Development and Implementation of a Culturally Centered Opioid Prevention Intervention for American Indian/Alaska Native Young Adults in California

为加利福尼亚州美洲印第安人/阿拉斯加原住民年轻人制定和实施以文化为中心的阿片类药物预防干预措施

• 批准号: 10475980
• 负责人: ELIZABETH J. D'AMICO
• 金额: $ 18.49万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10475980
• 关键词: 18 year old; Address; Adolescent and Young Adult; Adult; Affect; Age; Alaska Native; American Indians; California; Cessation of life; Communities; Data; Development; Diagnosis; Dose; Drug usage; Education; Educational workshop; Elderly; Emotional; Ensure; Evidence based treatment; Focus Groups; Helping to End Addiction Long-term; Hour; Individual; Intervention; Interview; Knowledge; Link; Marijuana; Mediation; Native Americans; Neurologic; Opioid; Outcome; Overdose; Parents; Peer Pressure; Personal Satisfaction; Pharmaceutical Preparations; Phase; Play; Population; Prevalence; Prevention program; Program Acceptability; Provider; Public Health; Randomized Controlled Trials; Risk; Risk Behaviors; Role; Scientific Advances and Accomplishments; Social Environment; Social Network; Spirituality; Technology; Teenagers; Testing; Time; United States; Urban Community; Visualization; Vulnerable Populations; Work; Youth; acceptability and feasibility; alcohol and other drug; clinical practice; clinically significant; cost effectiveness; economic evaluation; effectiveness evaluation; emerging adult; experience; hedonic; heroin use; informant; innovation; intervention program; motivational enhancement therapy; multidisciplinary; native youth; opioid misuse; opioid overdose; opioid use; opioid use disorder; peer; prescription opioid; prescription opioid misuse; prevent; preventive intervention; programs; psychologic; recruit; response; social; urban Native American; urban area; young adult

Summary/Abstract Data from 2015 show that American Indian/Alaska Natives (AI/AN) have the highest rates of diagnosis for opioid use disorders (OUD) and deaths from drug overdose. Of particular concern is the prevalence rate of opioid use among emerging adults (ages 18–25) as this is a developmental period of heightened vulnerability and critical social, neurological, and psychological development. This proposal responds to RFA-DA-19-035, HEAL initiative: Preventing OUD in Older Adolescents and Young Adults (ages 16-30) by developing and implementing a culturally-centered intervention to address opioid misuse among urban AI/AN emerging adults (EAs) in California: POMANAYA (Preventing Opioid Misuse Among Native American Young Adults). This proposal builds on our previous work over the past decade working closely with urban AI/AN communities across California to develop culturally-appropriate programming to address alcohol and other drug (AOD) use. The proposed project also builds off our team’s work identifying how social networks affect risk behaviors among vulnerable populations. We propose a multi-tiered intervention approach that will include intervening at the individual level (POMANAYA) and at the community level: wellness gatherings (WG). For the UG3 Phase, we plan to conduct focus groups with EAs, parents of EAs, AI/AN providers, and our Elder Advisory Board in urban communities throughout California to understand how to a) best identify, reach, and engage AI/AN EAs to access programming addressing opioid use, b) adapt and enhance our existing culturally-sensitive prevention intervention program, Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY), for AI/AN EAs to address social network factors that amplify (or reduce) opioid and AOD use risk, and c) pilot test POMANAYA to ensure feasibility and acceptability of the program. For the UH3 phase, our aims are to 1) Compare AI/AN EAs who receive POMANAYA+WG (n=185) to AI/AN EAs who receive opioid education (n=185) on outcomes at 3, 6, and 12 months, 2) explore potential mechanisms of change for decreases in opioid and AOD use outcomes through mediation analyses, focusing on changes in social networks and cultural connectedness, 3) develop and test strategies to facilitate sustainability of POMANAYA within these communities through key informant interviews and focus groups, and 4) conduct an economic evaluation to quantify programmatic costs and cost-effectiveness of the multi-tiered intervention approach, relative to opioid education. Results from this study could significantly advance scientific knowledge and clinical practice for AI/AN emerging adults.

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