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

描述（由申请人提供）：K08指导研究临床科学家发展奖的长期目标是扩大申请人的研究能力，包括青少年保留地居住的美国印第安人（RDAIs）物质使用。拟议的培训和研究计划非常符合国家药物开发协会促进与药物使用有关的健康差异研究和增加少数民族参与药物使用研究的战略计划。该候选人是一名美洲印第安人，她以前的研究经验是在成人RDAIs中与酒精使用有关的健康差异领域，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。在一组成年rdai中，我们发现，与中产阶级高加索人相比，rdai作为一个群体，在获得一些基本强化物（获得住房、就业等）方面的预期下降较少。由于成年人通常在青春期开始使用酒精和其他药物，因此研究在青少年RDAIs中不使用的强化物是一项高度优先的公共卫生工作。本申请提出了一个结构化的指导、培训和监督研究计划，以提高候选人进行高质量研究的能力，融合了最先进的定性和定量方法。本K08将通过职业发展和研究计划来实现这些目标。职业发展计划包括下列方面的指导培训：测量发展、与药物使用有关的青少年发展、青少年美洲印第安人药物使用研究、定性和先进定量方法，以及将研究成果转化为治疗和预防发展方面的培训。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和优秀的资源，以确保候选人的培训计划的成功实现。候选人已经组建了一个导师团队，他们都是专家，在培训计划的特定领域有全国知名的研究。Christopher Kahler博士（主要导师）是测量发展、先进定量方法和转化研究方面的专家。Don Operario博士（共同导师）是以社区为基础的参与性研究专家，重点关注不同种族人群的健康差异，以及混合定性和定量方法的使用和实施。Kristina Jackson博士（共同导师）是青少年发展和药物使用方面的专家。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。该研究计划提出了一个三个阶段的计划，以测试青少年rdai药物使用风险理论。第一阶段采用定性方法确定和构建这一人群特有的因素类型- -即社会/环境、文化和发展背景- -这些因素可能会加强观察到的物质使用模式。在这些访谈的基础上，我们将制定一套用于第二阶段的强化措施。第二阶段是对该措施的心理测量学评估，将从第一阶段进行的定性访谈和焦点小组发展而来。第三阶段是对这些因素与药物使用之间关系的横断面检验。候选人将写一个R01，以便跟踪这些个体，纵向调查这些因素的作用。预计这一研究项目的结果将最终为理论基础、发展和文化上适当的理论的发展提供信息，以防止这一人群中物质使用和与物质使用相关的危害。预计这种预防干预模式将针对物质使用的重要决定因素，这将在拟议的k奖和随后的R01提交中体现出来。总而言之，该奖项将为候选人提供必要的专业知识，以开发独立的创新研究计划，该计划将产生有助于我们了解这一高风险RDAI群体中物质使用风险的发现，并为更有效的预防和干预计划提供信息。

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.