Discovering Our Story, to develop the Chemawa Journey of Transformation

发现我们的故事，发展 Chemawa 转型之旅

• 批准号: 10573319
• 负责人: Teresa A Evans-Campbell
• 金额: $ 63.79万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10573319
• 关键词: Address; Affect; African American population; Age; Age Years; Alaska Native; Alcohol consumption; Alcohols; American Indians; Behavioral; Chlamydia; Coitus; Collaborations; Communities; Data; Disparity; Drug usage; Elderly; Epidemic; Ethnic Origin; Event; Evidence based program; Family; Future Generations; General Population; Gonorrhea; HIV; Health; Heart; High Prevalence; High School Student; Indigenous; Individual; Intervention; Lead; Leadership; Marijuana; Mediating; Metaphor; Methods; Modeling; Motivation; Native-Born; Opioid; Oral; Pain; Pathway interactions; Pattern; Pharmaceutical Preparations; Population; Population Programs; Poverty; Predisposition; Prevention; Primary Prevention; Process; Public Health; Quasi-experiment; Race; Randomized; Recording of previous events; Reproductive Health; Research; Research Infrastructure; Research Personnel; Risk; Risk Factors; Risk Reduction; Safe Sex; Schools; Self Efficacy; Sexual Health; Sexually Transmitted Diseases; Stress and Coping; Students; Substance abuse problem; Sustainable Development; Syphilis; Teenagers; Testing; Tobacco; Tobacco use; Training; Tribal School; Tribes; United States; Universities; Unsafe Sex; Waiting Lists; Washington; Youth; alcohol prevention; alcohol use initiation; behavior change; community based participatory research; cost; cost effective; digital; experience; health disparity; heroin use; high school; intervention effect; leadership development; multidisciplinary; native youth; opioid misuse; peer; positive youth development; programs; response; sex; sexual risk behavior; skills; smoking prevalence; social; stem; substance use; substance use prevention; syndemic; therapy development; Address; Affect; African American population; Age; Age Years; Alaska Native; Alcohol consumption; Alcohols; American Indians; Behavioral; Chlamydia; Coitus; Collaborations; Communities; Data; Disparity; Drug usage; Elderly; Epidemic; Ethnic Origin; Event; Evidence based program; Family; Future Generations; General Population; Gonorrhea; HIV; Health; Heart; High Prevalence; High School Student; Indigenous; Individual; Intervention; Lead; Leadership; Marijuana; Mediating; Metaphor; Methods; Modeling; Motivation; Native-Born; Opioid; Oral; Pain; Pathway interactions; Pattern; Pharmaceutical Preparations; Population; Population Programs; Poverty; Predisposition; Prevention; Primary Prevention; Process; Public Health; Quasi-experiment; Race; Randomized; Recording of previous events; Reproductive Health; Research; Research Infrastructure; Research Personnel; Risk; Risk Factors; Risk Reduction; Safe Sex; Schools; Self Efficacy; Sexual Health; Sexually Transmitted Diseases; Stress and Coping; Students; Substance abuse problem; Sustainable Development; Syphilis; Teenagers; Testing; Tobacco; Tobacco use; Training; Tribal School; Tribes; United States; Universities; Unsafe Sex; Waiting Lists; Washington; Youth; alcohol prevention; alcohol use initiation; behavior change; community based participatory research; cost; cost effective; digital; experience; health disparity; heroin use; high school; intervention effect; leadership development; multidisciplinary; native youth; opioid misuse; peer; positive youth development; programs; response; sex; sexual risk behavior; skills; smoking prevalence; social; stem; substance use; substance use prevention; syndemic; therapy development

Substance use and sexual health risk are increasingly prevalent, costly, and deadly -- fueling a synergistic epidemic in the United States (US) that disproportionately affects American Indian and Alaska Native (AIAN) communities. AIAN youth are at the heart of the AIAN health crisis. AIAN youth are disproportionately affected by many of these historical, structural, social, and behavioral factors that contribute to significant health disparities including high alcohol, tobacco, opiate and other drug (ATOD) use and sexual and reproductive health risks (SRH; ATOD-SHR). The overall mean age of tobacco use, alcohol use, and marijuana initiation for AIANs is much younger (11.5 years) than the general population, with AIAN youth having the highest prevalence of smoking and the earliest age of first use of ATOD. Alarmingly, more that 20% of Native high school students who used a prescription pain med without a prescription also used heroin in the past 30 days. Substance use is one of the most significant risk factors for unprotected sex and AIAN youth have the earliest age of first sexual intercourse. AIANs under 25 years of age have three times the rate of chlamydia, gonorrhea, and syphilis compared to White youth. Taken together, these ATOD-SHR disparities underscore the urgent need for interventions that simultaneously target ATOD and SHR among AI teens. While there is a paucity of research addressing the ATOD-SRH prevention needs of AIAN youth in general, there is even less information available on ATOD-SRH-related disparities for the nearly 1 out of 10 AIAN youth attending the 183 tribal day or boarding schools nationwide. To address this crisis and the dearth of evidence-based programs for this population, the proposed study, prepared in response to PAR-17-496, involves a 5-year RO1 to test the preliminary efficacy of the Chemawa Journey of Transformation–Native Youth Health Leadership Program (CHJ) which is an adapted and expanded version of the Discovering Our Story intervention, a 2010 SAMSHA- identified best practice AIAN strengths-based comprehensive substance use and health risk prevention and health leadership program for AIAN youth. The CJOT emphasizes a holistic, positive youth approach that incorporates storytelling with traditional archetypes and responsibilities as both a process and metaphor for guiding AIAN youth through behavioral change. The CJOT is a culturally-centered experiential 8-week (10 sessions) school-based positive youth health leadership development intervention to prevent ATOD use and SHR among AIAN youth (ages 13-16). The program involves a 2-month intervention (3 individual sessions + 10 sessions) + 5 booster sessions including digital storytelling training + 1 community event (digital and oral storytelling premiere) that targets behavior change relative storytelling and a youth-led storytelling event.

药物使用和性健康风险越来越普遍，昂贵且致命 - 加剧了协同作用 美国流行病（美国）对美国印第安人和阿拉斯加人（Aian）的影响不成比例 社区。艾安青年是艾安健康危机的核心。艾安青年是 受到贡献的许多历史，结构，社会和行为因素的影响不成比例的影响 出于重大健康差异，包括高酒精，烟草，优化和其他药物（ATOD）和性行为 和生殖健康风险（SRH； ATOD-SHR）。烟草使用，饮酒和的总体平均年龄 大麻的AIAN倡议比一般人群年轻（11。5年），而Aian青年 吸烟的患病率最高，最早使用ATOD的年龄。令人震惊的是，超过20％ 在没有处方的处方止痛药中使用处方止痛药的本地学生也使用了海洛因 过去30天。使用药物是无保护性和亚洲青年的最重要的风险因素之一 最早的第一次性交年龄。 25岁以下的Aians的衣原体率是三倍 与白人青年相比，淋病和梅毒。综上所述，这些ATOD-SHR差异强调 迫切需要仅针对AI的ATOD和SHR的干预措施。虽然有一个 对Aian青年的ATOD-SRH预防需求的研究很少，甚至更少 关于ATOD-SRH相关差异的信息可获得十分之一的Aian青年中的近1个 在全国范围内的部落日或寄宿学校。解决这一危机以及基于证据的计划的死亡 拟议的研究是针对PAR-17-496制备的，该人群涉及5年RO1来测试 Chemawa转型之旅 - 本地青年健康领导力计划的初步效率 （CHJ）这是发现我们的故事干预的改编和扩展版本，2010年的Samsha- 确定了最佳实践Aian优势的综合药物使用和预防健康风险，并且 艾亚青年的健康领导力计划。 CJOT强调了一种整体，积极的青年方法 将讲故事与传统原型和责任合并为一个过程和隐喻 指导艾安青年进行行为改变。 CJOT是一个以文化为中心的专家为8周（10 会议）基于学校积极的青年健康领导力发展干预措施，以防止使用ATOD和 SHR在Aian青年中（13-16岁）。该计划涉及2个月的干预措施（3个单个会议 + 10 会议） + 5个助推器会议，包括数字讲故事培训 + 1个社区活动（数字和口头活动 讲故事的首映式）针对行为改变相对讲故事和青年讲故事的事件。