Cultural Innovations for Recovery in Community-based Learning Environments

项目摘要 圈 阿拉斯加原住民和美洲印第安人（AN/AI）滥用酒精的比例不成比例地高， 然而，只有19.8%的人在其一生中寻求正规治疗。许多 患有酒精滥用的AN/AI患者，特别是在农村地区，由于偏好而不接受治疗 自我管理、摇摆不定的动机或无法及时获得服务。技术中介 医疗保健，如医疗信息技术和移动的医疗保健，提供了丰富的方法来改善医疗保健 获取（24/7），支持自我管理和健康成果。先前对AN/AI人员的研究表明， 远程干预，重点是社会环境和社区在加强 戒酒是有效的也是可以接受的 我们提出了一个混合方法，企业主参与的研究，以适应文化和测试现有的可扩展的 移动的干预，结合自我管理和同伴支持，为AN/AI成人滥用酒精。 我们将与主要利益相关者合作，调整和评估以下措施的可接受性、可行性和可衡量的效果： 一个基于文化的、可扩展的、移动的在线学习社区（OLC）工具。我们的具体目标是： 1.确定利益相关者在使用OLC工具支持自我管理方面的需求和偏好 以及通过访谈和焦点小组对酗酒问题的同伴支持。 2.采用安全的技术平台，提供文化上适当和可接受的自我管理 为寻求酒精滥用支持的农村和城市AN/AI成年人提供同伴支持。 3.测试文化适应的OLC工具的可接受性，可行性和可测量的效果，以减少 使用自我报告数据的酒精滥用和相关危害。 拟议的干预措施有可能成为那些寻求 酒精滥用的支持，之前，期间，或之后与正式的药物滥用服务的参与。 这种干预可能在预防和治疗方面发挥作用，并可能有助于减少酒精- 农村和城市环境中AN/AI人群的相关健康差异。

PROJECT SUMMARY CIRCLE Alaska Native and American Indian (AN/AI) people have disproportionately high rates of alcohol misuse and related mortality and morbidity; yet, only 19.8% of all people seek formal treatment during their lifetime. Many AN/AI people with alcohol misuse, particularly in rural areas, do not engage in treatment due to a preference for self-management, oscillating motivation, or lack of access to timely services. Technologies that mediate care, such as health information technology and mobile health, offer resourceful ways to improve healthcare access (24/7), support self-management, and health outcomes. Prior research with AN/AI people suggests a distance-delivered intervention that focuses on the role of social environment and community in reinforcing sobriety would be effective and acceptable. We propose a mixed-method, stakeholder-engaged study to culturally-adapt and test an existing scalable mobile intervention, that combines self-management and peer-support, for AN/AI adults with alcohol misuse. We will work with key stakeholders to adapt and assess the acceptability, feasibility, and measurable effects of a culturally grounded, scalable, mobile, online learning community (OLC) tool. Our Specific Aims are to: 1. Identify stakeholder needs and preferences regarding use of an OLC tool to support self-management and peer-support for alcohol misuse through interviews and focus groups. 2. Adapt a secure technology platform to provide culturally appropriate and acceptable self-management and peer-support for rural and urban AN/AI adults seeking support for alcohol misuse. 3. Test the acceptability, feasibility, and measureable effects of a culturally-adapted OLC tool to reduce alcohol misuse and related harms using self-report data. The proposed intervention has the potential to be an adjunctive or standalone intervention for those seeking support for alcohol misuse, before, during, or following engagement with formal substance abuse services. Such an intervention may play a role in both prevention and treatment and may help to decrease alcohol- related health disparities among AN/AI populations in rural and urban settings.