Developing and evaluating a culturally grounded Mother-Daughter intervention to promote protective factors and reduce early substance use among Apache girls

项目摘要 本研究，开发和评估一种基于文化的"母女"干预，以促进 保护因素，减少阿帕奇女孩的早期药物使用和相关的性风险， 解决了一个危险的上升，在早期的物质使用开始在美国印第安人（AI）女性通过一个 针对不同性别的文化驱动方法。国家和部落数据显示：1）女孩的物质使用正在迎头赶上 或超过男孩; 2）女孩使用药物的原因与男孩不同; 3）健康影响更多 对女孩有害; 4）保护因素的方法似乎比减少风险的战略更有效， AI社区本研究的主要目的是测试一种新颖的、基于文化的 利用母系文化资产加强保护和减少风险的母女干预 阿帕奇女孩过渡期早期物质使用和相关不安全性行为的因素 度过青春期有针对性的中介干预的变化是基于一个强大的线WMAT-JHU团队 研究，并包括：积极的产妇（母亲和其他女性照顾者）监测和参与， 母女沟通与女儿的积极文化认同、情绪调节、积极 同伴群体选择本研究的三个主要目的是：1）定性收集社区态度， 关于早期物质使用和性风险行为的保护性和风险因素的信念和实践， Apache女性通过30次深入访谈和10个焦点小组，或直到达到饱和，我们将 深入了解：与女孩积极的文化和社区发展有关的信念和做法 身份;文化、家庭和社区力量，促进女孩在青春期的积极转变; 女童与其母亲和其他成年女性照顾者之间保护关系的特点; 以及女孩使用药物和性冒险行为的其他决定因素。2)设计一个文化上 对8至11岁青春期前女孩及其母亲/女性进行接地"母女"干预 照顾者干预将由受过训练的Apache行为健康干预人员提供。第三章 评估干预的可行性、可接受性和初步有效性， 女儿二人组和相关的女性照顾者（即，祖母，阿姨）。这一建议高度 考虑到年轻人早期使用药物和性风险行为的威胁组合， 人工智能女孩对意外怀孕和不良行为健康结果的代际循环。研究 将应用强有力的证据表明，亲子策略可以防止青少年物质使用， 一种新型的母女干预的发展。如果研究目标得以实现，我们将产生一个性别- 基于阿帕奇文化和母系保护因素的特定代际干预，以减少早期 阿帕契族女孩中药物使用和相关危险性行为， 社区.

Project Summary This study, Developing and evaluating a culturally grounded “Mother-Daughter” intervention to promote protective factors and reduce early substance use and associated sexual risk among Apache girls, addresses a dangerous upturn in early substance use initiation among American Indian (AI) females through a gender-specific, culturally driven approach. National and tribal data show: 1) girls’ substance use is catching up or exceeding boys’; 2) girls use substances for different reasons than boys; 3) health effects are more deleterious for girls; and 4) protective factor approaches appear more effective than risk reduction strategies in AI communities. The primary goal of this research is to test the feasibility of a novel, culturally grounded mother-daughter intervention that taps matrilineal cultural assets to enhance protective and reduce risks factors for early substance use and associated unsafe sexual behaviors among Apache girls as they transition through puberty. Targeted mediators of intervention change are based on a strong line of WMAT-JHU team research, and include: positive maternal (mother and other female caregiver) monitoring and involvement, mother-daughter communication and daughter’s positive cultural identity, emotional regulation, and positive peer group selection. This study’s three primary aims are: 1) To qualitatively gather community attitudes, beliefs and practices about protective and risk factors for early substance use and sexual risk behaviors among Apache females. Through 30 in-depth interviews and 10 focus groups, or until saturation is reached, we will obtain insights on: beliefs and practices related to girls’ development of positive cultural and community identity; cultural, familial and community strengths that promote girls’ positive transition through puberty; characteristics of protective relationships between girls and their mothers and other adult female caregivers; and other determinants of girls’ substance use and sexual risk-taking behaviors. 2) To design a culturally grounded “mother-daughter” intervention for pre-pubescent girls ages 8 to 11 and their mothers/ female caregivers. The intervention will be delivered by trained Apache behavioral health interventionists. 3) To assess the feasibility, acceptability, and preliminary effectiveness of the intervention with n=40 mother- daughter dyads and associated female caregivers (i.e., grandmothers, aunties). This proposal is highly significant given the threatening combination of early substance use and sexual risk behaviors among young AI girls on intergenerational cycles of unintended pregnancy and poor behavioral health outcomes. The study will apply strong evidence that parent-child strategies can prevent adolescent substance use to the development of a novel mother-daughter intervention. If study aims are achieved, we will produce a gender- specific intergenerational intervention built on Apache cultural and matrilineal protective factors to reduce early substance use and related sexual risk behaviors among Apache girls, with import to other indigenous communities.