Discovering Our Story, to develop the Chemawa Journey of Transformation

发现我们的故事，发展 Chemawa 转型之旅

基本信息

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
项目类别：
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

项目摘要

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日益普遍、代价高昂且致命——加剧了协同作用美国 (US) 的流行病对美洲印第安人和阿拉斯加原住民 (AIAN) 的影响尤为严重 AIAN 青年是 AIAN 健康危机的核心。受到许多历史、结构、社会和行为因素的不成比例的影响严重的健康差异，包括酗酒、吸烟、阿片类药物和其他药物 (ATOD) 的使用以及性行为吸烟、饮酒和生殖健康风险（SRH；ATOD-SHR）。 AIAN 吸食大麻的年龄比一般人群年轻得多（11.5 岁），其中 AIAN 为青少年吸烟率最高，首次使用 ATOD 的最早年龄超过 20%。的本地高中生在没有处方的情况下使用处方止痛药，同时也使用海洛因过去 30 天，药物使用是无保护性行为的最重要风险因素之一，AIAN 青少年也有这种情况。首次性交最早年龄在25岁以下的AIAN感染率是衣原体感染率的三倍，与白人青年相比，这些 ATOD-SHR 的差异凸显了淋病和梅毒。迫切需要同时针对 AI 青少年的 ATOD 和 SHR 进行干预。总体而言，解决 AIAN 青少年 ATOD-SRH 预防需求的研究很少，甚至更少参加 183 届 AIAN 青年的近十分之一的 ATOD-SRH 相关差异信息全国范围内的部落走读学校或寄宿学校，以解决这一危机和缺乏基于证据的计划。对于这个人群，拟议的研究是针对 PAR-17-496 准备的，涉及 5 年 RO1 来测试 Chemawa 转型之旅 - 本土青年健康领导力计划的初步成效 (CHJ)，这是“发现我们的故事”干预措施的改编和扩展版本，2010 年 SAMSHA- 确定了 AIAN 基于综合药物使用和健康风险预防优势的最佳实践 AIAN 青年健康领导计划强调全面、积极的青年方法，将讲故事与传统原型和责任结合起来，作为过程和隐喻 CJOT 是一项以文化为中心的体验式为期 8 周（10 周）的活动，旨在引导 AIAN 青少年进行行为改变。会议）以学校为基础的积极的青少年健康领导力发展干预措施，以防止 ATOD 使用和 AIAN 青少年（13-16 岁）的 SHR 该计划包括为期 2 个月的干预（3 次单独课程 + 10 次）。课程）+ 5 场强化课程，包括数字讲故事培训 + 1 场社区活动（数字和口头）讲故事首映）以行为改变为目标，与讲故事有关，是一项由年轻人主导的讲故事活动。