Factors and Training Approaches that Enhance the Integration of American Indian Culture into Tele-Behavioral Substance Use/Substance Use Disorders Treatment.

促进美洲印第安人文化融入远程行为药物使用/药物使用障碍治疗的因素和培训方法。

• 批准号: 10441963
• 负责人: Julie Ann Baldwin
• 金额: $ 10万
• 依托单位: NORTHERN ARIZONA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10441963
• 关键词: Address; Adherence; Advocate; Age; Alaska Native; Alcohols; American Indians; Applications Grants; Area; Arizona; Behavioral; Budgets; COVID-19; COVID-19 pandemic; Caring; Certification; Client; Clinical Psychology; Communities; Community Actions; Comprehensive Health Care; Consultations; Counseling; Criminal Justice; Data; Diagnosis; Domestic abuse; Education; Enrollment; Ethnic group; Evidence based practice; Family; Gender; General Population; Goals; Grant; Health; Health Insurance; Health Occupations; Health Promotion; Health Services; Health Services Accessibility; Healthcare; Homelessness; Human; Human Resources; Imprisonment; Indigenous; Individual; Infrastructure; Link; Lung; Mental disorders; Mission; NIH Program Announcements; National Institute of Drug Abuse; Native Americans; Native-Born; Occupational Therapy; Occupations; Outcome; Parents; Participant; Performance; Pharmaceutical Preparations; Physical therapy; Prevention program; Preventive; Problem-Based Learning; Provider; Race; Research; Research Design; Research Methodology; Research Personnel; Research Project Grants; Research Training; Reservations; Risk; Rural; Rural Community; Rural Population; Schools; Services; Site; Southwestern United States; Structure; Students; Substance Use Disorder; Substance abuse problem; Suicide; System; Testing; Time; Tobacco; Training; Training Activity; Training Programs; Underserved Population; Unemployment; United States Indian Health Service; Universities; Violence; Work; addiction; base; behavioral health; certificate program; cohort; community based research; comorbidity; design; diabetes prevention program; disorder prevention; disparity reduction; doctoral student; evidence base; experience; falls; health care availability; health disparity; health equity promotion; high risk; innovation; interdisciplinary collaboration; mental health counseling; post-traumatic stress; prevent; prevention service; programs; racial and ethnic; racial health disparity; recruit; research study; resilience; respiratory; rural area; rural patients; scale up; service delivery; service programs; skills; substance misuse; substance use; substance use treatment; suicide mortality; telehealth; treatment center; treatment services; tribal community; underserved community; urban Native American; urban area

PROJECT SUMMARY In comparison to other groups, there are clear disparities in the higher rates of substance abuse, post- traumatic stress, violence, and suicide in American Indian/Alaska Natives (AI/AN). High rates of substance misuse in AI/AN communities is associated with unemployment, low academic performance, high-risk occupations, violence, domestic abuse, delinquency, lack of health insurance, mental illness, and mortality from suicide, alcohol, or other substance abuse. Substance use disorders (SUD) disproportionately impact AI/ANs in Arizona due to the lack of infrastructure and personnel on reservations needed to deliver evidence- based comprehensive treatment and prevention services. In addition, the lack of culturally-centered treatment is a barrier to AI/AN individuals living in both rural and urban areas. The COVID-19 pandemic has exposed well-established racial disparities in health care access and health outcomes in underserved communities. COVID-19 has particularly had devastating impacts on tribal communities in Arizona. People with SUD may be particularly at-risk for COVID-19 complications due to the effect of many drugs on respiratory and pulmonary health, and higher likelihood of homelessness, incarceration, and co-morbid health conditions than the general population. Given existing barriers to telehealth in providing comprehensive care for AI/AN and rural communities, the COVID-19 pandemic may have placed those with behavioral health issues and SUDs at even higher risk. Training a workforce to research the delivery of culturally-centered behavioral health and addiction care with telehealth as a viable option has the potential to reduce the lasting impact of COVID-19 in underserved populations and prevent disruption of substance use treatment. The overall goal of the parent R25, Culturally-Centered Addictions Research Training (C-CART) (1R25DA053805), is to educate clinicians, providers, and doctoral students in health professions (occupational therapy [OT], physical therapy [PT], counseling, school, & clinical psychology, and interdisciplinary health) in research skills that include culturally- centered practices, related to SU/SUDs applied in interprofessional practice and diverse settings.This proposed Supplement to our R25 will look at Native culture and traditional practices within tele-behavioral SU/SUD treatment at one of our community partner agencies – Native Americans for Community Action (NACA) - and determine the impact on behavioral health outcomes for clients during the first year of the COVID-19 pandemic. The specific aims of this project are: Aim 1: To understand the integration of Native culture and traditional practices within tele-behavioral SU/SUD treatment at NACA and explore its impact on behavioral health outcomes during the COVID-19 pandemic employing a mixed methods research design; and Aim 2: To incorporate the findings from Aim 1 into a tele-behavioral SU/SUD treatment training module that will be pilot tested with NACA SU/SUD providers and shared with the Indian Health Service (IHS) Western Region.

项目概要 与其他群体相比，吸毒后药物滥用率较高，存在明显差异。 美洲印第安人/阿拉斯加原住民 (AI/AN) 的创伤性压力、暴力和自杀率高。 AI/AN 社区中的滥用与失业、学业成绩低下、高风险有关 职业、暴力、家庭暴力、犯罪、缺乏健康保险、精神疾病和死亡率 自杀、酗酒或其他药物滥用造成的影响尤为严重。 亚利桑那州的 AI/AN 由于缺乏提供证据所需的基础设施和保留人员 - 此外，缺乏以文化为中心的治疗和预防服务。 COVID-19 大流行暴露了生活在农村和城市地区的 AI/AN 个人的障碍。 服务不足的社区在获得医疗保健和健康结果方面存在明显的种族差异。 COVID-19 对亚利桑那州的部落社区造成的影响尤其严重，SUD 患者可能会受到严重影响。 由于许多药物对呼吸道和肺部的影响，特别容易出现 COVID-19 并发症 健康状况，无家可归、监禁和并发健康状况的可能性比一般人更高 鉴于远程医疗在为 AI/AN 和农村地区提供全面护理方面存在障碍。 社区中，COVID-19 大流行可能使那些有行为健康问题和 SUD 的人处于甚至 培训劳动力来研究以文化为中心的行为健康和成瘾问题。 将远程医疗护理作为一种可行的选择有可能减少 COVID-19 对 服务不足的人群并防止药物使用治疗中断 家长的总体目标。 R25，以文化为中心的成瘾研究培训（C-CART）（1R25DA053805），是为了教育信徒， 健康专业的提供者和博士生（职业治疗 [OT]、物理治疗 [PT]、 咨询、学校、临床心理学和跨学科健康）的研究技能，包括文化- 以实践为中心，与跨专业实践和多样化环境中应用的 SU/SUD 相关。这 拟议的 R25 补充将着眼于远程行为中的本土文化和传统做法 我们的社区合作机构之一 - 美国原住民社区行动组织的 SU/SUD 治疗 (NACA) - 并确定第一年对客户行为健康结果的影响 COVID-19 大流行的具体目标是： 目标 1：了解 Native 的集成。 NACA 远程行为 SU/SUD 治疗中的文化和传统做法，并探讨其对 采用混合方法研究设计的 COVID-19 大流行期间的行为健康结果； 目标 2：将目标 1 的研究结果纳入远程行为 SU/SUD 治疗培训模块，该模块将 与 NACA SU/SUD 提供商进行试点测试，并与印度卫生服务 (IHS) 西部地区共享。