Localizing Prevention: Insights from Youth Voices on Culturally Grounded Substance Use Prevention Implementation in Windward O'ahu.

BACKGROUND: High rates of substance use among Native Hawaiian and Pacific Islander (NHPI) youth highlights the importance of culturally grounded prevention initiatives. Ho'ouna Pono (HP) is a culturally grounded substance use prevention program developed and tested with Hawai'i Island youth. Despite its efficacy, HP has yet to be implemented on other islands. This study explores the extent to which HP resonates with youth in Windward O'ahu and adaptations that may be necessary for local-level implementation. METHOD: Rapid qualitative analysis was used to synthesize youth input from five focus groups (N = 22) regarding: (a) general opinions on the relatability of drug offer scenarios presented in the HP curriculum, (b) adaptations to the drug offer scenarios (i.e., what details made the story realistic or unrealistic), (c) drug offer scenarios relevant to students' school districts that were not presented in the HP curriculum, and (d) stories of drug prevention in their community. RESULTS: Results suggest that many drug offer scenarios presented in HP resonate with Windward O'ahu youth. Youth input elucidated potential surface-level modifications to make the drug offer scenarios more relevant for the community, such as setting, language, or peer pressure modifications. CONCLUSION: This research emphasizes the importance of meaningful adaptation for culturally grounded interventions and highlights the important question of for whom, and under what conditions culturally grounded interventions warrant additional adaptation for proximal communities.