American Indians, substance use, and HIV risk behaviors:Secondary data analysis o

描述(由申请人提供)：美国印第安人，药物使用和艾滋病毒危险行为：摘要/摘要的次要数据分析虽然累积的证据清楚地表明，美国印第安人(AIS)比美国其他种族和民族群体更容易酗酒和非法药物使用/滥用以及艾滋病毒危险行为，但试图解释此类行为的研究相对较少，包括“种族差距”--为什么AI(相对于白人)此类行为的风险更高。在试图解释人工智能中这种行为的研究中，几乎没有一项研究使用了丰富的、具有全国代表性的数据集，跟踪青少年受访者进入成年期。本研究通过使用国家青少年健康纵向研究(ADD Health)数据来扩展我们的知识，以检查有助于解释AI物质使用和HIV危险行为、共病行为以及上述种族差距的风险和保护因素。该研究小组的长期目标是继续探索种族和经济分层如何有助于产生健康差距，并促进发现和实施有效的预防和干预措施，以缩小这种差距。这项应用的目的有三个：a)利用ADD Health数据来探索AI物质使用和HIV危险行为的前因；b)探索可能直接或间接影响AI物质使用和HIV危险行为的环境因素(学校和社区)的作用；以及c)考虑可能解释AI随着年龄增长而改变、放大和/或停止此类行为的因素。这一应用的中心假设是，压力暴露的差异，加上应对、个人和社会资源的差异，将预测个人和种族在物质使用和艾滋病毒危险行为方面的差异，上下文因素起到直接影响和调节压力-行为关联的作用。该计划将通过追求以下三个目标来填补这一知识空白：a)使用纵向的、具有全国代表性的样本，并通过压力过程框架，检查与人工智能物质使用、艾滋病毒危险行为、共病行为和种族差距相关的风险和保护因素；b)分析学校和社区背景因素在理解人工智能物质使用、艾滋病毒危险行为、共病行为和种族差距方面的直接和间接(调节)作用；以及c)使用Add Health数据(包括最近发布的第四波数据)的四波数据，研究与AI物质使用、艾滋病毒危险行为、共病行为和种族差距变化相关的纵向过程和因素。拟议的研究具有重要意义，因为它有望提供必要的基础知识，以构建有效的干预和预防措施，缩小人工智能-白人种族在药物使用和艾滋病毒危险行为方面的差距。

DESCRIPTION (provided by applicant): American Indians, substance use, and HIV risk behaviors: Secondary data analysis of the Summary/Abstract While cumulative evidence clearly indicates that American Indians (AIs) are at a much greater risk of alcohol and illicit substance use/abuse and HIV risk behaviors than other racial and ethnic groups in the U.S., there has been a relative paucity of research that has attempted to explain such behavior, including the "race gap"-why AIs are at an elevated risk for such behaviors (relative to whites). And of the studies that have attempted to explain such behaviors among AIs, virtually none have employed a rich, nationally representative data set that follows adolescent respondents into adulthood. The present study forwards our knowledge by using the National Longitudinal Study of Adolescent Health (Add Health) data to examine risk and protective factors that serve to explain AI substance use and HIV risk behaviors, comorbid behaviors, and the aforementioned race gap. The long-term goal of this research team is to continue to explore how racial and economic stratification serves to produce health disparities and to facilitate the discovery and implementation of efficacious prevention and interventions to reduce such disparities. The objective of this application is threefold: a) to explore the antecedents of AI substance use and HIV risk behaviors by utilizing the Add Health data; b) to explore the role of contextual factors (school and community) that may directly or indirectly influence AI substance use and HIV risk behaviors; and c) to consider factors that may explain change, amplification, and/or desistance in such behaviors among AIs as they age into adulthood. The central hypothesis of this application is that differences in stress exposure, coupled with differences in coping, personal, and social resources will predict both individual and race-specific variation in substance use and HIV risk behaviors, with contextual factors serving to directly influence and moderate the stress-behavior association. The plan is to fill this knowledge gap by pursuing the following three aims: a) examine the risk and protective factors associated with AI substance use, HIV risk behaviors, comorbid behaviors, and the race gap using a longitudinally, nationally representative sample and informed by a stress process framework; b) analyze the direct and indirect (moderator) role of school and community contextual factors for understanding AI substance use, HIV risk behaviors, comorbid behaviors, and the race gap; and c) study longitudinal processes and factors associated with changes in AI substance use, HIV risk behaviors, comorbid behaviors, and the race gap using the four waves of the Add Health data (including the recently released Wave IV data). The proposed research is significant because it is expected to provide fundamental knowledge necessary in order to construct effective interventions and preventions that will reduce the AI-white race gap in substance use and HIV risk behaviors.