Development and Implementation of a Culturally Centered Opioid Prevention Intervention for American Indian/Alaska Native Young Adults in California

为加利福尼亚州美洲印第安人/阿拉斯加原住民年轻人制定和实施以文化为中心的阿片类药物预防干预措施

• 批准号: 10224983
• 负责人: ELIZABETH J. D'AMICO
• 金额: $ 36.16万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224983
• 关键词: 18 year old; Address; Adolescent and Young Adult; Adult; Affect; Age; Alaska Native; American Indians; California; Cessation of life; Communities; Data; Development; Diagnosis; Dose; Drug usage; Education; Educational workshop; Elderly; Emotional; Ensure; Evidence based treatment; Focus Groups; Hour; Individual; Intervention; Interview; Knowledge; Link; Marijuana; Mediation; Native Americans; Neurologic; Opioid; Outcome; Overdose; Parents; Peer Pressure; Personal Satisfaction; Pharmaceutical Preparations; Phase; Play; Population; Prevalence; Prevention program; Preventive Intervention; Program Acceptability; Provider; Public Health; Randomized Controlled Trials; Risk; Risk Behaviors; Role; Scientific Advances and Accomplishments; Social Environment; Social Network; Spirituality; Technology; Teenagers; Testing; Time; United States; Visualization; Vulnerable Populations; Work; Youth; alcohol and other drug; clinical practice; clinically significant; cost effectiveness; economic evaluation; effectiveness evaluation; emerging adult; experience; hedonic; heroin use; informant; innovation; intervention program; motivational enhancement therapy; multidisciplinary; native youth; opioid misuse; opioid overdose; opioid use; opioid use disorder; peer; prescription opioid; prescription opioid misuse; prevent; programs; psychologic; recruit; response; social; urban Native American; urban area; young adult

Summary/Abstract Data from 2015 show that American Indian/Alaska Natives (AI/AN) have the highest rates of diagnosis for opioid use disorders (OUD) and deaths from drug overdose. Of particular concern is the prevalence rate of opioid use among emerging adults (ages 18–25) as this is a developmental period of heightened vulnerability and critical social, neurological, and psychological development. This proposal responds to RFA-DA-19-035, HEAL initiative: Preventing OUD in Older Adolescents and Young Adults (ages 16-30) by developing and implementing a culturally-centered intervention to address opioid misuse among urban AI/AN emerging adults (EAs) in California: POMANAYA (Preventing Opioid Misuse Among Native American Young Adults). This proposal builds on our previous work over the past decade working closely with urban AI/AN communities across California to develop culturally-appropriate programming to address alcohol and other drug (AOD) use. The proposed project also builds off our team’s work identifying how social networks affect risk behaviors among vulnerable populations. We propose a multi-tiered intervention approach that will include intervening at the individual level (POMANAYA) and at the community level: wellness gatherings (WG). For the UG3 Phase, we plan to conduct focus groups with EAs, parents of EAs, AI/AN providers, and our Elder Advisory Board in urban communities throughout California to understand how to a) best identify, reach, and engage AI/AN EAs to access programming addressing opioid use, b) adapt and enhance our existing culturally-sensitive prevention intervention program, Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY), for AI/AN EAs to address social network factors that amplify (or reduce) opioid and AOD use risk, and c) pilot test POMANAYA to ensure feasibility and acceptability of the program. For the UH3 phase, our aims are to 1) Compare AI/AN EAs who receive POMANAYA+WG (n=185) to AI/AN EAs who receive opioid education (n=185) on outcomes at 3, 6, and 12 months, 2) explore potential mechanisms of change for decreases in opioid and AOD use outcomes through mediation analyses, focusing on changes in social networks and cultural connectedness, 3) develop and test strategies to facilitate sustainability of POMANAYA within these communities through key informant interviews and focus groups, and 4) conduct an economic evaluation to quantify programmatic costs and cost-effectiveness of the multi-tiered intervention approach, relative to opioid education. Results from this study could significantly advance scientific knowledge and clinical practice for AI/AN emerging adults.

摘要/摘要 2015年的数据表明，美洲印第安人/阿拉斯加本地人（AI/AN）的阿片类药物诊断率最高 使用疾病（OUD）和药物过量死亡。特别关注的是阿片类药物使用的患病率 在新兴的成年人中（18-25岁），因为这是一个增强脆弱性和关键的发展时期 社会，神经和心理发展。此提案对RFA-DA-19-035的反应，治愈 主动性：通过发展和 实施以文化为中心的干预措施来解决Urban AI/新兴成年人中的阿片类药物的失误 （EAS）在加利福尼亚：Pomanaya（预防美国原住民年轻人的阿片类药物滥用）。这 提案建立在过去十年来与城市AI/A A/A社区紧密合作的以前的工作的基础 在整个加利福尼亚州，开发具有文化的适当节目，以解决酒精和其他药物（AOD）的使用。 拟议的项目还建立了我们团队的工作，确定社交网络如何影响风险行为 脆弱的人群。我们提出了一种多层干预方法，其中将包括干预 个人级别（Pomanaya）和社区层面：健康聚会（WG）。对于UG3阶段，我们 计划与EA，EA/AI/A A A/A AN提供商的父母和Urban的老年顾问委员会进行焦点小组 整个加利福尼亚州的社区了解如何）最好识别，接触和参与AI/A EAS访问 解决阿片类药物使用的编程，b）适应和增强我们现有的文化敏感预防 干预计划，美国原住民青年（Micunay）的动机访谈和文化， 为了解决AI/A EA，以解决扩大（或减少）阿片类药物和AOD使用风险的社交网络因素，c）飞行员 测试Pomanaya，以确保该计划的可行性和可接受性。对于UH3阶段，我们的目标是1） 将接受Pomanaya+WG（n = 185）的AI/A EA与接受阿片类药物教育的AI/A EA（n = 185）进行比较 关于3、6和12个月的结果，2）探索阿片类药物和AOD下降的变化的潜在机制 通过调解分析来使用结果，专注于社交网络和文化联系的变化， 3）制定和测试策略，通过关键在这些社区中促进Pomanaya的可持续性 线人访谈和焦点小组，以及4）进行经济评估以量化程序成本 相对于阿片类药物教育，多层干预方法的成本效益。结果 研究可以显着提高AI/A/A新兴成年人的科学知识和临床实践。