Year 1 Partner with Yakama Facilitators to conduct suicide-focused LCs for Intervention Board. Adapt PC CARES suicide prevention curriculum to reflect Yakama priorities, preferences and context. Find ways to integrate local suicide risk data into the ‘What does the research show?’ section of the learning circles (LCs). Modify and cognitively test existing outcome measures of PC CARES (focused on suicide prevention) to reflect Yakama priorities, context and practices. Begin to develop the DO (drug overdose) prevention curriculum for Yakama Behavioral Health based on their local data. Identify bite-size evidence-based best practices for reducing stigma, preventing polysubstance misuse, using peer support to prevent polysubstance misuse, reduce harm for current users, and increase access to a variety of recovery strategies. Identify key implementation facilitators and barriers for PC CARES-DO in Yakama Nation. Year 2 Complete the development of DO (drug overdose) prevention curriculum for PC CARES learning circles (LCs) to be implemented through Yakama Behavioral Health. The DO LCs will be based on Yakama data and will provide near ‘real time’ perspectives about the problem and offer bite-size actionable evidence-based best practices for reducing stigma, preventing polysubstance misuse, using peer support to prevent polysubstance misuse, reduce harm for current users, and increase access to a variety of recovery strategies. Conduct new DO LCs for Intervention Board. Get feedback from Intervention Board about relevance and usefulness of DO content. Refine PC CARES-DO curriculum focused on universal and selective intentional self-harm to include polysubstance misuse, and related morbidity and mortality. Work with Intervention Board to identify roles within Yakama Behavioral Health and community institutions who could be recruited as facilitators to lead PC CARES-DO in communities across the Yakama Nation (e.g. tribal leaders, school counselors, public health service professionals). Develop Facilitator Guides and Toolboxes that include polysubstance misuse, reduction of morbidity and mortality. Modify existing outcome measures to reflect the new content and to capture proximal learning outcomes of awareness and self-efficacy of participants in PC CARES-DO learning circles to address polysubstance misuse, enhancement of participants community of practice for this work, and changes in behavior and local initiatives to prevent or address polysubstance misuse and overdoses and increase access to and variety of available care. Develop research plan for piloting PC CARES-DO in Yakama Nation and assessing impact as well as facilitators and barriers to implementation.