Healthy Native Nations: Identifying Effective Alcohol Policies for American Indian Tribes

健康的原住民国家：为美洲印第安部落确定有效的酒精政策

• 批准号: 10363646
• 负责人: JULIET P LEE
• 金额: $ 57.59万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-05 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10363646
• 关键词: AODR mortality; Accident and Emergency department; Address; Adopted; Advocacy; Affect; Alaska Native; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohols; American Indians; Area; Attitude; Charge; Communities; Community Health; Conflict (Psychology); Congresses; Data; Documentation; Economics; Effectiveness; Ensure; Epidemiologic Methods; Epidemiology; Foundations; Genetic; Geographic state; Hand; Health; Health Policy; High Prevalence; Hospitalization; Hospitals; Indian reservation; Indigenous; Individual; Information Dissemination; Information Systems; Injury; Intervention; Interview; Investigation; Joints; Knowledge; Law Enforcement; Laws; Legal; Literature; Low Prevalence; Measures; Methods; Modeling; National Institute on Alcohol Abuse and Alcoholism; Outcome; Police; Policies; Policy Making; Policy Research; Population; Prevention Research; Prevention approach; Price; Psychology; Public Health; Public Policy; Qualitative Research; Records; Regulation; Research; Research Institute; Research Methodology; Research Personnel; Reservations; Risk; Sales; Sampling; Scientist; Site; Surveys; Tribes; Typology; United States; Universities; Vehicle crash; Voice; Washington; Work; alcohol availability; alcohol measurement; alcohol policy information system; alcohol related problem; authority; base; behavioral study; community based participatory research; community engagement; comparative; contextual factors; design; epidemiology study; evidence base; experience; health disparity; health inequalities; heterogenous data; improved; insight; population health; public policy on alcohol; repository; social; social structure; tribal Nation; tribal community; tribal health; tribal lands; tribal leader; underage drinking

ABSTRACT This Tribal Community-Engaged project uses spatial and legal epidemiological methods within community participatory frameworks to assess the differential relationships of state and tribal alcohol policies to alcohol- related health risks for residents of American Indian reservations. We propose to compile and summarize alcohol regulatory policies established by sovereign tribal nations in conjunction with extant alcohol policies of the U.S. states with which they are collocated. Many correlates of the high rates of alcohol-related problems observed among American Indians (AI) compared to other U.S. populations have been extensively addressed in individual social-behavioral studies in, for example, genetics, psychology, and community health. Very few studies have considered contrasting state vs. tribal alcohol policies as social-structural determinants that may be related to AI alcohol related problems. Sovereign tribal nations have the right to establish their own alcohol policies, which may vary according to adjacent state policy conditions and attitudes towards alcohol across tribal communities. Tribal alcohol policies are publicly registered, but there has been no common repository nor systematic typology established that allows researchers to characterize these ordinances and relate them to state alcohol conditions (see, e.g. NIAAA’s Alcohol Policy Information System). Prior studies of tribal alcohol policies were not able to consider the full impacts of collocated state alcohol regulatory conditions on tribal alcohol problems. Recent studies have developed an Alcohol Policy Score (APS) that characterizes the strengths of alcohol policies across U.S. states. The APS may now be applied to studies of tribal alcohol regulatory conditions. Cross-site studies of tribal alcohol outcomes have also been hampered by the use of heterogenous data systems. We demonstrate that hospitalization records and motor vehicle crash data collected in similar ways across U.S. states can be used to assess tribal alcohol outcomes using common data frames and advanced spatial epidemiological methods. Finally, analyses of tribal policies will be limited in interpretive scope without obtaining local insights and knowledge of tribal leaders who have designed, enacted, and are charged with enforcing tribal alcohol ordinances. We use Tribal Community-Based Participatory and qualitative research methods at multiple levels of community engagement (Tribal Community Advisory Board; tribal research review; Tribal Key Leader Interview; Tribal and Local Law Enforcement Survey) to assess how tribal and state alcohol policies are effected on tribal lands and may support or reduce alcohol-related risks for residents of tribal nations. Our engagement plans ensure tribal community oversight of the interpretation of findings, and dissemination of results to tribal leaders as well as scientific communities.

摘要 这个部落社区-社区卫生项目在社区内使用空间和法律的流行病学方法 参与性框架，以评估国家和部落酒精政策与酒精的不同关系， 美国印第安人保留地居民的相关健康风险。我们建议汇编和总结 由主权部落国家制定的酒精监管政策与现存的酒精政策相结合， 美国各州与之并列。与酒精相关问题的高发病率有许多相关性， 与其他美国人口相比，在美国印第安人（AI）中观察到的问题已经得到了广泛的解决 在个体社会行为研究中，例如，遗传学，心理学和社区健康。很少 研究认为，对比国家与部落的酒精政策作为社会结构的决定因素， 与酒精有关的问题。拥有主权的部落民族有权建立自己的酒 政策，这可能会根据相邻国家的政策条件和对酒精的态度而有所不同。 部落社区。部落酒精政策是公开登记的，但没有共同的储存库， 建立了系统的类型学，使研究人员能够描述这些法令的特点，并将其与 国家酒精条件（见，例如，NIAAA的酒精政策信息系统）。先前对部落酒精的研究 政策不能考虑到州酒精监管条件对部落的全面影响。 酒精问题。最近的研究已经开发出一种酒精政策评分（APS）， 美国各州酒精政策的优势。APS现在可以应用于部落酒精的研究 监管条件。对部落饮酒结果的跨地点研究也受到了使用 异构数据系统我们证明了住院记录和机动车碰撞数据 在美国各州以类似方式收集的数据可用于评估部落饮酒的结果 先进的空间流行病学方法。最后，对部落政策的分析将限于 没有获得当地的见解和知识的部落领导人谁设计，颁布， 负责执行部落禁酒令我们使用部落社区为基础的剥离和 社区参与多层次的定性研究方法（部落社区咨询委员会; 部落研究审查;部落主要领导人访谈;部落和地方执法调查），以评估如何 部落和州的酒精政策影响部落土地，可能会支持或减少与酒精相关的风险， 部落民族的居民。我们的参与计划确保部落社区监督对 调查结果，并向部落领导人和科学界传播结果。