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

项目概要/摘要 这个K 01指导研究科学家发展奖将提供候选人，妮可R。杜伊特博士 高级培训和结构化指导，以促进她过渡到研究独立。的 候选人的目标是成为一名独立的调查员，在国家的最先进的方法， 制定和评价与文化相关的、基于优势的多层次干预措施， 城市美洲印第安人和阿拉斯加原住民之间的物质使用和性健康差异， 黑人青年拟议的工作范围将填补现有文献中关于多层次办法的空白， 物质使用和性健康的不平等在青年的颜色。无法努力减少青少年 药物使用和性健康方面的差距，以产生持续的改善可能源于未能考虑到 相互强化的结构性不利因素和多方面机制，包括所有社会生态 青少年健康不平等的根源。大多数减少风险的战略只注重个人， 人际层面。制定和实施基于实力的概念框架， 社会生态学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- 在城市的AIAN和黑人青年中。候选人将采用一种变革性的、连续的混合 方法的方法，以实现以下具体目标，每个培训目标是匹配的目标， 研究人员将运用她的新技能。目的1：检查物质使用的多层次决定因素， 在丹佛地铁，CO的黑人和AIAN高青年（14-18岁）中的性风险行为培训：（1） 推进社会和空间流行病学理论和方法基础方面的专业知识， 了解结构背景对青少年药物使用和性行为风险和弹性的影响 风险承担;（2）多层次结构方程模型，与地理环境，探索直接， 间接的、跨层次的互动关系。AIM 2.让城市的AIAN和黑人青年参与进来， 明确的风险概念框架以及对药物使用和性冒险的抵御能力， 目标1的调查结果;并确定进行干预的最关键水平。培训：（1）培养技能 以内罗毕为基础的定性访谈（SBI），让青年参与解释发展中的定量数据 风险和复原力的概念框架。K 01奖将把Tuitt博士定位为训练有素的研究人员 具有结构性不利因素对青少年药物使用和性冒险行为影响的专门知识 以及多层次的方法。考虑到她从关注个体行为转向关注结构性行为 因素，SBI，社会和空间流行病学的专业知识以及多层次SEM将确保候选人 成功过渡到一个独立的研究人员，并将帮助她加强青少年领域 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.