Vaping Endgame: cultural approaches and preliminary findings of an adapted vaping pilot intervention for American Indian youth.

BACKGROUND: American Indian (AI) youth report disproportionately high e-cigarette use (16%), twice that of Non-Hispanic White youth (8%). However, culturally tailored vaping prevention interventions remain. Preliminary findings from the pilot assessment of Vaping Endgame (VE), an AI culturally adapted vaping prevention curriculum developed through a community-informed process, highlights pre-post outcomes, participant acceptability, and satisfaction. METHODS: Using Community-Based Participatory Research and Positive Youth Development principles, the VE curriculum was adapted from the Intervention for Nicotine Dependence: Education, Prevention, Tobacco, and Health and included Medicine Wheel elements. AI students participated in the 5-day VE program. Pre-post assessment included knowledge, attitudes, perceived behavioral control, intentions toward e-cigarette use, and readiness to change vaping behaviors. Feedback from participants and Youth Advocate Team (YAT) members assessed acceptability and satisfaction of the curriculum. RESULTS: Of 63 eligible AI students (7-12 grade), 32 participated in the VE pilot intervention (50.8% participation; 100% retention). Participants had a significant increase in knowledge of vaping harms (100% vs. 88%), commercial tobacco marketing tactics toward youth (94% vs. 97%), and ceremonial tobacco use (6% vs. 16%). Their perceived behavioral control against vaping significantly increased (r = -0.50, P < .001). Students rated the curriculum and facilitator (average 8.8/10). YAT members described pride contributing to the VE program. CONCLUSION: Preliminary outcomes showed changes in knowledge and perceived behavioral control of vaping, and high satisfaction of the VE program. To our knowledge, this is the first culturally responsive vaping curriculum developed and assessed for AI youth, suggesting potential for broader delivery.