Culturally grounded early substance use prevention for American Indian families

描述（由申请人提供）：有问题的物质使用在许多美国印第安社区普遍存在，青春期早期是随后物质问题发展的关键时期。许多保留地正在努力防止早期药物滥用，但往往没有有效的科学证据- -这主要是因为严重缺乏这种证据。我们建议与一个物质问题高发的保留地社区合作，以适应、实施和严格评估一个旨在防止早期开始使用物质和伴随早期使用的无数问题的计划。我们提出的早期物质使用作为目标的识别和特定干预方法的选择直接源于长期的大学-部落社区关系，特别是来自NIDA最近资助的两个项目背景下的社区投入（RC4DA029974, Whitesell & Beals， PI；和R01DA027665， Whitesell， PI）。从这两个项目中产生的一个明确信息是，需要让家庭和文化参与预防早发性药物使用。在这个项目中，我们将继续这种伙伴关系，将经过严格评估的循证实践转化为部落家庭使用，并将其融入社区内产生的文化实践中。我们将利用大学和社区合作伙伴的优势，在社区合作研究和评估的背景下实施创新的干预发展方法。我们将解决三个具体目标：1.；开发一个文化基础，以家庭为基础的早期药物使用预防干预量身定制的北部平原美国印第安人保留地。“在新的背景下，采用基于证据的实践方法来实施一个经过验证的项目（爱荷华州加强家庭项目/ISFP），与社区合作伙伴合作，将ISFP转化为当地的环境，包括对课程内容的交付方式进行深刻而有意义的调整。”“使用基于实践的证据方法，将社区内开发的文化课程（七个方向/SD）整合到ISFP课程中，利用当地有效实践的知识，在文化背景下进一步奠定预防物质使用的基础。2. 试点改编的“加强家庭七个方向”（SDSF）计划，以确定可行性，完善细节，并最大限度地适应社区。3. 使用多阶段优化策略（MOST）的原则进行干预评估和发展，以确定不同干预成分的相对效果大小，并告知最终的SDSF计划，以平衡有效性和效率。4. 为部落卫生管理部门广泛实施SDSF和全面干预的随机对照试验奠定基础。

DESCRIPTION (provided by applicant): Problematic substance use is widespread in many American Indian communities, and early adolescence is a critical period for the development of subsequent substance problems. Efforts to prevent early substance abuse are ongoing on many reservations but often are not informed by scientific evidence of effectiveness - largely because such evidence is sorely lacking. We propose to partner with a reservation community with high rates of substance problems to adapt, implement, and rigorously evaluate a program designed to prevent early initiation of substance use and the myriad of problems that accompany early use. The identification of early substance use as a target and the selection of the particular intervention approach we propose have directly resulted from a longstanding university-tribal community relationship and, in particular, from community input within the context of two recent projects funded by NIDA (RC4DA029974, Whitesell & Beals, PIs; and R01DA027665, Whitesell, PI). A clear message arising out of both projects has been the need to engage families and culture in the prevention of early onset substance use. In this project, we will continue this partnership to translate a rigorously evaluated evidence-based practice for use with tribal families, adapting and anchoring it within a cultural practice arising from within the community. We will draw on the strengths of both university and community partners, implementing innovative intervention development methods within a community collaborative research and evaluation context. We will address three specific aims: 1. Develop a culturally grounded, family-based early substance use prevention intervention tailored to a Northern Plains American Indian Reservation. "Use an evidence-based practice approach to implement a proven program (Iowa Strengthening Families Program/ISFP) within a new context, working with community partners to translate ISFP for the local context, including deep and meaningful adaptations in how the curricular content is delivered. "Use a practice-based evidence approach to integrate a cultural curriculum (Seven Directions/SD) developed within the community into the ISFP curriculum, drawing on local knowledge of effective practices to further ground substance use prevention efforts within the cultural context. 2. Pilot the adapted Seven Directions for Stronger Families (SDSF) program to determine feasibility, refine details, and maximize fit within the community. 3. Use the principles of the Multiphase Optimization Strategy (MOST) for intervention evaluation and development, to determine the relative effect size of different intervention components and inform a final SDSF program that balances effectiveness and efficiency. 4. Set the stage for broad implementation of SDSF by the tribal health administration and a randomized controlled trial of the full intervention.