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.

阿拉斯加原住民（AN）青年自杀是阿拉斯加229个农村村庄的公共卫生危机。酒精和其他物质使用障碍也不成比例地影响AN人，是AN成年人死亡的主要原因。作为回应，阿拉斯加土著部落健康联合会（ANTHC）于2008年制定了行为健康援助计划（BHA）。BHA计划的目标是为乡村咨询师提供文化相关的培训和教育，以促进AN个人，家庭和社区的行为健康和健康。BHA是土著社区卫生工作者，具有必要的技能，相关培训和在其部落或卫生组织内的适当安置，以提供化学品依赖评估和咨询，健康教育，危机管理和宣传服务。BHA有助于解决个人和社区的行为健康需求，包括悲伤，创伤，抑郁，自杀和药物滥用。虽然BHA培训和服务模式显示出增加获得优质行为健康护理的前景，但没有研究对其过程或结果进行过研究。印度卫生服务局（IHS）已经接受了BHA模式，在美国各地的部落卫生环境中复制，和BHA候选人目前正在美国多个部落卫生系统中使用ANTHC课程和认证计划进行雇用和培训。本申请的目的是测试井底钻具组合实践的范围，以及井底钻具组合程序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，迫切需要基于地方的、文化上一致的行为健康服务，以解决目前获得护理的挑战。随着COVID-19大流行导致行为健康差异危机，这种需求只会加剧。有前途的做法，如在AK BHA模式需要加快沿着转化科学途径，以证据为基础的可偿还服务模式的部落卫生系统的地位。