Discovering Our Story, to develop the Chemawa Journey of Transformation

发现我们的故事，发展 Chemawa 转型之旅

• 批准号: 10379288
• 负责人: Teresa A Evans-Campbell
• 金额: $ 64.54万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10379288
• 关键词: Address; Affect; African American population; Age; Age-Years; Alaska Native; Alcohol consumption; Alcohols; American Indians; Behavioral; Chlamydia; Coitus; Collaborations; Communities; Data; Drug usage; Elderly; Epidemic; Event; Evidence based program; Family; Future Generations; General Population; Gonorrhea; HIV; Health; Heart; High Prevalence; High School Student; Indigenous; Individual; Intervention; Lead; Leadership; Marijuana; Mediating; Metaphor; Methods; Modeling; Motivation; Native-Born; Opioid; Oral; Pain; Pathway Analysis; Pattern; Pharmaceutical Preparations; Population; Population Programs; Poverty; Predisposition; Prevention; Primary Prevention; Process; Public Health; Quasi-experiment; Randomized; Recording of previous events; Reproductive Health; Research; Research Infrastructure; Research Personnel; Risk; Risk Factors; Risk Reduction; Safe Sex; Schools; Self Efficacy; Sexual Health; Sexually Transmitted Diseases; Stress and Coping; Students; Substance abuse problem; Sustainable Development; Syphilis; Teenagers; Testing; Time; Tobacco; Tobacco use; Training; Tribal School; Tribes; United States; Universities; Unsafe Sex; Waiting Lists; Washington; Youth; alcohol prevention; base; behavior change; community based participatory research; cost; cost effective; digital; experience; health disparity; heroin use; high school; intervention effect; leadership development; multidisciplinary; native youth; opioid misuse; peer; positive youth development; programs; racial and ethnic; response; sex; sexual risk behavior; skills; smoking prevalence; social; stem; substance use; substance use prevention; syndemic; therapy development

Substance use and sexual health risk are increasingly prevalent, costly, and deadly -- fueling a synergistic epidemic in the United States (US) that disproportionately affects American Indian and Alaska Native (AIAN) communities. AIAN youth are at the heart of the AIAN health crisis. AIAN youth are disproportionately affected by many of these historical, structural, social, and behavioral factors that contribute to significant health disparities including high alcohol, tobacco, opiate and other drug (ATOD) use and sexual and reproductive health risks (SRH; ATOD-SHR). The overall mean age of tobacco use, alcohol use, and marijuana initiation for AIANs is much younger (11.5 years) than the general population, with AIAN youth having the highest prevalence of smoking and the earliest age of first use of ATOD. Alarmingly, more that 20% of Native high school students who used a prescription pain med without a prescription also used heroin in the past 30 days. Substance use is one of the most significant risk factors for unprotected sex and AIAN youth have the earliest age of first sexual intercourse. AIANs under 25 years of age have three times the rate of chlamydia, gonorrhea, and syphilis compared to White youth. Taken together, these ATOD-SHR disparities underscore the urgent need for interventions that simultaneously target ATOD and SHR among AI teens. While there is a paucity of research addressing the ATOD-SRH prevention needs of AIAN youth in general, there is even less information available on ATOD-SRH-related disparities for the nearly 1 out of 10 AIAN youth attending the 183 tribal day or boarding schools nationwide. To address this crisis and the dearth of evidence-based programs for this population, the proposed study, prepared in response to PAR-17-496, involves a 5-year RO1 to test the preliminary efficacy of the Chemawa Journey of Transformation–Native Youth Health Leadership Program (CHJ) which is an adapted and expanded version of the Discovering Our Story intervention, a 2010 SAMSHA- identified best practice AIAN strengths-based comprehensive substance use and health risk prevention and health leadership program for AIAN youth. The CJOT emphasizes a holistic, positive youth approach that incorporates storytelling with traditional archetypes and responsibilities as both a process and metaphor for guiding AIAN youth through behavioral change. The CJOT is a culturally-centered experiential 8-week (10 sessions) school-based positive youth health leadership development intervention to prevent ATOD use and SHR among AIAN youth (ages 13-16). The program involves a 2-month intervention (3 individual sessions + 10 sessions) + 5 booster sessions including digital storytelling training + 1 community event (digital and oral storytelling premiere) that targets behavior change relative storytelling and a youth-led storytelling event.

药物使用和性健康风险日益普遍、代价高昂和致命——助长了协同效应