Preventing Alcohol Exposed Pregnancy among Urban Native Young Women During the COVID-19 Pandemic

COVID-19 大流行期间预防城市本地年轻女性因酒精暴露而怀孕

• 批准号: 10531748
• 负责人: CAROL E KAUFMAN
• 金额: $ 7.55万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10531748
• 关键词: Accounting; Achievement; Address; Adult; Age; Alaska Native; Alcohol consumption; Alcohols; American Indians; Birth Rate; Black Populations; Centers for Disease Control and Prevention (U.S.); Chippewa; Communities; Congenital Abnormality; Contraceptive Usage; Contraceptive methods; Disease; Educational process of instructing; Ethnic group; Evaluation; Fetal Alcohol Exposure; Fetal Alcohol Spectrum Disorder; Fetal Alcohol Syndrome; Foundations; Funding; Future; Goals; Health Technology; High Risk Woman; Hispanic Populations; Intervention; Intervention Studies; National Institute on Alcohol Abuse and Alcoholism; Neighborhoods; Neurodevelopmental Deficit; Not Hispanic or Latino; Pharmaceutical Preparations; Population; Process; Public Health; Race; Reporting; Research; Research Methodology; Reservations; Sampling; School-Age Population; Services; Thinness; Translating; Translations; Woman; Work; Youth; alcohol measurement; alcohol prevention; alcohol risk; base; community based participatory research; cultural health; disability; drinking; early alcohol use; effective intervention; effectiveness evaluation; effectiveness study; effectiveness testing; evidence base; girls; handheld mobile device; high risk; high school; innovation; mHealth; motivational enhancement therapy; native youth; peer; pregnancy prevention; preservation; preventive intervention; recruit; reproductive; sex; sexual risk taking; sexually active; social media; success; teen birth; tribal community; underage drinking; urban Native American; urban area; young adult; young woman

The devastating impact of COVID-19 on American Indian and Alaska Native (AIAN) communities has been well-documented, with substantial focus on reservation communities, often rural and remote. However, more than 72% of AIANs reside in urban settings, a majority of the racial group, but a small fraction – often less than 1% - of most urban communities. Many urban AIANs are tightly connected to tribal communities and cultural practices, commonly traveling between urban areas and reservations to participate in family events or important cultural celebrations and ceremonies. However, this group is likely to experience different cultural, social, and economic impacts of the pandemic compared to those living in reservation settings. Those differences are likely critical to alcohol-exposed pregnancy (AEP) risk. Early data in the general population indicate increased alcohol use by youth, and decreased access to effective contraception among women. The combination is likely to increase risk of AEP, and for urban AIAN young women – often with limited local resources – that risk may be especially elevated. Yet, as research efforts scramble to monitor risk of the most vulnerable in a pandemic, this demographic often becomes invisible. We know little about the impact of COVID-19, the changes in alcohol use, sexual activity, or contraceptive use to assess risk among urban AIANs. Similarly, we know little about the way in which these young women are able to find resilience and strength in their communities to overcome the hardships presented by the pandemic or to engage in the promise of vaccines. Our project, Native WYSE CHOICES, uses a randomized trial to evaluate a culturally appropriate AEP prevention program translated to a smartphone app for urban AIAN young women (ages 16- 20) nationally. With our research infrastructure in place, we have the opportunity to tap shifts in behaviors, attitudes, and perceptions of urban AIAN young women, their families, and communities as they navigate the changing dynamics of the pandemic. We will (1) include additional survey measures with a national sample of 700 to capture the evolving pandemic in four main areas: (a) COVID-19 disease, risk exposure, and safety; (b) social and economic impacts; (c) COVID-19 vaccine attitudes, experience, and status; and (d) cultural and historical trauma impacts. To contextualize these findings, we will (2) conduct in-depth interviews with participants purposively selected based on baseline survey responses. To maximize insights in the diversity of experience of the pandemic and gain timely, in-the-moment, insights, we will recruit and interview young women from our RCT sample (n=32) over 2 years. We will also interview selected participants (n=8) at regular intervals over 2 years to capture their experiences longitudinally as circumstances of the pandemic shift. With this qualitative design – i.e. cross-sectional insights complemented by a longitudinal view of urban AIAN young women’s journey through the changing circumstances – we will be able to integrate our statistical findings within an agile interpretive frame.

COVID-19 对美洲印第安人和阿拉斯加原住民 (AIAN) 社区造成的破坏性影响 有据可查，重点关注保留社区，通常是农村和偏远地区。然而，更多 超过 72% 的 AIAN 居住在城市环境中，占该种族群体的大多数，但只有一小部分——通常少于 1% - 大多数城市社区。许多城市 AIAN 与部落社区和文化紧密相连 惯例，通常在城市地区和保留地之间旅行参加家庭活动或 重要的文化庆典和仪式。然而，这个群体可能会经历不同的文化， 与生活在保留地的人们相比，这一流行病的社会和经济影响。那些 差异可能对酒精暴露妊娠（AEP）风险至关重要。一般人群的早期数据 表明青少年饮酒量增加，而妇女获得有效避孕措施的机会减少。这 组合可能会增加 AEP 的风险，对于城市 AIAN 年轻女性来说——通常当地的情况有限 资源——这种风险可能会特别高。然而，随着研究工作争先恐后地监测最重要的风险 在大流行病中脆弱的人群往往被忽视。我们对影响知之甚少 COVID-19，酒精使用、性活动或避孕药具使用的变化，以评估城市人群的风险 爱安人。同样，我们对这些年轻女性如何找到韧性和恢复能力知之甚少。 社区有力量克服大流行带来的困难或参与 疫苗的承诺。我们的项目“Native WYSE CHOICES”使用随机试验来评估文化 适当的 AEP 预防计划已转化为针对城市 AIAN 年轻女性（16 岁至 16 岁）的智能手机应用程序 20) 全国范围内。有了我们的研究基础设施，我们就有机会利用行为的转变， 城市 AIAN 年轻女性、她们的家庭和社区在应对社会问题时的态度和看法 大流行的动态变化。我们将 (1) 在全国样本中纳入额外的调查措施 700 捕捉四个主要领域不断演变的流行病：(a) COVID-19 疾病、风险暴露和安全； (二) 社会和经济影响； (c) 对 COVID-19 疫苗的态度、经验和状况； (d) 文化和 历史创伤的影响。为了将这些发现结合起来，我们将 (2) 进行深入访谈 参与者根据基线调查答复有目的地选择。最大限度地洞察多样性 疫情期间的经验并获得及时、即时的见解，我们将招募和面试年轻人 我们的 RCT 样本 (n=32) 中的女性超过 2 年。我们还将定期采访选定的参与者（n=8） 每隔两年多的时间，随着大流行情况的变化，纵向记录他们的经历。和 这种定性设计——即横截面见解与城市 AIAN 年轻人的纵向视图相辅相成 女性经历不断变化的环境的旅程——我们将能够整合我们的统计结果 在敏捷的解释框架内。

项目成果

Virtual Research with Urban Native Young Women: Cautionary Tales in the Time of a Pandemic.

• DOI: 10.1353/cpr.2022.0041
• 发表时间: 2022
• 期刊: PROGRESS IN COMMUNITY HEALTH PARTNERSHIPS-RESEARCH EDUCATION AND ACTION
• 影响因子: 1.1
• 作者: Tuitt, Nicole R.;Shrestha, Umit;Reed, Nicole;Moore, Roland S.;Sarche, Michelle;Kaufman, Carol E.
• 通讯作者: Kaufman, Carol E.