Cultural Innovations for Recovery in Community-based Learning Environments

项目总结 圆圈 阿拉斯加原住民和美国印第安人(AN/AI)有不成比例的高酒精滥用率和 与此相关的死亡率和发病率；然而，只有19.8%的人在有生之年寻求正规治疗。许多 酒精滥用者，特别是在农村地区，由于偏好而不进行治疗 自我管理、动机摇摆不定或无法获得及时服务。调解技术 医疗保健，如健康信息技术和移动医疗，为改善医疗保健提供了足智多谋的方法 获取(全天候)、支持自我管理和健康结果。之前对AN/AI人群的研究表明 远程干预，重点关注社会环境和社区在加强 戒酒是有效的，也是可以接受的。 我们提出了一项混合方法、利益相关者参与的研究，以在文化上适应和测试现有的可扩展 结合自我管理和同伴支持的移动干预，用于酒精滥用的AN/AI成年人。 我们将与主要利益攸关方合作，调整和评估可接受性、可行性和可衡量的影响 一种基于文化的、可扩展的移动在线学习社区(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为酗酒提供同伴支持。 2.采用安全的技术平台，以提供文化上合适和可接受的自我管理 以及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.测试适应文化的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。 拟议的干预有可能成为那些寻求帮助的人的附加干预或独立干预 在与正式的药物滥用服务机构接触之前、期间或之后，支持酒精滥用。 这样的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人群之间的相关健康差距。

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.