeth D'Amico
• Organization: RAND Corporation

damico@rand.org

310-393-0411

Study Officials

• Elizabeth D'Amico, PhD

  RAND

  PRINCIPAL INVESTIGATOR

• Daniel Dickerson, DO, MPH

  UCLA Integrated Substance Abuse Programs

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 26, 2020
• First Posted: November 5, 2020
• Study Start: November 23, 2020
• Primary Completion: March 6, 2025
• Study Completion: July 28, 2025
• Last Updated: July 6, 2026
• Results First Posted: July 6, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (3)