Discovering Our Story, to develop the Chemawa Journey of Transformation

物质使用和性健康风险越来越普遍，代价越来越高，而且是致命的--助长了协同效应 美国的一种流行病，对美国印第安人和阿拉斯加原住民的影响不成比例 社区。AIAN青年是AIAN健康危机的核心。Aian青年都是 不成比例地受到许多历史、结构、社会和行为因素的影响 严重的健康差距，包括高酒精、烟草、阿片剂和其他药物(ATOD)的使用和性行为 和生殖健康风险(SRH；ATOD-SHR)。吸烟、饮酒和吸烟的总体平均年龄 吸食大麻的AIAN人比普通人群年轻得多(11.5岁)，AIAN的年轻人 吸烟率最高，首次使用ATOD的年龄最早。令人震惊的是，超过20% 在没有处方的情况下使用处方Pain Meded的土著高中生中，也有一部分在 过去30天。物质使用是无保护措施性行为的最重要的危险因素之一，AIAN青少年有 第一次性交的最早年龄。25岁以下的艾滋病人的衣原体感染率是前者的三倍， 淋病和梅毒与白人青年相比。综上所述，这些ATOD和SHR的差异突显了 迫切需要在人工智能青少年中同时针对ATOD和SHR的干预措施。当有一个 针对AIAN青年的ATOD-SRH预防需求的研究很少，总的来说，更少 近1/10的AIAN青年参加了183届奥运会，关于ATOD-SRH相关差异的信息 全国的部落日制或寄宿学校。为了解决这一危机和缺乏基于证据的计划 这项针对PAR-17-496的拟议研究涉及为期5年的RO1，以测试 切玛瓦转型之旅--本土青年健康领导计划的初步效果 (CHJ)是发现我们的故事干预的改编和扩展版本，2010年的SAMSHA- 确定了AIAN基于优势的综合物质使用和健康风险预防的最佳做法 AIAN青年健康领导计划。CJOT强调全面、积极的青年方法， 将讲故事与传统的原型和责任结合起来，作为一种过程和隐喻 引导AIAN青年进行行为改变。CJOT是一个以文化为中心的8周(10周)体验课程 会议)以学校为基础的积极的青年健康领导能力发展干预措施，以防止使用安非他明类兴奋剂和 AIAN青年(13-16岁)中的自发性高血压。该计划包括为期2个月的干预(3次个人会议+10次 会议)+5个促进会议，包括数字讲故事培训+1个社区活动(数字和口头 讲故事首映式)，目标是改变行为，相对讲故事，以及由年轻人领导的讲故事活动。

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.