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

创伤性事件在生活在美国的成年人的生活中很常见。大约四分之一经历过创伤性事件的人随后会完全符合创伤后应激障碍（PTSD）的标准；另外四分之一的人会经历严重程度的创伤后应激障碍。创伤后应激障碍与不良健康结果有关。包括与其他行为健康障碍、身体健康障碍的显著合并症，以及服务利用率增加。对美国印第安人和阿拉斯加原住民（AI/ANs）的创伤和创伤相关疾病（包括创伤后应激障碍）的了解明显较少。有证据表明，在AI/AN社区和临床样本中，创伤暴露和创伤相关疾病的发生率高于美国一般人群。卫生保健环境为发现创伤相关疾病提供了丰富的机会。在经历创伤性事件的人当中，有很大比例的人在事件发生数年后仍因受伤或因与创伤有关的后遗症而接受医疗保健服务。提出的概念是科罗拉多大学丹佛分校美洲印第安人和阿拉斯加土著健康差异中心（P60）拨款更新中的两个相关研究项目之一。这一研究项目建立在现有研究的基础上，这些研究检查了初级保健机构对人工智能/人工智能人群的行为健康筛查和检测。采用基于社区的参与式方法，拟议的研究项目将使主要利益相关者参与考虑、开发和试点在为两个独特的人工智能/人工智能群体服务的地点对人工智能/人工智能成人进行系统的创伤筛查，具体做法如下：1)与主要利益相关者合作，考虑和开发系统筛查创伤的方法，然后在两个人工智能/人工智能医疗机构中转诊受影响的个人进行干预；2)试点创伤筛查和转诊，然后评估未来在两种情况下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.