Community Based System Dynamics Models of Alcohol and Substance Exposed Pregnancy in Northern Plains American Indian Women

北部平原美洲印第安妇女酒精和物质暴露怀孕的社区系统动力学模型

• 批准号: 10634665
• 负责人: Arielle R. Deutsch
• 金额: $ 35.74万
• 依托单位: AVERA MCKENNAN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-10-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10634665
• 关键词: Accounting; Address; Age; Alcohol consumption; Alcohols; American Indians; Area; Behavior; Biological Models; Birth; Calibration; Case Management; Characteristics; Collaborations; Communities; Community Developments; Community Health; Complement; Complex; Data; Data Sources; Disparity; Evaluation; Failure; Goals; Individual; Institution; Intervention; Legal; Literature; Marijuana; Methamphetamine; Methods; Modeling; Neurological outcome; Opioid; Outcome; Periodicity; Persons; Pharmacotherapy; Physiological; Policies; Policy Developments; Policy Maker; Populations at Risk; Pregnancy; Pregnancy Rate; Pregnant Women; Prevention; Prevention program; Quality of Care; Race; Recommendation; Research; Research Personnel; Reservations; Risk; Risk Factors; Role; Socioeconomic Status; Strategic Planning; Surveys; System; Testing; Tobacco; Translating; Translations; Woman; Work; alcohol measurement; alcohol prevention; behavior change; community based participatory research; community engagement; community partnership; disparity reduction; dynamic system; health disparity; high risk; improved; in silico; innovation; interest; intervention program; intimate partner violence; models and simulation; predictive modeling; pregnancy health; pregnancy prevention; prescription opioid; programs; reduced substance use; reproductive; simulation; substance use; success; syndemic; translational framework; trend; unintended pregnancy; vulnerable community

PROJECT SUMMARY Continued trends of alcohol and substance exposed pregnancy (ASEP) indicate a great need for higher quality ASEP-reduction programs, particularly those that address ASEP health disparities within at-risk populations and communities, such as American Indian (AI) women. These programs do not account for the broad constellation of factors pertinent to ASEP, in particular, the role of intimate partner violence (IPV), which forms a syndemic association with two other ASEP indicators (alcohol and substance use and unplanned pregnancy). System dynamics methods are effective strategies for understanding of how ASEP and this syndemic are nested within a broader system of interpersonal, intrapersonal, and institutional factors. This method is especially beneficial for addressing the current ASEP-related health disparities within AI communities. Community-based system dynamic models allow practitioners and policymakers to determine the best system areas for implementing policies and programs that will produce the biggest changes in ASEP. The current proposal uses community- based approaches to develop ASEP system models for AI women within two communities: a small metro and a neighboring reservation. These models allow for a researcher-community partnership to discover important system leverage points for ASEP intervention (reducing ASEP within pregnant women) and ASEP prevention (focusing on the cyclic relationship between IPV and alcohol and substance use). The goals of this project are to build and simulate system dynamic models that that represent the ASEP system in partnership with our highly collaborative community-researcher team. We will calibrate and validate these models utilizing a variety of community data sources, and then distinguish the most effective areas to target for reducing ASEP and ASEP predictors that a) generalize across communities and substance legality, and b) may be uniquely effective within specific communities or for specific substances. This work will be complemented by individual-level analyses which can estimate the strength of high-priority leverage points on individual ASEP and ASEP risk. The proposed research is significant as it accounts for the often-ignored underlying matrix of contributors which maintain community levels of ASEP and ASEP health disparities, and provides clear recommendations for high-impact methods to reduce ASEP within communities at need. This project is innovative due to the integration of system simulation and community-based approaches to address complexity, of this issue, and the integration of descriptive and predictive analyses to provide distinct empirically-based solutions to address these issues within a translational framework. The strong interdisciplinary team of researchers with unique, but complementary areas of expertise and the close working partnership between researchers and the communities of interest are together a powerful collaborative to facilitate project success and meaningful contributions to community health. Findings from this study provide critical information about highly effective ways of reducing ASEP and ASEP health disparities, as well as a clear mechanism for developing a strategic blueprint for systematic change within AI communities.

项目概要 酒精和物质暴露妊娠 (ASEP) 的持续趋势表明对更高质量的巨大需求 ASEP 减少计划，特别是那些解决高危人群中 ASEP 健康差异的计划， 社区，例如美洲印第安人 (AI) 妇女。这些计划没有考虑到广泛的星座 与 ASEP 相关的因素，特别是亲密伴侣暴力 (IPV) 的作用，它形成了一种综合症 与另外两个 ASEP 指标（酒精和药物使用以及意外怀孕）相关。系统 动力学方法是了解 ASEP 和这种流行病如何嵌套的有效策略 一个更广泛的人际、个人内部和制度因素系统。这个方法特别有用 解决人工智能社区内当前与 ASEP 相关的健康差异。基于社区的系统 动态模型使从业者和政策制定者能够确定实施的最佳系统领域 将为 ASEP 带来最大变化的政策和计划。当前的提案使用社区- 基于方法为两个社区内的人工智能女性开发 ASEP 系统模型：一个小型地铁和一个 邻近预订。这些模型允许研究人员与社区建立伙伴关系来发现重要的 ASEP 干预（减少孕妇 ASEP）和 ASEP 预防的系统杠杆点 （重点关注 IPV 与酒精和物质使用之间的循环关系）。该项目的目标是 与我们的高度合作伙伴建立和模拟代表 ASEP 系统的系统动态模型 协作社区研究团队。我们将利用各种方法来校准和验证这些模型 社区数据源，然后区分减少 ASEP 和 ASEP 的最有效目标领域 预测因子 a) 可以在社区和物质合法性中推广，b) 可能在特定范围内具有独特的有效性 特定社区或特定物质。这项工作将得到个人层面的分析的补充 它可以估计高优先级杠杆点对单个 ASEP 和 ASEP 风险的强度。拟议的 研究很重要，因为它解释了经常被忽视的贡献者的基本矩阵，这些矩阵维持着 社区层面的 ASEP 和 ASEP 健康差异，并为高影响力提供明确的建议 在有需要的社区内减少 ASEP 的方法。该项目由于系统集成而具有创新性 模拟和基于社区的方法来解决这个问题的复杂性，以及集成 描述性和预测性分析，以提供独特的基于经验的解决方案来解决这些问题 一个翻译框架。强大的跨学科研究团队，具有独特但互补的优势 专业领域以及研究人员和利益群体之间的密切工作伙伴关系 强强联手，促进项目成功并为社区健康做出有意义的贡献。 这项研究的结果提供了有关减少 ASEP 和 ASEP 的高效方法的关键信息 健康差异，以及制定系统性变革战略蓝图的明确机制 人工智能社区。

项目成果

How Funding Policy Maintains Structural Inequity Within Indigenous Community-Based Organizations.

资助政策如何维持土著社区组织内的结构性不平等。

• DOI: 10.1377/hlthaff.2023.00483
• 发表时间: 2023
• 期刊: Health affairs (Project Hope)
• 作者: Deutsch,ArielleR;Frerichs,Leah;Hasgul,Zeynep;Murphey,Foster;Coleman,AddieK;Bachand,AnnieY;Bettelyoun,Arlana;Forney,Paul;Tyon,Gene;Jalali,MohammadS
• 通讯作者: Jalali,MohammadS

Equitable Policies Need Equitable Practices: Alcohol- and Substance-Exposed Pregnancy as a Case Study.

公平的政策需要公平的做法：酒精和药物暴露怀孕作为案例研究。

• DOI: 10.1177/15248399221107605
• 发表时间: 2024
• 期刊: Health promotion practice
• 影响因子: 1.9
• 作者: Deutsch,ArielleR;Jalali,MohammadS;Stout,Sarah;Frerichs,Leah
• 通讯作者: Frerichs,Leah