Research Project 2

研究项目2

基本信息

批准号：
10713134
负责人：
Jennifer Rai Richards
金额：
$ 46.18万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2028-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10713134
关键词：
Accidents Address Adolescent Adult Age Alaska Alaska Native Alcohols Ally American Indians Awareness Biological Models Caring Child Cognitive Collaborations Communities Coupled Data Diagnostic Drug usage Early Intervention Ecosystem Education Educational Curriculum Effectiveness Elements Enrollment Epidemic Equity Ethnic Population Evidence based intervention Fathers Female Foundations Funding Gender Health Homicide Indigenous Inequity Injury Intervention Knowledge Leadership Male Adolescents Mediating Mediator Mental Health Methods Modification Morbidity - disease rate Mothers National Institute of Drug Abuse Native-Born Navajo Outcome Participant Pathway interactions Pattern Prevention Prevention Research Prevention program Prevention strategy Program Effectiveness Public Health Randomized, Controlled Trials Research Research Methodology Research Personnel Research Project Grants Resource-limited setting Risk Risk Factors Rural Rural Community Science Secondary Prevention Self Efficacy Services Source Substance Use Disorder Testing Time Trauma Tribes Violence Woman Work acceptability and feasibility access disparities active control group addiction aged alcohol comorbidity alcohol use disorder commune community based participatory research coping design effectiveness evaluation effectiveness measure evidence base experience follow-up health disparity high risk high risk population implementation strategy improved innovation male men mortality neglect perceived discrimination personalized approach prevent primary outcome programs protective factors racial population reduced substance use skills social determinants substance use substance use prevention synergism treatment arm trial design universal prevention young adult young man

项目摘要

PROJECT SUMMARY Problematic substance use (SU) is an ongoing epidemic across American Indian and Alaska Native (AIAN) communities, with AIAN people experiencing the highest rates of SU-related morbidity and mortality of any racial/ethnic group. However, AIAN young men have been largely neglected by SU prevention science. There is a lack of prevention strategies supported by science, and specifically designed for AIAN men during the critical time as they transition from adolescents to adulthood. Moreover, no current prevention programming has been designed to leverage contextual (e.g., historical trauma and colonization) and cultural strengths to optimize effectiveness and sustainability. Rich cultural and traditional practices are particularly vital for AI men, yet these practices and worldviews are largely untapped to date. Our team has spent the past two years adapting and piloting the Common Elements Treatment Approach (CETA), an evidence-based, transdiagnostic intervention that can be tailored to meet the unique needs of participants. The proposed study builds on this track record of adapting CETA for Indigenous prevention science, 35+ years of research collaboration between the Johns Hopkins Center for Indigenous Health (CIH; formerly Center for American Indian Health) and the Navajo Nation, and CIH's decades of experience disseminating and scaling evidence-based interventions that have now reached over 150+ AIAN communities. Led by a team of Indigenous researchers and allied co-investigators, and in collaboration with a Community Research Council, our team will collaborate with two rural Navajo communities to adapt CETA and test this adapted version, Hastóí Bidziil (Strong Men), in a randomized controlled trial through the following Aims: Aim 1: Adapt CETA and associated implementation strategies for young AI men, age 18-26 years, resulting in the Hastóí Bidziil (Strong Men) intervention. Hypothesis: Standard delivery of CETA will require modifications for cultural and gendered specific delivery of CETA for maximum community impact. Aim 2: Determine the effectiveness of Hastóí Bidziil for reducing SU among N=160 AI men (ages 18-26) using a randomized controlled trial design. Hypothesis: Hastóí Bidziil will reduce SU among young adult males enrolled in the intervention arm of the randomized controlled trial. Aim 3: Explore mediators and moderators of Hastóí Bidziil, guided by the Indigenist Ecological Systems Model, to inform a precision approach to implementation. Hypothesis: Program effectiveness will be driven by several moderating and mediating factors which will help inform how best to scale, implement, and tailor the program if proven effective. This project synergizes with CIRCLE's aims of advancing Indigenous and allied leadership, understanding heterogeneous patterns of SU to further a precision public health approach to SU prevention, and building on Indigenous sources of strength. Our focus also aligns with recent NIDA funding priorities particularly focused on reducing drug use inequities.

项目概要有问题的物质使用 (SU) 是美洲印第安人和阿拉斯加原住民 (AIAN) 中持续存在的流行病社区中，AIAN 人群的 SU 相关发病率和死亡率是所有社区中最高的然而，AIAN 年轻人在很大程度上被 SU 预防科学所忽视。缺乏科学支持的、专门为 AIAN 男性在关键时期设计的预防策略此外，目前还没有制定预防规划。旨在利用背景（例如历史创伤和殖民化）和文化优势来优化丰富的文化和传统实践对于人工智能人来说尤其重要，但这些都是有效的。迄今为止，我们的团队在过去两年中一直在适应和调整实践和世界观。试行共同要素治疗方法 (CETA)，这是一种基于证据的跨诊断干预措施拟议的研究建立在这一跟踪记录的基础上。将 CETA 应用于土著预防科学，约翰夫妇之间超过 35 年的研究合作霍普金斯土著健康中心（CIH；前身为美洲印第安人健康中心）和纳瓦霍族， CIH 在传播和扩大循证干预措施方面拥有数十年的经验，这些经验现已由土著研究人员和联合研究人员团队领导，覆盖超过 150 个 AIAN 社区，并且我们的团队将与社区研究委员会合作，与两个纳瓦霍农村社区合作适应 CETA 并在一项随机对照试验中测试该改编版本 Hastóí Bidziil（大力士）目标如下：目标 1：针对年轻 AI 男性、年龄调整 CETA 和相关实施策略 18-26 岁，导致 Hastóí Bidziil（强人）干预假设：标准交付。 CETA 将需要对 CETA 的文化和性别特定交付进行修改，以实现最大社区目标 2：确定 Hastóí Bidziil 对减少 N=160 名 AI 男性（年龄）的 SU 的有效性。 18-26）使用随机对照试验设计假设：Hastóí Bidziil 将减少年轻人的 SU。成年男性参加了随机对照试验的干预组，目标 3：探索中介者和参与者。 Hastóí Bidziil 的主持人在原住民生态系统模型的指导下，提供精确的信息假设：计划的有效性将由多个调节和因素驱动。如果证明有效的话，调解因素将有助于告知如何最好地扩展、实施和定制该计划。该项目与 CIRCLE 的目标相协同，即促进原住民和盟国的领导力、理解 SU 的异质模式，以进一步采用精确的公共卫生方法来预防 SU，并在此基础上我们的重点也与最近 NIDA 的资助重点相一致，特别是关注本土资源。减少药物使用的不平等。