A Native Path to Courage

美洲原住民（NA）在生命早期患焦虑和抑郁的风险更大，其中10%至39%的NA 报告临床焦虑或抑郁水平的青年。这是考虑到潜在的负面影响， 这些条件在整个生命周期（物质使用，自杀）。现有的适应文化的预防和 早期干预（PEI）的焦虑和抑郁在NA青年是有限的。2例适用于风险 青年（例如，创伤）;一个普遍的PEI是无效的;社区利益攸关方担任顾问 没有青少年或家长参与;评价采用最低限度的混合方法。因此，有一个关键的 需要制定和评估符合文化的短期预防和早期干预措施 (PEI)使用CBPR方法，包括青年和父母， 混合方法评价我们的短期目标是为社区提供一个潜在的成功PEI 为了减轻洛基男孩青少年的焦虑和抑郁， 学校本研究的具体目标是：1）文化适应性指南针的勇气 （由我们的CAB选择）为NA青年; 2）评估文化适应的可行性和可接受性 COMPASS与NA Rocky Boy青年; 3）估计焦虑和抑郁的效应量变化 适应文化的COMPASS与NA青年的症状。我们建议建立在我们强大的 社区关系和CBPR方法来实现这些目标。我们将与CAB合作， 在CBPR框架内，在文化上适应1年级NA青年的COMPASS，包括Rocky Boy青年 和家长在第二年，我们将培训三名NA Rocky Boy提供者，并在30名学生中对改编后的PEI进行试点测试。 洛基男孩8至12岁的孩子在两所学校服务青年从保留在第二年和第三年。我们将 使用混合方法评估可行性和可接受性，包括主要利益相关者的焦点小组 （青少年、家长和教师），并估计焦虑和抑郁症状变化的效应量 采用前组后组设计。我们假设洛基男孩的年轻人会发现 指南针干预是可接受的，愉快的，文化上适当的，将有预先 干预后焦虑和抑郁症状的减少。我们的长期目标是继续完善 调整适应的COMPASS干预措施，并评估其有效性和可持续性。我们计划 提交R 01（临床试验），以响应FOA干预研究，以改善本地 美国健康（PAR-20-238）在第3年进行全面的临床试验，将根据我们的研究结果。

Native Americans (NA) are at greater risk for anxiety and depression early in life, with 10 to 39% of NA youth reporting clinical levels of anxiety or depression. This is concerning given potential negative effects of these conditions across the lifespan (substance use, suicide). Available culturally adapted prevention and early interventions (PEIs) for anxiety and depression in NA youth are limited. Two are indicated for at-risk youth (e.g., trauma); one universal PEI was not efficacious; community stakeholders served as consultants with no youth or parents involved; and evaluation used minimal mixed methods. Thus, there is a critical need for the development and evaluation of a culturally consonant, brief prevention and early intervention (PEI) for anxiety and depression in NA youth using a CBPR approach that includes youth and parents and mixed-method evaluation. Our short-term goal is to provide the community with a potentially successful PEI to mitigate Rocky Boy youths’ anxiety and depression that integrates culture and traditions for delivery in schools. The Specific Aims of the proposed research are to: 1) culturally adapt COMPASS for Courage (chosen by our CAB) for NA youth; 2) evaluate the feasibility and acceptability of the culturally adapted COMPASS with NA Rocky Boy youth; and 3) estimate effect size changes in anxiety and depressive symptoms of the culturally adapted COMPASS with NA youth. We propose to build upon our strong community relationships and CBPR methods to achieve these aims. We will partner with the CAB to culturally adapt COMPASS for NA youth in Year 1 within a CBPR framework, including Rocky Boy youth and parents. In Year 2, we will train three NA Rocky Boy providers and pilot-test the adapted PEI among 30 Rocky Boy 8- to 12-year-olds in two schools serving youth from the reservation in Years 2 and 3. We will evaluate feasibility and acceptability using mixed methods, including focus groups of key stakeholders (youth, parents, and teachers), and estimate effect sizes of changes in anxiety and depressive symptoms using a pre-post, single-group design. We hypothesize that Rocky Boy youth will find the adapted COMPASS intervention to be acceptable, enjoyable, and culturally appropriate and there will be pre- to post-intervention reductions in anxiety and depressive symptoms. Our long-term goal is to continue refining and tailoring the adapted COMPASS intervention and evaluate its efficacy and sustainability. We plan to submit an R01 (Clinical Trial) in response to the FOA Intervention Research to Improve Native American Health (PAR-20-238) in Year 3 for a full-scale clinical trial that will be informed by our findings.