The Native American Prevention Project Against AIDS and Substance Abuse (NAPPASA) school curriculum consists of a 24-session program that addresses multiple issues facing Native American communities. Classroom sessions were designed to build knowledge, acquire and practice prevention skills with peers, and foster new positive peer group norms for preventive communications and behaviors in the context of Native American values. The curriculum covers facts and issues about alcohol and other drug (AOD) abuse; basic reproductive biology; HIV/AIDS; linking AOD to HIV; sexually transmitted diseases (STDs) and how they are transmitted; how assertive communication skills can prevent unwanted sex, pregnancy, and STDs; decision-making skills; healthy options; social skills; coping with pressures; and reinforced practice and role-plays. Booster sessions involve activities, community meetings, and showing NAPPASA-produced videos and print media.

The primary goals of this project are to prevent HIV/AIDS and substance abuse among Native Americans.

The evaluation used a pretest-posttest quasi-experimental design with nonequivalent control groups. Compared with nonintervention groups, a significantly higher percentage of NAPPASA intervention participants remained in or moved to the lower risk alcohol and other drug (AOD) use category at both 9th and 10th grade follow-up. Among the baseline nonusers, the "normal developmental trend toward increased AOD use" was slowed. Intervention youths showed greater maintenance of virginity and lower rates of some types of risky sexual behavior in nonvirgins. Among the older nonvirgin youths, NAPPASA participants were less likely to have had sex while drunk or high, a particularly risky behavior for transmission of STDs including HIV. The NAPPASA students consistently showed a marked increase in their use of family, rules, laws, religion, traditional ways, and community protective influences to help them avoid health-risking behaviors.