Indigenous Pathways of Substance Use and Mental Health through Early Adulthood

 描述(由申请人提供)：严重的酒精和药物滥用障碍和精神健康差距在许多美洲印第安人/原住民(土著)社区造成了毁灭性的影响。来自不同部落群体的证据表明，土著青年在整个青春期早期发病、频繁使用药物，精神障碍的共生率相当高。然而，这些早期生活模式如何影响土著人民成年后的轨迹和结果尚不清楚。一般人口研究表明，成年早期(20-30岁)是影响物质使用模式和心理健康的角色、责任和关系转变的关键时期。文化规范和背景可能转化为土著物质使用和精神健康结果的潜在独特发展路径、风险和保护因素。我们建议在土著成年早期研究这些可能性，这是理解从青春期到长期饮酒、药物使用以及精神健康问题和韧性的关键时期。该项目将把我们对土著青少年的8波小组研究的数据与3年来拟议的成年早期新数据联系起来。数据将通过计算机辅助的个人面谈收集。结果将是我们所知道的唯一一个横跨土著儿童、青少年和成年早期的纵向数据集。这项以社区为基础的参与性研究有三个主要目标：1)确定从儿童后期到成年早期土著药物使用和精神健康问题的轨迹；2)确定土著青年使用药物和精神健康的早期生命历程预测因素；3)描述对成年早期幸福的文化上适当的定义，并记录这些积极结果的流行率和预测因素。这项研究的结果将提高人们对酒精、药物使用、精神健康问题及其在土著保留地/保留区社区的共病的性质、病因和后果的认识。另一个成果是加强了对保护因素和积极土著发展的理解和新的衡量标准。该项目的结果有可能为土著社区预防方案的实施时机和风险/保护因素提供信息。

 DESCRIPTION (provided by applicant): Significant alcohol and substance abuse disorders and mental health disparities have had devastating impacts in many American Indian/First Nations (Indigenous) communities. Evidence from diverse tribal groups demonstrates early onset, high frequency substance use with substantial rates of co-occurring mental disorders among Indigenous youth throughout their adolescence. Yet, how these early life patterns affect trajectories and outcomes in adulthood for Indigenous people is unknown. General population studies have shown that early adulthood (20 - 30 years of age) is a critical period of transitions in roles, responsibilities, and relationships impacting patterns of substance use and mental health. Cultural norms and contexts may translate into potentially unique developmental pathways, risks, and protective factors for Indigenous substance use and mental health outcomes. We propose to investigate these possibilities in Indigenous early adulthood, a critical period for understanding transitions from adolescence to longer-term alcohol, substance use, and mental health problems and resilience. The project will link data from our 8-wave panel study of Indigenous adolescents with 3 years of proposed new data in early adulthood. Data will be collected via computer-assisted personal interviews. The result will be the only longitudinal data set spanning Indigenous childhood, adolescent, and early adult years of which we are aware. Three major aims guide this community- based participatory research: 1) Determine trajectories of Indigenous substance use and mental health problems from late childhood to early adulthood, 2) Identify early life-course predictors of substance use and mental health among Indigenous young adults, and 3) Describe culturally appropriate definitions of wellbeing in early adulthood and document the prevalence and predictors of these positive outcomes. Results of this research will increase awareness of the nature, etiology, and consequences of alcohol, substance use, mental health problems and their comorbidity in Indigenous reservation/reserve communities. Another outcome is enhanced understanding and novel measurement of protective factors and positive Indigenous development. The results of this project have potential to inform the timing of and risk/protective factors targeted by prevention programs in Indigenous communities.