A multiregional RCT of Parenting in 2 Worlds for Urban Indian Families

印度城市家庭在两个世界中养育子女的多区域随机对照试验

• 批准号: 10403206
• 负责人: Stephen S. Kulis
• 金额: $ 70.1万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10403206
• 关键词: Address; Adolescent; Adolescent Risk Behavior; Affect; Age; Alaska Native; American Indians; Area; Arizona; Buffaloes; Child; Child Rearing; Child Welfare; Cities; Communities; Cultural Diversity; Depression and Suicide; Educational Curriculum; Effectiveness; Effectiveness of Interventions; Face; Family; Family health status; Feeling suicidal; Foundations; Geography; Health; Health Services; Health behavior; Home environment; Income; Individual; Intervention; Knowledge; Lead; Link; Mediating; Mediation; Mental Depression; Mental Health; Midwestern United States; Modeling; Morbidity - disease rate; Nonprofit Organizations; Outcome; Parents; Participant; Population; Poverty; Prevention program; Process; Public Health; Randomized; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Research Personnel; Resistance; Resources; Risk; Risk Behaviors; Sexual Health; Sexually Transmitted Diseases; Site; Social Network; Social Work; Stress; Substance abuse problem; Suicide; Testing; Time Study; Underserved Population; United States National Institutes of Health; Unsafe Sex; Urban Health; Work; Youth; adolescent health; adolescent substance use; behavior influence; behavioral health; comparative effectiveness trial; cultural values; depressive symptoms; design; effectiveness testing; effectiveness trial; evidence base; experience; health disparity; high risk sexual behavior; improved; innovation; intervention delivery; intervention effect; medical services inaccessibility; migration; mortality; native youth; non-Native; parent-adolescent communication; prevent; preventive intervention; programs; recruit; resilience; service organization; skills; social; social determinants; socioeconomics; stressor; substance use; suicidal behavior; therapy design; tribal lands; urban Native American; urban area; urban underserved

Project Summary/Abstract A large and rapidly growing majority of American Indian/Alaska Native (AI) families now reside in urban areas. Although they experience severe health disparities associated with substance abuse, risky sexual behavior, depression and suicide, few evidence-based prevention interventions address their distinctive needs. Family disruption, stresses due to migration and poverty, and cultural and social losses are often implicated in adverse health outcomes for urban AI families. By improving effective parenting skills and overall family functioning, culturally grounded parenting interventions enable parents to model and promote their children's well-being and reduce their children’s vulnerability to risk behaviors. The proposed study extends the project team's prior research on a culturally grounded parenting intervention for urban AIs, Parenting in 2 Worlds (P2W), which was co-developed with a coalition of urban Indian non-profit organizations, tested in three Arizona cities, and demonstrated efficacious. The research team joins two AI and two non-AI investigators, who together have extensive experience conducting collaborative research with AI populations in urban and tribal settings. This proposed multi-regional study will create new knowledge in four areas. First, the study will test P2W’s effectiveness beyond Arizona in improving parenting and family functioning, among a wider and more diverse group of urban AI communities located in cities spread across four regions: Northeast (Buffalo/Niagara), Midwest (St. Paul/Minneapolis), Mountain (Denver), and Southwest (Phoenix). Through the auspices of collaborating urban Indian center partners, the trial will recruit 720 families of AI youth age 12-17 (180 per city) and individually randomize them to receive P2W or an informational family health curriculum. Second, the study will test for moderators of the effectiveness of P2W, whether desired outcomes vary by the level of socioeconomic vulnerability, experiences of historical loss, or AI cultural identity of the parent participants. Third, the study will expand on the original Arizona trial to examine the adolescent’s reports on family functioning and an enlarged range of youth health behaviors potentially impacted by the P2W intervention, including mental health (depressive symptoms, suicidality) as well as substance use and risky sexual behaviors. Fourth, the study will test for mediation—whether positive changes in parenting and family functioning that result from P2W lead to changes in the youth health behaviors. This would be the first cross- site multiregional trial of a culturally grounded parenting intervention designed specifically for urban AIs. It will advance critical knowledge on community prevention interventions for an under-served group severely affected by health disparities, and establish whether urban Indian centers and their communities can readily employ P2W to strengthen urban AI families and promote the behavioral health of their youth. It will also provide a foundation for advancing knowledge on effective prevention interventions in urban AI communities that have different migration histories and tribal compositions.

项目摘要/摘要 现在，大量且迅速增长的美洲印第安人/阿拉斯加本地人（AI）家庭现在居住在城市地区。 尽管他们经历了与药物滥用，风险性行为相关的严重健康分布，但 抑郁和自杀，很少有循证预防干预措施满足其独特的需求。家庭 破坏，由于移民和贫穷引起的压力以及在广告中经常实施文化和社会损失 城市AI家庭的健康成果。通过提高有效的育儿技能和整体家庭功能， 文化扎根的育儿干预措施使父母能够建模和促进孩子的幸福 并减少孩子对风险行为的脆弱性。拟议的研究扩展了项目团队的先验 研究城市AIS的文化扎根育儿干预措施，在两个世界中的育儿（P2W），这是 与印度城市非营利组织联盟共同开发，在三个亚利桑那州的城市进行了测试， 证明有效。研究小组加入了两个AI和两个非AI调查人员，他们共同 在城市和部落环境中与AI人群进行合作研究的丰富经验。这 拟议的多区域研究将在四个领域创造新知识。首先，该研究将测试P2W的 超越亚利桑那州改善育儿和家庭功能的有效性，在更广泛的潜水员中 位于城市的城市AI社区遍布四个地区：东北（布法罗/尼亚加拉）， 中西部（圣保罗/明尼阿波利斯），山（丹佛）和西南（凤凰城）。通过 该审判将合作于城市印度中心合作伙伴，将招募720个年轻人12-17岁（每个城市180）的家庭 并单独将它们随机接收以接受P2W或信息家庭健康课程。第二， 研究将测试P2W有效性的主持人，期望的结果是否因 社会经济脆弱性，历史损失的经历或父母参与者的AI文化认同。 第三，该研究将扩大亚利桑那州的原始试验，以检查青少年关于家庭的报告 功能和扩大的青年健康行为可能受到P2W干预的影响， 包括心理健康（抑郁症状，自杀）以及药物使用和危险性 行为。第四，该研究将测试调解 - 育儿和家庭的积极变化 P2W导致的功能会导致青年健康行为的变化。这将是第一个交叉 专门为城市AIS设计的文化基础育儿干预措施的现场多区域试验。会 对服务不足的群体的社区预防干预措施提出批判性知识严重影响 通过健康差异，并确定印度城市中心及其社区是否可以轻松雇用 P2W加强城市AI家庭并促进其年轻人的行为健康。它也将提供 促进有关有效预防干预措施的知识的基础 不同的迁移历史和部落组成。