{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:33:47Z","timestamp":1793298827697,"version":"4.5.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The present study used qualitative research methods to assess interest in contingency management (CM; where incentives are provided after the return of an alcohol negative urine sample) enhanced with substance-free activities among emerging adults residing on a rural reservation. The research informs the future development and implementation of a clinical trial to address alcohol use among American Indian and Alaska Native (AI\/AN) 18-29-year-olds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Semi-structured qualitative interviews and two focus groups were conducted at a rural reservation outpatient treatment healing center. Participant- relatives (i.e., study participants) were 18\u201329\u202fyears old and currently using alcohol or in recovery; family members of emerging adults who were currently using alcohol or in recovery; or Elders and healthcare professionals (\n                      <jats:italic>N<\/jats:italic>\n                      \u202f=\u202f32). Applying the Healing Center Medicine Wheel (i.e., a framework that focuses on holistic health related to the physical, mental, emotional, and spiritual as well as the structural factors impacting health), a codebook was developed using a qualitative descriptive approach and data analyzed under the guidance of a Community Advisory Board (CAB).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five themes were identified: (1) Importance of Culture and Ceremony; (2) Substance-Free Activities with Higher Levels of Enjoyment-Physical, Mental, Emotional and Spiritual; (3) Substance Free Activities: Barriers and Engagement; (4) Family Impact on Alcohol Use and Recovery; and (5) Views on Health and Recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Through community-driven strategies, frameworks and CAB guidance, a culturally responsive CM intervention was developed and is ongoing. This research provides a culturally informed process template for other Indigenous communities interested in addressing alcohol use among younger adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1745254","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:33:34Z","timestamp":1775626414000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cGuide them to have a future orientation\u201d: qualitative findings in developing a reinforcement-based intervention to address alcohol use with American Indian emerging adults"],"prefix":"10.3389","volume":"14","author":[{"given":"Katherine A.","family":"Hirchak","sequence":"first","affiliation":[{"name":"Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University","place":["Spokane, WA, United States"]},{"name":"Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University","place":["Spokane, WA, United States"]},{"name":"Connections in Indigenous Research, Cultural Leadership, Equity, & Solidarity, Washington State University","place":["Spokane, WA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie","family":"Webb","sequence":"additional","affiliation":[{"name":"Tribal Healing Center","place":["WY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Wagon","sequence":"additional","affiliation":[{"name":"Tribal Healing Center","place":["WY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey","family":"Bajet","sequence":"additional","affiliation":[{"name":"Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University","place":["Spokane, WA, United States"]},{"name":"Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University","place":["Spokane, WA, United States"]},{"name":"Connections in Indigenous Research, Cultural Leadership, Equity, & Solidarity, Washington State University","place":["Spokane, WA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyson","family":"Kelley","sequence":"additional","affiliation":[{"name":"Allyson Kelley & Associates","place":["Sisters, OR, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James G.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Memphis","place":["Memphis, TN, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamilla L.","family":"Venner","sequence":"additional","affiliation":[{"name":"Department 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