Preventing Underage Drinking by Southwest California Indians

描述（由申请人提供）：拟议的五年研究计划的目标是实施和评估旨在解决居住在圣地亚哥县农村9个相邻印第安保留地及其周围的美国土著青年未成年人饮酒问题的干预措施。该应用程序直接建立在印第安健康中心公司（为这些部落服务的诊所）、预防研究中心和斯克里普斯研究所之间的成功合作之上。该研究小组评估了加利福尼亚西南部印第安人未成年人群中酒精相关问题的程度，并为选择、实施和评估适当的预防和治疗干预措施以减少青少年饮酒奠定了基础。本建议的总目标将通过两项相辅相成的努力来实现，一项针对社区一级，另一项针对个人一级。以社区为基础的环境预防计划将侧重于：1)通过奖励和提醒计划来减少未成年人接触酒精，并加强合规检查；2)通过部落、地方和州执法部门高度宣传的人力不足的检查站来防止未成年人饮酒和开车。为了动员社区，这些项目将得到印度卫生委员会医生、部落领袖和当地社区联盟的支持。这些社区层面的项目将与个人层面的干预相辅相成，包括a)筛查部落青年是否有酗酒行为；b)诊所工作人员以对报告未成年饮酒的青年进行动机性访谈的对照试验的形式提供简短的干预。这些个人层面的干预措施将在文化上量身定制，以适当地解决来自九个部落的美洲原住民青年的饮酒问题。我们将通过分析多种数据来源来评估这些项目的有效性：a)部落青年动机访谈试验的结果数据，b)学校和社区青年自我报告饮酒和饮酒问题的调查数据，c)急诊室出院数据，d)酒精相关事件的执法数据。为进行评价，将把来自印第安人健康委员会集水区的这些数据与未参与干预活动的美洲土著青年的调查数据进行比较。项目完成后，结果将报告给九个部落的代表、比较小组和其他社区利益相关者，如执法部门和为青年和家庭服务的机构。

DESCRIPTION (provided by applicant): The goal of the proposed five-year program of research is to implement and evaluate interventions designed to address underage alcohol consumption among Native American youth residing in and around 9 contiguous Indian reservations in rural San Diego County. The application directly builds upon the successful collaboration between Indian Health Center, Inc. (the clinics serving these tribes), the Prevention Research Center, and The Scripps Research Institute. This team assessed the extent of alcohol-related problems in these underage populations of Southwest California Indians and established the groundwork for selecting, implementing, and evaluating appropriate prevention and treatment interventions to reduce drinking among its youth. The overall goal of the present proposal will be accomplished through two complementary efforts, one aimed at the community level and the other at the individual level. The community-based environmental prevention program will focus on a) reducing underage access to alcohol through a reward and reminder program for off-premise retail clerks, backed by increased compliance checks and b) preventing underage drinking and driving through highly publicized low-manpower checkpoints by tribal, local, and state law enforcement. To mobilize the community, these programs will be supported by Indian Health Council doctors and tribal leaders and local community coalitions. These community-level programs will be complemented with interventions at the individual level, including a) screening tribal youth for alcohol involvement and b) offering brief interventions by clinic staff in the form of a controlled trial of motivational interviewing with youths who report underage drinking. These individual level interventions will be culturally tailored to appropriately address drinking by Native American youths from the nine tribes. We will evaluate the effectiveness of these programs by analyzing multiple data sources: a) outcome data from the Motivational Interviewing trial among tribal youth, b) data from school and community youth surveys on youths' self-reported drinking and drinking problems, c) emergency room discharge data, and d) law enforcement data on alcohol-related events. For the purposes of evaluation, these data from the Indian Health Council catchment area will be compared to data from surveys of Native American youth who were not involved in the intervention activities. Once the project is completed, the results will be reported to representatives of the nine tribes as well as the comparison groups and other community stakeholders such as law enforcement and agencies serving youths and families. PUBLIC HEALTH RELEVANCE: Building upon successful capacity building efforts, the proposed 5 year study will implement and evaluate interventions designed to address underage alcohol consumption and problems in and around 9 Indian reservations in rural San Diego County. The proposed interventions integrate community based environmental underage alcohol access and DUI prevention programs with individual screening and motivational interviewing in a culturally appropriate way. This project offers significant potential reductions in immediate as well as long-term harm resulting from underage drinking among rural Native Californians.