Cultural Innovations for Recovery in Community-based Learning Environments

项目总结

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.