Preventing Alcohol Exposed Pregnancy among Urban Native Young Women: Mobile CHOICES

胎儿酒精谱系障碍（FASD）导致神经发育缺陷和终身残疾;它们是 这是美国可预防的出生缺陷的主要原因。根据疾病预防控制中心的数据， 育龄期饮酒且未采取有效避孕措施的人有酒精暴露风险。 妊娠（AEP）可能导致FASD。根据这个定义，美国印第安人和阿拉斯加原住民（AIAN）年轻人 女性尤其容易受到AEP的影响，因为她们的饮酒量和性风险都很高 与其他种族/族裔群体的同行相比。尽管估计72%的AIAN年轻女性 生活在城市地区，很少有研究包括他们;城市AIAN需求往往被忽视的研究 旨在开发、实施和评估文化上适当的服务。最近的研究表明 移动的健康干预措施可能提供一种有前途的机制， 对难以接触到的人群进行干预。该项目的目标是将覆盖面和服务扩大到城市， AIAN年轻女性通过移动健康技术预防AEP和FASD。拟议项目建立在 之前NIAAA资助的项目，使用密集的基于社区的参与性研究（CBPR）方法， 适应选择，由疾病预防控制中心支持的基于证据的简短AEP干预，以美国印第安青年 选择（AIY-C）。AIY-C包含的功能使其非常适合移动健康方法，包括 整合不同文化教学的框架，短期的几个模块和具体的机会 目标设定和成就。针对这一群体的创新计划是， 通过社交媒体在美国的主要城市地区，并通过移动的设备提供AIY-C， 在青少年中普遍存在。虽然社交媒体招聘和移动医疗干预并不新鲜， 直到最近，它们才被用于AIAN人群。我们将与城市AIAN组织合作 通过社交媒体招聘策略、移动健康干预措施的翻译和实施， 和评估在城市AIAN设置。我们提出了三个具体目标：（1）发展和试点基于社交媒体的 为城市AIAN年轻女性制定招聘战略;（2）通过一个 迭代和理论驱动的过程，并试点已制定的移动健康AIY-C干预措施;以及 (3)使用确定的社交媒体策略招募700名（最终N=525）城市AIAN年轻女性， RCT严格评估移动健康翻译AIY-C预防AEP的有效性， FASD。拟议的项目承诺广泛接触AIAN的年轻妇女，以解决重大的，但 可预防的公共卫生问题- AEP和FASD;重要的是，该项目还承诺推进 预防干预研究的蓝图与城市AIAN人口在很大程度上被忽视了。

Fetal Alcohol Spectrum Disorders (FASD) result in neurodevelopmental deficits and lifelong disability; they are a leading cause of preventable birth defects in the U.S. According to the CDC, any sexually active woman of reproductive age who drinks alcohol and does not use effective contraception is at risk for an alcohol exposed pregnancy (AEP) that could cause FASD. By this definition, American Indian and Alaska Native (AIAN) young women are especially vulnerable to AEP, with high levels of alcohol consumption and sexual risk taking compared to their counterparts in other race/ethnic groups. Although an estimated 72% of AIAN young women live in urban areas, very little research has yet included them; urban AIAN needs are often ignored in research aimed at developing, implementing, and evaluating culturally appropriate services. Recent research indicates that mobile health (mHealth) interventions may offer a promising mechanism for delivering effective interventions to hard-to-reach populations. The goal of this project is to expand reach and services to urban AIAN young women through mHealth technology to prevent AEP and FASD. The proposed project builds on a prior NIAAA-funded project which used intensive community-based participatory research (CBPR) methods to adapt CHOICES, an evidence-based brief AEP intervention supported by the CDC, to American Indian Youth CHOICES (AIY-C). AIY-C contains features that make it highly amenable to mHealth approaches, including a framework for integrating diverse cultural teachings, few modules of short duration, and concrete opportunities for goal-setting and achievement. Innovative for this population is the plan to recruit young AIAN women from major urban areas in the US through social media—and to deliver AIY-C via mobile devices, increasingly ubiquitous among AIAN young adults. While social media recruitment and mHealth interventions are not new, only very recently have they been used with AIAN populations. We will partner with urban AIAN organizations to guide us through social media recruitment strategies, mHealth intervention translation and implementation, and evaluation in urban AIAN settings. We propose 3 specific aims: (1) Develop and pilot social-media-based recruitment strategies for urban AIAN young women; (2) translate AIY-C for mHealth delivery through an iterative and theoretically driven process and pilot the developed translated mHealth AIY-C intervention; and (3) recruit 700 (final N=525) urban AIAN young women using identified social media strategies, and conduct an RCT to rigorously evaluate the effectiveness of the mHealth translation of AIY-C for preventing AEP and FASD. The proposed project promises expansive reach to AIAN young women to address significant yet preventable public health concerns – AEP and FASD; importantly, the project also promises to advance a blueprint for preventive intervention research with urban AIAN populations largely ignored to date.