Effects of the “Circle of Life” HIV-prevention program on marijuana use among American Indian middle school youths: a group randomized trial in a Northern Plains tribe
Open accessAbstract
BACKGROUND: Early substance use threatens many American Indian/Alaska Native (AI/AN) communities, as it is a risk factor for maladaptive use and adverse health outcomes. Marijuana is among the first substances used by AI/AN youth, and its use becomes widespread during adolescence. Interventions that delay or reduce marijuana use hold the promise of curbing substance disorders and other health risk disparities in AI/AN populations. OBJECTIVES: We evaluated the effectiveness of the Circle of Life (COL) program in reducing marijuana use among young AI adolescents. COL is a culturally tailored, theory-based human immunodeficiency virus (HIV) and sexually transmitted disease (STD) intervention shown to delay sexual initiation among AI youths. METHODS: We conducted secondary analyses of data from a school-based group randomized trial conducted between 2006 and 2007 in all 13 middle schools on a rural, Northern Plains reservation (N = 635, 47% female). We used discrete-time survival analysis (DTSA) to assess COL effectiveness on risk of marijuana initiation among AI youths and latent growth curve modeling (LGCM) to evaluate effects on frequency of marijuana use over time. RESULTS: DTSA models showed that the overall risk of marijuana initiation was 17.3% lower in the COL group compared to the control group. No intervention effect on frequency of marijuana use emerged in LGCM analyses. CONCLUSION: COL is a multifaceted, culturally tailored, skills-based program effective in preventing marijuana uptake among AI youth.
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Culturally grounded school-based programs report lower risk of marijuana initiation among AI youth.
“Culturally grounded school-based programs report lower risk of marijuana initiation among AI youth (Asdigian et al., 2018)”
From Bridging Traditions and Prevention: Insights into Implementing and Sustaining Substance Use Programs for Urban AI/AN Communities (2026) · cites this paper as Asdigian et al., 2018
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Palimaru, A. I., Malika, N., Brown, R. A., Holmes, P., Dickerson, D. L., Johnson, C. L., Sanchez, V. A., Schweigman, K., & D’Amico, E. J. (2026) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2026.209892
- Authors
- Asdigian, N. L., Whitesell, N. R., Keane, E. M., Mousseau, A. C., & Kaufman, C. E.
- Affiliations
- Colorado School of Public Health (US)
- Corresponding author
- Asdigian, Nancy L.
- Venue
- The American Journal of Drug and Alcohol Abuse
- Publisher
- Informa UK Limited
- Published
- 2016-12-29
- Volume
- 44
- Issue
- 1
- Pages
- 120-128
- ISSN
- 0095-2990 (ISSN-L)
- 1097-9891
- PMC
- PMC6774242
- OpenAlex
- W2565935203
- Cited by
- 14
- References
- 29
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2022: 4 · 2021: 2 · 2020: 2 · 2019: 1
- FWCI
- 0.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Drug and Alcohol Abuse (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01 MH069086)
- Office of Adolescent Health (TP2AH000003)
- National Institute on Drug Abuse (R01 DA027665)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- cannabis use, Native American youth, HIV prevention, culturally tailored interventions, substance use prevention, marijuana initiation, adolescent substance use, school-based intervention, Northern Cheyenne
- MeSH terms
- Marijuana Use, Adolescent, Female, Humans, Indians, North American, Male, Primary Prevention, Schools, Sexually Transmitted Diseases, Students, United States, HIV Infections, Outcome Assessment, Health Care
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