Factors and Training Approaches that Enhance the Integration of American Indian Culture into Tele-Behavioral Substance Use/Substance Use Disorders Treatment.

促进美洲印第安人文化融入远程行为药物使用/药物使用障碍治疗的因素和培训方法。

• 批准号: 10441963
• 负责人: Julie Ann Baldwin
• 金额: $ 10万
• 依托单位: NORTHERN ARIZONA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10441963
• 关键词: Address; Adherence; Advocate; Age; Alaska Native; Alcohols; American Indians; Applications Grants; Area; Arizona; Behavioral; Budgets; COVID-19; COVID-19 pandemic; Caring; Certification; Client; Clinical Psychology; Communities; Community Actions; Comprehensive Health Care; Consultations; Counseling; Criminal Justice; Data; Diagnosis; Domestic abuse; Education; Enrollment; Ethnic group; Evidence based practice; Family; Gender; General Population; Goals; Grant; Health; Health Insurance; Health Occupations; Health Promotion; Health Services; Health Services Accessibility; Healthcare; Homelessness; Human; Human Resources; Imprisonment; Indigenous; Individual; Infrastructure; Link; Lung; Mental disorders; Mission; NIH Program Announcements; National Institute of Drug Abuse; Native Americans; Native-Born; Occupational Therapy; Occupations; Outcome; Parents; Participant; Performance; Pharmaceutical Preparations; Physical therapy; Prevention program; Preventive; Problem-Based Learning; Provider; Race; Research; Research Design; Research Methodology; Research Personnel; Research Project Grants; Research Training; Reservations; Risk; Rural; Rural Community; Rural Population; Schools; Services; Site; Southwestern United States; Structure; Students; Substance Use Disorder; Substance abuse problem; Suicide; System; Testing; Time; Tobacco; Training; Training Activity; Training Programs; Underserved Population; Unemployment; United States Indian Health Service; Universities; Violence; Work; addiction; base; behavioral health; certificate program; cohort; community based research; comorbidity; design; diabetes prevention program; disorder prevention; disparity reduction; doctoral student; evidence base; experience; falls; health care availability; health disparity; health equity promotion; high risk; innovation; interdisciplinary collaboration; mental health counseling; post-traumatic stress; prevent; prevention service; programs; racial and ethnic; racial health disparity; recruit; research study; resilience; respiratory; rural area; rural patients; scale up; service delivery; service programs; skills; substance misuse; substance use; substance use treatment; suicide mortality; telehealth; treatment center; treatment services; tribal community; underserved community; urban Native American; urban area

PROJECT SUMMARY In comparison to other groups, there are clear disparities in the higher rates of substance abuse, post- traumatic stress, violence, and suicide in American Indian/Alaska Natives (AI/AN). High rates of substance misuse in AI/AN communities is associated with unemployment, low academic performance, high-risk occupations, violence, domestic abuse, delinquency, lack of health insurance, mental illness, and mortality from suicide, alcohol, or other substance abuse. Substance use disorders (SUD) disproportionately impact AI/ANs in Arizona due to the lack of infrastructure and personnel on reservations needed to deliver evidence- based comprehensive treatment and prevention services. In addition, the lack of culturally-centered treatment is a barrier to AI/AN individuals living in both rural and urban areas. The COVID-19 pandemic has exposed well-established racial disparities in health care access and health outcomes in underserved communities. COVID-19 has particularly had devastating impacts on tribal communities in Arizona. People with SUD may be particularly at-risk for COVID-19 complications due to the effect of many drugs on respiratory and pulmonary health, and higher likelihood of homelessness, incarceration, and co-morbid health conditions than the general population. Given existing barriers to telehealth in providing comprehensive care for AI/AN and rural communities, the COVID-19 pandemic may have placed those with behavioral health issues and SUDs at even higher risk. Training a workforce to research the delivery of culturally-centered behavioral health and addiction care with telehealth as a viable option has the potential to reduce the lasting impact of COVID-19 in underserved populations and prevent disruption of substance use treatment. The overall goal of the parent R25, Culturally-Centered Addictions Research Training (C-CART) (1R25DA053805), is to educate clinicians, providers, and doctoral students in health professions (occupational therapy [OT], physical therapy [PT], counseling, school, & clinical psychology, and interdisciplinary health) in research skills that include culturally- centered practices, related to SU/SUDs applied in interprofessional practice and diverse settings.This proposed Supplement to our R25 will look at Native culture and traditional practices within tele-behavioral SU/SUD treatment at one of our community partner agencies – Native Americans for Community Action (NACA) - and determine the impact on behavioral health outcomes for clients during the first year of the COVID-19 pandemic. The specific aims of this project are: Aim 1: To understand the integration of Native culture and traditional practices within tele-behavioral SU/SUD treatment at NACA and explore its impact on behavioral health outcomes during the COVID-19 pandemic employing a mixed methods research design; and Aim 2: To incorporate the findings from Aim 1 into a tele-behavioral SU/SUD treatment training module that will be pilot tested with NACA SU/SUD providers and shared with the Indian Health Service (IHS) Western Region.

项目摘要 与其他群体相比，在吸毒后的较高药物滥用率方面存在着明显的差异。 美国印第安人/阿拉斯加原住民（AI/AN）的创伤应激，暴力和自杀。物质含量高 AI/AN社区的滥用与失业，低学业成绩，高风险 职业、暴力、家庭虐待、犯罪、缺乏健康保险、精神疾病和死亡率 自杀酗酒或其他药物滥用物质使用障碍（SUD）不成比例地影响 亚利桑那州的人工智能/人工智能由于缺乏提供证据所需的基础设施和保留地的人员- 综合治疗和预防服务。此外，缺乏以文化为中心的治疗 这对居住在农村和城市地区的AI/AN个人来说是一个障碍。2019冠状病毒病疫情暴露了 在服务不足的社区，在获得医疗保健和健康结果方面存在着根深蒂固的种族差异。 COVID-19尤其对亚利桑那州的部落社区造成了毁灭性的影响。SUD患者可能 由于许多药物对呼吸和肺的影响， 健康状况，无家可归、监禁和合并症的可能性高于一般人 人口鉴于远程保健在为人工流产/人工流产和农村地区提供全面护理方面存在的障碍， 社区，COVID-19大流行可能使那些有行为健康问题和SUD的人甚至 更高的风险。培训工作人员，研究以文化为中心的行为健康和成瘾的交付 作为一种可行的选择，远程医疗护理有可能减少COVID-19的持久影响， 服务不足的人群，防止药物使用治疗中断。家长的总体目标 R25，以文化为中心的成瘾研究培训（C-CART）（1 R25 DA 053805），是为了教育临床医生， 提供者和卫生专业的博士生（职业治疗[OT]，物理治疗[PT]， 咨询，学校，临床心理学和跨学科健康）的研究技能，包括文化- 以实践为中心，与跨专业实践和不同环境中应用的SU/SUD相关。 建议补充我们的R25将着眼于本土文化和传统做法，在远程行为 SU/SUD治疗在我们的社区合作伙伴机构之一-美洲原住民社区行动 （NACA）-并确定在第一年期间对客户行为健康结果的影响， 2019冠状病毒病大流行。该项目的具体目标是：目标1：了解原生 在NACA的远程行为SU/SUD治疗中的文化和传统做法，并探讨其对 采用混合方法研究设计的COVID-19大流行期间的行为健康结果;以及 目标2：将目标1的发现纳入远程行为SU/SUD治疗培训模块， 与NACA SU/SUD供应商进行试点测试，并与印度卫生服务（IHS）西部地区共享。