Urban American Indian Youth Substance Use: Ecodevelopmental Influences

项目总结(见说明)： 生活在城市地区的大多数美国印第安人(Al)家庭由于滥用药物而经历着不成比例的健康差距。这些健康差距通过更高的比率、更早的开始和更严重的药物使用后果来影响Al青年。快速增长的城市铝家庭人口几乎没有基于证据的预防方法，这些方法具有文化根基，反映了塑造城市铝社区的特定社会环境力量。家庭破裂和药物滥用、与搬到城市环境有关的压力以及经常建立和维持社会和文化联系的困难被认为是造成城市青年健康不良后果的原因。利用生态发展理论，这项研究将解决在同龄人、家庭/父母、学校和社区层面上的背景影响如何影响亚利桑那州城市Al青年的物质使用的知识空白。这项研究将使用一个全面的模型记录这些不同层面上的因素的相对影响，测试积极和消极的家庭影响如何与其他层面上的影响相互作用，并审查它们在按性别、年级和遗产界定的城市Al青年亚群中可能如何不同地运作，这些亚群是纯Al或混合Al和非AI遗产。这项研究使用了2010年全州范围内对青年药物使用情况的调查，大量城市青年(N=3450)生活在规模和迁徙历史不同的城市社区。拟议的研究借鉴了项目团队在NIMHD卓越中心进行的关于Al家庭行为健康的社会决定因素、显著的风险和复原力因素、抵制风险行为的文化适当战略以及适应文化的预防计划的系统方法的研究。这项研究旨在通过与政府和社区卫生组织的伙伴关系，将科学与实践和政策联系起来，提供解释和传播研究结果的机制；为 翻译研究。这项研究将通过查明城市青年和家庭在城市环境中面临的问题，创造关于如何有针对性地全面提供预防干预措施的基本知识。

PROJECT SUMMARY (See instructions): The majority of American Indian (Al) families living in urban areas experience disproportional health disparities associated with substance abuse. These health disparities affect Al youth through higher rates, earlier initiation, and more severe consequences of substance use. The rapidly growing population of urban Al families is served by few evidence-based prevention approaches that are culturally grounded and reflective of specific socio-environmental forces shaping urban Al communities. Family disruption and substance abuse, stresses related to moving to urban settings, and difficulties in establishing and sustaining social and cultural connections frequently are mentioned as contributing to adverse health outcomes for urban Al youth. Using ecodevelopmental theory, this research will address gaps in knowledge of how contextual influences operating at peer, family/parental, school, and neighborhood levels influence substance use among urban Al youth in Arizona. The study will document the relative influence of factors at these different levels using a comprehensive model, test how positive and negative family influences interact with those at other levels, and examine how they may operate differently in subgroups of urban Al youth defined by gender, grade level, and heritage that is Al-only or mixed Al and non-AI heritage. The research uses a 2010 state-wide survey of youth substance use with large numbers of urban Al youth (N=3,450) living in a range of urban communities that vary in size and migration histories. The proposed study draws upon the project team's research, conducted at an NIMHD Center of Excellence, on the social determinants of Al family behavioral health, salient risk and resiliency factors, culturally appropriate strategies for resisting risk behaviors, and systematic methods for culturally adapting prevention programs. The study is designed to bridge science to practice and policy via partnerships with governmental and community-based health organizations to provide mechanisms for interpreting and disseminating findings; providing a foundation for translational research. The study will create essential knowledge about how to target and deliver prevention interventions comprehensively by identifying issues that urban Al youth and families face in urban contexts.