Implementing a strength-based adverse childhood experiences prevention program for predominantly Indigenous families: A mixed-method process evaluation

Background: Given high rates of adverse childhood experiences (ACEs) among Indigenous youth, it is critical to develop and evaluate strategies to prevent these experiences; one part of evaluation is process evaluation, including analysis of fidelity, attendance and barriers to attendance, contamination, and program acceptability.

Objective: To present a process evaluation of Tiwahe Wicagwicayapi, a strengths-based, family-based program for predominantly Indigenous youth (ages 10 to 14) and their caregivers. The program aimed to prevent ACEs including child abuse and neglect.

Participants and setting: The project included 124 families from a small-sized city in the Great Plains region of the United States.

Method: The mixed-method evaluation included multiple data sources, including researcher-collected and observations, and participant surveys and interviews.

Results: Results indicated 93 % fidelity on average. About three-quarters of caregivers and children attended at least one session, and the primary barriers to attendance included busyness, medical events, and transportation issues. Contamination was common (32.6 % among children and 36.2 % among caregivers), reflecting the close-knit nature of the surrounding community and consistent with extended kinship systems in Indigenous communities. Finally, participants found the program acceptable and impactful, particularly programming directly related to Lakota culture, traditions, and ceremony.

Conclusions: Findings indicate the importance of cultural relevance to successful and effective programming. These process data along with outcome data published elsewhere suggest that the Tiwahe Wicagwicayapi program is a promising approach to prevent ACEs including child abuse and neglect among Indigenous children.