Behavioral and Mental Health outcomes from an RCT of a Youth Entrepreneurship Intervention among Native American Adolescents. (December 2020)

• Record Type: Journal Article
• Authors: Tingey, Lauren; Larzelere, Francene; Goklish, Novalene; Rosenstock, Summer; Jennings Mayo-Wilson, Larissa; O'Keefe, Victoria; Pablo, Elliott; Goklish, Warren; Grass, Ryan; Sprengeler, Feather; Ingalls, Allison; Craig, Mariddie; Barlow, Allison
• Is Part Of: Children and youth services review. Volume 119(2020)
• Publication Date: 2020-12
• Subjects: Substance use -- Adolescent -- Entrepreneurship education -- Native American -- Randomized controlled trial -- Violence; Apache/WMAT White Mountain Apache Tribe -- NA Native American -- YRBS Youth Risk Behavior Survey -- CBPR Community Based Participatory Research -- ABG Arrowhead Business Group -- CAB Community Advisory Board -- ACASI Audio Computer Assisted Self-Interview technology -- ITT Intent to treat; Social work with children -- Periodicals; Social work with youth -- Periodicals; Adolescent -- Periodicals; Child Welfare -- Periodicals; Social Work -- Periodicals; Service social aux enfants -- Périodiques; Service social à la jeunesse -- Périodiques; Electronic journals; 362.705
• DOI: 10.1016/j.childyouth.2020.105603
• Languages: English
• ISSNs: 0190-7409

Abstract

Graphical abstract: Highlights: Study presents a culturally tailored entrepreneurship education program for Native American youth living in communities with economic, education, and behavioral and mental health disparities. Results show the program reduced substance use and violence toward others. This strength-based, social determinants approach holds promise to address the most vexing issues facing U.S. youth living in poverty. Abstract: Purpose: This study reports the impact of an entrepreneurship education intervention designed and evaluated specifically for its impact on substance use, suicide and violence-related outcomes among Native American adolescents. Methods: This randomized controlled trial included N = 394 Native Americans ages 13–16. Participants were randomly assigned 2:1 (n = 267:127) to the Arrowhead Business Group intervention versus a control condition. Logistic mixed effects regression models examined within group and between group differences in trajectory from baseline to 24 months follow-up. Results: Fewer intervention vs. control participants used marijuana at 6-, 12- and 24-months post-intervention (19.6% vs. 28.0%, p = 0.032; 20.4% vs. 31.8%, p = 0.01; and 24.1% vs. 31.4%, p = 0.047). All violence-related measures (suicide attempts, carrying a weapon, missing school because felt unsafe, fighting, and fighting at school) statistically significantly declined between baseline and 24 months for both groups. Positive between group differences favoring intervention participants were observed at 6-months for missing school because felt unsafe, and at 24-months for fighting at school. While alcohol use increased for both groups over time, control participants experienced a two-fold higher increase in binge alcohol use than intervention participants (control: 7.1–16.7% vs. intervention: 8.1–13.0%). Conclusions: This is the first report in the US literature of a youth entrepreneurship intervention designed and evaluated to promote behavioral and mental health outcomes. It shows promise for reducing substance abuse and violence toward self and others, the largest health disparities for Native American youth.