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

基本信息

批准号：
9319534
负责人：
JAMES R. ALLEN
金额：
$ 64.36万
依托单位：
UNIVERSITY OF ALASKA FAIRBANKS
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-08-10 至 2020-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9319534
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 Databases 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 Risk Rural Rural Community Series Social Network Suicide Suicide prevention Techniques Testing Time Toxicology Treatment Efficacy Universities Videotape Waiting Lists Youth Yup&apos 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 public health relevance randomized trial response rural Alaska success suicidal behavior suicide rate theories trend

项目摘要

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（由申请人提供）：过去 10 年来，我们一直致力于解决两个相互关联的公共卫生问题，即 12-18 岁尤皮克阿拉斯加原住民 (AN) 的酒精使用障碍 (AUD) 和自杀。 2001 年至 2005 年间，AN 人群因所有酒精引起的疾病而导致的 AN 死亡率与美国普通人群相比存在显着的健康差异 (1)。 53.8/100,000，而阿拉斯加其他族裔群体的自杀率为 6.3/100,000 (2)，而年龄调整后的自杀率是全国平均水平的两倍 (3) 总体而言，1960-95 年间，AN 自杀率增加了约 500%（ 4) 最近的数据表明这些趋势仍在继续，并且将集群自杀行为确定为 AN 青少年自杀的一个特征 (5)。 AUD 和自杀是他们的首要任务。为此，我们与多个社区合作，设计了一项以社区为基础的主导干预措施（Qungasvik - 工具箱），该干预措施旨在开发保护因素，最终减少 AUD 和自杀的发生率。我们目前提出的研究表明，有可能：（1）在偏远农村社区获得干预；（2）对两个最终结果（即关于酒精后果的反思过程和原因）进行有效和可靠的衡量。寿命）和中间它们背后的保护因素变量；（3）显示出剂量反应效应：一个人参加的干预次数（剂量）越多，测量到的保护因素（反应）就越强；（4）通过以下方式从干预中获得最大的保护效果：将干预的持续时间从一年延长到两年。拟议的研究是对干预措施修改版本的评估，重点关注三个具体目标（SA）：（SA1）通过对两个保护因素的影响来测试 Quungasvik 干预的功效和作用。链接那些直接测量酒精使用和自杀意念的措施；（SA2）通过以下方面的增长来研究响应干预的变化机制：（a）个人、家庭、同伴和社区层面的保护因素的中间结果测量； ) 与长者、直接和延伸亲属关系以及社区成年人的支持关系的社会网络特征，并描述社会网络变化；以及 (c) 使用定性访谈和扎根理论分析技术，描述老年人社区和家长干预的过程和影响；观点；以及 (SA3) 检查实施干预的忠诚度。