Evidence-Based Practices and Substance Abuse Treatment for Native Americans

美洲原住民的循证实践和药物滥用治疗

• 批准号: 7431560
• 负责人: DOUGLAS K NOVINS
• 金额: $ 31.19万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-15 至 2012-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7431560
• 关键词: Alaska Native; Alcohol or Other Drugs use; Alcohols; American Indians; Case Study; Communities; Data; Depth; Drug usage; Evidence based practice; Funding Mechanisms; Health; Human Resources; Medical Surveillance; Methods; Native Americans; Native-Born; Numbers; Pharmaceutical Preparations; Prevalence; Prevention; Public Health; Rate; Reporting; Research; Research Design; Staging; Study models; Substance abuse problem; Surveys; System; Telephone; Tribes; improved; insight; named group; programs; treatment program

DESCRIPTION (provided by applicant): Despite decades of research as well as concerted efforts to improve prevention and treatment, available information suggests that the prevalence of problematic alcohol and drug use (referred to hereafter as substance use) has not appreciably changed in most American Indian and Alaska Native (AI/AN) communities. Research and health surveillance activities further document the substantial impacts of problematic substance use on the health of AI/AN people at rates that continue to far exceed those of non-AI/ANs. Fortunately, a number of Evidence-Based Practices (EBPs) have now been developed that hold substantial promise for improving treatment for AI/ANs with substance use problems, as they do for non-AIs. Anecdotal reports suggest, however, that the use of EBPs in programs that serve AI/ANs is limited. Furthermore, the unique funding mechanisms for programs serving AI/ANs, as well as the sovereign status of AI/AN tribes, mean that we cannot assume that the factors influencing the implementation of EBPs in programs more generally, such as mandates for the use of EBPs in federally-sponsored programs, impact programs serving this special population in the manner in which they were intended. Organizational factors may also operate differently given the severe fiscal and human resource limitations under which these programs operate. In addition, concerns about the cultural appropriateness of some EBPs may discourage their use. The specific aims of this project are as follows: 1) to describe the use of specific EBPs in substance abuse treatment programs serving AI/AN communities; 2) to describe the factors associated with the decision to implement EBPs in these programs; and 3) to identify methods for more effective dissemination of EBPs to substance abuse treatment programs serving AI/AN communities. We will utilize a three-stage study design. First, we will conduct a focused set of 2 case studies of model substance abuse treatment systems serving AI/AN communities. Second, we will conduct a telephone survey of the directors of all 480 substance abuse treatment programs serving AI/AN communities. Finally, we will conduct in-depth case studies of 12 of these programs. We will collect and analyze both quantitative and qualitative data. The results of this project will provide the first description of the use of EBPs in substance abuse treatment programs serving AI/AN communities, much- needed insights regarding the dynamics around the decision to implement such practices, and carefully formulated methods for more effective dissemination. PUBLIC HEALTH RELEVANCE: The results of this project will provide the first description of the use of Evidence-Based Practices in substance abuse treatment programs serving American Indian and Alaska Native communities. Along with these descriptions, we will also develop a detailed understanding of how these substance abuse treatment programs decide to implement Evidence-Based Practices, and how we could improve our methods for encouraging their use in these programs

描述（由申请人提供）：尽管经过数十年的研究以及为改善预防和治疗而做出的共同努力，现有信息表明，在大多数美洲印第安人中，有问题的酒精和药物使用（以下称为物质使用）的流行率并没有明显改变和阿拉斯加原住民 (AI/AN) 社区。研究和健康监测活动进一步记录了有问题的物质使用对 AI/AN 人群健康的重大影响，其影响程度继续远远超过非 AI/AN 人群。幸运的是，现在已经开发出许多循证实践（EBP），这些实践对于改善具有药物使用问题的 AI/AN 的治疗具有巨大的希望，就像对非 AI 的治疗一样。然而，轶事报告表明，EBP 在服务于 AI/AN 的程序中的使用是有限的。此外，服务于 AI/AN 的项目的独特融资机制，以及 AI/AN 部落的主权地位，意味着我们不能假设更普遍地影响项目中 EBP 实施的因素，例如使用联邦政府资助的计划中的 EBP 影响计划以预期的方式为这一特殊人群提供服务。鉴于这些计划运作所面临的严重财政和人力资源限制，组织因素也可能以不同的方式运作。此外，对某些 EBP 文化适应性的担忧可能会阻碍其使用。该项目的具体目标如下： 1) 描述特定 EBP 在为 AI/AN 社区服务的药物滥用治疗项目中的使用； 2) 描述与在这些计划中实施 EBP 的决定相关的因素； 3) 确定更有效地将 EBP 传播到服务于 AI/AN 社区的药物滥用治疗项目的方法。我们将采用三阶段研究设计。首先，我们将对服务 AI/AN 社区的药物滥用治疗系统模型进行一组重点案例研究，共 2 个。其次，我们将对服务 AI/AN 社区的所有 480 个药物滥用治疗项目的负责人进行电话调查。最后，我们将对其中 12 个项目进行深入的案例研究。我们将收集和分析定量和定性数据。该项目的结果将首次描述 EBP 在为 AI/AN 社区服务的药物滥用治疗项目中的使用，提供有关实施此类实践的决策动态的急需见解，以及为更有效传播而精心制定的方法。公共健康相关性：该项目的结果将首次描述在服务美洲印第安人和阿拉斯加原住民社区的药物滥用治疗计划中使用循证实践。除了这些描述之外，我们还将详细了解这些药物滥用治疗计划如何决定实施循证实践，以及我们如何改进我们的方法以鼓励在这些计划中使用它们