In 1990, the Native American Prevention Project of AIDS and Substance Abuse began to develop, implement, and evaluate culturally sensitive in-school prevention programs for Navajo youth and their families. This project paper combines ethnographic interviews and observations with baseline quantitative data collection. A baseline survey of 174 9th- and 10th-grade students demonstrated a significant number of indicators that put students at risk of dropping out, including poverty, early sexual relations and unplanned pregnancies, physically and socially risky behaviors, and drug and alcohol abuse. At least five primary Navajo cultural themes must be accommodated in designing outreach and in-school programs that are relevant to at-risk Navajo youth: (1) individual autonomy; (2) experiential learning; (3) proper public behavior, including the need for public recognition of expertise prior to speaking on a subject; (4) family, including the extended family and other kinsmen, and (5) respect for elders and those with authority. The research suggests that prevention curriculum should emphasize culturally relevant practices that promote youth self-efficacy and involve the family and community. This paper contains numerous personal narratives from Native American youth interviewed. (KS)