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 个邻近印第安保留地及其周围的美国原住民青少年未成年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（为这些部落提供服务的诊所）、预防研究中心和斯克里普斯研究所之间的成功合作之上。该团队评估了西南加州印第安人未成年人中与酒精相关的问题的程度，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。本提案的总体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：a）通过针对店外零售店员的奖励和提醒计划减少未成年人饮酒，并加强合规检查；b）通过部落、地方和州执法部门广为人知的低人力检查站防止未成年人饮酒和驾驶。为了动员社区，这些计划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。这些社区层面的计划将得到个人层面干预措施的补充，包括 a) 筛查部落青年是否酗酒；b) 由诊所工作人员以对照试验的形式提供简短的干预措施，对报告未成年饮酒的青年进行动机性访谈。这些个人层面的干预措施将根据文化进行定制，以适当解决来自九个部落的美洲原住民青年的饮酒问题。我们将通过分析多个数据源来评估这些计划的有效性：a) 来自部落青年动机访谈试验的结果数据，b) 来自学校和社区青年调查的关于青年自我报告的饮酒和饮酒问题的数据，c) 急诊室出院数据，以及 d) 有关酒精相关事件的执法数据。出于评估目的，来自印度健康委员会服务区的这些数据将与对未参与干预活动的美国原住民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以及比较群体和其他社区利益相关者，例如执法部门和为青少年和家庭服务的机构。 公共卫生相关性：在成功的能力建设努力的基础上，拟议的为期 5 年的研究将实施和评估旨在解决圣地亚哥县农村 9 个印第安人保留地及其周边地区的未成年人饮酒和问题的干预措施。拟议的干预措施将以文化上适当的方式将基于社区的环境未成年人饮酒和酒后驾车预防计划与个人筛查和动机访谈结合起来。该项目可以显着减少加州原住民农村地区未成年人饮酒造成的直接和长期伤害。

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.