Developing and evaluating a culturally grounded Mother-Daughter intervention to promote protective factors and reduce early substance use among Apache girls

制定和评估基于文化的母女干预措施，以促进保护因素并减少阿帕奇女孩的早期药物使用

• 批准号: 10021003
• 负责人: MARIDDIE J CRAIG
• 金额: $ 17.97万
• 依托单位: WHITE MOUNTAIN APACHE TRIBE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-21 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10021003
• 关键词: 11 year old; 17 year old; Address; Adult; Age; Alcohol or Other Drugs use; Alcohols; American Indians; Apache; Attitude; Behavior; Belief; Caregivers; Characteristics; Child; Clinical Trials; Communication; Communities; Dangerousness; Data; Daughter; Dependence; Development; Educational workshop; Effectiveness of Interventions; Elderly; Enrollment; Ethics; Evaluation; Family; Fathers; Female; Focus Groups; Funding; Gender; Goals; Health; Home visitation; Intervention; Intervention Trial; Interview; Lead; Marijuana; Mediator of activation protein; Mentors; Minority Groups; Monitor; Moods; Mothers; National Institute of Drug Abuse; Native American Research Center for Health; Outcome; Parents; Peer Group; Population; Pregnancy Rate; Pregnancy in Adolescence; Prevention strategy; Process; Protocols documentation; Puberty; Research; Research Design; Research Methodology; Research Personnel; Risk; Risk Factors; Risk Reduction; Sex Behavior; Teenagers; Testing; Training; Trust; White Mountain Apache; addiction; adolescent substance use; base; behavioral health; boys; comorbidity; cultural values; data management; design; early onset substance use; efficacy trial; emotion regulation; ethnic minority population; experience; feasibility trial; girls; improved; indigenous community; insight; intergenerational; member; novel; parental monitoring; prevent; protective factors; sexual risk behavior; sexual risk taking; substance use prevention; teenage mother; therapy development; unintended pregnancy

Project Summary This study, Developing and evaluating a culturally grounded “Mother-Daughter” intervention to promote protective factors and reduce early substance use and associated sexual risk among Apache girls, addresses a dangerous upturn in early substance use initiation among American Indian (AI) females through a gender-specific, culturally driven approach. National and tribal data show: 1) girls’ substance use is catching up or exceeding boys’; 2) girls use substances for different reasons than boys; 3) health effects are more deleterious for girls; and 4) protective factor approaches appear more effective than risk reduction strategies in AI communities. The primary goal of this research is to test the feasibility of a novel, culturally grounded mother-daughter intervention that taps matrilineal cultural assets to enhance protective and reduce risks factors for early substance use and associated unsafe sexual behaviors among Apache girls as they transition through puberty. Targeted mediators of intervention change are based on a strong line of WMAT-JHU team research, and include: positive maternal (mother and other female caregiver) monitoring and involvement, mother-daughter communication and daughter’s positive cultural identity, emotional regulation, and positive peer group selection. This study’s three primary aims are: 1) To qualitatively gather community attitudes, beliefs and practices about protective and risk factors for early substance use and sexual risk behaviors among Apache females. Through 30 in-depth interviews and 10 focus groups, or until saturation is reached, we will obtain insights on: beliefs and practices related to girls’ development of positive cultural and community identity; cultural, familial and community strengths that promote girls’ positive transition through puberty; characteristics of protective relationships between girls and their mothers and other adult female caregivers; and other determinants of girls’ substance use and sexual risk-taking behaviors. 2) To design a culturally grounded “mother-daughter” intervention for pre-pubescent girls ages 8 to 11 and their mothers/ female caregivers. The intervention will be delivered by trained Apache behavioral health interventionists. 3) To assess the feasibility, acceptability, and preliminary effectiveness of the intervention with n=40 mother- daughter dyads and associated female caregivers (i.e., grandmothers, aunties). This proposal is highly significant given the threatening combination of early substance use and sexual risk behaviors among young AI girls on intergenerational cycles of unintended pregnancy and poor behavioral health outcomes. The study will apply strong evidence that parent-child strategies can prevent adolescent substance use to the development of a novel mother-daughter intervention. If study aims are achieved, we will produce a gender- specific intergenerational intervention built on Apache cultural and matrilineal protective factors to reduce early substance use and related sexual risk behaviors among Apache girls, with import to other indigenous communities.

项目摘要 这项研究，开发和评估了一种文化扎根的“母女”干预措施，以促进 保护因素并减少阿帕奇女孩的早期使用和相关的性风险， 解决了美洲印第安人（AI）女性在早期使用的危险上涨 性别特定的文化驱动方法。国家和部落数据显示：1）女孩的吸毒正在追赶 或超过男孩的； 2）女孩出于与男孩不同的原因使用物质； 3）健康影响更多 对女孩有害； 4）保护因素方法似乎比降低风险策略更有效 AI社区。这项研究的主要目的是测试一种新颖的文化扎根的可行性 母女干预措施，以利用矩阵文化资产来增强保护性并降低风险 早期使用物质使用的因素以及Apache Girls过渡时相关的不安全性行为 通过青春期。干预变化的有针对性的调解人基于WMAT-JHU团队的强大线条 研究，包括：正面材料（母亲和其他女性护理人员）监测和参与， 母女交流和女儿的积极文化身份，情感调节和积极 对等组选择。这项研究的三个主要目的是：1）定性地聚集社区与会者， 关于早期药物使用和性风险行为的保护和风险因素的信念和实践 Apache女性。通过30个深入的访谈和10个焦点小组，或者直到达到满意度，我们将 获得有关：与女孩发展积极文化和社区发展有关的有信心和实践 身份;文化，家庭和社区优势通过青春期促进女孩的积极过渡； 女孩与母亲和其他成年女性护理人员之间的保护性关系的特征； 以及其他女孩使用物质使用和性冒险行为的决定者。 2）在文化上设计 扎根于8至11岁的青春期前女孩及其母亲/女性的“母女”干预 照顾者。干预将由训练有素的Apache行为健康干预者提供。 3） 评估干预n = 40母亲的可行性，可接受性和初步效果 女儿二元和关联的女性护理人员（即祖母，阿姨）。该提议很高 鉴于年轻人的早期药物使用和性风险行为的威胁结合很大 AI女孩在意外怀孕和行为健康状况不佳的代际周期中。研究 将应用有力的证据表明，亲子策略可以防止青少年物质使用 开发新颖的母女干预。如果实现了学习目标，我们将产生性别 基于Apache文化和基质受保护因素建立的特定代际干预措施以减少早期 Apache Girls中的药物使用和相关的性风险行为，进口到其他土著 社区。