Williams, EmilySimon, Claire2025-08-012025-08-012025Simon_washington_0250O_28198.pdfhttps://hdl.handle.net/1773/53319Thesis (Master's)--University of Washington, 2025American Indian/Alaska Native (AI/AN) communities are disproportionately impacted by harms from substance use and mental illness. Contingency management (CM) reduces substance use by providing positive reinforcement to reward abstinence. We partnered with the Quinault Indian Nation (QIN) to explore perspectives on a culturally adapted community-based CM program for adolescents and young adults (AYA) that provides positive reinforcement to reward engagement in cultural activities that build cultural connection. This study was guided by community-based participatory principles and a community advisory board (CAB) of QIN members. We conducted 15 semi-structured, 30–60-minute interviews with QIN community members. Interviews asked about community connection and community needs and preferences for a culturally adapted contingency management program. Interview transcripts were double coded by three qualitative researchers and analyzed using a combination of Rapid Assessment Process and thematic analysis. Our sample included 6 AYA and 9 adults/elders from the QIN community. Five themes emerged: 1) community connection involves reflecting community values in daily life, 2) QIN AYA have fewer formal and informal pathways to learn cultural practices and traditions, 3) QIN AYA frequently face logistical and/or structural barriers when trying to access cultural activities, 4) shyness, isolation, and competing interests may also hinder QIN AYA engagement in cultural activities, and 5) new approaches to fostering cultural connection are needed to promote health and wellbeing. QIN community members reported AYA face significant barriers to engaging in cultural activities that build cultural connection. While contingency management offers a possible framework to increase community and cultural connection, community member perspectives focused more broadly on upstream factors that may prevent substance use and mental health problems in the future.application/pdfen-USnoneHealth sciencesHealth servicesThesis