Elluam Tungiinun - Toward Wellness

描述（由申请人提供）：阿拉斯加原住民面临着与酒精使用障碍和自杀相关的重大健康差异。“Elluam Tungiinun”是爱斯基摩语，意为“走向健康”。ET是一种以文化为基础的预防干预措施，旨在减少阿拉斯加土著爱斯基摩族青年的自杀风险和共病未成年人饮酒。环境教育过程方法通过一系列密集的社区共同研究者适应过程程序，将其干预计划与阿拉斯加每个农村社区的当地需求和文化相结合。该提案为一项为期五年的CBPR预防试验寻求资金，该试验涉及五个偏远农村的Yup'ik社区的239名12至18岁的青少年。样本为159。在三个社区中，将使用随机动态等待名单控制设计测试干预两年后的有效性，以及ET情境化过程方法对干预模型的保真度。80人的样本将在另外两个社区测试五年影响的持久性和可持续性，我们在过去三年中与这些社区合作开发和试点了ET干预措施。该提案代表了与阿拉斯加原住民长达15年的CPBR进程的下一阶段。

DESCRIPTION (provided by applicant): Alaska Natives face significant health disparities associated with alcohol use disorders and suicide. Elluam Tungiinun is a Yup'ik Eskimo term translatable as "towards wellness." Elluam Tungiinun (ET) is a culturally-based preventative intervention to reduce suicide risk and co-morbid underage drinking among Alaska Native Yup'ik Eskimo youth. The ET process approach contextualizes its intervention program to the local needs and culture of each rural Alaska community it serves through a set of intensive community co-researcher adaptation process procedures. This proposal seeks funding for a five-year CBPR prevention trial of the ET intervention with 239 youth, ages 12 through 18, in five rural, remote Yup'ik communities. A sample of 159.in three communities will test effectiveness two years post intervention using a randomized dynamic wait list control design, along with the fidelity of the ET contextualizing process approach to the intervention model. A sample of 80 will test durability and sustainability of impact over five years in two additional communities with whom we have worked in the past three years developing and piloting the ET intervention. This proposal represents the next stage in a 15-year CPBR process with Alaska Natives. Elluam Tungiinun has three specific aims: Specific Aim 1: Test the effectiveness of the ET intervention through contrasts of impact on outcome measures using a randomly assigned, staggered baseline, dynamic wait list control design with three remote, rural AN villages at completion of the intervention. Specific Aim 2: Test the fidelity of implementation of the ET toolbox local contextualization approach to the ET intervention model in three communities, and impact of fidelity on outcomes. Specific Aim 3: Monitor the sustainability and durability of intervention impact on outcome measures in randomly assigned communities 1- 3 at year 1 and 2 post intervention, and in communities 4- 5, where the intervention was developed and piloted, at year 1-5 post intervention. The ultimate goal of this project is to create evidence-based prevention practices for Alaska Natives. The project has three direct contributions to public health relevance. It seeks to (1) reduce the most significant source of health disparity of public health importance disproportionately affecting Alaska Natives and American Indians, (2) advance CBPR methods in health related research with tribal communities and other ethnic minority, low socioeconomic status, medically underserved, and rural populations, and (3) enhance understanding of factors predictive of health among indigenous and other ethnic minority groups.