In previous research, Andrew Subica and his colleagues found exceptionally high rates of alcohol use disorder (or alcohol abuse) and alcohol-related harms among Pacific Islander young adults. Now Subica, an associate professor in the UC Riverside School of Medicine’s Department of Social Medicine, Population, and Public Health, has received a $3 million grant from the National Institute on Alcohol Abuse and Alcoholism, or NIAAA, of the National Institutes of Health to conduct research aimed at preventing these disorders and harms in Pacific Islander young adults.

“Almost half of Pacific Islander young adults we surveyed screened positive for probable alcohol use disorder and 40% experienced significant harms — impacting health, finances, and family — from their alcohol use,” said Subica, the five-year grant’s principal investigator. “These rates far surpass the rates for the general young adult population, demonstrating the extreme alcohol risk that exists in Pacific Islander communities.”

According to Subica, no known tailored intervention currently exists to effectively reduce the alcohol risk in this population. As a result, he said, the study will design and conduct a full-scale clinical trial of “Strategies for Pacific Empowerment and Alcohol Reduction,” or SPEAR. 

“The ultimate product of this study will be the demonstrated effectiveness of SPEAR: a culturally tailored group-based intervention to prevent alcohol addiction and consequences in Pacific Islander young adults,” he said. “SPEAR will combine Pacific Islander cultural elements with evidence-based alcohol education content, professional storytelling films with Pacific Islander characters, and cognitive behavioral skills training.”

To conduct the research, which will take place in Southern California and northwest Arkansas, Subica and his team will partner with Pacific Islander communities to help shape and refine the SPEAR intervention, which will use a group format chosen by Pacific Islander young adults. The researchers will design a treatment manual and conduct a three-year randomized controlled trial of SPEAR with Pacific Islander young adults in California and Arkansas.

“Pacific Islander communities are a combination of both Indigenous and immigrant communities who are connected by legacies of cultural traumatization by the U.S.,” Subica said. “By using our innovative community-engaged research methods to study and test a culturally tailored intervention to reduce alcohol addiction and harms in Pacific Islanders, this study may have significant implications for designing similar interventions that target the unique alcohol risks of other culturally traumatized groups in the U.S.”

Subica will be joined in the study by Scott Okamoto at the University of Hawaii Cancer Center, Li-Tzy Wu at Duke University School of Medicine, Esra Kurum and Dr. Howard Moss at UCR, Nia Aitaoto at the Pacific Islander Center of Primary Care Excellence, Erick Guerrero at Research to End Healthcare Disparities, and Derek Iwamoto at the University of Maryland.