Brief Intervention for Substance Using Native Youth

针对吸毒的本土青少年的简短干预

• 批准号: 8249821
• 负责人: John R., RN, PHD, FAAN Lowe
• 金额: $ 60.65万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8249821
• 关键词: Adolescent; Alcohol abuse; Alcohol or Other Drugs use; Attention; Behavior Therapy; Cherokee Indian; Clinical Trials; Development; Drug usage; Effectiveness; Elderly; Ensure; Ethnic group; Evaluation; Feedback; Gender; General Population; Goals; Intervention; Life; Mediator of activation protein; Minority; Native Americans; Not Hispanic or Latino; Oklahoma; Older Population; Paper; Participant; Pharmaceutical Preparations; Phase; Population; Process; Publishing; Questionnaires; Randomized; Randomized Clinical Trials; Readiness; Recruitment Activity; Reporting; Research; Research Project Grants; Risk; Sampling; Schools; Screening procedure; Self Efficacy; Students; Substance abuse problem; Target Populations; Teenagers; Testing; Time; Training; Treatment outcome; Tribal School; Youth; aged; alcohol intervention; base; brief advice; brief intervention; brief motivational intervention; college; design; drinking; high risk; high school; innovation; motivational enhancement therapy; native youth; post intervention; public health priorities; public health relevance; racial and ethnic; response; self reliance; treatment effect; treatment response

DESCRIPTION (provided by applicant): "Brief Intervention for Substance Using Native Youth" is a 5-year research project designed to develop and test a school-based, brief motivational intervention for substance using, Native American high school students. Motivational Interviewing (MI) is a behavioral treatment for substance use problems that has already shown efficacy in some populations. Clinical trials support the effectiveness of MI with adults and older adolescents with substance use problems. However, MI clinical trials to date have been limited by (a) insufficient ethnic/racial diversity of samples (i.e., almost every MI RCT published to date has focused on predominantly non-Hispanic white samples), (b) lack of attention to non-treatment seeking populations, (c) no direct examination of putative mechanisms of change, and (d) no direct examination of how culture-related variables may influence treatment response. MI's effectiveness for minority populations, and especially Native American populations, has received scant research attention, and remains unknown. Moreover, Native American youth, compared to youth from other racial/ethnic backgrounds, are at especially high risk for drug use and drinking, which makes them particularly susceptible to the development of substance use problems. The primary goal of the proposed study is to conduct a clinical trial evaluating a culturally congruent, school-based motivational interviewing intervention targeting substance use among Native American high school students. The development phase of the project (6 months) will focus on (a) adapting our assessment and intervention materials in order to ensure cultural and developmental congruency with our target population, (b) training staff in conducting MI assessment and intervention with developmental and cultural sensitivity, and (c) collaborating with school and tribal representatives in the planning and implementation the clinical trial phase of the project. Clinical trial participants will be recruited from three predominantly Native American public high schools located in Oklahoma. A school-wide paper-and-pencil substance use screening questionnaire will be used to select a sample of "high risk substance users" (n = 480), who will be randomly assigned to one of three treatment conditions: (1) brief advice and a personalized feedback report alone (BA+PFR; n = 160), (2) brief advice, a personalized feedback report, and motivational interviewing (BA+PFR+MI; n =160), or (3) brief advice, a personalized feedback report, motivational interviewing, and a 6-months post- intervention booster session (BA+PFR+MI+BOOST; n =160). Participants will be evaluated at study entry, and at 3-, 6-, 9-, and 12-month follow-ups. We hypothesize Native American high school students who receive motivational interviewing will demonstrate significantly greater post-intervention reductions in substance use and substance- related negative consequences than their counterparts who do not receive MI (i.e., BA+PFR participants). We also hypothesize adolescents who receive the booster session will demonstrate significantly greater and longer-lived substance use reductions than adolescents who do not receive the booster. A secondary aim is to examine mechanisms of change (i.e., mediators) associated with MI response. We hypothesize pre-to post-intervention changes in perceived readiness to change, perceived importance of change, and self-efficacy will predict participants' response to intervention. Our third aim is to explore gender and Native American-specific cultural variables (Cherokee self- reliance & Native American ethnic identity) as moderators of the differential effectiveness of MI; this aim is specifically designed as a preliminary evaluation of the gender and cultural invariance of our school-based MI intervention. We believe our proposed study is significant and innovative, and represents an important next step in the development of cross-culturally effective, brief, and school- based interventions for drug use and drinking among teenagers. PUBLIC HEALTH RELEVANCE: The proposed project evaluates the efficacy of a motivational interviewing intervention for reducing drug and alcohol use problems among Native American high school students. Native American adolescents are a public health priority, as they are at greater risk than adolescents from other ethnic/cultural groups for the development of long-term substance use problems. The proposed project is intended to test the effectiveness of an empirically supported substance abuse intervention that is accessible and transportable across settings and cultures, with this high risk and underserved group.

描述（由申请人提供）：“使用本地青年的物质简短干预”是一个为期5年的研究项目，旨在开发和测试一种基于学校的，简短的动机干预，用于使用美国原住民高中生。动机访谈（MI）是对药物使用问题的行为治疗，在某些人群中已经显示出功效。临床试验支持MI对具有物质使用问题的成年和年长青少年的有效性。 However, MI clinical trials to date have been limited by (a) insufficient ethnic/racial diversity of samples (i.e., almost every MI RCT published to date has focused on predominantly non-Hispanic white samples), (b) lack of attention to non-treatment seeking populations, (c) no direct examination of putative mechanisms of change, and (d) no direct examination of how culture-related variables may influence treatment response. MI对少数族裔，尤其是美国原住民的有效性受到了研究的关注很少，并且尚不清楚。此外，与其他种族/族裔背景的青年相比，美洲原住民青年尤其容易出现吸毒和饮酒的风险，这使他们特别容易受到药物使用问题的发展。 拟议的研究的主要目标是进行一项临床试验，评估一份文化一致的，基于学校的动机访谈干预措施，以针对美国原住民高中生的药物使用。该项目的开发阶段（6个月）将重点介绍（a）调整我们的评估和干预材料，以确保与我们的目标人群进行文化和发展的一致性，（b）培训员工在进行MI评估和干预方面，并与发展和部落在计划和实施该项目的计划和部落代表中，以进行发展和文化敏感性。临床试验参与者将从位于俄克拉荷马州的三所美国原住民公立高中招募。一份学校范围内的纸和铅笔使用筛查问卷将用于选择“高风险用户”（n = 480）的样本，后者将随机分配到三个治疗条件之一：（1）单独的建议和个性化反馈报告（BA+PFR; ba+pfr; n = 160; n = 160; n = 160）;简短的建议，个性化的反馈报告，动机访谈和6个月的干预后助推器会议（BA+PFR+MI+Boost; n = 160）。参与者将在研究条目中进行评估，并在3日，6日，9个月和12个月的随访中进行评估。 我们假设接受动机面试的美国原住民高中生将表明，与未接受MI的药物相比，药物使用后的干预后减少和与物质相关的负面后果要大得多（即BA+PFR参与者）。我们还假设接受助推器会议的青少年比未接受助推器的青少年表现出更大且更长的寿命使用物质。第二个目的是检查与MI响应相关的变化机制（即介体）。我们假设在干预前的变化发生后，感知到变化的准备就绪，变化的重要性以及自我效能感将预测参与者对干预的反应。我们的第三个目的是探索性别和美国原住民特定的文化变量（切诺基自我依赖和美国原住民身份）作为MI差异效果的主持人；该目标专门设计为对我们学校MI干预的性别和文化不变性的初步评估。我们认为，我们拟议的研究具有重要意义和创新性，代表了跨文化有效，简短和基于学校的毒品使用和饮酒干预措施发展的重要下一步。 公共卫生相关性：拟议的项目评估了动机访谈干预措施减少美国原住民高中生中毒品和酒精使用问题的功效。美国原住民青少年是公共卫生的重点，因为它们的风险比其他种族/文化群体的青少年更大，用于发展长期药物使用问题。拟议的项目旨在测试凭经验支持的药物滥用干预措施的有效性，该干预措施可在各种环境和文化中可访问和运输，并具有高风险和服务不足的群体。