Advancing Methods for Multilevel Interventions to Support Health Equity for Urban American Indian/Alaska Native and Black Youth

项目摘要/摘要 K01指导研究科学家发展奖将为候选人Nicole R.Tuitt博士提供 通过高级培训和有组织的指导，促进她向研究独立的过渡。这个 候选人的目标是成为一名独立的调查员，在最先进的方法方面拥有专业知识 制定和评估与文化相关的、以优势为基础的多层次干预措施，旨在减少 美国城市印第安人和阿拉斯加原住民(AIAN)和 黑人青年。拟议的工作范围将填补现有文献中关于减少 有色人种青年中的物质使用和性健康不平等。无力努力减少青春期 导致持续改善的物质使用和性健康差异可能源于没有考虑到 对于相辅相成的结构性劣势和多方面的机制，包括所有社会生态 青少年健康不平等的基础水平。大多数风险降低策略只关注个人和 人际层面。开发和实施基于优势的概念框架，其基础是 社会生态模型对于为减少药物使用和性风险的多层次干预提供信息至关重要。 在城市AIAN和黑人青年中。候选人将采用变革性的、顺序混合的 方法实现以下具体目标，每个培训目标与目标相匹配 这位研究人员将应用她的新技能。目标1：审查物质使用的多层次决定因素和 科罗拉多州丹佛市黑人和AIAN高中生(14-18岁)的性风险接受情况。培训：(1) 在社会和空间流行病学的理论和方法基础方面的高级专门知识 了解结构性环境对青少年吸毒和性行为的风险和恢复能力的影响 风险承担；以及(2)多层次结构方程建模，结合地理背景，探索直接、 跨级别的间接和交互关系。目标2.让城市AIAN和黑人青年来阐明 对物质使用和性冒险行为的风险和恢复力的独特概念框架 目标1的调查结果；并确定需要干预的最关键水平。培训：(1)培养技能 基于情景的定性访谈(SBI)，让青年参与解释发展中的量化数据 风险和复原力的概念框架。K01奖将使图伊特博士成为一名训练有素的研究员 拥有结构性劣势对青少年物质使用和性风险的影响方面的专业知识 以及多层次的方法。鉴于她从关注个人行为转向关注结构性行为 这些因素、印度国家研究院、社会和空间流行病学方面的专业知识以及多层次结构分析将确保应聘者 成功转型为独立研究人员，将使她加强青少年领域的研究 健康公平研究和预防科学。

PROJECT SUMMARY/ABSTRACT This K01 Mentored Research Scientist Development Award will provide the candidate, Nicole R. Tuitt, DrPH, with advanced training and structured mentoring to facilitate her transition to research independence. The candidate's goal is to become an independent investigator with expertise in state-of-the-art approaches in the development and evaluation of culturally relevant, strengths-based multilevel interventions which aim to reduce substance use and sexual health disparities among urban American Indian and Alaska Native (AIAN) and Black youth. The proposed scope of work will fill a gap in existing literature on multilevel approaches to reduce substance use and sexual health inequities among youth of color. The inability of efforts to reduce adolescent substance use and sexual health disparities to yield sustained improvements likely stem from failure to account for mutually-reinforcing structural disadvantages and multifaceted mechanisms that include all socioecological levels that underlie adolescent health inequities. Most risk reduction strategies focus only at the individual and interpersonal levels. Developing and operationalizing a strengths-based conceptual framework grounded in the socioecological model is critical to inform a multilevel intervention to reduce substance use and sexual risk- taking among urban AIAN and Black youth. The candidate will employ a transformative, sequential mixed methods approach to accomplish the following specific aims, each training goal is matched with the aim in which the researcher will apply her new skills. AIM 1: Examine multilevel determinants of substance use and sexual risk-taking among Black and AIAN high youth (ages 14-18) in Denver Metro, CO. Training: (1) Advance expertise in theoretical and methodological foundations in social and spatial epidemiology to understand the impact of structural contexts on risk and resilience to adolescent substance use and sexual risk-taking; and (2) multilevel structural equation modeling, with geographic contexts, to explore the direct, indirect, and interactive relationships across levels. AIM 2. Engage urban AIAN and Black youth to elucidate distinct conceptual frameworks of risk and resilience to substance use and sexual risk-taking guided by findings from Aim 1; and identify the most critical levels on which to intervene. Training: (1) Develop skills in scenario-based qualitative interviewing (SBI) to engage youth to interpret quantitative data in the development of conceptual frameworks of risk and resilience. The K01 award will position Dr. Tuitt as a trained researcher with expertise on the influence of structural disadvantages on adolescent substance use and sexual risk-taking as well as multilevel approaches. Given her shift away from a focus on individual behaviors to structural factors, expertise in SBI, social and spatial epidemiology, and multilevel SEM will ensure the candidates successful transition into an independent researcher and will situate her to strengthen the field of adolescent health equity research and prevention science.