Healthy Native Nations: Identifying Effective Alcohol Policies for American Indian Tribes

健康的原住民国家：为美洲印第安部落确定有效的酒精政策

• 批准号: 10582531
• 负责人: JULIET P LEE
• 金额: $ 45.3万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-05 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10582531
• 关键词: AODR mortality; Accident and Emergency department; Address; Adopted; Advocacy; Affect; Alaska Native; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohols; American Indians; Area; Attitude; Authorization documentation; Charge; Communities; Community Health; Congresses; Data; Documentation; Economics; Effectiveness; Ensure; Epidemiologic Methods; Epidemiology; Foundations; Genetic; Hand; Health; Health Policy; High Prevalence; Hospitalization; Hospitals; Indian reservation; Indigenous; Individual; Information Dissemination; Information Systems; Injury; Intervention; Interview; Investigation; Joints; Knowledge; Law Enforcement; Laws; Legal; Literature; Low Prevalence; Measures; Methods; Modeling; National Institute on Alcohol Abuse and Alcoholism; Outcome; Police; Policies; Policy Making; Policy Research; Population; Prevention Research; Prevention approach; Price; Psychology; Public Health; Public Policy; Qualitative Research; Records; Regulation; Research; Research Institute; Research Methodology; Research Personnel; Reservations; Risk; Sales; Sampling; Scientist; Site; Surveys; Tribes; Typology; US State; United States; Universities; Vehicle crash; Voice; Washington; Work; Writing; alcohol availability; alcohol measurement; alcohol policy information system; alcohol related problem; authority; behavioral study; community based participatory research; community engagement; comparative; contextual factors; design; epidemiology study; evidence base; experience; health assessment; health disparity; health inequalities; heterogenous data; improved; insight; population health; public policy on alcohol; repository; social; social structure; spatial epidemiology; structural determinants; tribal Nation; tribal community; tribal health; tribal lands; tribal leader; underage drinking

ABSTRACT This Tribal Community-Engaged project uses spatial and legal epidemiological methods within community participatory frameworks to assess the differential relationships of state and tribal alcohol policies to alcohol- related health risks for residents of American Indian reservations. We propose to compile and summarize alcohol regulatory policies established by sovereign tribal nations in conjunction with extant alcohol policies of the U.S. states with which they are collocated. Many correlates of the high rates of alcohol-related problems observed among American Indians (AI) compared to other U.S. populations have been extensively addressed in individual social-behavioral studies in, for example, genetics, psychology, and community health. Very few studies have considered contrasting state vs. tribal alcohol policies as social-structural determinants that may be related to AI alcohol related problems. Sovereign tribal nations have the right to establish their own alcohol policies, which may vary according to adjacent state policy conditions and attitudes towards alcohol across tribal communities. Tribal alcohol policies are publicly registered, but there has been no common repository nor systematic typology established that allows researchers to characterize these ordinances and relate them to state alcohol conditions (see, e.g. NIAAA’s Alcohol Policy Information System). Prior studies of tribal alcohol policies were not able to consider the full impacts of collocated state alcohol regulatory conditions on tribal alcohol problems. Recent studies have developed an Alcohol Policy Score (APS) that characterizes the strengths of alcohol policies across U.S. states. The APS may now be applied to studies of tribal alcohol regulatory conditions. Cross-site studies of tribal alcohol outcomes have also been hampered by the use of heterogenous data systems. We demonstrate that hospitalization records and motor vehicle crash data collected in similar ways across U.S. states can be used to assess tribal alcohol outcomes using common data frames and advanced spatial epidemiological methods. Finally, analyses of tribal policies will be limited in interpretive scope without obtaining local insights and knowledge of tribal leaders who have designed, enacted, and are charged with enforcing tribal alcohol ordinances. We use Tribal Community-Based Participatory and qualitative research methods at multiple levels of community engagement (Tribal Community Advisory Board; tribal research review; Tribal Key Leader Interview; Tribal and Local Law Enforcement Survey) to assess how tribal and state alcohol policies are effected on tribal lands and may support or reduce alcohol-related risks for residents of tribal nations. Our engagement plans ensure tribal community oversight of the interpretation of findings, and dissemination of results to tribal leaders as well as scientific communities.

抽象的 这个部落社区参与的项目使用社区内的空间和法律流行病学方法 参与框架评估国家和部落酒精政策与酒精的不同关系 - 对美洲印第安人保留的居民的相关健康风险。我们建议编译和摘要 主权部落国家制定的酒精调节政策与额外的酒精政策 与他们共处的美国州。许多与酒精相关问题的高率有关 与其他美国人口相比，在美洲印第安人（AI）中观察到已广泛解决 在个人社会行为研究中，例如遗传学，心理学和社区健康。很少 研究已将对比的国家与部落酒精政策视为可能的社会结构决定者 与AI与酒精有关的问题有关。主权部落国家有权建立自己的酒精 政策可能会根据邻近国家政策条件而有所不同，并在遍布酒精 部落社区。部落酒精政策已公开注册，但没有共同的存储库，也没有 建立了系统的类型学，使研究人员能够将这些条例描述并将其与之相关联 陈述酒精状况（例如，参见NIAAA的酒精政策信息系统）。先前对部落酒精的研究 政策无法考虑共处国家酒精调节条件对部落的全部影响 酒精问题。最近的研究开发了一种饮酒政策评分（AP），以表征 美国各州酒精政策的优势。 AP现在可以应用于部落酒精的研究 监管条件。对部落酒精结果的跨场研究也因使用而受到阻碍 异源数据系统。我们证明住院记录和机动车撞车数据 以类似方式收集的美国各州可以使用常见数据来评估部落酒精的结果 框架和先进的空间流行病学方法。最后，对部落政策的分析将受到限制 解释性范围而没有获得当地见解和对设计，制定， 并被指控执行部落酒精条例。我们使用基于部落社区的参与性和 多个社区参与的定性研究方法（部落社区顾问委员会； 部落研究评论；部落主要领导人面试；部落和地方执法调查）评估如何评估 部落和州酒精政策受到部落土地的影响，可能支持或减少与酒精有关的风险 部落国家的居民。我们的参与计划确保部落社区对解释的监督 调查结果，并将结果传播给部落领导人以及科学社区。