Preventing Alcohol Exposed Pregnancy among Urban Native Young Women: Mobile CHOICES

胎儿酒精谱系障碍(FASD)会导致神经发育障碍和终身残疾；它们是 这是美国可预防出生缺陷的主要原因。根据美国疾病控制与预防中心的数据，任何性活跃的女性 适龄饮酒且未使用有效避孕措施的人有接触酒精的风险 妊娠(AEP)可能导致FASD。根据这个定义，美国印第安人和阿拉斯加原住民(AIAN)年轻人 女性尤其容易患AEP，饮酒量高，性行为风险大 与其他种族/民族的同龄人相比。尽管估计有72%的AIAN年轻女性 居住在城市地区，很少有研究将他们包括在内；城市AIAN的需求在研究中往往被忽视 旨在开发、实施和评估适合文化的服务。最近的研究表明 移动健康(MHealth)干预可能提供一种有希望的机制，以提供有效的 对难以接触到的人群进行干预。该项目的目标是将覆盖范围和服务扩展到城市 AIAN年轻女性通过mHealth技术预防AEP和FASD。拟议的项目建立在一个 之前由NIAAA资助的项目，使用密集的基于社区的参与性研究(CBPR)方法来 适应选择，一项由疾控中心支持的基于证据的简短AEP干预，适用于美国印第安人青年 选项(AIY-C)。AIY-C包含使其高度服从mHealth方法的功能，包括 整合多元文化教学的框架，短期的几个模块，以及具体的机会 设定目标和实现目标。对这一群体来说，创新的是招募AIAN年轻女性的计划 通过社交媒体在美国的主要城市地区-并通过移动设备提供AIY-C，越来越多 在AIAN年轻人中无处不在。虽然社交媒体招聘和移动健康干预并不新鲜， 直到最近，它们才被用于AIAN种群。我们将与城市AIAN组织合作 通过社交媒体招聘战略、移动健康干预翻译和实施来指导我们， 以及在城市AIAN环境下的评估。我们提出了三个具体目标：(1)开发和试点基于社交媒体的 面向城市AIAN年轻女性的招聘战略；(2)通过 迭代和理论驱动的进程，并试点开发的翻译后的mHealth AIY-C干预措施；以及 (3)使用确定的社交媒体战略招募700名(最终N=525)城市AIAN年轻女性，并开展 RCT严格评估AIY-C的mHealth翻译对预防AEP和AEP的有效性 FASD。拟议中的项目承诺向AIAN年轻女性提供广泛的影响，以解决尚未解决的重大问题 可预防的公共卫生问题-AEP和FASD；重要的是，该项目还承诺推进 预防干预研究的蓝图，到目前为止，城市AIAN人口基本上被忽视。

Fetal Alcohol Spectrum Disorders (FASD) result in neurodevelopmental deficits and lifelong disability; they are a leading cause of preventable birth defects in the U.S. According to the CDC, any sexually active woman of reproductive age who drinks alcohol and does not use effective contraception is at risk for an alcohol exposed pregnancy (AEP) that could cause FASD. By this definition, American Indian and Alaska Native (AIAN) young women are especially vulnerable to AEP, with high levels of alcohol consumption and sexual risk taking compared to their counterparts in other race/ethnic groups. Although an estimated 72% of AIAN young women live in urban areas, very little research has yet included them; urban AIAN needs are often ignored in research aimed at developing, implementing, and evaluating culturally appropriate services. Recent research indicates that mobile health (mHealth) interventions may offer a promising mechanism for delivering effective interventions to hard-to-reach populations. The goal of this project is to expand reach and services to urban AIAN young women through mHealth technology to prevent AEP and FASD. The proposed project builds on a prior NIAAA-funded project which used intensive community-based participatory research (CBPR) methods to adapt CHOICES, an evidence-based brief AEP intervention supported by the CDC, to American Indian Youth CHOICES (AIY-C). AIY-C contains features that make it highly amenable to mHealth approaches, including a framework for integrating diverse cultural teachings, few modules of short duration, and concrete opportunities for goal-setting and achievement. Innovative for this population is the plan to recruit young AIAN women from major urban areas in the US through social media—and to deliver AIY-C via mobile devices, increasingly ubiquitous among AIAN young adults. While social media recruitment and mHealth interventions are not new, only very recently have they been used with AIAN populations. We will partner with urban AIAN organizations to guide us through social media recruitment strategies, mHealth intervention translation and implementation, and evaluation in urban AIAN settings. We propose 3 specific aims: (1) Develop and pilot social-media-based recruitment strategies for urban AIAN young women; (2) translate AIY-C for mHealth delivery through an iterative and theoretically driven process and pilot the developed translated mHealth AIY-C intervention; and (3) recruit 700 (final N=525) urban AIAN young women using identified social media strategies, and conduct an RCT to rigorously evaluate the effectiveness of the mHealth translation of AIY-C for preventing AEP and FASD. The proposed project promises expansive reach to AIAN young women to address significant yet preventable public health concerns – AEP and FASD; importantly, the project also promises to advance a blueprint for preventive intervention research with urban AIAN populations largely ignored to date.