Brief Intervention for Substance Using Native Youth

针对吸毒的本土青少年的简短干预

• 批准号: 8445335
• 负责人: John R., RN, PHD, FAAN Lowe
• 金额: $ 58.26万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8445335
• 关键词: Adolescent; Alcohol abuse; Alcohol or Other Drugs use; Attention; Behavior Therapy; Cherokee Indian; Clinical Trials; Development; Drug usage; Effectiveness; Elderly; Ensure; Ethnic group; Evaluation; Feedback; Gender; General Population; Goals; Intervention; Life; Mediator of activation protein; Minority; Native Americans; Not Hispanic or Latino; Oklahoma; Older Population; Paper; Participant; Pharmaceutical Preparations; Phase; Population; Process; Publishing; Questionnaires; Randomized; Randomized Clinical Trials; Readiness; Recruitment Activity; Reporting; Research; Research Project Grants; Risk; Sampling; Schools; Self Efficacy; Students; Substance abuse problem; Target Populations; Teenagers; Testing; Time; Training; Treatment outcome; Tribal School; Youth; aged; alcohol intervention; base; brief advice; brief intervention; brief motivational intervention; college; design; drinking; high risk; high school; innovation; motivational enhancement therapy; native youth; post intervention; public health priorities; public health relevance; racial and ethnic; reduced substance use; response; screening; self reliance; treatment effect; treatment response

DESCRIPTION (provided by applicant): "Brief Intervention for Substance Using Native Youth" is a 5-year research project designed to develop and test a school-based, brief motivational intervention for substance using, Native American high school students. Motivational Interviewing (MI) is a behavioral treatment for substance use problems that has already shown efficacy in some populations. Clinical trials support the effectiveness of MI with adults and older adolescents with substance use problems. However, MI clinical trials to date have been limited by (a) insufficient ethnic/racial diversity of samples (i.e., almost every MI RCT published to date has focused on predominantly non-Hispanic white samples), (b) lack of attention to non-treatment seeking populations, (c) no direct examination of putative mechanisms of change, and (d) no direct examination of how culture-related variables may influence treatment response. MI's effectiveness for minority populations, and especially Native American populations, has received scant research attention, and remains unknown. Moreover, Native American youth, compared to youth from other racial/ethnic backgrounds, are at especially high risk for drug use and drinking, which makes them particularly susceptible to the development of substance use problems. The primary goal of the proposed study is to conduct a clinical trial evaluating a culturally congruent, school-based motivational interviewing intervention targeting substance use among Native American high school students. The development phase of the project (6 months) will focus on (a) adapting our assessment and intervention materials in order to ensure cultural and developmental congruency with our target population, (b) training staff in conducting MI assessment and intervention with developmental and cultural sensitivity, and (c) collaborating with school and tribal representatives in the planning and implementation the clinical trial phase of the project. Clinical trial participants will be recruited from three predominantly Native American public high schools located in Oklahoma. A school-wide paper-and-pencil substance use screening questionnaire will be used to select a sample of "high risk substance users" (n = 480), who will be randomly assigned to one of three treatment conditions: (1) brief advice and a personalized feedback report alone (BA+PFR; n = 160), (2) brief advice, a personalized feedback report, and motivational interviewing (BA+PFR+MI; n =160), or (3) brief advice, a personalized feedback report, motivational interviewing, and a 6-months post- intervention booster session (BA+PFR+MI+BOOST; n =160). Participants will be evaluated at study entry, and at 3-, 6-, 9-, and 12-month follow-ups. We hypothesize Native American high school students who receive motivational interviewing will demonstrate significantly greater post-intervention reductions in substance use and substance- related negative consequences than their counterparts who do not receive MI (i.e., BA+PFR participants). We also hypothesize adolescents who receive the booster session will demonstrate significantly greater and longer-lived substance use reductions than adolescents who do not receive the booster. A secondary aim is to examine mechanisms of change (i.e., mediators) associated with MI response. We hypothesize pre-to post-intervention changes in perceived readiness to change, perceived importance of change, and self-efficacy will predict participants' response to intervention. Our third aim is to explore gender and Native American-specific cultural variables (Cherokee self- reliance & Native American ethnic identity) as moderators of the differential effectiveness of MI; this aim is specifically designed as a preliminary evaluation of the gender and cultural invariance of our school-based MI intervention. We believe our proposed study is significant and innovative, and represents an important next step in the development of cross-culturally effective, brief, and school- based interventions for drug use and drinking among teenagers.

描述(由申请者提供)：“使用物质的短暂干预”是一个为期5年的研究项目，旨在开发和测试以学校为基础的、针对使用物质的美洲原住民高中生的简短动机干预。动机访谈(MI)是一种针对物质使用问题的行为治疗，已经在一些人群中显示出有效性。临床试验支持MI对有药物使用问题的成年人和老年青少年的有效性。然而，到目前为止，MI临床试验受到以下因素的限制：(A)样本的种族/种族多样性不足(即，迄今发表的几乎所有MI RCT都侧重于主要是非西班牙裔白人样本)，(B)对寻求非治疗的人群缺乏关注，(C)没有对假定的变化机制进行直接研究，以及(D)没有直接研究文化相关变量如何影响治疗反应。MI对少数民族人群的有效性，特别是对美洲原住民的有效性，几乎没有受到研究的关注，而且仍然不清楚。此外，与其他种族/族裔背景的青年相比，美洲原住民青年吸毒和酗酒的风险特别高，这使他们特别容易出现药物使用问题。这项拟议研究的主要目标是进行一项临床试验，评估针对美洲原住民高中生使用物质的文化契合的、基于学校的动机访谈干预措施。该项目的发展阶段(6个月)将侧重于：(A)调整我们的评估和干预材料，以确保与我们的目标人口的文化和发展一致；(B)培训工作人员进行对发展和文化敏感的MI评估和干预；(C)与学校和部落代表合作，规划和实施该项目的临床试验阶段。临床试验参与者将从位于俄克拉何马州的三所以美国原住民为主的公立高中招募。将使用全校范围的纸笔物质使用筛查问卷来选择样本(n=480)，他们将被随机分配到三种治疗条件之一：(1)简短建议和单独的个性化反馈报告(BA+PFR；n=160)；(2)简短建议、个性化反馈报告和激励性访谈(BA+PFR+MI；n=160)；或(3)简短建议、个性化反馈报告、激励性访谈和为期6个月的干预后促进会议(BA+PFR+MI+Boost；n=160)。参与者将在研究开始时以及3个月、6个月、9个月和12个月的随访中接受评估。我们假设，接受激励性访谈的美国原住民高中生在干预后在物质使用和与物质相关的负面后果方面的减少量将显著高于未接受MI的高中生(即BA+PFR参与者)。我们还假设，接受强化治疗的青少年将比没有接受强化治疗的青少年表现出更大和更长时间的物质使用减少。第二个目标是研究与MI反应相关的变化机制(即中介)。我们假设干预前后感知变化准备程度、感知变化重要性和自我效能感的变化将预测参与者对干预的反应。我们的第三个目标是探索性别和美国原住民特有的文化变量(切诺基人的自力更生和美国原住民的民族认同)作为MI差异有效性的调节变量；这个目标是专门设计的，作为我们以学校为基础的MI干预的性别和文化不变性的初步评估。我们相信，我们建议的研究具有重大意义和创新性，并代表着在发展跨文化有效的、简短的、以学校为基础的青少年吸毒和饮酒干预措施方面迈出的重要的下一步。