Table 1.

Health Director Interview Questions

We asked the same 6 primary questions of all ten interviewees, with follow-up questions asked as needed:
First, we would like to hear about your community: Would you tell me a little bit about your community, please? (Follow-up questions: Where are you located? Is it a small or large community, spread out or tight-knit? Are there special community events or activities that happen each year or on another regular basis?)
Next, we’d like to ask you about substance use and abuse in your community (i.e., prevalence): What substances are of the biggest concern right now in your community? (Follow-up questions: What changes or trends have you noticed in abused substances? How do you believe individuals access those substances?)
We would also like to ask you about how the substances you’ve talked about affect your community (i.e., impact): Who is most affected by substance abuse in your community, and what are the consequences for all people? (Follow-up questions: How does substance abuse affect the individual who is using the substance? How does substance abuse affect the overall community? How does substance abuse affect the individual’s family members or friends? Are the harms/challenges different with different types of substances?)
Next, we would like to ask you about the availability and effectiveness of substance abuse treatment in your community (i.e., treatment availability): What are the available treatment options for substance abuse in your community? (Follow-up questions: What is most effective in treatment? How do clients access treatment in your clinic? Are there any changes in those programs that would improve treatment for substance abuse? What do you think could be done to increase access to treatment for AIANs?)
We also think it is important to ask you about how your community’s culture might help prevention or treatment of substance abuse (i.e., culture): What role does your community’s culture (values, beliefs, traditions) play in preventing substance abuse or in helping individuals in substance abuse treatment? (Follow-up questions: What role does spirituality play in your clients’ substance abuse care/treatment? Are there traditional healing practices that you believe would help to prevent or treat substance abuse, at an individual or community level?)
Finally, we would also like to learn about what your community does to prevent substance abuse (i.e., prevention): What is currently working in your community that helps to prevent substance abuse? (Follow-up questions: What strengths or resources within the community are helpful in substance abuse prevention? What strategies are most effective? What changes would you like to see in these prevention strategies?)