Contextual Risk Factors for Substance Use in Adolescent Reservation-Dwelling Amer

描述(由申请者提供)：K08指导研究临床科学家发展奖的长期目标是扩大申请者的研究能力，将青少年保留地美洲印第安人(RDAI)物质的使用包括在内。拟议的培训和研究计划非常符合NIDA的战略计划，即促进与物质使用有关的健康差距的研究，并增加少数群体在物质使用研究中的代表性。候选人是一名美国印第安人，她之前的研究经验是在成人RDAI中与酒精使用相关的健康差距领域，涉及定量方法。尽管研究表明，RDAI青少年使用药物的风险更高，但我们对这种风险增加的原因知之甚少。在一组成人RDAI中，我们发现RDAI作为一个群体，与中产阶级高加索人相比，预计由于大量饮酒而获得一些基本补充剂(获得住房、就业等)的机会下降较少。由于成年人通常在青春期开始使用酒精和其他药物，因此研究不在青少年RDAI中使用的增强剂是一个高度公共卫生优先事项。本申请提出了指导、培训和监督研究的结构化计划，以提高候选人进行高质量研究的能力，将最先进的定性和定量方法结合在一起。这位K08将通过职业发展和研究计划实现这些目标。职业发展计划包括在测量发展、与物质使用有关的青少年发展、青少年印第安人物质使用研究、定性和高级定量方法方面的指导培训，以及将研究成果转化为治疗和预防发展的培训。布朗大学酒精和成瘾研究中心提供了一个智力刺激的环境，拥有出色的资源，以确保候选人成功实现培训计划。这位候选人组建了一个导师团队，每个人都是专家，在培训计划的特定领域以研究而闻名全国。Christopher Kahler博士(首席导师)是测量开发、高级定量方法和翻译研究方面的专家。Don OPARIO博士(共同导师)是以社区为基础的参与性研究的专家，专注于不同种族人群的健康差距，以及定性和定量混合方法的使用和实施。克里斯蒂娜·杰克逊博士(共同导师)是青少年发展和药物使用参与方面的专家。最后，保罗·斯派塞博士(共同导师)是美国印第安人成人和青少年研究方面的专家。该研究计划提出了三个阶段的计划，以测试青少年RDAI中使用药物的风险理论。第一阶段采用定性方法来确定和构建这一人群特有的因素--即社会/环境、文化和发展背景--的类型学，这些因素可能会加强所观察到的物质使用模式。在这些访谈的基础上，我们将制定第二阶段使用的这些增强剂的测量方法。第二阶段是根据第一阶段进行的定性访谈和焦点小组制定的测量方法的心理测量学评估。第三阶段是对这些因素与药物使用参与度之间的关联的横断面测试。候选人将写一份R01，以便跟踪这些人，纵向调查这些因素的作用。这一研究计划的结果有望最终为开发一种基于理论、发展和文化上合适的理论提供信息，以防止在这一人群中使用药物和与药物使用相关的危害。预计这一预防干预模式将针对物质使用的重要决定因素，这将在本建议的K奖和随后提交的R01中得到描述。总之，该奖项将为候选人提供开发独立创新研究计划所需的专业知识，该计划将产生有助于我们了解在这一高风险RDAI群体中使用药物的风险的结果，并为更有效的预防和干预计划提供信息。 公共卫生相关性：青少年RDAI开始使用物质的年龄较早，并且比非保守的美国印第安人和非美国印第安人青年使用更多的物质。该项目将有助于我们了解青少年参与药物滥用的风险过程，这将有助于：(A)了解哪些人滥用药物的风险最大，(B)制定有效的预防方案。

DESCRIPTION (provided by applicant): The long-term goal of the K08 Mentored Research Clinical Scientist Development Award is to expand the applicant's research capabilities to include adolescent Reservation-dwelling American Indian (RDAIs) substance use. The proposed training and research plan fit well with NIDA's strategic plan to promote research on health disparities related to substance use and to increase minority representation in substance use research. The candidate is an American Indian, and her prior research experiences have been in the area of health disparities related to alcohol use in adult RDAIs, involving quantitative methodologies. Although research shows that RDAI adolescents are at a higher risk for substance use, we know little about the reasons for this increased risk. In a group of adult RDAIs, we found that RDAIs as a group expected less of a drop in access to some basic reinforcers (access to housing, employment, etc) as a function of heavy drinking compared to middle class Caucasians. Because adults typically begin using alcohol and other drugs during adolescence, studying reinforcers for not using in adolescent RDAIs is a high public health priority. The present application proposes a structured program of mentoring, training, and supervised research to increase the candidate's capacity to conduct high-quality research blending state of the art qualitative and quantitative methodologies. This K08 will accomplish these objectives through the career development and research plans. The career development plan consists of mentored training in measurement development, adolescent development as it relates to substance use, adolescent American Indian substance use research, qualitative and advanced quantitative methods, and training in translating research findings to treatment and prevention development. The Brown University Center for Alcohol and Addiction Studies provides an intellectually stimulating environment with outstanding resources to ensure the successful achievement of the candidate's training plan. The candidate has assembled a team of mentors who are each experts and nationally known for their research in areas specific to the training plan. Dr. Christopher Kahler (primary mentor) is an expert in measurement development, advanced quantitative methods, and translational research. Dr. Don Operario (co- mentor) is an expert in community based participatory research focusing on health disparities in ethnically diverse populations, and in the use and implementation of mixed qualitative and quantitative methods. Dr. Kristina Jackson (co-mentor) is an expert in adolescent development and substance use involvement. Finally, Dr. Paul Spicer (co-mentor) is an expert in American Indian research with adults and adolescents. The research plan proposes a three phase plan to test a theory of risk for substance use in adolescent RDAIs. The first phase employs qualitative methods to identify and construct a typology of factors unique to this population - i.e., the social/environmental, cultural, and developmental context - that might reinforce observed patterns of substance use. Based on these interviews, we will develop a measure of these reinforcers to be used in Phase 2. Phase 2 is a psychometric evaluation of the measure that will be developed from the qualitative interviews and focus groups conducted in Phase 1. Phase 3 is a cross-sectional test of the association between these factors and substance use involvement. The candidate will write an R01 in order to follow these individuals to investigate the role of these factors longitudinally. Results of this program of research are expected to ultimately inform the development of a theoretically based, developmentally and culturally appropriate theory to prevent the use and harms associated with substance use in this population. It is anticipated that this prevention intervention model will target important determinants of substance use, which will be characterized in this proposed K-Award and subsequent R01 submission. In sum, this award will provide the candidate the necessary expertise to develop an independent innovative research program that will generate findings that will contribute to our understanding of risk for substance use in this high risk RDAI group and inform more effective prevention and intervention programs. PUBLIC HEALTH RELEVANCE: Adolescent RDAIs initiate substance use at an earlier age and use more substances that non-reservation American Indian and non-American Indian youth. This project will contribute to our understanding of the risk process for substance use involvement in adolescent RDAIs, which will have value for: (a) understanding which individuals are at greatest risk for substance abuse and (b) developing effective prevention programs.