Development of a Culturally Grounded, Trauma-Informed Alcohol Intervention with a Reserve-Dwelling First Nation Group

对居住在保护区的原住民群体制定基于文化、针对创伤的酒精干预措施

• 批准号: 10443601
• 负责人: Nichea Solomon Spillane
• 金额: $ 21.06万
• 依托单位: UNIVERSITY OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-05 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10443601
• 关键词: AODR mortality; Address; Advocate; Alcohol abuse; Alcohol consumption; Alcohols; Assimilations; Belief; Canada; Clinical Trials; Collaborations; Communities; Coupled; Dancing; Data; Data Collection; Development; Elderly; Emotional; Ethnic group; Excision; Exclusion; Exhibits; Feedback; Generations; Genocides; Goals; Health; Heavy Drinking; Indigenous; Individual; Intervention; Intervention Trial; Knowledge; Language; Left; Manuals; Memory; Methods; Modeling; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Native-Born; New Brunswick; Outcome; Outcome Measure; Pain; Participant; Pattern; Personal Satisfaction; Persons; Plant Roots; Population; Procedures; Process Measure; Protocols documentation; Public Health; Randomized Controlled Trials; Recording of previous events; Recovery; Relapse; Research; Research Methodology; Research Personnel; Role; Sampling; Specific qualifier value; Strategic Planning; Testing; The Sun; Time; Training; Trauma; Treatment Efficacy; Vulnerable Populations; Waiting Lists; Work; Yang; acceptability and feasibility; alcohol abuse therapy; alcohol intervention; alcohol misuse prevention; alcohol related consequences; alcohol use disorder; base; binge drinking; community based participatory research; community living; comparison intervention; coping; coping mechanism; design; emotional distress; experience; healing; health disparity; improved; indigenous community; innovation; member; open label; programs; racial and ethnic; recruit; reduced alcohol use; reinforcer; response; stem; therapy design; therapy development; treatment guidelines

PROJECT SUMMARY/ABSTRACT Alcohol is one of the primary determinants of health disparity facing Indigenous populations today. Indigenous populations exhibit the highest rates of binge and heavy drinking, and lifetime (43.4%) and 12- month (19.2%) rates of alcohol use disorder are substantially higher than among other racial/ethnic groups. Further, Indigenous populations are significantly less likely to complete alcohol treatment; those that complete treatment are quicker to relapse and display more severe patterns of alcohol use. There is a paucity of empirically based interventions designed by and for Indigenous communities, which has led communities and research partners to rely on adaptations of existing empirically based interventions originally designed for non- Indigenous populations. Indigenous populations have increasingly advocated for health interventions to be culturally grounded. A culturally grounded approach involves close collaboration among communities and researchers in the design of intervention efforts rooted in Indigenous knowledge, protocols, and practices. This draws from cultural strengths, using Indigenous history, language, values, and healing traditions as a way for Indigenous populations to reclaim their cultural beliefs and practices. Research that applies a culturally grounded framework to address historical trauma in alcohol interventions is a critical next step to improving the health and well-being of Indigenous populations. Indigenous populations have faced histories of genocide, colonization, forced assimilation, and exclusion that undermine health and well-being. Historical trauma resulted in cultural shifts in alcohol use. Acts of oppression stemming from colonization such as the banning of traditional ways of healing left Indigenous people without mechanisms for coping with emotional distress. This coupled with the emotional aftereffects of historical trauma made Indigenous people vulnerable to developing maladaptive ways of coping. Indigenous populations began using alcohol as a way of self-medicating to escape or avoid traumatic memories and emotional pain associated with historical trauma. The objective of this project is to develop and obtain preliminary data on a culturally grounded, trauma- informed alcohol intervention. The specific aims are to (1) use Community-Based Participatory Research methods to deepen partnerships with Kingsclear First Nation through capacity-building and knowledge sharing; (2) collect and apply qualitative data to develop a culturally grounded, trauma-informed alcohol intervention that is focused on historical trauma for use with a First Nation sample; and (3) conduct a pilot RCT study to examine acceptability, sustainability, and initial efficacy data of the intervention compared to waitlist control. The research team (PIs: Spillane and Weiss; Co-I: Yang; Consultants: Gore and Moore) has expertise in the study content (e.g., alcohol use and historical trauma among Indigenous populations) and methods (e.g., intervention development, clinical trials). This work is important, timely, and innovative. Addressing alcohol use has important implications for the health of Indigenous populations.

项目概要/摘要 酒精是当今原住民面临的健康差异的主要决定因素之一。 土著居民的暴饮暴食率和终生酗酒率最高 (43.4%)，12- 酒精使用障碍的月发病率 (19.2%) 远高于其他种族/族裔群体。 此外，原住民完成酒精治疗的可能性明显较低；那些完成的 治疗后复发速度更快，并且表现出更严重的饮酒模式。有少量 由土著社区设计并为土著社区设计的基于经验的干预措施，引导社区和 研究伙伴依赖于现有的基于经验的干预措施的调整，这些干预措施最初是为非 土著居民。土著居民越来越主张采取健康干预措施 有文化基础。立足文化的方法涉及社区和社区之间的密切合作 研究人员设计植根于土著知识、协议和实践的干预措施。这 汲取文化优势，利用土著历史、语言、价值观和治疗传统作为治疗的方式 原住民恢复他们的文化信仰和习俗。应用文化的研究 解决酒精干预中的历史创伤的扎根框架是改善酒精干预的关键下一步 原住民的健康和福祉。原住民曾面临种族灭绝的历史， 殖民化、强迫同化和排斥损害了健康和福祉。历史创伤 导致饮酒文化的转变。源自殖民化的压迫行为，例如禁止 传统的治疗方法使土著人民没有应对情绪困扰的机制。这 再加上历史创伤的情感后遗症，使原住民很容易受到发展的影响。 适应不良的应对方式。原住民开始使用酒精作为自我治疗的方式 逃避或避免与历史创伤相关的创伤记忆和情感痛苦。 该项目的目标是开发并获取有关具有文化基础的创伤性研究的初步数据。 知情的酒精干预。具体目标是 (1) 使用基于社区的参与式研究 通过能力建设和知识共享深化与 Kingsclear 原住民伙伴关系的方法； (2) 收集并应用定性数据来制定基于文化、基于创伤的酒精干预措施 重点关注历史创伤，用于原住民样本； (3) 进行试点随机对照试验研究 与候补名单控制相比，检查干预措施的可接受性、可持续性和初始功效数据。 研究团队（PI：Spillane 和 Weiss；Co-I：Yang；顾问：Gore 和 Moore）拥有专业知识 研究内容（例如，原住民中的饮酒和历史创伤）和方法（例如， 干预开发、临床试验）。这项工作重要、及时且具有创新性。解决饮酒问题 对原住民的健康具有重要影响。