WELCOME TO THE NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM WEBINAR, SUBSTANCE ABUSE PREVENTION FOR YOUTH IN INDIGENOUS COMMUNITIES. WE ARE PLEASED THAT YOU CAN JOIN OUR CONVERSATION WITH NIA STAFF SUPPORTED BY NIAAA AND ALASKA INDIGENOUS COMMUNITY MEMBERS WHO COLLABORATE WITH US. THE OBJECTIVE OF TODAY'S WEBINAR IS TO DISCUSS INNOVATIVE PREVENTION STRATEGIES FOR INDIGENOUS COMMUNITIES. IN PARTICULAR, I'LL TAP INTO THE COMMUNITY'S CULTURE CAN SERVE AS A CORNER STONE FOR PREVENTION EFFORTS. MUCH OF TODAY'S DISCUSSION WILL FOCUS ON A TOOLKIT THAT DEVELOPED BY THE NIAAA GRANTEES FROM THE UNIVERSITY OF ALASKA FAIRBANKS AND THE TOOLKIT WAS IN COLLABORATION WITH ONE SPECIFIC INDIGENOUS POPULATION NATIVE ALASKAN COMMUNITY. EQUALLY IMPORTANT, WE WILL DISCUSS HOW A FOCUS ON CULTURALLY APPROPRIATE AND COMMUNITY-BASED PRINCIPLES MAY BE APPLICABLE IN YOUTH PREVENTION EFFORTS IN COMMUNITIES. WITH ALL THE, EVIDENCE-BASED SERVICES TO RURAL AREAS, THE DISPROPORTIONATE AMOUNT AND IMPACT OF ALCOHOL USE AND ZOOS I'SUICIDE ON INDIGENOUS COMMUNITIES AND THE RECENT DISPROPORTIONATE IMPACT OF COVID-19 ON RACIAL AND ETHNIC MINORITY COMMUNITIES, I CANNOT THINK OF A BETTER TIME TO HAVE THIS CONVERSATION. AS A SIGN I HAVE I CAN COMMUNITY WE NEED TO HELP OUR OFTEN, UNDERSERVED, INDIGENOUS COMMUNITIES. THIS RESEARCH IS AN IMPORTANT PART OF THAT EFFORT. WE HAVE A LONG COMMITMENT TO SUPPORT RESEARCH THAT ADDRESSES THE NEEDS OF UNDERSERVED MINORITY AND INDIGENOUS AND THIS SESSION WAS INSPIRED IN PART BY A TRIP I MADE TO ALASKA. WE VISITED BETHAL, OSCARVILLE AND ILLUSTRATED IN THIS PHOTO WITH ME IS DR. BARBRA MAYSON, WHO IS ALSO GIVING CNE PRESENTATIONS DURING THIS TRIP AND TIFFANY HALL, OUR HOST IN RECOVER ALASKA. THE EXPERIENCE AFFECTED ME GREATLY. I RETURNED TO THE LOWER 48 WITH STRONG AND I MUST SAY, MIXED EMOTIONS. I FELT SAD BY THE PERSISTENT HARDSHIPS THAT I WITNESSES IN THESE SMALL INDIGENOUS TOWNS. I FELT FRUSTRATED BY THE INTRACTABLE ALCOHOL PROBLEMS THAT EXIST THERE AND THE FORMIDABLE BARRIERS IN IMPLEMENTED INCOMPETENTER SELECTIONSIMPLEMENTINTERVENTIONS AND THE A PPROACHES OF THE SERVICE OF THE COMMUNITY HEALTHCARE PROFESSIONALS AND THE PERIOD OF A PROUD PEOPLE WHO LIVES, OFTEN UNDER VERY DIFFICULT CIRCUMSTANCES. WHEN I RETURNED, I ASKED MY STAFF TO THINK CREATIVELY ABOUT NEW WAYS OF GETTING THE WORD OUT ABOUT THE NEED TO ADDRESS ALCOHOL USE IN INDIGENOUS COMMUNITIES. ABOUT PROMISING EVIDENCE-BASED PREVENTION STRATEGIES. AND THE SIMPLE FACT THAT WE NEED TO BRING EMPATHY TO OUR SCIENTIFIC ENDEAVORS MAKING SURE WE NEVER FORGET THAT THE RESEARCH COMMUNE CAN HELP THESE CARING PEOPLE WHO ARE STRUGGLING TO CREATE HEALTHY ENVIRONMENTS AND PROMISING FUTURES FOR THEIR CHILDREN AND FAMILIES. MY TEAM RESPONDED WONDERFULLY AND WORKED DILIGENTLY AS PART OF THIS EFFORT AND I'D LIKE TO TURN THE PRESENTATION OVER TO BOB FREEMAN, WHO WILL INTRODUCE OUR PRESENTERS, IT'S ALL YOURS. OUR FIRST SPEAKER TODAY WILL BE BILL CHARLES. HE IS A MEMBER OF THE NATIVE VILLAGE OF AND SEVERAL CAPACITY IN HIS COMMUNITIES BEING A FORMER TRIBAL PRESIDENT, MAYOR AND PRESIDENT OF HIS VILLAGE CORPORATION. HE IS AN ACTIVE MEMBER OF HIS SONG AND DANCE GROUP AND CO INVESTIGATOR ON THE KUNDASTIC PROJECTS. THE SECOND SPEAKER, GEORGIANA IS A MEMBER. GROWING UP SHE WAS A STRONG YOUTH LEADER AND AD ADD VOW KID FOR THE QUNGASVIK PROJECT. SPEAKER NUMBER THREE, STACEY RASMUSS, IS A RESEARCH ASSOCIATE PROFESSOR AND DIRECTOR OF THE CENTER FOR ALASKA NATIVE HEALTH RESEARCH. AT THE UNIVERSITY OF ALASKA FAIRBANKS. SHE IS JOINTLY APPOINTED WITH THE NORTHWEST INDIAN COLLEGE WHERE SHE DISTRICTS A NATIVE AMERICAN RESEARCH CENTER FOR THERE. THEY ADVANCE INDIGENOUS-LED RESEARCH FOR EFFECTIVE AND CULTURALLY CENTERED INTERVENTIONS TO REDUCE DISPARITIES AND SUBSTANCE USE AND SUICIDE IN ALASKA NATIVE AND AMERICAN INDIAN COMMUNITIES. AND THE FOURTH SPEAKER JAMES ALLEN, IS A CLINICAL AND COMMUNITY PSYCHOLOGIST AT THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOLS AND IS MEMORY KEEPERS MEDICAL DISCOVERY TEAM ON AMERICAN INDIAN AND RURAL HEALTH EQUITY. DR. ALLEN HAS WORKED WITH THE UNIVERSITY OF ALASKA FAIRBANKS AND COLLABORATIONS WITH ALASKA NATIVE COMMUNITIES SINCE 1990. ONE LAST WORD I JUST WANT TO POINT OUT THAT THIS SPEAKERS IN TODAY'S WEBINAR ARE SEPARATED BY HUNDREDS OF MILES AND THE RESEARCH AREAS INVOLVES HUNDREDS OF SQUARE MILES HAS BAND WITT PROBLEMS AND WE ASK YOU TO BE PATIENTS. NEXT SPEAKER IS MR. BILL CHARLES. >> IN TRUE NATIVE FASHION, ACTUALLY, WE WILL GO IN A DIFFERENT ORDER. WE'RE SPEAKING UNLESS, YEAH, NO WE'LL STICK WITH OUR SPEAKER ORDER. SO, WE'LL START WITH MYSELF, THERE IS STACEY RASMUS SPEAKING FOR OUR TEAM TO INTRODUCE OUR PRESENTATION TODAY. BUT BEFORE WE BEGIN, OUR TEAM WOULD LICK TO EXPRESS OUR GRATITUDE TO THE NIAAA TEAM PROVIDING OUR TEAM TO SHARE OUR WORK ON A NATIONAL STAGE AND SO WE CONNECT TO THE IMAGES OF THE BARRING SEA COAST OR FAR WEST AS YOU CAN GO. I WOULD ALSO LIKE TO ACKNOWLEDGE THAT I'M PRESENTING TODAY ON THE ANCESTORIAL LAND OF THE INTERIOR ALASKA WHERE THE CENTER FOR ALASKA NATIVE HEALTH RESEARCH IS BASED IN FAIRBANKS. THE PRESENT OF OUR PRESENTATION WILL BE THE LANDS AND PEOPLE REPRESENTED HERE IN THESE PHOTOS AND IN MANY OTHER GLORIOUS PHOTOS THAT WE WILL BE SHOWING THAT SHOWCASE CULTURE AS PREVENTION AND CULTURE AS OUR STRENGTH. THE YOUNG LADY MAKING POWER PROOF CLOTHING AND FOOD STORAGE. ALL THESE PHOTOS ARE COMING FROM ACTIVITIES THAT ARE TAKING PLACE IN FIVE UPIK COMMUNITIES RIGHT NOW. NEXT, OUR TEAM ACKNOWLEDGES THE WISDOMS OF THE ELDERS WHO GUIDED THIS WORK FROM THE VERY BEGINNING. THE LATE DR. JESSE MOHAT FROM THE ALASKA HEALTH RESEARCH WHO IS MY PHD ADVISER AND MENTOR, JOE PHILLIP AND MARY T. AUGUST TEEN, TWO ELDERS FROM THE UPIK COMMUNITY WHO INSTRUCTED JERRY AND ALL OF US ABOUT THE NEED FOR OUR SCIENCE TO BE SPIRITUAL LOW CENTERED AND WHAT THEY'RE DOING I'M GOING TO GOING OVER OUR PRESENTATION TODAY. THERE WILL BE ALL FOUR OF US SPEAKING ABOUT DIFFERENT PARTS OF THE PROCESS. I'M GOING TO BE TAKING US THROUGH A PREVIOUS INTRODUCTION OF ALASKA, IT'S AGREE OGRAPHY, FAST DAY VERSE TE -- AND DESCRIBE FACTORS CONTRIBUTING TO INDIGENOUS HEALTH TRANSITIONS IN OUR STATE AND OVERVIEW CURRENT DISPARITIES AMONG RURAL ALASKA NATIVE YOUTH. ALL THAT CALLS FOR PREVENTION THAT BUILDS UP FROM COMMUNITY AND CULTURAL STRENGTH AND ENGAGES YOUTH AND ACTIVITIES DURING THEIR CHILDHOOD AND FORMATIVE YEARS THAT ARE PROTECTIVE. NEXT, WE'LL BE INVITED TO BEAR WITNESS TO CULTURE AS PREVENTION TAKING PLACE IN REAL TIME RIGHT NOW FOR YOUTH WHO ARE AT HIGH RISK FOR ENCOUNTERING PROBLEMS IN THEIR LIVES OR THREATS RELATED TO ALCOHOL OR SUICIDE. SHE WILL SHOW US HOW SHE'S LEADING A COMMUNITY EFFORT TO PROVIDE DAILY EXPOSURE TO YOUNG PEOPLE TO THE PARTS OF THE CULTURE THAT CREATE PURPOSE AND PHYSICAL, SPIRITUAL AND EMOTIONAL CONNECTIONS. WITH A GROUNDING IN COMMUNITY THEN, BILLY CHARLES WILL TAKE US FURTHER INTO UNDERSTANDING YUP'IK CULTURE AND HOW THIS PROCESS MODEL OF COMMUNITY-DRIVEN CARE HOLDS THE PROMISE AND LAYS OUT AND IMPLEMENTATION PRACTICE. WE WILL TURN THE PRESENTATION TO OUR OTHER ELDER ON THE TEAM. DR. JIM ALLEN HAS LONG SERVED AS A BRIDGE BETWEEN THE WESTERN AND INDIGENOUS SCIENCE THAT GUIDES THIS WORK AND HAS BROKEN MANY TRAIL THROUGH MANY TANGLED WILLOW TO GET US TO UNDERSTAND THE IMPACTS AND OUTCOMES OF THIS 20-YEAR INTERVENTION SCIENCE INITIATIVE. SO FIRST, WE ALWAYS WANT TO BEGIN THE STORY OF THE WORK BEING DONE WITH THE STRENGTH OF THE ANCESTORS. ALASKA NATIVE PEOPLE, INDIGENOUS PEOPLE OF ALASKA THROUGH THE MILLENNIUM WERE STRONG AND PROVIDED PROTECTIVE CHILDHOODS AND EXPERIENCES AND TEACHINGS TO THE CHILDREN AND SURVIVED GREAT HARDSHIPS IN VERY EXTREME CLIMATES BY RELYING ON THEIR INDIGENOUS KNOWLEDGE OF THAN THIS LAND, OF THEIR SOCIAL LIVES AND SUICIDE AMONG YOUNG PEOPLE WERE UNHEARD OF IN THE MEMBERS OF TODAY'S ELDERS. SO, FOR THOSE ATTEND TAG ARE NOT ATTENDING THAT ARE NOT FAMILIAR WITH OUR STATE. IT'S VAST AND LARGE. ONE-THIRD SIZE OF THE UNITED STATES AND FOR ANYONE ON THE CALL FROM TEXAS, I'M SORRY, I KNOW, WE'RE BIGGER. WE'RE ALSO EXTRAORDINARILY DIVERSE. AS YOU CAN SEE, WE HAVE MANY DIFFERENT LANGUAGE FAMILIES, EXTRAORDINARILY UNINTELLIGIBLE FROM EACH OTHER. THE REGION WE'LL TALK ABOUT IS THE BLUE CENTRAL YUP'IK AND THE UNIVERSITY OF ALASKA FAIRBANKS IS LOCATED IN THE TANNANA REGION AS YOU JUST SAID AND IT TAKES ABOUT FOUR PLANE RIDES AND ABOUT 14 HOURS FOR ME TO TRAVEL OUT TO THE COMMUNITIES AND WORK WITH THE COMMUNITIES. IT'S CULTURALLY DIVERSE. THE REGION WE WILL TALK ABOUT IS NOW, AFTER TRANSITIONS, AFTER ALASKA BECAME A STATE IN 1959, AND AFTER THE ALASKA NATIVE CLAIMED SETTLE ACT IN THE EARLY '70s ESTABLISHED REGIONS, BOTH CORPORATE, NON-PROFIT AND PROFIT REGIONS AND WE'LL TALK ABOUT THE YUKON CUPS REGION OF ALASKA. I SHOULD HAVE MENTIONED AS PART OF DIVERSITY, ALASKA'S HOME TO OVER HALF OF OUR FEDERALLY RECOGNIZED TRIBES. IT'S 258 IN THE STATE OF ALASKA IN THE REGION. THERE ARE 58 SERVICED BY ONE HEALTH REGION. AND THERE'S A HOSPITAL IN BETHEL ALTHOUGH ANY HIGH LEVEL NEED TO GO TO RANK REGINA AND ALL THE VILLAGE HAVE CLINICS SO VERY DEPENDENT ON THE COMMUNITY HEALTH AID AND PRACTITIONER PROGRAMS AND SOME COMMUNITIES HAVE BE BEHAVIORAL HEALTH AIDS. MOST VILLAGES BAN THE SALE OF ALCOHOL IS AND DRY UNDER THE ALASKA LOCAL OPTION LAW. STUDIES HAVE SHOWN THAT LOCAL OPTION -- STUDIES IN OUR STATE EPIDEMIOLOGY DATA SHOW US THAT LOCAL OPTION LAWS ARE NOT PROVING EFFECTIVE IN REDUCING DISPARITIES WE SEE IN ALCOHOL-RELATED INJURIES, DEATHS OR CONSEQUENCES OR SUICIDE RISKS. SO, IN TERMS OF HEALTH TRANSITIONS, AS WE SPOKE ABOUT ALASKA NATIVE COMMUNITIES, UNTIL THE 1960s, STILL LIVED A FAIRLY MOBILE, SUBSTANTIVE WAY OF LIFE, MOVING AROUND FROM FALL CAMPS, SUMMER CAMPS, WINTER CAMPS BUT BY THE 1960s SETTLED OR WERE SETTLED INTO VILLAGE COMMUNITIES, STORES CAME IN THE AREA, THERE'S A LOT OF INFLUX OF NEW PEOPLE, NEW PROCESSES, AND WHAT WE SAW WAS THAT ALCOHOL, EVEN IN COMMUNITIES THAT BAN I FORTATION AND SALES AND ALCOHOL DISPARITIES INCREASED. AND DEATHS IN THIS ONE SLIDE JUST SHOWS DEATHS FROM ALCOHOL ABUSE ARE STILL IMPACTING ALASKA NATIVE PEOPLE. SIMILARLY, AGAIN, WE WORK IN THE YUKON REGION AND HEALTH TRANSITIONS ALSO HAVE, FROM ABOUT THE 1960s AND 70s, WE HAVE SEEN AN INCREASE OF SUICIDE YOUNG AMONG YOUNG PEOPLE AND THESE ARE THE MOST REMOTE REGIONS, WITHIN ALASKA HAVE THE HIGHEST RATES OF SUICIDE. SUICIDE AMONG ALASKA NATIVE PEOPLE GENERALLY IS MUCH HIGHER THAN THE, S. AVERAGE RATE AND IMPACTS ALASKA NATIVE DEATHS FROM SUICIDE IMPACT, ALASKA NATIVE MEN AND YOUNG MEN IN PARTICULAR FROM THE AGES OF 15 AND 24. ALCOHOL IS RELATED UP TO HALF OF SUICIDE DEATHS RECORDED AND AGAIN TWO-THIRDS OF ALASKA NATIVE ARE SUICIDES UNDER 20. SOMETIMES A PROBLEM THAT IS RELATIVELY NEW. IN THE 1980s THERE WERE ARTICLES THAT RAN UPWARDS OF A PEOPLE IN PERIL AND IT WAS 15 ARTICLES THAT OUTLINED THE CRY ADVERTISE IN ALASKA NATIVE COMMUNITIES. REALLY PAINTED A PICTURE OF VANISHING PEOPLE AND AGAIN, IT DID CREATE A LOT OF ATTENTION FOR THE PROBLEMS THAT WERE VERY REAL AND VERY ACUTE. THERE WAS A CALL TO ACTION FOLLOWING THE PEOPLE IN PERIL SERIES BY THE ALASKA FEDERATION OF NATIVES FOR RESEARCH TO EXAMINE WHAT IS GOING RIGHT IN ALASKA NATIVE COMMUNITIES AND UNDERSTANDING AND LOOK ATLAS KA NATIVE PEOPLE AND WITHIN COMMUNITIES WHO ARE LIVING STRONG AND WELL AND SOBER LIVES. DR. JERRY MOHA AND DR. JIM ALLEN WERE AMONG THOSE LEADING THE CHARGE TO APPLY TO THE NIAAA, OUR FIRST FUNDER -- AND I CAME UP TO DO WORK ON PHD. IT WAS THE FIRST TIME I WORKED AT COLLEGE AND JERRY TALKED ABOUT THIS PROJECT THAT I HAD HEARD A UNIVERSITY RESEARCHER WHO WANTED TO LOOK AT THE GOOD THINGS IN NATIVE COMMUNITIES AND TO TRY AND FOCUS ON BUILDING SOBRIETY AND PATHWAYS TO SOBRIETY FROM THE STRENGTHS THAT ARE THERE IN OUR PEOPLE. I WAS EXCITED TO DO THAT. THE PEOPLE IN THE AWAKENING PROJECT IDENTIFIED, AGAIN, A SET OF PROTECTIVE FACTORS SO WE DID INTERVIEWS AND SURVEYS AND WE WERE LOOKING AT WHAT WAS PROTECTIVE AND PRO VEN TIVE FROM THE DEVELOPMENT OF ALCOHOL USE DISORDERS, SO WE INTERVIEWED INTERVIEWED PEOPLE WHO NEVER HAD A PROBLEM WITH ALCOHOL. MUCH MORE THAN ANY OTHER RACIAL ETHNIC GROUP HAVE HIGHLIGHTS OF SEW BROADWASOBRIETY. WE INTERVIEWED OVER 100 PEOPLE TO IDENTIFY THOSE PROTECTIVE AND PRO VEN TIVPREVENTATIVE. WE ALSO HAD FACTORS THAT CONTRIBUTED TO RECOVER ROW FOR RECOVERY FO R THOSE WHO HAD A STATE OF WELLNESS FOR MANY YEARS. THE FACTORS OFTEN OVERLAP THOSE FACTORS PROTECTIVE, THAT HELPED PEOPLE RECOVER, HELPED PREVENT AN ALCOHOL USE DISORDER FROM DEVELOPING. WE'RE GOING TO MOVE INTO TALKING ABOUT ANOTHER COMMUNITY INITIATED RESEARCH THAT CAME ABOUT 10 YEARS AFTER THE PEOPLE AWAKENING PROJECT. OTHER PROJECTS WERE HAPPENING AT THE SAME TIME, AS YOU WILL SEE LATER ON. BUT THE WORK TO DEVELOP AN INTERVENTION TO REDUCE RISK FOR ALCOHOL USE AND SUICIDE LEVERAGED PEOPLE AWAKENING PROTECTIVE FACTORS AND FINDINGS BUT IT ALSO LEVERAGED THE PEOPLE AWAKENING PROCESS. THIS IS A PROCESS THAT REALLY WAS SUCCESSFUL AND ENGAGING ALASKA NATIVE COMMUNITIES IN RESEARCH, THE FUNDAMENTALLY WITH INDIGENOUS-LY DRIVEN AT ALL STATES OF THE RESEARCH AND SCIENCE PROCESS. WE'RE GOING TO LOOK AT HOW COMMUNITIES ARE ENGAGING PREVENTION AND HOW HOW WE DEVELOPED WHAT WE'D LIKE TO DO IS INVITE GEORGEIANNA NOW TO BRING US INTO HER HOME AND HELP GUIDE US THROUGH WORK BEING DONE THERE. >> GOOD MORNING, EVERYONE. I'M GORGEIANNA. WITH THE NEW SEASON, STARTING AT THE END OF MAY, IT BROUGHT NEW OPPORTUNITIES, NEW LIFE BACK TO OUR COMMUNITY, THE HERRING FISH WERE RETURNING AND THE BIRDS WERE RETURNING AND SO, WE SAW IT AS AN OPPORTUNITY, ESPECIALLY WHEN COVID HIT WE SAW THIS AS AN OPPORTUNITY TO START BRINGING THE YOUTH OUT SO THEY COULD DO THINGS THEY HAVEN'T HAD SCHOOL SO STARTING AT THE END OF MAY, WE HAD NONSTOP ACTIVITIES AND OVER THE SUMMER WE DEVELOPED A TRUSTED RELATIONSHIP WITH MANY OF THE YOUTH MANY OF THOSE GUYS HERE LACK FATHER FIGURES AND THE OPPORTUNITY TO DO CULTURAL ACTIVITIES WHETHER IT'S HAVING NO VEHICLES TO USE AND SO, THAT WAS THE KICK-START OF OUR SUMMER. THEY DID MANY, MANY ACTIVITIES% THAT ESPECIALLY AT THE VERY END OF MAY, AND THESE ACTIVITIES I SPOKE ABOUT ARE NOT JUST ACTIVITIES THEY'RE LEARNING THINGS, TOOLS FOR THEIR LIFE AND THINGS THAT ARE IMPORTANT LIKE THEY HAVE RESPONSIBILITIES AND AWARENESS AND GIVING THINGS THAT DEVELOP WHO THEY ARE AND WE SAW THAT AS REALLY IMPORTANT THINGS TO TEACH THEM IN THESE PHOTOS WE HAVE HERE, WE HAVE YOUNG MEN WITH THEIR FIRST CATCHES AND FIRST CATCHES ARE VERY -- THEY'RE A BIG THING HERE AND YOU KNOW, AND AS A PART OF OUR CULTURE, WE GIVE THE WHOLE CATCHOE AND BECAUSE OF THAT, WE BELIEVE WE'LL BE THE PERSON WHO GAVE AWAY WILL BE BLESSED WITH MORE IN THE FUTURE. A LOT OF THESE BOYS WERE NERVOUS. THEY DIDN'T BELIEVE IN THEMSELVES WHEN THEY WERE HUNTING. AFTER THEIR SUCCESSFUL CATCH, THEY WERE -- THEIR HAPPINESS WAS VERY CONTAGIOUS. I WAS REALLY HAPPY FOR THEM. ALL OF THESE BOYS HERE YOU SEE GAVE AWAY THEIR FIRST CATCHES TO THE WHOLE COMMUNITY AND WE ALSO GATHERED A BIG PILE OF DRIFTWOOD THAT WE STARTED TO THE ELDERS A FEW DAYS AGO AND THE YOUNG MEN ARE SPLITTING THEM AND WORE DELIVERING THEM TO EVERY ELDER HOUSEHOLD IN THAT COMMUNITY THE WEATHER SCOLD OUT THERE SO WE WILL BE DOING THAT THE REST OF THIS WEEK. THE BOTTOM THERE IS A PHOTO OF ALL YOUNG LADIES WHO WERE BRINGING DRIFTWOOD TO THE BOAT AND THERE'S MANY RELATIONSHIPS BUILD OVER THE SUMMER AND FRIENDSHIPS, STRENGTHENED. WE LIVE IN A COMMUNITY THAT IS -- WE KNOW EVERYTHING THAT IS GOING ON. AT THE BEGINNING OF THIS SUMMER, I WOULD SEE THESE YOUNG MEN IN THEIR DIFFERENT GROUPS THAT THEY WOULD HANGOUT WITH NORMALLY. EVEN RECENTLY, I BROUGHT THIS UP OF HOW I'M SEEING THEM TOGETHER AND THOSE RELATIONSHIPS BECAUSE IT'S MORE PEOPLE YOU CAN RELY ON AND GO TO. THE GUY ON THE TOP-LEFT, HE TALKED TO THEM ABOUT RESPONSIBILITY AND HOW YOU SHOULD WORK HARD AND WORK IF YOU CATCH SOMETHING, HOW YOU SHOULD RESPECTFULLY WORK ON IT. IF YOU GIVE SOMETHING TO ELDERS, MAKE SURE IT'S RESPECTFUL AND IT'S CLEAN. LITTLE THINGS LIKE THAT, THAT SET A SPARK IN THESE YOUNG MEN'S MINDS. CAN YOU GO TO THE NEXT SLIDE WITH THE MEN AND THE WHALE. THE NEXT SLIDE. THEY GAVE THE PHOTO WITH THE YOUNG MEN AND THE WHALE 234 THE BOAT, ALL OF THESE WERE THEIR FIRST CATCHES AND THEY GAVE TO THE WHOLE COMMUNITY. OUR COMMUNITY WAS VERY APPRECIATIVE OF THIS AND THE YOUNG MEN, THEY GO BECAUSE OF THIS AND YOU COULD TELL THEY FELT REALLY GOOD WE HAVE MANY MEMORIES OVER THE SUMMER. I MYSELF LEARNED A LOT OF THESE THINGS JUST OBSERVING THESE WORK ON THEIR CATCH AND THERE WERE FIRSTS THROUGHOUT THE SUMMER. NEXT SLIDE, STACEY. AND HERE THESE PHOTOS HERE WERE JUST THE OTHER WEEK WE ATE OFF THE LAND AND CONNECTED TO OUR CULTURE AND NATURE. IT'S ALL THE RESULTED IN HAPPINESS. I DIDN'T REALIZE HOW OFTEN ANYBODY SAID IT HERE BUT IF ANYONE WAS FEELING DOWN OR IF YOU SAID I'M HAVING A ROUGH DAY, THE ANSWER EVERY SINGLE TIME IS TO GO OUT AND DO SOMETHING AND THAT IS SOMETHING THAT WE'VE BEEN TALKING TO THESE BOYS A LOT ABOUT, YOU KNOW. SO AT THE DON'T TURN TO ALCOHOL AND THEY DON'T TURN TO DRUGS. IF YOU ARE HAVING A HARD TIME, AND YOU WANT TO GO OUT AND DO SOMETHING, CONTACT US. WHEN OUR THERE, IT'S WHEN YOU ARE BUSY DOING SOMETHING LIKE THAT, YOUR MIND WON'T BE SO BUSY AND IT'S BEEN - A REALLY GREAT SUMMER WITH THESE GUYS AND WE ENCOURAGE THEM TO STAY SOBER AND KEEP BUSY DOING CULTURAL ACTIVITIES. IT'S VERY IMPORTANT TO US THAT THEY KNOW THEY CAN DO THINGS, DO HEALTHY THINGS AND OUR COMMUNITY IS SMALL ENOUGH THAT WE KNOW WHAT IS GOING ON AND SO WHEN WE HEAR ANYTHING, YOU KNOW, WE TAKE THESE YOUNG MEN OUT THAT WE I'M DOING GOOD OUTSIDE OF SCHOOL AND ACTUALLY WE'VE DONE THAT RECENTLY AND THE BEHAVIOR AFTERWARDS AND THE ENCOURAGEMENT BEING OUT AND DOING SOMETHING REMINDING THEM TO CONNECT TO NATURE AND EVERYTHING AROUND US, IT'S BEEN WONDERFUL TO SEE AND THERE'S THINGS THAT I DON'T REALIZE THAT I DON'T SEE. JUST YESTERDAY, SOMEONE MADE A COMMENT THAT SINCE THIS YOUNG MAN HAS BEEN WITH YOU, HE HASN'T GOT INTO TROUBLE. AND, YOU KNOW, THAT JUST PUTS A SMILE ON MY FACE BECAUSE IT MAKES -- IT'S JUST PROVEN THAT DOING THESE THINGS, CONNECTING THEM TO THEIR CULTURE AND WHO THEY ARE AS YUP'IK PEOPLE, IT'S HEALTHY FOR THEM AND ALLOWS THEM TO WALK THE RIGHT PATH AND I'M VERY HAPPY TO BE A PART OF THIS. I MYSELF, STARTED -- WHEN WE BEGAN THESE ACTIVITIES AT THE END OF MAY, I MYSELF WAS NOT GOING -- I WAS HAVING A HARD TIME. IT'S THE MONTH THAT MY VERY GOOD FRIEND COMMITTED SUICIDE AND IT'S ALWAYS BEEN HARD MONTH FOR ME. I TOOK MY FIRST ACTIVITY. MAY 21st, IT WAS MY FIRST ACTIVITY AND EVERY SINCE THEN, YOU KNOW, MY MENTAL HEALTH HAS BEEN BETTER IT GOT ME OUT OF THE DEPRESSION I WAS STARTING TO FALL INTO AND IT WAS THE SAME THING WE REMIND THESE KIDS. YOU NEED TO STAY BUSY SO YOUR MIND WON'T BE BUSY AND I CAN'T BELIEVE NOW THAT -- I MENTIONED THAT THE BOYS ARE SPLITTING DRIFTWOOD AND DELIVERING TO ELDERS. I THOUGHT THAT WE WOULD HAVE A HARD TIME FINDING YOUNG MEN AND WOMEN TO DO THESE THINGS BUT, WE HAD 10 SHOW UP OUT OF THE GOODNESS OF THEIR HEARTS SO I REALLY HOPE AND WE WAY CONTINUE WITH THIS AND ONE CAME TO ME JUST WITH ONE QUESTION AND HE SAID WILL IT GO ON FOREVER AND IT'S ENCOURAGE TO GO SEE THAT AND THIS PHOTO HERE, OUR PART-TIME COORDINATOR IS THE YOUNG MAN IN THE BACKGROUND THERE AND HE IS NOW THE COORDINATOR AND THIS IS GENERATIONS OF STRENGTH AND GENERATIONS OF I'M HAPPY TO BE A PART OF THIS WORK SO THANK YOU. >> THANK YOU SO MUCH. IT'S BEAUTIFUL. SHE'S OUR TALENT IN-HOUSE WITH THE CAMERA. WE HAVE A SECOND CAREER THERE. WE'RE GOING TO TRANSITION LOOKING AT THE CULTURAL PROCESS MODEL. AND BILLY, ARE YOU ABLE TO UNMUTE? >> I CAN HEAR YOU. >> CAN YOU HEAR ME? >> YES. >> YEAH. >> I JUST WANT TO SAY THAT IN YUP'IK. MY ANCESTOR AND REMEMBERING THE ANCESTORS. THANK YOU FOR BEING THE HOST AND I NIH AND NIAAA AND THANK YOU ALL VERY MUCH. LET'S TALK ABOUT QASQIQ. IT'S A COMMUNAL PLACE. IT'S AN ACTIVITY. IT'S A PLACE WHERE PEOPLE COME TOGETHER AND TALK ABOUT -- QASAGIQ IS A PLACE WHERE YOU CAN FEEL WELCOME AND THERE'S IT'S ALSO A STRUCTURE, A COMMUNITY PLACE WHERE PEOPLE COME TOGETHER AND WHEN THE MEN COME TOGETHER AND DISCUSS THINGS THAT, YOU KNOW, ARE OF A -- WHEN THE ANCESTORS IT COMES FROM THE WORD -- COMES FROM THE WORD CASUGA THAT MEANS COMPREHENSIVE AND IT MEANS COMPLETE, IT MEANS HOLISTIC. SO EVERYTHING THAT HAPPENS IS HOLISTIC, COMPREHENSIVE, IT'S DEALING WITH THE MIND, THE BODY AND THE SPIRIT OF AN INDIVIDUAL. FIRST WE WILL SEE BEFORE WE GET OFF, YOU WILL SEE THE SMALL AROUND THE MAIN COMMUNAL PLACE AND THOSE ARE WHERE THE WOMEN TEACH THE YOUNG. THE EARLY CHILDHOOD DEVELOPMENT AND THAT IN ITS SELF IS WE GO INTO THE AND INTO THE PLACE. >> WHEN WE DO THESE ACTIVITIES AND THEY START BACK AND HOW THESE ACTIVITIES ARE RELEVANT TO THE TEACHINGS OF OUR ELDERS, EVERYTHING THAT WE DO IN THE LAPPED WITH ACTIVITIES WE'VE SEEN JUST A MOMENT AGO, THEY'RE PROTECTIVE FACTORS AND THEY ARE IMPORTANT ACTIVITIES THAT WE DO OUT ON THE LAND AND IT PROVIDES FOR THE FAMILIES AND IT BRINGS CAMARADERIE TOGETHERNESS AND BEING ABLE TO WORK TOGETHER TO SURVIVE ON THIS LAND AND THESE ACTIVITIES EVEN THOUGH THEY'RE ESSENTIAL, YOU KNOW, THEY DO PRACTICAL SUPERVISORS THEY ARE EMBEDDED THEM AND WE LOOK INSIDE THE WALKING WILL SHOW YOU IT'S RIGHT BIT STRUCTURE AND THE CANOE OR THE FRAME OF THE CANOE AND YOU SEE ON OUR RIGHT-HAND SIDE IT'S A WALKING STICK AND JUST THAT ALONE WILL DEMONSTRATE YOUR LOVE AND CONCERN FOR THE YOUNG MAN THAT GOES OUT ON THE LAND. IT'S JUST LIKE WHEN YOU MAKE THAT, IT'S IT DEMONSTRATES AND THAT YOU LOVE HIM AND YOU DON'T WANT HIM TO WALK INTO DANGEROUS AREAS WHILE HE IS OUT ON THE LAND. HE IS A MAN AND HE IS A PROVIDER. AND THAT WALKING STICK HELPS THEM EVEN THOUGHHE IS ALONE, EGG BEING GUIDED AND THE TOOLS OF PROVIDING THE CANOE. THE TOOLS OF PROVIDING FOR THE FAMILY, THE CANOE. AND THOSE OTHER TOOLS YOU MIGHT USE TO SURVIVE AND THE OTHER ONE IS A SPIRITUAL COMPONENT AND THIS IS A PLACE WHERE WE SHARED BALANCE AND AND SOME OF OUR COMMUNITIES AND HEARING IN THIS COMMUNITY GEORGE IAN IS FROM IS WE DO ANNUAL MOMENTS OF REMEMBERING THE PEOPLE THAT HAD PASSED ON AND SO IN THIS STRUCTURE EVERYBODY THAT WE DID WAS WITHIN THE COMMUNITY AND WORKING WITH ONE MIND AND HAVING NOT ALL THE MEMBERS IN THE COMMUNITY AND WHEN THEY MET, IT WAS LIKE I SAID, IT WAS COMPREHENSIVE AND EVERYTHING WAS SHARED IN THAT AND WHEN WE COME OUT OF THE, THAT WAS IT. THERE WAS NO DISCUSSION ABOUT THE EVENTS OR THE WHAT IS PERSONAL AND THAT WAS WE DON'T SHARE THAT BUT THE ELDERS WANT TO THEY'RE SHE'S GOOD TEACHINGS THAT WE WERE -- THESE PROTECTIVE FACTORS AND WE REMEMBER THOSE ELDERS FROM (INAUDIBLE) AND HOW THEY RECOGNIZED THE PROBLEMS OF ALCOHOLISM AND SUICIDE AND THEY RECOGNIZED IT AND THEY ACKNOWLEDGED IT AND THEY HAD A SOLUTION AND THEY POSED IT AND THEY HAD A GATHERING ABOUT THE SOLUTIONS AND THE PROBLEMS. THEY WOULD -- THEY DID MORE. THEY WENT TO THE UNIVERSITY AND JERRY MOHAD, REST IN PEACE FOR THOSE PEOPLE THAT HAVE PASSED ON, AND WANTED TO -- GAVE US A TOOL TO SHARE THIS, NOT ONLY WITHIN THE COMMUNITY BUT ALSO PREPARE (INAUDIBLE). IT CAN ALSO HAPPEN TODAY. THIS IS COMMUNAL AND IT'S COMPREHENSIVE AND INCLUDES EVERYBODY. TOO MANY TIMES -- THIS IS THE PROBLEM THAT WE SEE IN OUR COMMUNITIES IS THAT YOU KNOW, WE HAVE DIFFERENT ENTITIES IN OUR COMMUNITY AND WE'RE ALL FRAGMENTED. EVEN THOUGH WE SHARE FROM THE SAME PEOPLE, WE KIND OF ARE WORKING IN SILOS BUT IF WE -- WHEN WE ARE POSITIVE IT BRINGS US TOGETHER OF ONE MIND AND HOW WE CAN DESIGNATE NEGOTIATE THINGS THAT ARE NOT SERVICES THAT HAVE BEEN PROVIDED TO THE COMMUNITIES AND MORE AND BETTER WAY AND MORE EFFECTIVE WAY. LIKE I SAID, WHEN WE DO THE ACTIVITIES, WE -- LET ME GO BACK A LITTLE BIT. EARLIER, THESE ACTIVITIES, SOME OF OUR PEOPLE ARE LIMITED TO THESE ACTIVITIES WHETHER IT'S THROUGH RULES, REGULATIONS. WHETHER IT'S BY ECONOMICS AND OPPORTUNITIES AND TOOLS. SOME OF US, WE DON'T HAVE THE TOOLS TO GO OUT EVERYDAY TO PROVIDE FOR OUR FAMILIES AND THOSE BECOME VERY CHALLENGING AND YOU KNOW, WHEN WE BECOME CHALLENGED, YOU KNOW, THERE ARE THINGS THAT ARE UNHEALTHY THAT WE MIGHT ROW SORT TO. BEING ABLE TO PROVIDE AND SHARE, IT BRINGS HAPPINESS TO THE INDIVIDUAL. THAT BRINGS HAPPINESS TO THE YOUNG PEOPLE. IT BRINGS HAPPINESS TO PROVIDE FOR THEM. AS I WRAP-UP, THESE ARE AND WE HAVE A WORKING GROUP AND GEORGEIANNA ONE OF THE LEADERS OF THESE ACTIVITIES KNOWS THOSE PROTECTIVE FACTORS AND KNOWS HOW TO DO THE ACTIVITY. IN THE END, THESE INDIVIDUALS WERE DEPENDENT AND AS A COMMUNITY WE HAVE BECOME WHEN WE SEE THE VALUE IN THIS, WE SEE THE VALUE OF THE INDEPENDENCE AND WE WORK TOGETHER IN HARMONY. THAT WILL WRAP IT UP. >> NOW THAT WE TOUCHED ON IT TODAY, BUT -- >> OK. CAN YOU HEAR ME? >> YES. >> OK. EVERY COMMUNITY HAS A PRESIDENT. THIS IS JUST A FORMAT THAT EACH COMMUNITY CAN TAYLO TAILOR FOR THEMSELVES. GEORGEIANNA LIVES 50 MILES SOUTH OF HERE BUT THE ELDERS THEY COME WITH THE SAME PRINCIPLES IN LIVING AND WORKING TOGETHER. THOSE ARE BASIC PRINCIPLES THAT KEEP THE COMMUNITY TOGETHER. HOW THEY DO THESE ACTIVITIES IS, , UP TO THE COMMUNITIES ITSELF. EVERY COMMUNITY, YOU KNOW, MAYBE INDIGENOUS KNOW NO MATTER WHERE, THERE'S A POSITIVE AND THE IN THE COMMUNITY AND THERE'S IN AFRICAN COMMUNITY AND THERE'S QASGIQ NO MATTER WHERE YOU GO. >> THANK YOU SO MUCH. >> I'M GOING TO TURN IT OVER TO DR. ALLEN NOW. TAKE US TO OUR OUTCOMES MEASUREMENT. WOULD YOU LIKE TO START WITH THIS SLIDE BRIEFLY AND THEN WE'LL MOVE INTO YOUR PRESENTATION. >> YEAH. >> ON THE. >> I WILL MAKE THIS ON TIME I WILL GLOBAL QUICKL THROUGH THE DAT.>> I WOULD LIKE TO BEGIN BY PROVIDING SOME INTRODUCTION TO HOW WE ASSESS ASSESSMENTS, ALTHOUGH VERY QUICKLY, THROUGH SOME OF THE OUTCOME DATA AND SALE SHOW SOME DATA THAT IS NOT PUBLISHED THAT I THINK THIS IS IS FASCINATING AND PROVOCATIVE. EACH ACTIVITY THROUGH LOCAL TAILORING TO THE CULTURAL PRACTICES OF THE COMMUNITY, THOUGH, FOCUSES ON DELIVERY OF THE SAME SET OF PROTECTIVE FACTORS IN DIFFERENT WAYS. SO, THIS ACTIVITY, WATCH THE ICE, IS DELIVERING SELF-EFFICACY AND SOMETHING BOTH BILLY AND GEORGIAN A HAVE BEEN DESCRIBING THROUGH YUP' IK IS EFFECTIVE AWARENESS ABOUT SOCIAL, SPIRIT AND ENVIRONMENT AND ONES' IMPACT ON INTER DEPENDENT WORLD. I WAS MOST I AME I IMPRESSED WHEN THEY WATCHED ICWATCHED THE ICE AND CONDUCTED IT. IT WAS FASCINATING. THE ELD HERE IS HAD THE YOUNG ELDERS HAD T HE YOUNG PEOPLE LOOK AT ICE AND THE COLORS. I REMEMBER THE ELDER CONDUCTING IT. HE BROUGHT EVERYONE BACK TOGETHER AND DISCUSSED THE TEACHINGS, THE PROTECTIVE FACTORS AND TO THE PEOPLE YOU MIGHT WANT TO THINK THIS WAS IN GREAT RESPECT FOR THE AUTONOMY OF OTHERS AND THE CULTURAL VALUES. YOU MIGHT WANT TO THINK ABOUT THESE THINGS IF YOU ARE ASKED TO GO OUT AND DRINK. BEING ON THIN-ICE. BACK TO THE PRESENTATION, NEXT SLIDE, PLEASE, THANK YOU. OUR OUTCOMES, I WANTED TO ACKNOWLEDGE A QUANTITIVE TEAM COLLEGE AND THEY ARE REALLY TWO DISTRICTED STAT IS TISDISTRICTGIFTED STATI STICIAN. NEXT SLIDE, PLEASE. THESE TERMS YOU WILL SEE IN A MOMENT, INCLUDE AND WILL FOCUS ON TWO ULTIMATE VARIABLE, REASON FOR SOBRIETY AND REASONS FOR LIFE. ALL THESE MEASURES WERE DEVELOPED FOR THE PROJECT FOR THE CONTEXT AND THIS IS A PROTECTIVE FACTOR AS A MODEL, NOT A RISK REDUCTION MODEL. WE'RE GOING TO HAVE TO UNDERSTAND THINGS A LITTLE BIT DIFFERENTLY IF IT'S LOOKING AT THE OUTCOMES. THE WORD ABOUT SOBRIETY. THIS IS A LOCAL TERM. IT MEANS A LOT MORE THAN RECOVERY FROM AN ALCOHOL-USE DISORDER. IT DESCRIBES A RELATIONSHIP. AND EACH OF THESE TERMS HAS A YUP'IK WORD. FOR THOSE WHO ARE NOT PART OF THE CULTURE TO RECOGNIZE THESE ENGLISH WORDS ARE ONLY ROUGH EQUIVALENCE OF A LOCAL CULTURAL UNDERSTANDING OF ALL THESE FACTORS AND IN CLASSIC INTERVENTIONS SCIENCE FORMAT. THE VARIABLES ARE WHAT THE INTERENTION IMPACTS AND THE ULTIMATE VARIABLES PROTECTION FROM ALCOHOL, PROTECTION FROM SUICIDE ARE THE OUTCOMES. WE TESTED THE MODEL VERY QUICKLY. THIS IS MANY WHO WILL RECOGNIZE THE STRUCTURAL EQUATION MODEL. WE SHOWED, AS A THEORY OF INTERVENTION, THESE CHARACTERISTICS OR PROTECTIVE FACTORS AND MULTIPLE LEVELS INDIVIDUAL FAMILY AND COMMUNITIES AND DID IMPACT REASONS FOR LIFE OR REFLECTIVE PROCESSES ABOUT THE CONSEQUENCES OF ALCOHOL USE AND IMPORTANTLY, THESE OUTCOMES ARE CO-OCCURRING. WE'LL TURN TO THAT IN A MOMENT BECAUSE THIS IS IMPORTANT. NEXT SLIDE, PLEASE. >> YOU CAN SLOW DOWN A LITTLE BIT. WE CAN GO A LITTLE BIT OVER THE HOUR IF NEED BE. >> THANK YOU, JUDY, I WOULD LOVE TO. SO, I AM NOT GOING TO GO INTO THE DETAILS OF THIS, BECAUSE OF TIME. I AM GOING TO FOCUS, THIS IS NOT -- AN EFF ICACY TRIAL, THIS IS ONE OF OUR FIRST FEASIBILITY TRIALS AND ONE OF THE FIRST COMMUNITIES WE WORKED WITH. 54 YOUTH PARTICIPANTS, I WANT TO HIGHLIGHT, THIS IS NEAR THE ENTIRE POPULATION OF ELIGIBLE-AGE YOUTH IN THE COMMUNITY AND YOU CAN SEE THIS IS USING MODELING SOMETIMES CALLED MIXED EFFECTS REGRESSION AND WE CONTROLLED FOR GENDER, AGE, AND DOSE, MEANING THE NUMBER OF INTERVENTION ACTIVITIES ATTENDED. BECAUSE THIS IS A ROLLING INTERVENTION THE ELDERS ARE INSISTENT IT SHOULD BE OPEN TO ALL YOUNG PEOPLE WHEN THEY DECIDE THEY WANT TO JOIN, COHORTS OF ENROLLMENT. YOU CAN SEE BIT EFFECT SIZE ON THE RIGHT SIDE, THIS WAS A VERY IMPACTFUL INTERVENTION. IN FACT, QUITE A USUALLY FOR SUCH A SMALL SAMPLE AND WE ACTUALLY OBTAINED SIGNIFICANT EFFECTS OF GROWTH FOR REASONS FOR SE SOBRIETY. HOW DO YOU SHARE THIS INFORMATION BACK TO COMMUNITY? WE'RE VERY, VERY INTERESTED IN THIS AND WE CAN DEPEND ON THE CULTURE AS WELL. THE SALMON IS SOMETHING EVERYONE IN THE COMMUNITY IS FAMILIAR WITH AND IT'S SOMETHING OF A CULTURAL ICON AND WE CAN SHOW CLEARLY HERE, AND THIS WAS TO IT'S IMMENSE IN TERMS OF THE GROWTH AND PROTECTION IN RESPONSE TO THE INTERVENTION. NEXT SLIDE, PLEASE. WE DID A COMPARATIVE DYNAMIC WEIGHT LISTED DESIGN WE'RE ABLE TO COMPARE TWO COMMUNITIES AND ONE WHICH PRODUCED LOW DOSE OF INTERVENTION TO HIGH DOSE COMMUNITY AND WE FOUND DIFFERENCES AND REASONS FOR LIFE THIS PERPLEXED US SO WE WANTED LEARN MORE. I'M GOING TO APOLOGIZE. THIS IS A BUSY SLIDE AND SIMPLE CONCEPT. THE NIAAA IS INTERESTING IN A SPECIAL AND UNIQUE BETWEEN ALCOHOL AND SUICIDEALITY. WE DO KNOW THAT ALCOHOL IS IN THE TOXICOLOGY TESTS OF THE MAJORITY OF ALASKA NATIVE WHO DIED FROM SUICIDE. THIS IS THE CASE WITH OTHER STUDIES IN THE UNITED STATES AND OTHER POPULATIONS. SIMILARLY, ALCOHOL USE DISORDER IS A RISK FACTOR FOR SUICIDE. WHAT IF WE TURN THINGS ON ITS HEAD AND LOOK AT PROTECTION? WHAT DOES THIS SAY ABOUT SUICIDE? THIS IS AGAIN USING A LINEAR MIXED EFFECTS MODEL LOOKING AT LONGITUDAL DATA. I HAD TO REALIZE THIS BUT IT WAS DEVELOPED ON CONTRACT FROM NIAAA. THIS IS AN IMPORTANT TOOL WE USE. INTERVENTION IS MORE THAN DID IT WORK HOW DID IT WORK AND STUDIES OR STUDIES OF THE MECHANISMS IN A THEORY OF CHANGE, REALLY DESCRIBED AND HOW DOES THIS WORK AND CAN WE UNDERSTAND BETTER RESULTS BECAUSE OF THIS. THE LITTLE BOXES ARE THE FOUR MEASUREMENT POINTS WE DID IN THIS STUDY FROM TWO COMMUNITIES AND A WAIT LISTED DESIGN. THE CIRCLES ARE WHAT THEY COMMUNITY AND YOU CAN SEE COMMUNITY AND INDIVIDUAL PROTECTIVE FACTORS THAT GROW IN A BY-DIRECTIONAL FASHION IN RESPONSE TO INTERVENTION. YOU ARE LOOKING AT GROWTH IN PROTECTION NOT A STATIC VARIABLE HERE AND YOU ARE LOOKING AT THE IMPACT OF INTERVENTION. WHAT HAPPENS THOUGH, MAKING SENSE ON CHANGES IN THE INDIVIDUAL LEVEL, LEAD TO CHANGES IN THE INDIVIDUAL AND REASONS FOR LIFE. NOT DIRECTLY TO REASONS FOR SOBRIETY. WHAT WE FOUND, THIS IS AT THE POINT ONE LEVEL OF SIGNIFICANCE. WE SET IT AT THIS BECAUSE WE'RE LOOKING AT MEDIATION EFFECTS AND SMALL SAMPLES. WE FOUND REASONS FOR LIFE, CHANGES IN REASONS FOR LIFE, PREDICTED REASONS FOR SOBRIETY BUT NOT THE OTHER WAY AROUND. THIS SUGGESTS IMPORTANT THINGS BOTH ABOUT SEQUENCING OF OUR INTERVENTION AND EVEN DEEPER, IN TERMS OF HOW SUICIDE AND ALCOHOL PREVENTION ARE RELATED TOGETHER. THIS DATA SHOWS AND THESE COMMUNITIES, IF YOU DO SUICIDE PREVENTION INTERVENTION, YOU DO ALCOHOL PREVENTION. THE TWO ARE LINKED AND IN FACT, IF YOU THINK BACK TO THE ELDER TALKING ABOUT THE LESSON FROM THE ICE SAFETY ACTIVITY, IN ORDER FOR HIM TO HAVE AN EFFECT THE YOUNG PEOPLE HAVE TO VALUE THEIR LIVES AND THEY HAVE TO UNDERSTAND THEY ARE OWN IMPORTANCE IN RURAL AND COMMUNITY. THEN IT MAKES SENSE TO WORRY ABOUT YOUR SAFETY AND TO VALUE YOUR LIFE OUT ON THE ICE AND WHEN YOU ARE ASKED TO GO DRINKING. IN SUMMARY, OUR RESULTS SHOW THIS IS A STRENGTH-BASED COMMUNITY LEVEL INTERVENTION AND IT'S BASED EMPIRICALLY AND A LOCAL INDIGENOUS MULTI-LEVEL THEORY PROTECTION AND IN AN INDIGENOUS THEORY OF CHANGE AND IMPLEMENTATION THAT GEORGEIANNI AND BILLY HAVE DESCRIBED. IT CAN BE INTIMATE IMPLEMENTED AND PRODUCING MEASURABLE EFFECTS AND A HIGH INTENSITY INTERVENTION PRODUCES ENHANCED PROTECTION IN CONTRAST TO LOWER INTENSITY INTERVENTIONS. ACKNOWLEDGING THE LATE DAVID HENRY THAT DID SOME FASCINATING SUB GROUP ANALYSIS AND SHOWED HOW OUR EFFECTS ARE STRONGEST AMONG YOUTH WITH LOWER LEVELS OF PROTECTION BASELINE AND AMONG MALES, UNDER THE AGE OF 15. ON GOING WORK NOW INCLUDES ANALYSIS FROM A SMALL DYNAMIC WEIGHT LISTED DESIGN AND THE TEAM IS CURRENTLY IMPLEMENTING A MUCH LARGER PREVENTION TRIAL THAT HAS ENROLLED 561 YOUTH. THANK YOU, I'LL TURN IT BACK OVER TO YOU, STACEY. SNAPSHOT OF OUR TEAM AND AT THIS POINT WE JUST TO AGAIN, EXPRESS OUR GRATITUDE, OUR HONOR AND OUR RESPECT FOR ALL OF THE ALASKAN PEOPLE, COMMUNITIES, OUR FUNDERS, AND THANK YOU, EVERYONE. >> AND THERE'S OUR CONTACT INFORMATION. IF YOU WANT TO E-MAIL QUESTIONS. JUDY, AT THIS POINT I WAS GOING TO TURN IT OVER TO YOU TO DO A CLOSING. IF WE STILL HAVE TIME FOR THIS. YOU MIGHT BE ON MUTE. IF YOU ARE TRYING TO SPEAK. >> I'M ON MUTE AND I NEED TO START MY VIDEO. WE'RE GOING TO BASICALLY HAVE A LITTLE BIT OF TIME FOR SOME MORE QUESTIONS AND ANSWERS AS SOON AS I CAN GET THEM ALL. I DID WANT TO INDICATE A COUPLE THINGS IN TERMS OF, I'VE BEEN A ASSOCIATED WITH THIS FOR NEAR 20 YEARS. IT'S VERY IMPORTANT FOR US TO RECOGNIZE THAT THIS PEOPLE AWAKENING, THIS RESEARCH PATHWAY HAS BEEN A VERY LONG PATHWAY, ALL RIGHT. IT STARTED BACK IN 1996. WITH SOME OF THE VERY ORIGINAL RESEARCH. THINK ABOUT IT, IT'S BASICALLY APPROXIMATELY 35 YEARS TO GET FROM BEING ABLE TO UNDERSTAND WHAT THE COMMUNITY MEMBERS NEEDED AND WANTED, IN ORDER TO BE ABLE TO TAKE IT ALL THE WAY OUT TO AN INTERVENTION THAT PROBABLY HAS CONSIDERABLE GENERALIZE ABILITY, WHEN YOU THINK OF CULTURE AS A FACTOR THAT CAN OVERCOME THROUGH PREVENTION AND MAY ACTUALLY BE ASSOCIATED INTO TREATMENT. WE NEED TO THANK THE INVESTIGATORS. KEEP IN MIND GERALD MOHATT AND DAVID HENRY PASSED AWAY DURING THESE 35 YEARS. WE HAVE TO BE PATIENT IN WORKING WITH COMMUNITIES. THE SCIENTISTS HAVE A TENDENCY TO WANT TO JUMP INTO SOMETHING, ALL RIGHT. I HEARD THAT THERE'S SOME THINGS IN TERMS OF CULTURE BEING THINGS THAT MAKE PEOPLE HAPPY AND WE MAY TAP NO THEIR REASONS FOR LIVING AND BY TAPPING INTO REASONS FOR LIVING, THAT IS THE WAY TO GET PEOPLE TO LIVE A HEALTHIER LIFESTYLE. AND I THINK THAT I'LL TRY TO WRAP THIS THINGS UP, WE DO HAVE SOME QUESTIONS. ALTHOUGH I'M NOT SURE. THERE WAS ONE QUESTION THAT CAME IN EARLIER, WHICH CAME IN FROM SOMEONE IN THE FASD COMMUNITY. IT WAS BASICALLY ASKING, AND THIS IS GOING TO BE SOMETHING THAT I WOULD SEND OUT TO ALL THE PANELISTS, ALL RIGHT. WHICH WOULD BE, DO YOU SEE THAT THERE'S A ROOM IN THIS TYPE OF INTERVENTIONS TO ADDRESS COMMUNITY KNOWLEDGE OF FASD? THAT CULTURE IS IMPORTANT TO CONNECT PEOPLE BUT THAT WHETHER OR NOT THERE'S OTHER THINGS THAT NEED TO BE DONE IN ORDER TO ADDRESS SPECIFIC ISSUES LIKE FASD? >> YOU ARE THROWING THAT OPEN TO ALL OF THE PANEL? >> ALL OF YOU. I THINK THAT IT'S FOR ALL OF YOU TO THINK ABOUT. WHAT IS THE RELATIONSHIP WITH THE TYPES OF INTERVENTIONS THAT YOU HAVE DONE AND INFORMING COMMUNITY AND FASD PREVENTION? >> I'LL TACK A SHOT AT IT. WE SEPARATE THE MEN AND THE WOMEN IN MANY CASES. A LOT OF WOMEN, I HAVE HEARD, THEY WANT TO TALK ABOUT THE CHILD -- CHILDBIRTH AND EARLY CHILD DEVELOPMENT. THERE IS A LOT SAID AROUND IF IT'S AROUND IN THAT FORM AND MORE AND THEY HAVE BEEN MORE INVOLVED IN THOSE AND WE DO SEPARATE THE MEN AND WOMEN WHEN WE HAVE TO HAVE SOME THINGS. >> YES, BUILT INTO ACTIVITIES CERTAINLY OUR CONVERSATIONS AROUND PROTECTING THE IMPORTANCE OF PROTECTING YOUR BODY AND YOUR HEALTH AND THE MODULES BECAUSE THEY FELT THE WORD ACTIVITY DIDN'T COMMUNICATE THE POWER SO THEY ASKED JERRY, WHAT WOULD YOU CALL A PSYCHO THERAPEUTIC SESSION, A MODULE AND LET'S CALL THEM MODULES SO WE HAVE A MAUD ACTUAL THAT LOOK AT THE EFFECTS OF ALCOHOL AND HEALTHY RELATIONSHIPS AND PREGNANCY AND PREVENTION OF TEEN PREGNANCY AND HEALTHY BODIES AND HEALTHY MINDS AND WE DEFINITELY IT'S ALL INTEGRATED. DO YOU WANT TO SAY ANYTHING ELSE ABOUT THAT? >> >> YOU GUYS COVERED IT. >> THIS IS JUDY AGAIN. I'M SEEING SOME QUESTIONS, WELL IT'S MORE LIKE COMMENTS. I'M SEEING COMMENTS THAT ARE BASICALLY PRICING GEORG PRAISING GORGEIANN A AND SEEING BEAUTIFUL PICTURES AND THE SPIRIT IN HER COMMUNITY. IT'S IMPORTANT TO SEE THAT. COMMENTS SPECIFICALLY FROM SUSANA HELM. LOVE HER PHOTOS ESPECIALLY THE ONE SHE REFERRED TO AS GENERATIONS OF STRENGTH. THERE'S A QUESTION, ALSO, ABOUT WHETHER OR NOT THE SLIDES ARE AVAILABLE. WE CAN MAKE THOSE AVAILABLE AND THE VIDEO CAST WILL BE RECORD AND IT WILL BE AVAILABLE IN THE NIH PLATFORM FOR VIDEO CASTS. WE HAVE THAT. LET ME FIND SOME MORE QUESTIONS. AND WE HAD A COMMENT I THINK. I WANT TO DID COMES IF FEELING DEPRESS AND I WANT TO SHARE THAT NOT EVERYONE PLANS TO BE AN ALCOHOLIC. SOME YOUNGSTERS CAN TRY ALCOHOL AND DRUGS OUT OF CURIOSITY AND TO SHARE STORIES ABOUT HOW THEY CAN GET HOOKED IF TO SUBSTANCES FROM ONE TRY. IS THAT SOMETHING THE PANELIST SEEMS TO THINK THEY CAN ADDRESS? JIM, IT SOUNDED LIKE A GOOD COMMENT. >> DEPRESSION AND PROBLEMS. >> MAYBE OTHER THINGS AS WELL. >> BILLY ALWAYS TALKS ABOUT THE ELDERS, THE YUP'IK ELDERS THEY UNDERSTAND THE CHILD DEVELOPMENTAL PSYCHOLOGY. I CAN'T THINK OF SS AND OBSERVER AND A STUDENT WITH THE CULTURE AND SOMEONE WHO HAS BEEN REALLY FORTUNATE TO HAVE THE ELDERS EXPLAIN THINGS TO ME AND ONE STRIKING THING MIRRORS THOSE YOUNG PEOPLE NEED TO EXPLORE AND MAKE THEIR OWN DECISIONS FROM ELDERS AND THE ENTIRE INTERVENTION AND THIS WAS AT THE GUIDANCE OF THE DEVELOPERS, THE COMMUNITY DEVELOPEDDERS OF THE INTERVENTION AND PLACES GREAT AUTONOMY ON THE YOUNG INDIVIDUAL TO COME AND GO AS THEY PLEASE TO MAKE THEIR OWN DECISIONS. YOU REMEMBER, I MADE NOTE, YOU MIGHT WANT TO THINK ABOUT, NOT THINK ABOUT THIS BUT I THINK THAT'S CENTRAL TO THE WAY OF COMMUNITIES WORKING TRAIN AND ENSURE THE PROTECTIVE FACTORS, WHICH HAVE A WORD IN LANGUAGE AS WELL AND IT'S THROUGH OBSERVATION AND ENGAGEMENT AND PARTICIPATION. NOT LECTURE AND NOT LIMITING OR PRESCRIBING BEHAVIOR AS SOMETHING THEY SHOULDN'T DO. >> THAT PURCHASED HOW YOU SAW ON THE PRESENTATION HOW SHE STRESSED THE HAPPINESS, THE SMILING AND THE LAUGHTER AND THE FUN THAT WAS HAD AND THE BASIS OF IT, YOU WILL HEAR ABOUT THEY DRINK BECAUSE THEY'RE BORED AND THEY WANT TO HAVE FUN. THESE ACTIVITIES PROVIDE FUND TIMES, YOU KNOW, EXPERIENCES FOR YOUNG PEOPLE. THEY DON'T HAVE TO GET HIGH. THEY CAN ENJOY THE LAND AND THE GOOD FEELING. >> >> THANK YOU. >> I JUST WANT TO ADD, THESE ACTIVITIES ARE BASICALLY THEY ARE THE ELDERS AND THEY WERE HELPING US SEE FOR A CHILD TO MAKE HIS OWN DECISIONS LATER ON WHEN COME UP TO MAKE (INAUDIBLE) ABOUT THE PROBLEM. THIS IS A WAY OF GETTING OUT OF THE PROBLEM AND LOOKING INTO THE FUTURE AND PERSONAL AND CHOICE BUT ELDERS ARE (INAUDIBLE). >> I SOMETIMESSED THAT YOU BROKE UP A LITTLE BIT AND YOU NEED TO BE CAREFUL TO MAKE SURE WE PUT OURSELVES ON MUTE WHEN WE'RE NOT SPEAKING. ONE OF THE THINGS I CAN JUMP IN IS IT'S IMPORTANT TO NOTE THAT THESE WERE THE COMMUNITY MEMBERS THEMSELVES AND ALL THE DIFFERENT COMMUNITIES DECIDED WHAT THEY WANTED TO DO SO THAT IF THEY DECIDED THAT IT WAS IMPORTANT TO FOCUS ON POSITIVE RESILIENCY FACTORS, NOT OTHER TYPES OF FACTOR IT'S BECAUSE THIS IS WHAT THE COMMUNITY MEMBERS WANTED IT'S A QUESTION TO JIM ALLEN ABOUT THE MEASURES THAT YOU DEVELOPED AND THEY WERE REASONS FOR SOBRIETY AND REASONS FOR LIVING. THEY DON'T SEEM LIKE THE TYPICAL MEASURES. CAN YOU COMMENT A LITTLE BIT ON THIS? >> YEAH, I'LL TALK ABOUT REASONS FOR LIFE BUT I'LL DESCRIBE AND EXPERIENCE I HAVE IN BILLY'S COMMUNITY AND WE ARE GOING TO USE THE A BRIEF MEASURE OF SUICIDAL I'DATION THAT WAS WELL VALIDATED AND AN ELDER TOOK ME ASIDE AND TOLD ME PRIVATELY, TO NOT EMBARRASS ME IN FRONT OF THE ELDERS, INSTEAD OF ASKING INTRUSIVE QUESTIONS, NOT HIS WORDS, BUT THESE WERE WORDS, IF YOU OBSERVE THE YOUNG PERSON CLOSELY, WE WANT TO KNOW AND YOU WILL NOT NEED TO ASK THESE THINGS AND I TOOK THAT AS A MESSAGE, THE TEAM NEED TODAY LOOK IN A DIFFERENT WAY AND ALSO STICK TO THE POSITIVE AND LOOK TO THE STRENGTHENS AND THE COMMUNITY PUSHED US TO ADOPT A FACTOR FRAMEWORK AND WE WENT BACK TO, WE HAD A LOT OF QUALITATIVE DATA FROM PEOPLE AWAKENING AND WE WANT BACK TO THE QUALITATIVE DATA AND GENERATED ITEMS THAT EMERGED OUT OF THESE INTERVIEWS ABOUT DIFFICULTIES REFLECTING BACK THEIR DECISION REGARDING ALCOHOL AND IN CHOOSING LIFE EARLY IN LIFE ITSELF. WE DID A LOT OF VERY CAREFUL WORK OF RESPONSE THEORIES AND FACTOR ANALYSIS AND WE WERE ABLE ACTUALLY TO DEVELOP VERY STRONG MEASURES OF THESE LOCAL UNDERSTANDINGS OF PROTECTION AND THE YUP'IK WORD IS REFERRING TO TEACHINGS AND AS BILLY WAS SAYING, WE DON'T DO AN ACTIVITY JUST FOR THE SAKE OF AN ACTIVITY THERE'S A LESSON, TEACHING AND LEARNING FROM THE YOUNG PEOPLE INVOLVED IN EVERYTHING THEY DO AND IT'S 'EM BADDED IN THE VALUES AND PROTECTIVE FACTORS ARE TAUGHT THROUGH THAT ACTION. >> THERE'S A QUESTION ABOUT HELLO, I'M IN ONTARIO CANADA AND IS BUILDING NATIVE LANGUAGE IN AND AROUND ALCOHOL USE CONNECTED TO -- ANYONE OF YOU CAN ASK THAT ONE. WHAT DO YOU THINK ABOUT THE LANGUAGE ISSUE? >> THE LANGUAGE BEING IMPORTANT? I DIDN'T CAPTURE THE COMPLETE QUESTION. >> THE QUESTION WAS. IS BUILDING NATIVE LANGUAGE IN AND AROUND ALCOHOL USE CONNECTED TO SUICIDE IDEATION IMPORTANT? THE QUESTION IS, DO YOU ALSO DEVELOP A LANGUAGE COMPONENT IN THE CULTURAL INTERVENTIONS? >> TO SOME EXTENT WE DO AND THOSE IMPORTANT THINGS THAT WE TRIED TO EMPHASIZE OR SHOW AS A PROTECTIVE FACTOR AND BECOMING AWARE. THOSE HAVE BEEN WITH US FOREVER. LANGUAGE IS VERY IMPORTANT BECAUSE THE ROW DETECTIVE FACTORS AND FOR ONE ANOTHER ARE WRITTEN IN A LANGUAGE THAT NO ONE THAT CAN YOU NOT EXPRESS AND MAYBE LIKE SAY ENGLISH AS MUCH AS AS MUCH AS IT SHOULD BE. DOES THAT ANSWER? >> IT SEEMS TO ADDRESS SOME OF IT. OK. IT'S HARD BECAUSE WE CAN'T INTERACT DIRECTLY WITH OUR AUDIENCE. I'M GOING TO MOVE ON TO ANOTHER QUESTION. IT HAS TO DO WITH I'M A AND I WANT TO KNOW IF YOU OR YOUR COLLEAGUES HAVE SHARED THIS MODEL AND OTHER INDIGENOUS COMMUNITIES THROUGH OUT THE UNITED STATES OR IN OTHER PARTS OF THE COUNTRY. THE ISSUE OF AGAIN EYES ABILITIES HERE AND STACEY OR JIM, DO YOU WANT TO HANDLE THIS ONE? >> I'LL TAKE THIS ONE. BILLY IS GOOD AT ADDRESSING THIS. THERE WAS THE SLIDE THAT BILLY HAD THAT SAID EVERY COMMUNITY HAS IT AND TO ANSWER THE FIRST PART OF THAT QUESTION ABOUT SHARING THIS WORK, WE SHARE IT OF COURSE IN PRESENTATIONS LIKE WE'VE BEEN DOING. WE HAVE NOT, AT THIS POINT YESTERDAY, WITH THE MODEL, SINCE WE'RE STILL IN THE PROCESS OF UNDERSTANDING ITS EFFECTIVENESS AND LOOKING AT FACILITY AND HOW TIME NOTMENT IT AND REACH THE KINDS OF OUTCOMES THAT JIM WAS TALKING ABOUT. WE HAVE NOT ADAPTED AND TRANSPORTED THE MODEL INTO OTHER INDIGENOUS OR NON INDIGENOUS CONTEXT ALTHOUGH WE FEEL THERE'S A LOT OF PROMISING EVIDENCE IT COULD WELL BE ADAPTED BECAUSE ONCE AGAIN, ANOTHER COMMUNITY WHERE I WORK AND THERE'S A LONG HOUSE MODEL THAT COULD BE AGAIN, AKIN AND ADAPTABLE TO THE MODELS SO, OUR COMMITMENT IS TO SUSTAINABILITY BEFORE WORE THINKING ABOUT SCALING UP AND AS YOU HEARD, A YOUNG PERSON IS WISHING THEY WILL GO OUT FOREVER IN THEIR COMMUNITIES AND WE BELIEVE THAT THROUGH THIS WORK, THIS TIME OF A PREVENTION MODEL WILL BE SUSTAINABILITY FOREVER, WE'RE NOT BRINGING IN LOTS OF -- WE'RE NOT BRINGING IN OUTSIDE PSYCHIATRISTS OR OTHER KINDS OF EXPERTS ALTHOUGH, THIS IS A INCRADDOCK EFFORT WHERE WE HAVE DIFFERENT KINDS OF EXPERTISE COMING BUT AT THIS POINT OF THE STAGE WE'RE LOOKING AT LONGER STAGE SUSTAINABILITY AND THE COMMUNITIES THAT DEVELOP THE INTERVENTION AND LOOKING AT OPPORTUNITIES TO SEE HOW THIS MODEL COULD BE APPLIED IN OTHER CULTURAL COMMUNITIES GEOGRAPHIC CONTEXTS. HAS THAT ANSWERED THE QUESTION? >> JUDY, YOU ON MUTE. IF YOU ARE TRYING TO JUMP BACK IN. >> I'M WONDERING ABOUT THE LEVEL OF PARTNERSHIPS TO MEET WITH OTHERS WHO ARE DOING SIMILAR WORK. THERE'S NATURAL HELPERS AND SOON THERE WILL BE A -- AND FRAMEWORK AND I HOPE TO LEARN ABOUT THE EVALUATION EFFORTS AND A NEARLY MEETINGS WITH THE KEY TAKE HOLDERS AND I WONDER IF IT'S STILL OCCURRING OUTSIDE OF COVID? >> IT'S A VERY GOOD QUESTION. YEAH, WE DO TRY, WE DO MEET WITH OUR STAKEHOLDERS AND WE HAVE CLOSE RELATIONSHIPS WITH THE PROGRAM AND A COMMUNITY THAT SHARES AND AND THE NATURAL HELPERS AND LEADERS IN THE YK REGION IS ONE OF OUR EARLY COMMUNITY PREVENTION COORDINATORS AND WE WERE CLOSER TO THE SCHOOL DISTRICTS AND DO HAVE PLANS TO CONTINUE OUR ANNUAL, REGIONAL MEETINGS BUT IT IS SOMETHING -- IT'S ONE OF THE CHALLENGES WE HAVE FACED IS ONCE AGAIN OUR STATE IS REALLY LARGE AND IT'S REALLY -- THERE ARE A LOT OF GRASSROOTS EFFORTS THAT ARE HAPPENING TOO THAT WE MIGHT NOT EVEN HEAR ABOUT. I GUESS WE DID RECENTLY, IN THE LAST TWO OR THREE YEARS, WE RECEIVED AT THE GRANT FOR THE CENTER OF ALASKA HEALTH RESEARCH THROUGH THE NMIH AND IT'S THE ALASKA NATIVE COLLABORATIVE HUB ON RESEARCH ON RESILIENCE. IT'S A SUICIDE PREVENTION HUB. WE'VE BEEN SHIFTING THAT KIND OF COLLABORATIVE STATE WIDE COMMUNICATION ABOUT WHAT WE ARE DOING TO EVALUATE AND RESEARCH AND ALSO PROMOTE AND PROVIDE PREVENTATIVE SERVICES FOR IN RURAL COMMUNITIES. WE MEET THROUGH OUR COLLABORATIVE HUB TO PROVIDE MORE INFORMATION. THERE'S MORE INFORMATION ON THE WEBSITE ABOUT ANCHOR. THAT'S THE INITIATIVE THAT WE'RE TRYING TO USE TO DO MORE CROSS-REGIONAL COMMUNICATIONS AND DISSEMINATION. >> I THINK THAT MAY BE WRAPPING IT UP. WE'LL HAVE A RECORDING OF THIS AVAILABLE. I HAVE TO CHECK TO MAKE SURE THAT WE HAVE THE SLIDES AVAILABLE FOR PEOPLE WHO REQUEST THEM. I REALLY WANT TO THANK OUR SPEAKERS AND THE NIAAA STAFF THAT WENT INTO MAKING THIS HAPPEN IN THIS WAY. TO OUR COMMUNITY MEMBERS WHO WERE ABLE TO BE PART OF THIS AND IT MADE IT REAL. I'M NOT GOING TO SURE THE WORK OF ANY POSITIVE COMMENTS ABOUT THE WAY IN WHICH BILLY AND GEORGEIANNA COULD MAKE THE CULTURAL PRESENTATIONS AND WHAT IS GOING ON IN THE COMMUNITIES REAL FOR PEOPLE IN A WAY THAT WE DON'T OFTEN TIMES HEAR. THANK YOU, VERY MUCH. >> CAN I TAKE THIS OPPORTUNITY TO THANK YOU FOR YOUR HELP. THE WORK THAT YOU'VE DID NOT DOING IS A LONG ROAD. 30 YEARS AND PLUS. BUT YOU KNOW, AS WE STARTED UP IN PUBLIC SERVICE AND MORE THAN 30 YEARS AGO, WE USED TO HAVE $30,000 A YEAR IF WE WERE LUCKY AND THESE WERE COMPETITIVE GRANTS TO TRY AND DEAL WITH THIS ISSUE. EVERY TIME IT WAS A DIFFERENT MODEL THAT CAME FROM SOMEWHERE ELSE AND YOU'VE BEEN OUT THERE REALLY UNDERSTANDING THE EFFORT THAT WE HAVE INTERESTED AND WE APPRECIATE YOUR SUPPORT. >> I REALLY DO APPRECIATE THAT, BILLY. IT'S IMPORTANT IN THAT ONE SIDE THAT I WENT THROUGH QUICKLY. THIS HAS BEEN A COLLABORATIVE EFFORT AND SEVERAL INSTITUTES, MINORITY HEALTH AND HEALTH DISPARITIES AND NIAAA AND NOW SAM SA THAT STACEY WAS MENTIONING THERE ARE OTHER EFFORTS TO BASICALLY PRESENT THIS PREVENTION INTERVENTION TO OTHER COMMUNITIES, NOT NECESSARILY IN RESEARCH PARADIGM BUT ACTUALLY TO DO IT FOR COMMUNITIES WHO JUST WANT TO HAVE THIS THING. WHEN IT GETS LEGS IT JOGS ALONG QUITE NICELY. THANK YOU. >> THANK YOU. >> ALL RIGHT. >> I JUST WANT TO THANK YOU FOR AN EXCELLENT PRESENTATION. THIS IS REALLY BEEN A WONDERFUL WEBINAR. THANK YOU, EVERYBODY.