Focus groups to increase the cultural acceptability of a contingency management intervention for American Indian and Alaska Native Communities.
Focus groups to increase the cultural acceptability of a contingency management intervention for American Indian and Alaska Native Communities.
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DOI：
10.1016/j.jsat.2018.04.014
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发表时间：
2018-07
影响因子：
3.9
通讯作者：
HONOR Study Team
中科院分区：
文献类型：
--
作者：
Hirchak KA;Leickly E;Herron J;Shaw J;Skalisky J;Dirks LG;Avey JP;McPherson S;Nepom J;Donovan D;Buchwald D;McDonell MG;HONOR Study Team
许多美洲印第安人和阿拉斯加土著（AI/AN）人寻求循证、具有成本效益和文化上可接受的治疗酒精使用障碍的解决办法。应急管理（CM）是一种可行的、低成本的治疗酒精使用障碍的方法，它使用“强化剂”来促进和支持戒酒。在AI/AN社区中，CM尚未得到评估。本研究探索了CM的文化可接受性，并使其适应于不同的AI/AN社区。我们在三个AI/AN社区共进行了9个焦点小组：一个农村保留地，一个城市健康诊所和一个大型阿拉斯加原住民医疗保健系统。受访者包括正在康复的成年人、目前有饮酒问题的成年人、服务提供者和其他感兴趣的社区成员（n=61）。焦点小组的问题集中在“强化物”的文化适当性上，用于激励禁欲和干预的文化可接受性。焦点小组由两名研究小组成员使用先验代码和紧急代码独立录音、转录和编码。然后我们分析编码数据。在所有三个地点，焦点小组参与者都描述了提供具有文化特色（例如，头饰和文化艺术工作用品）以及实用（例如，加油卡和公交卡）强化物的重要性。焦点小组参与者强调了为干预参与者的子女和家庭提供强化物的重要性，以帮助他们重新与家庭接触，重建可能在饮酒期间受损的信任。受访者表示，他们认为CM与人工智能/人工智能的文化价值观是一致的。大家一致认为，由长者或德高望重的社区成员实施这一干预措施会提高参与度。焦点小组参与者强调，除了在提供干预措施时纳入适当的文化符号和意象外，还应使用当地的人工智能/人工智能语言。针对酒精使用障碍的CM干预应与现有的文化和社区做法（如戒酒）保持一致，如果长老和社区领导人是干预措施的拥护者，干预措施与咨询或治疗方法兼容，并且干预措施提供的奖励既具有文化特异性又具有实用性，则更有可能取得成功。
Many American Indian and Alaska Native (AI/AN) people seek evidence-based, cost-effective, and culturally acceptable solutions for treating alcohol use disorders. Contingency management (CM) is a feasible, low-cost approach to treating alcohol use disorders that uses “reinforcers” to promote and support alcohol abstinence. CM has not been evaluated among AI/AN communities. This study explored the cultural acceptability of CM and adapted it for use in diverse AI/AN communities. We conducted a total of nine focus groups in three AI/AN communities: a rural reservation, an urban health clinic, and a large Alaska Native healthcare system. Respondents included adults in recovery, adults with current drinking problems, service providers, and other interested community members (n=61). Focus group questions centered on the cultural appropriateness of “reinforcers” used to incentivize abstinence and the cultural acceptability of the intervention. Focus groups were audio-recorded, transcribed, and coded independently by two study team members using both a priori and emergent codes. We then analyzed coded data. Across all three locations, focus group participants described the importance of providing both culturally specific (e.g., bead work and cultural art work supplies), as well as practical (e.g., gas cards and bus passes) reinforcers. Focus group participants underscored the importance of providing reinforcers for the children and family of intervention participants to assist with reengaging with family and rebuilding trust that may have been damaged during alcohol use. Respondents indicated that they believed CM was in alignment with AI/AN cultural values. There was consensus that Elders or a well-respected community member implementing this intervention would enhance participation. Focus group participants emphasized use of the local AI/AN language, in addition to the inclusion of appropriate cultural symbols and imagery in the delivery of the intervention. A CM intervention for alcohol use disorders should be in alignment with existing cultural and community practices such as alcohol abstinence, is more likely to be successful when Elders and community leaders are champions of the intervention, the intervention is compatible with counseling or treatment methodologies, and the intervention provides rewards that are both culturally specific and practical.
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影响因子：
5.9
作者：
Barrera, Manuel, Jr.;Castro, Felipe G.;Strycker, Lisa A.;Toobert, Deborah J.
通讯作者：
Toobert, Deborah J.
影响因子：
3.4
作者：
Barry, Danielle;Sullivan, Brendan;Petry, Nancy A.
通讯作者：
Petry, Nancy A.
影响因子：
2.3
作者：
Dickerson, Daniel L.;Spear, Suzanne;Hser, Yih-Ing
通讯作者：
Hser, Yih-Ing
DOI：
10.1146/annurev-clinpsy-032511-143127
发表时间：
2012-01-01
期刊：
ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 8
影响因子：
--
作者：
Gone, Joseph P.;Trimble, Joseph E.
通讯作者：
Trimble, Joseph E.
影响因子：
2.2
作者：
McDonell, Michael G.;Nepom, Jenny R.;Buchwald, Dedra
通讯作者：
Buchwald, Dedra