Trauma Screening, brief intervention and referral among AI/AN adults

创伤性事件是生活在美国的成年人生活中常见的事件。大约四分之一经历过创伤事件的人随后将符合创伤后应激障碍（PTSD）的全部标准;另四分之一将经历部分PTSD，并具有显著的损伤水平。PTSD与不良的健康结果有关。包括与其他行为健康障碍、身体健康障碍和服务利用增加的显著共病。关于创伤和创伤相关疾病，包括美国印第安人和阿拉斯加原住民（AI/ANs）的PTSD，人们知之甚少。有证据表明，AI/AN社区和临床样本中的创伤暴露和创伤相关疾病的发生率高于美国普通人群。卫生保健环境为发现创伤相关疾病提供了丰富的机会。在经历创伤事件的人中，有很大比例的人在事件发生多年后仍因创伤后遗症而接受医疗保健服务。提出的概念是两个相关的研究项目之一，在美国印第安人和阿拉斯加土著健康差异中心（P60）的科罗拉多丹佛大学赠款的更新。该研究项目建立在现有研究的基础上，研究了AI/AN人群在初级保健环境中的行为健康筛查和检测。使用基于社区的参与式方法，拟议的研究项目将通过以下具体的施舍，在为两个独特的AI/AN群体服务的地点，让主要利益相关者参与AI/AN成人创伤的系统筛查的考虑，开发和试点：1）与关键利益攸关方合作，考虑并制定系统筛查创伤的方法，然后将受影响的个人转介到两个人工智能/AN卫生保健环境;和2）试点创伤筛查和转诊，然后评估未来在这两种环境中进行大规模试验的可接受性和可行性。

Traumatic events are common occurrences in the lives of adults living in the United States. Roughly one quarter of those who experience a traumatic event will subsequently meet full criteria for posttraumatic stress disorder (PTSD); another quarter will experience partial PTSD with significant levels of Impairment. PTSD is related to adverse health outcomes. Including significant comorbidity with other behavioral health disorders, physical health disorders, and increased service utilization. Significantly less is known about trauma and trauma-related disorders including PTSD in American Indian and Alaska Native people (AI/ANs). Evidence suggests higher rates of trauma exposure and trauma-related disorders in AI/AN community and clinical samples than the general United States population. The health care setting offers a rich opportunity for the detection of trauma-related disorders. A high proportion of those experiencing a traumatic event receive health care services for injuries sustained or present for trauma-related sequelae even years after the event. The concept proposed is one of two related research projects within a renewal of the American Indian and ALaska Native Health Disparities center (P60) grant of the University of Colorado Denver. This research project builds upon existing studies examing behavioral health screening and detection in primary care settings for AI/AN people. Using a community based participatory approach, the proposed research project will engage key stakeholders In the consideration, development, and piloting of systematic screening for trauma among AI/AN adults at sites serving two unique AI/AN groups through the following specific alms: 1) Work with key stakeholders to consider and develop means to systematically screen for trauma then refer affected Individuals for intervention in two AI/AN health care settings; and 2) Pilot trauma screening and referral then assess the acceptability and feasibility of a future large scale trial in both settings.