Advancing Methods for Multilevel Interventions to Support Health Equity for Urban American Indian/Alaska Native and Black Youth

推进多层次干预措施的方法，支持城市美洲印第安人/阿拉斯加原住民和黑人青年的健康公平

• 批准号: 10283506
• 负责人: Nicole R Tuitt
• 金额: $ 16.32万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10283506
• 关键词: Address; Adolescent; Adolescent Risk Behavior; African American; Age; Alaska Native; Alcohol consumption; Alcohols; American Indians; Behavior; Biometry; Characteristics; Child; Color; Communities; Comparative Study; Complex; Data; Development; Disadvantaged; Discrimination; Drug usage; Ensure; Equation; Ethnic group; Evaluation; Exposure to; Failure; Foundations; Geography; Goals; Group Affiliation; Individual; Intervention; Interview; Literature; Mentored Research Scientist Development Award; Mentors; Mentorship; Methodology; Methods; Modeling; Monitor; Neighborhoods; Not Hispanic or Latino; Outcome; Parent-Child Relations; Parents; Pattern; Peer Group; Physical environment; Positioning Attribute; Poverty; Pregnancy Outcome; Pregnancy in Adolescence; Prevention; Public Health; Race; Recording of previous events; Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Risk Reduction; School-Age Population; Schools; Science; Sexual Health; Sexual Partners; Sexually Transmitted Diseases; Social Environment; Structure; Students; Tobacco use; Training; Translating; Work; Youth; adolescent health; adolescent substance use; base; condoms; consistent condom use; data integration; educational atmosphere; experience; health disparity; health equity; health inequalities; high risk; high school; improved; infancy; marijuana use; multidisciplinary; native youth; opioid use; peer; racial and ethnic; racial disparity; racial identity; reduced substance use; research study; residential segregation; resilience; segregation; sex; sexual risk taking; skills; social epidemiology; spatial epidemiology; stem; substance use; teacher; urban Native American; vaping

PROJECT SUMMARY/ABSTRACT This K01 Mentored Research Scientist Development Award will provide the candidate, Nicole R. Tuitt, DrPH, with advanced training and structured mentoring to facilitate her transition to research independence. The candidate's goal is to become an independent investigator with expertise in state-of-the-art approaches in the development and evaluation of culturally relevant, strengths-based multilevel interventions which aim to reduce substance use and sexual health disparities among urban American Indian and Alaska Native (AIAN) and Black youth. The proposed scope of work will fill a gap in existing literature on multilevel approaches to reduce substance use and sexual health inequities among youth of color. The inability of efforts to reduce adolescent substance use and sexual health disparities to yield sustained improvements likely stem from failure to account for mutually-reinforcing structural disadvantages and multifaceted mechanisms that include all socioecological levels that underlie adolescent health inequities. Most risk reduction strategies focus only at the individual and interpersonal levels. Developing and operationalizing a strengths-based conceptual framework grounded in the socioecological model is critical to inform a multilevel intervention to reduce substance use and sexual risk- taking among urban AIAN and Black youth. The candidate will employ a transformative, sequential mixed methods approach to accomplish the following specific aims, each training goal is matched with the aim in which the researcher will apply her new skills. AIM 1: Examine multilevel determinants of substance use and sexual risk-taking among Black and AIAN high youth (ages 14-18) in Denver Metro, CO. Training: (1) Advance expertise in theoretical and methodological foundations in social and spatial epidemiology to understand the impact of structural contexts on risk and resilience to adolescent substance use and sexual risk-taking; and (2) multilevel structural equation modeling, with geographic contexts, to explore the direct, indirect, and interactive relationships across levels. AIM 2. Engage urban AIAN and Black youth to elucidate distinct conceptual frameworks of risk and resilience to substance use and sexual risk-taking guided by findings from Aim 1; and identify the most critical levels on which to intervene. Training: (1) Develop skills in scenario-based qualitative interviewing (SBI) to engage youth to interpret quantitative data in the development of conceptual frameworks of risk and resilience. The K01 award will position Dr. Tuitt as a trained researcher with expertise on the influence of structural disadvantages on adolescent substance use and sexual risk-taking as well as multilevel approaches. Given her shift away from a focus on individual behaviors to structural factors, expertise in SBI, social and spatial epidemiology, and multilevel SEM will ensure the candidates successful transition into an independent researcher and will situate her to strengthen the field of adolescent health equity research and prevention science.

项目概要/摘要 K01 指导研究科学家发展奖将为候选人 Nicole R. Tuitt，博士， 接受高级培训和结构化指导，以促进她过渡到独立研究。这 候选人的目标是成为一名独立调查员，拥有该领域最先进方法的专业知识 制定和评估与文化相关、基于优势的多层次干预措施，旨在减少 城市美洲印第安人和阿拉斯加原住民 (AIAN) 之间的物质使用和性健康差异 黑人青年。拟议的工作范围将填补现有文献中关于多层次方法减少 有色人种青少年中的药物使用和性健康不平等。无法努力减少青少年 物质使用和性健康方面的差异导致持续改善可能源于未能考虑到 相互强化的结构性劣势和包括所有社会生态因素的多方面机制 造成青少年健康不平等的水平。大多数风险降低策略仅关注个人和 人际关系层面。制定并实施基于优势的概念框架 社会生态模型对于采取多层次干预措施以减少物质使用和性风险至关重要 关注城市 AIAN 和黑人青年。候选人将采用变革性的、顺序混合的 方法方法来实现以下具体目标，每个培训目标都与以下目标相匹配 研究人员将应用她的新技能。目标 1：检查物质使用的多层次决定因素和 科罗拉多州丹佛市黑人和 AIAN 青少年（14-18 岁）的性冒险行为。 培训：(1) 提高社会和空间流行病学理论和方法基础的专业知识 了解结构性背景对青少年物质使用和性行为风险和复原力的影响 承担风险； (2) 多级结构方程建模，结合地理环境，探索直接、 跨层次的间接、互动关系。目标 2. 让城市 AIAN 和黑人青年参与阐明 物质使用和性冒险的风险和复原力的独特概念框架 目标 1 的发现；并确定需要干预的最关键级别。培训： (1) 培养技能 基于情景的定性访谈（SBI），让年轻人解释发展中的定量数据 风险和复原力的概念框架。 K01 奖将使 Tuitt 博士成为一名训练有素的研究员 拥有关于结构性劣势对青少年药物使用和性冒险影响的专业知识 以及多层次的方法。鉴于她从关注个人行为转向结构性 因素、SBI、社会和空间流行病学以及多层次 SEM 方面的专业知识将确保候选人 成功转型为独立研究员，将使她加强青少年领域的研究 健康公平研究和预防科学。