An Efficacy Trial of the Ho‘ouna Pono Drug Prevention Curriculum: An Evaluation of a Culturally Grounded Substance Abuse Prevention Program in Rural Hawai‘i

This study reports on the drug use outcomes in an efficacy trial of a culturally grounded, school-based, substance abuse prevention curriculum in rural Hawai‘i. The curriculum (Ho‘ouna Pono) was developed through a series of preprevention and pilot/feasibility studies funded by the National Institute on Drug Abuse, and focuses on culturally relevant drug resistance skills training. The present study used a dynamic wait-listed control group design (Brown, Wyman, Guo, & Peña, 2006), in which cohorts of middle/intermediate public schools on Hawai‘i Island were exposed to the curriculum at different time periods over a 2-year time frame. A total of 486 youth participated in the study. Approximately 90% of these youth were 11 or 12 years of age at the start of the trial. Growth curve modeling over 6 waves of data was conducted for alcohol, marijuana, cigarettes/e-cigarettes, crystal methamphetamine, and other hard drugs. The findings for alcohol use were contrary to the hypothesized effects of the intervention, but may have been a reflection of a lack equivalence among the cohorts in risk factors that were unaccounted for in the study. Despite this issue, the findings also indicated small, statistically significant changes in the intended direction for cigarette/e-cigarette and hard drug use. The present study complements prior pilot research on the curriculum, and has implications for addressing Native Hawaiian and Pacific Islander health disparities.