Qungasvik (Toolbox): Prevention of Alcohol/Suicide Risk in Alaska Native Youth

Quungasvik（工具箱）：阿拉斯加原住民青少年酒精/自杀风险的预防

• 批准号: 9754722
• 负责人: JAMES R. ALLEN
• 金额: $ 73.26万
• 依托单位: UNIVERSITY OF ALASKA FAIRBANKS
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-10 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9754722
• 关键词: 18 year old; Accidental Injury; Address; Adult; Age; Alaska; Alaska Native; Alcohol consumption; Alcohol-Induced Disorders; Alcohols; Cessation of life; Characteristics; Code; Collaborations; Communities; Data; Dose; Effectiveness; Effectiveness of Interventions; Elderly; Ethnic group; Evaluation; Exhibits; Exposure to; Family; Feeling suicidal; Female; General Population; Goals; Growth; Health; Health Promotion; Incidence; Individual; Instruction; Interruption; Intervention; Interview; Investments; Lead; Learning; Life; Link; Manuals; Measurable; Measures; Modeling; Native Americans; Native-Born; Outcome; Outcome Measure; Parents; Patient Self-Report; Pattern; Persons; Pilot Projects; Population; Prevention; Prevention trial; Preventive Intervention; Process; Process Measure; Public Health; Randomized; Research; Research Personnel; Resources; Rural; Rural Community; Series; Social Network; Suicide; Suicide prevention; Techniques; Testing; Time; Toxicology; Treatment Efficacy; Universities; Videotape; Waiting Lists; Youth; Yup' ik; alcohol consequences; alcohol prevention; alcohol use disorder; alcohol use initiation; alcohol-related death; base; community based participatory research; community intervention; community planning; comparative effectiveness; cultural values; design; disorder prevention; experience; follow-up; health disparity; intervention effect; male; member; mortality; native youth; peer; primary outcome; prospective; protective effect; protective factors; public health relevance; randomized trial; response; rural Alaska; success; suicidal behavior; suicidal risk; suicide rate; theories; trend

 DESCRIPTION (provided by applicant): For the past 10 years we have focused on addressing two interrelated public health issues, alcohol use disorder (AUD) and suicide in 12-18 year old Yup'ik Alaska Natives (AN). AUD and suicide are among the leading causes of mortality among AN people and a significant health disparity in contrast to the U.S. general population (1). AN mortality rates from all alcohol-induced disorders between 2001 2005 were 53.8/100,000 in contrast to 6.3/100,000 for other ethnic groups in Alaska (2), while the age-adjusted rate for suicide is twice the national average (3). Overall, between 1960-95 AN suicide rates increased approximately 500% (4). More recent data indicate continuation of these trends and also identify cluster suicide behavior as a feature of AN youth suicide (5). Yup'ik community leaders have made addressing AUD and suicide among their highest priorities. In response, working with several communities, a community-based and led intervention (Qungasvik - toolbox) was designed. The intervention is designed to develop protective factors that will ultimately reduce the incidence of AUD and suicide. Our research leading up to the currently proposed study has shown that it is possible to: (1) deliver the intervention in remote rural communities; (2) obtain valid and reliable measures of two ultimate outcomes (i.e., Reflective Processes regarding alcohol consequences and Reasons for Life) and intermediate protective factors variables that underlie them; (3) show a dose-response effect: the more intervention sessions a person attends (dose) the stronger the measured protective factors (response); and (4) obtain a maximum protective effect from the intervention by lengthening the duration of the intervention from one to two years. The proposed study is an assessment of a modified version of the intervention and focuses on three specific aims (SA): (SA1) test Qungasvik intervention efficacy through impact on the two protective factors and to link those measures to direct measures of alcohol use and suicidal ideation; (SA2) examine the mechanisms of change in response to the intervention through growth in: (a) intermediate outcome measures of protective factors at the individual, family, peer, and community level; (b) social network characteristics of supportive relationships with elders, immediate and extended kinship relations, and community adults and describe social network change; and (c) using qualitative interviewing and grounded theory analysis techniques, describe process and impact of the intervention from community elder and parent perspectives; and (SA3) examine the fidelity of implementing the intervention.

 描述（由适用提供）：在过去的10年中，我们专注于解决两个相互关联的公共卫生问题，酒精使用障碍（AUD）和12-18岁的Yup'ik Yup'ik Alaska本地人（AN）。与美国普通人群相比，AUD和自杀是人民死亡的主要原因之一，健康差异很大（1）。在2001年2001年之间，所有酒精引起的疾病的死亡率均为53.8/100,000，而阿拉斯加其他族裔群体的死亡率为6.3/100,000（2），而自杀年龄调整的率是全国平均水平的两倍（3）。总体而言，自杀率在1960 - 95年之间增加了约500％（4）。最新的数据表明这些趋势的延续，还确定了自杀自杀的群集自杀行为（5）。 Yup'ik社区领导人已将AUD和自杀介绍给他们的最高优先事项。作为回应，与几个社区合作，设计了基于社区的LED干预措施（Qungasvik -Toolbox）。该干预措施旨在开发受保护的因素，最终会降低AUD和自杀的发生率。我们进行当前提出的研究的研究表明，可以：（1）在偏远的农村社区中进行干预； （2）获得两个最终结果的有效且可靠的度量（即有关酒精后果和生命原因的反思过程）和中间保护因素的变量； （3）显示剂量反应效应：一个人参加（剂量）的干预措施越多，测量的受保护因素（响应）越强； （4）通过将干预持续时间从一年延长到两年，从干预措施中获得最大保护效果。拟议的研究是对干预措施的修改版本的评估，并重点介绍了三个特定目标（SA）：（SA1）测试Qungasvik干预效率，通过对两个受保护因素的影响，并将这些措施与直接测量酒精使用和自杀的想法联系起来； （SA2）检查通过增长的干预措施的变化机制： （b）与长者，直接和扩展的亲属关系以及社区成年人的社交网络特征，并描述社交网络变化； （c）使用定性访谈和扎根理论分析技术，描述社区长者和父母观点的干预的过程和影响； （SA3）检查实施干预的保真度。