Teen Intervention Project-Cherokee (TIP-C)

COUNTRY: UNITED STATES

REGION: AMERICAS

Implementer: Lowe and colleagues

Partners: The Cherokee Nation

Program Overview: TIP-C is a cultural school-based intervention developed to reduce substance abuse among Cherokee adolescents.

Program Design: TIP-C consists of a 10-week group intervention, implemented over 3 years for Cherokee adolescent substance abusers. The project was adapted from its parent project, the Teen Intervention Project (TIP), which was itself adapted from the Student Assistance Program (SAP), a school-based intervention designed to help adolescents address alcohol and drug abuse problems. TIP-C was developed with Cherokee culture and history in mind, paying particular attention to the Cherokee conception of self-reliance, which was integrated into the program as a justification for abstaining from drugs. The program design also integrates elements of social learning theory and problem behavior theory.

Students receive instruction in small groups (<12) that meet for ten 45-minutes sessions over the course of the 10-week period. These sessions are led by an interventionist trained especially for the project, and comprise the following topics:

1. Group introduction and guidelines
2. Substance abuse education and Native American History and substance abuse
3. Recognition and acknowledgement of personal substance use problems; self-monitoring of substance use; Cherokee traditions of being responsible; and being disciplined and confident 
4. Identifying high-risk situations
5. Commitment generation; identifying alternatives to substance use; and Cherokee traditional activities
6. Commitment generation; alternatives to use; and lifestyle change
7. Coping with stress and Cherokee concept of self
8. Relationship building; Cherokee life-way of right relationships; family conflict resolution; and Cherokee family structures/roles
9. Abstinence violation effect; practicing resistance/refusal; and review of Cherokee way of being disciplines
10. Social support and closing ceremony

Evaluation: The program was evaluated using a randomized, controlled trial with a total of 108 participants recruited from the Cherokee Nation, all high school students between the ages of 13-18 years old. After the intervention, the program's efficacy was evaluated using 3 sets of surveys; one pre-intervention survey, one immediate post-intervention survey, and a final 90-day post-intervention survey. Paired ANOVA analyses were conducted to compare participants' scores on three measures; rates of substance abuse, levels of stress, and demonstration of Cherokee self-reliance. 

Key findings: The evaluation yielded the following results:

• Stress was reduced immediately post intervention, but returned to their pre-intervention levels after 90 days
• Substance abuse was significantly decreased immediately post-intervention and 90 days post-intervention
• Levels of Cherokee self-reliance significantly increased immediately post-intervention and 90 days post-intervention

References:

1. Lowe, J. (2006). Teen Intervention Project--Cherokee (TIP-C). Pediatric Nursing, 32(5), 495-500.

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