Tribal Collaborative in the Preventive or Alcohol-Exposed Pregnancies

描述（由申请人提供）：拟议研究的总体目标是预防美国印第安人社区的酒精暴露妊娠（AEP）和胎儿酒精谱系障碍。为了实现这一目标，拟议的研究将利用基于社区的参与性研究（CBPR）模式来加强现有的伙伴关系，并利用社区参与项目的制定、实施和评估。以前的报告、会议和讨论都强调了在本赠款所包括的部落中开展AEP预防项目的必要性。因此，拟议研究的目标是与社区合作伙伴合作，使用CBPR合作研究方法来支持与北部平原部落的伙伴关系，这些部落对AEP预防计划感兴趣（SA 1）。我们会进行社区需要评估，以收集社区对预防不良反应工作重要性的有效意见；AEP预防项目的理想状态是什么；以及，如果需要的话，如何最好地修改当前的AEP预防项目，使其适合个别部落社区（SA 2）。最后，根据社区需求评估的结果和社区咨询委员会的意见，AEP预防试点项目将在三个大型医院印第安人健康服务（IMS）站点实施：Pine Ridge IHS医院、Sioux San IHS医院和Rosebud综合IHS医院，所有这些都采用CBPR原则（SA 3）。本研究具有重要意义。首先，它针对的是来自高危人群的非孕妇，它针对的是与AEP相关的不止一种危险行为。在妇女怀孕前预防FASD和AEP将克服FASD预防领域的一个关键障碍。利用CBPR方法，成功完成具体目标将改变Al社区预防FASD的重点，从对怀孕可能已经接触酒精的孕妇进行更多干预努力，转向关注预防，其最终目标是防止任何和所有怀孕都接触酒精。这个拟议的CBPR项目的目标将导致科学知识和临床实践的改进。该项目还具有创新性，因为它促进了部落之间的合作，利用一个项目的经验开发和扩展与其他部落和更大的临床站点的项目。

DESCRIPTION (provided by applicant): The overarching objective of the proposed research is to prevent alcohol-exposed pregnancies (AEP) and Fetal Alcohol Spectrum Disorders in American Indian communities. To accomplish this objective, the proposed research will utilize a Community-Based Participatory Research (CBPR) model to strengthen existing partnerships and utilize community participation in program development, implementation, and evaluation. Previous presentations, meetings, and discussions have highlighted the need for an AEP prevention project in the tribes included in this grant. Therefore, it is the goal of the proposed study to work with community partners using a CBPR collaborative research approach to support partnerships with tribes in the Northern Plains who have an interest in an AEP prevention program (SA 1). We will implement a community needs assessment to establish effective input from the community on the importance of AEP prevention efforts; what an AEP prevention project would ideally look like; and, if desired, how to best modify current AEP prevention projects to make appropriate for individual tribal communities (SA 2). Finally, based on results from the community needs assessment and input from Community Advisory Boards, AEP prevention pilot projects will be implemented in three large, hospital Indian Health Service (IMS) sites: Pine Ridge IHS Hospital, Sioux San IHS Hospital, and Rosebud Comprehensive IHS Hospital, all using CBPR principles (SA 3). There is great significance in this proposed study. First, it targets non-pregnant women from an extremely high-risk population, and it targets more than one risky behavior related to AEP. A focus on preventing FASD and AEP before a woman becomes pregnant would overcome a critical barrier in the field of FASD prevention. Utilizing CBPR methodology, a successful completion of the specific aims will alter the focus of FASD prevention with Al communities from more intervention efforts with pregnant women, where the pregnancy might already be alcohol-exposed, to a focus on prevention, where the ultimate goal is to prevent any and all pregnancies from having an alcohol-exposure. The goals of this proposed CBPR project will lead to an improvement both in scientific knowledge and clinical practice. The project is also innovative in that it promotes collaboration between tribes, utilizing experiences from one program to develop and expand on programs with other tribes and with larger clinical sites. RELEVANCE The short-term goal of this study is to, through CBPR methods; implement alcohol-exposed pregnancy (AEP) prevention programs with non-pregnant American Indian women, focusing on evaluating such programs for effectiveness in decreasing risky behaviors related to AEP. This leads to the long-term goal, which is to utilize CBPR principles to foster sustainable efforts to prevent AEP.