Prevention Trial in the Cherokee Nation


This multi-component prevention trial combines a community organizing process from an established intervention (Communities Mobilizing for Change on Alcohol) with screening, brief intervention, and referral to treatment from a newer intervention (CONNECT). Designed to be culturally appropriate for Native American populations, particularly Cherokee youth, this intervention is intended for all high school students in a community.


  • To increase youth bonding, social support, and inclusion
  • To influence youth perceptions of access to alcohol, enforcement, drinking norms, drinking behaviors, and alcohol-related risks and outcomes
  • To reduce social and commercial access to alcohol among youth

Typical Elements

  • An expanded version of the Communities Mobilizing for Change on Alcohol (CMCA) strategic planning process includes (Komro et al., 2015):
    • A local communities organizer to coordinate the CMCA process
    • A series of meetings with community residents to assess local needs and resources related to underage drinking
    • A trained (e.g., on evidence-based environmental prevention strategies) community action team to collaborate with the community organizer
    • Public support for the project, built by conducting additional meetings with influential stakeholders, attending and presenting at community events, and employing media advocacy techniques
    • An action plan, developed using a participatory process that attends to social inequalities, which outlines selected evidence-based, community-level prevention strategies
    • Selected prevention strategies which have been chosen for implementation with the assistance of the community action team and community organizer.
      • Note: In the original demonstration project, communities implemented the CMCA intervention enhanced by compliance checks, hot-spot policing, and media campaigns.
  • Implementation of the CONNECT program (Komro et al., 2015) which includes:
    • The hiring of experienced school-based social workers, counselors, or other certified staff to serve as coaches
    • The training of coaches to implement brief interventions using motivational interviewing techniques with Native American populations, particularly Cherokee youth
    • The delivery of brief one-to-one screening and motivational interviewing sessions to every high school student twice a year by coaches
    • The training of school and community members who work with youth to identify signs of alcohol-related problems and provide referrals to appropriate school and community resources
    • The education of family and community members about the problem and prevention of underage drinking (e.g., mailing postcards to adolescents’ family residences with tips on communicating and connecting with teens, monitoring youth behavior, identifying high-risk behaviors and community resources)
    • Continuous monitoring to improve and institutionalize program components (e.g., delivering in-person booster trainings to help CONNECT coaches communicate effectively with adolescents about alcohol).


  • High school students
  • Other community groups, depending on selected programs and strategies


Compared to control communities, communities exposed to CMCA, CONNECT, or both interventions demonstrated a decrease in current use, heavy episodic drinking, and alcohol-related consequences among high school students (Komro et al., 2017). 


Alcohol Screening and Brief Intervention for Youth: A Practitioner's Guide

​Communities Mobilizing for Change on Alcohol (CMCA)


No recognition found for role of the prevention trial in the Cherokee Nation in preventing underage drinking and/or its consequences.


Komro, K. A., Livingston, M. D., Wagenaar, A. C., Kominsky, T. K., Pettigrew, D. W., & Garrett, B. A. (2017). Multilevel prevention trial of alcohol use among American Indian and White high school students in the Cherokee Nation. American Journal of Public Health, 107(3), 453-459. Retrieved from 

Komro, K. A., Wagenaar, A. C., Boyd, M., Boyd, B. J., Kominsky, T., Pettigrew, . . . Molina, M. M. (2015). Prevention trial in the Cherokee Nation: Design of a randomized community trial. Prevention Science, 16(2), 291-300. Retrieved from