Zuni MI/CRA Project

进念 MI/CRA 项目

• 批准号: 7682206
• 负责人: Kamilla L. Venner
• 金额: $ 39.44万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7682206
• 关键词: Alcohol or Other Drugs use; American Indians; Behavior Therapy; Certification; Client; Clinical Research; Clinical Trials; Collaborations; Communication; Communities; Consultations; Development; Evidence based treatment; Extended Family; Health; Health Professional; Healthcare; Interview; Knowledge; Life; Mails; Manuals; Mental Health; Methods; National Institute of Drug Abuse; National Institute on Alcohol Abuse and Alcoholism; Native Americans; Operations Research; Operative Surgical Procedures; Outcome; Outcomes Research; Pilot Projects; Population; Preparation; Prevalence; Procedures; Professional counselor; Psychological reinforcement; Publishing; Pueblo Race; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Relative (related person); Research; Research Personnel; Reservations; Social Problems; Staging; Structure; Substance Use Disorder; Substance abuse problem; Supervision; Testing; Training; Treatment outcome; Tribes; United States Indian Health Service; Work; behavioral health; effective intervention; effective therapy; emotional distress; evidence base; follow-up; health disparity; instrument; member; mortality; motivational enhancement therapy; named group; programs; reservation-based; social; therapy development; treatment as usual; tribal member

DESCRIPTION (provided by applicant): The prevalence of substance use disorders among Native Americans is at least twice that in the general U.S. population, with correspondingly high rates of mortality, health and social problems. Yet there have been very few clinical studies, and no randomized trials, to discover and document effective treatment methods for American Indians. In seeking effective treatment methods for a special population, it is reasonable to begin with and adapt approaches with more general evidence of efficacy. Our preliminary research indicates that among evidence-based treatment methods, motivational interviewing (Ml) and the community reinforcement approach (CRA) show particular promise as culturally congruent methods in working with reservation-dwelling tribal populations. In contrast to more directive or confrontational styles, Ml mirrors tribal communication norms, and CRA is particularly well suited to make use of the extended family and unique clan structure of reservation life. This is a Stage 1 Behavior Therapy Development proposal to adapt and test a combination of these two evidence-based methods (MICRA) with the Zuni pueblo, in preparation for a subsequent formal clinical trial. Working collaboratively with team members from the Zuni community, we propose to develop research materials needed for a larger randomized trial: a MICRA counselor manual, assessment instruments adapted to a Native American context, and a detailed manual of research operations. At least three Zuni behavioral health professionals will be trained and certified in MICRA, and a small randomized trial (N=60) will be completed to estimate the effect size for MICRA relative to reservation-based treatment as usual, with follow-up interviews through one year post-randomization. After development and testing of MICRA, further consultation will assess the generalizability of MICRA for use with other tribes.

描述（由申请人提供）： 美洲原住民物质使用障碍的患病率至少是美国普通人口的两倍，死亡率、健康和社会问题也相应较高。然而，很少有临床研究，也没有随机试验来发现和记录对美洲印第安人有效的治疗方法。在为特殊人群寻求有效的治疗方法时，合理的做法是从具有更普遍疗效证据的方法开始并进行调整。我们的初步研究表明，在基于证据的治疗方法中，动机访谈（Ml）和社区强化方法（CRA）作为与保留地部落人口合作的文化一致方法显示出特别的前景。与更具指导性或对抗性的风格相比，ML 反映了部落沟通规范，而 CRA 特别适合利用保留地生活的大家庭和独特的氏族结构。这是第一阶段行为治疗开发提案，旨在调整和测试这两种循证方法 (MICRA) 与 Zuni pueblo 的组合，为后续的正式临床试验做准备。我们建议与 Zuni 社区的团队成员合作，开发更大规模随机试验所需的研究材料：MICRA 顾问手册、适合美洲原住民背景的评估工具以及详细的研究操作手册。至少三名 Zuni 行为健康专业人员将接受 MICRA 培训和认证，并将完成一项小型随机试验 (N=60)，以估计 MICRA 相对于通常基于预约的治疗的效果大小，并通过以下方式进行后续访谈随机化后一年。 MICRA 开发和测试后，进一步协商将评估 MICRA 在其他部落中使用的普遍性。