ADOLESCENT AMERICAN INDIAN MULTISECTOR HELP INQUIRY

青少年美国印第安人多部门帮助查询

• 批准号: 6379021
• 负责人: Arlene Rubin Stiffman
• 金额: $ 37.74万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-10 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6379021
• 关键词: Medicare /Medicaid; Native Americans; adolescence (12-20); behavioral /social science research tag; clinical research; disease /disorder proneness /risk; drug abuse; drug abuse therapy; health care cost /financing; health care service utilization; health services research tag; human subject; interview; longitudinal human study; managed care; mental disorders

Despite high rates of drug and other co-occurring mental health problems among American Indian youths, we know little about their service utilization. Their health care system (The Indian Health Service) developed separately from other federal and state programs. Although they are eligible to receive state-funded services, political resistance, difficulty in accessing Medicaid reimbursement, and lack of on-reservation services impede access differentially for urban and reservation-based youths. The AIM- HI (Adolescent American Indian Multisector Help Inquiry) study will collect service use and drug-use information over a 4-year period (from adolescence to young adulthood) on urban and reservation-based American Indian youths. The samples are both from Arizona, providing stability in state financed services, yet one lives on the Salt River Pima-Maricopa Tribal lands and the other in urban Phoenix. The project will interview 1,000 youths in Year 1, sample 400 of the 1,000 for intensive longitudinal interviewing, and survey 600 of these youths' gateway service providers. Multisector service use will be studied in the specialty sectors of drug/alcohol and mental health; the nonspecialty sectors of child welfare, education, juvenile justice, and primary health; the informal sector comprised of parents, relatives and friends; and the traditional sector of Native healers. The study will achieve three aims: 1. To test two service use hypotheses: a) Youths' use of services for their drug or comorbid problems is determined by their need, their predisposing characteristics, and service enabling characteristics; their need as perceived by gateway providers; and those gateway providers' resources, service connections, and service knowledge. and b) After controlling for baseline environmental factors and needs, American Indian youths who have accessed and utilized more extensive and intensive services for their drug use and related behavioral problems will be less likely to have impaired functioning and substance misuse, abuse or dependence. 2. To test a hypothesis concerning the consequences of service reimbursement: The use of specialty substance-use services is positively associated with the availability and accessibility of Medicaid and managed care reimbursement to those services. 3. To document: a) the prevalence, severity and duration of substance abuse and other problems, as well as the protective and risk factors, b) The multisector configurations of services and their complementary or supplementary relationships; and c) The relationship between barriers and changes in the configurations of services. AIM-HI's impact is accelerated by the participation of American Indian community representatives; the association of its PIs with the George Warren Brown School of Social Work's Center for Mental Health Services Research, and the Buder Center for American Indian Studies; and the collaboration of key researchers in the field.

尽管在美国印度青年中，药物和其他同时发生的心理健康问题率很高，但我们对他们的服务利用率一无所知。 他们的医疗保健系统（印度卫生服务）与其他联邦和州计划分开发展。 尽管他们有资格获得国家资助的服务，政治抵抗，难以获得医疗补助报销以及缺乏保留服务，但仍阻碍了基于城市和预订的年轻人的差异访问。 AIM-HI（青少年印度多人帮助查询）研究将在4年（从青春期到成年期）在城市和预订的美国印第安人青年中收集服务使用和药物使用信息。 样品均来自亚利桑那州，在国家融资服务中提供稳定性，但一个人居住在盐河Pima-Maricopa部落土地上，另一个居住在Urban Phoenix。 该项目将在第1年中采访1,000名青年，对1,000个纵向访谈的1,000名年轻人进行采访，并调查这些年轻人的门户服务提供商中的600名。 将在毒品/酒精和心理健康的专业领域研究多部门服务的使用；儿童福利，教育，少年司法和初级健康的非专业部门；非正式部门由父母，亲戚和朋友组成；以及原生治疗师的传统部门。这项研究将实现三个目标：1。测试两个服务使用假设：a）年轻人将服务用于药物或合并症问题取决于他们的需求，诱人的特征和启用特征的服务；网关提供商所感知的他们的需求；以及那些网关提供商的资源，服务连接和服务知识。 b）在控制了基线环境因素和需求之后，已经访问和利用更广泛和密集的服务来吸毒和相关行为问题的美洲印第安人的功能和药物滥用，滥用或依赖的可能性较小。 2。检验有关服务报销后果的假设：使用特殊物质使用服务的使用与医疗补助和托管护理报销对这些服务的可用性和可访问性呈正相关。 3。文件：a）滥用药物和其他问题的普遍性，严重性和持续时间，以及保护性和风险因素，b）服务的多部门配置及其补充或补充关系； c）障碍与服务配置的变化之间的关系。 美洲印第安人社区代表的参与加速了Aim-Hi的影响。 PIS与乔治·沃伦·布朗（George Warren Brown）社会工作中心的精神卫生服务研究中心和布德美洲印第安研究中心的协会；以及该领域主要研究人员的合作。