Alaska Behavioral Health Aide Program: Formative research to evaluate a rural training and service delivery model to reduce disparities in AN/AI mental health and substance use disorders

阿拉斯加行为健康援助计划：评估农村培训和服务提供模式的形成性研究，以减少 AN/AI 心理健康和药物滥用障碍方面的差异

• 批准号: 10494090
• 负责人: STACY M RASMUS
• 金额: $ 45万
• 依托单位: NORTHWEST INDIAN COLLEGE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10494090
• 关键词: Address; Adoption; Adult; Advocacy; Alaska; Alaska Native; Alcohol consumption; Alcohols; American Indians; Area; Board Certification; COVID-19 pandemic; Caring; Cause of Death; Certification; Clinic; Clinical; Clinical Trials; Communities; Community Health; Community Health Aides; Competence; Counseling; Data; Depression and Suicide; Drug Addiction; Early identification; Educational Curriculum; Effectiveness; Equilibrium; Family; Goals; Grief reaction; Health; Health Personnel; Health Services; Health Services Accessibility; Health education; Health system; Healthcare; Individual; Interview; Measures; Mental Health; Modeling; Native American Research Center for Health; Native-Born; Outcome; Pathway interactions; Persons; Process; Professional counselor; Provider; Public Health; Reporting; Research; Risk Management; Role; Route; Rural; Scanning; Service delivery model; Services; Stress; Structure; Students; Substance Use Disorder; Suicide; Supervision; Surveys; System; Technology Transfer; Testing; Training; Training and Education; Translational Research; Trauma; Tribes; United States Indian Health Service; Variant; acceptability and feasibility; base; behavior test; behavioral health; career development; certificate program; clinical care; college; community setting; disparity reduction; evidence base; experience; health care service; health disparity; health organization; implementation science; improved; indigenous community; native youth; programs; public health relevance; response; rural Americans; satisfaction; severe mental illness; skills; substance misuse; suicidal behavior; suicidal risk; suicide rate; tribal health

Program Summary Alaska Native (AN) youth suicide is a public health crisis across the 229 rural villages of Alaska. Alcohol and other substance use disorders also disproportionately impact AN people and are a leading cause of death among AN adults. In response, the Alaska Native Tribal Health Consortium (ANTHC) established a Behavioral Health Aide (BHA) Program in 2008. The goals of the BHA Program are to provide culturally relevant training and education for village-based counselors to promote behavioral health and wellness in AN individuals, families and communities. A BHA is an Indigenous community health worker with the requisite skills, relevant training and appropriate placement within their Tribe or health organization to provide chemical dependency assessment and counseling, health education, crisis management and advocacy services. BHAs help address individual and community behavioral health needs, including grief, trauma, depression, suicide and substance misuse. While the BHA training and service model shows promise for increasing access to quality behavioral health care, no research has examined its process or outcomes. The Indian Health Service (IHS) has embraced the BHA model for replication in Tribal health settings across the U.S., and BHA candidates are currently being employed and trained in multiple Tribal health systems across the U.S. utilizing the ANTHC curriculum and certification program. The objective for this application is to test the scope of BHA practice, and the feasibility and acceptability of the BHA program in addressing this practice scope. There is a critical need for place-based, culturally congruent behavioral health services in rural and remote AIAN settings to address current access to care challenges. This need has only intensified as the behavioral health disparities crises with the COVID-19 pandemic. Promising practices such as the BHA model in AK need to be accelerated along the translational science pathway to evidence-based reimbursable service model status for tribal health systems.

计划摘要阿拉斯加人（AN）青年自杀是阿拉斯加229个乡村的公共卫生危机。酒精和其他物质使用障碍也会对人民产生不成比例的影响，并且是成年人中死亡的主要原因。作为回应，阿拉斯加土著部落卫生联盟（ANTHC）于2008年建立了行为健康助手（BHA）计划。BHA计划的目标是为基于乡村的辅导员提供与文化相关的培训和教育，以促进个人，家庭和社区的行为健康和健康。 BHA是一名本地社区卫生工作者，具有必要的技能，相关的培训以及其部落或健康组织中的适当安置，以提供化学依赖评估和咨询，健康教育，危机管理和倡导服务。 BHA有助于满足个人和社区行为健康需求，包括悲伤，创伤，抑郁，自杀和滥用毒品。尽管BHA培训和服务模型显示出增加获得优质行为医疗保健机会的希望，但没有研究检查其过程或结果。印度卫生服务局（IHS）已采用BHA模型在美国的部落卫生环境中进行复制，目前正在使用ANTHC课程和认证计划在美国多个部落卫生系统中雇用和培训BHA候选人。此应用的目的是测试BHA实践的范围，以及BHA计划在解决此实践范围方面的可行性和可接受性。在农村和偏远的AIAN环境中，基于地方的，文化的一致行为卫生服务迫切需要解决当前对护理挑战的访问。这种需求只会加剧，因为与19日大流行有关的行为健康差异危机。诸如AK中的BHA模型之类的有前途的实践需要沿转化科学途径加速到基于证据的部落卫生系统的可偿还服务模型状态。