Research Project 2

项目总结 问题物质使用(SU)在美洲印第安人和阿拉斯加原住民(AIAN)中是一种持续的流行病 社区，AIAN人经历了与SU相关的发病率和死亡率 种族/民族群体。然而，AIAN青年男性在很大程度上被苏预防科学忽视了。的确有 缺乏科学支持的预防策略，并专门为AIAN男性在危急时刻设计 当他们从青少年过渡到成年的时候。此外，目前没有制定预防方案。 旨在利用背景(例如，历史创伤和殖民)和文化优势来优化 有效性和可持续性。丰富的文化和传统做法对人工智能男性尤为重要，但这些 到目前为止，实践和世界观在很大程度上还没有得到开发。我们的团队在过去的两年里一直在适应和 试行共同要素治疗方法(CETA)--一种循证的跨诊断干预措施 这可以根据参与者的独特需求进行量身定做。拟议的研究是建立在这一记录的基础上的 将CETA用于土著预防科学，约翰夫妇之间35年以上的研究合作 霍普金斯土著健康中心(前美洲印第安人健康中心)和纳瓦霍民族， 以及CIH几十年来传播和推广循证干预措施的经验，这些干预措施现在已经 覆盖了150多个AIAN社区。由一组土著研究人员和盟军合作调查人员领导，以及 在与社区研究理事会的合作下，我们的团队将与两个农村纳瓦霍社区合作 为了改编CETA并测试这个改编版本HastóíBidziil(Strong Men)，通过以下随机对照试验 以下目标：目标1：为年轻的人工智能男子调整CETA和相关的执行战略 18-26岁，导致HastóíBidziil(壮汉)干预。假设：标准交付 CETA将要求对CETA的文化和性别特定交付进行修改，以实现最大限度的社区 冲击力。目的2：确定HastóíBidziil在N=160名AI男性(年龄)中降低SU的有效性 18-26)采用随机对照试验设计。假设：HastóíBidziil将减少年轻人的SU 成年男性参加了随机对照试验的干预组。目标3：探索调解人和 HastóíBidziil的主持人，在土著生态系统模型的指导下，告知精确度 实施的方法。假设：计划的有效性将由几个调节和 中介因素，将有助于告知如何最好地扩展、实施和定制计划(如果证明有效)。 该项目与Circle促进土著和盟国领导层、理解 SU的异质模式以进一步精确的公共卫生方法预防SU，并在此基础上 本土力量的源泉。我们的重点也与NIDA最近的资金优先事项保持一致，特别是 减少吸毒不平等现象。

PROJECT SUMMARY Problematic substance use (SU) is an ongoing epidemic across American Indian and Alaska Native (AIAN) communities, with AIAN people experiencing the highest rates of SU-related morbidity and mortality of any racial/ethnic group. However, AIAN young men have been largely neglected by SU prevention science. There is a lack of prevention strategies supported by science, and specifically designed for AIAN men during the critical time as they transition from adolescents to adulthood. Moreover, no current prevention programming has been designed to leverage contextual (e.g., historical trauma and colonization) and cultural strengths to optimize effectiveness and sustainability. Rich cultural and traditional practices are particularly vital for AI men, yet these practices and worldviews are largely untapped to date. Our team has spent the past two years adapting and piloting the Common Elements Treatment Approach (CETA), an evidence-based, transdiagnostic intervention that can be tailored to meet the unique needs of participants. The proposed study builds on this track record of adapting CETA for Indigenous prevention science, 35+ years of research collaboration between the Johns Hopkins Center for Indigenous Health (CIH; formerly Center for American Indian Health) and the Navajo Nation, and CIH's decades of experience disseminating and scaling evidence-based interventions that have now reached over 150+ AIAN communities. Led by a team of Indigenous researchers and allied co-investigators, and in collaboration with a Community Research Council, our team will collaborate with two rural Navajo communities to adapt CETA and test this adapted version, Hastóí Bidziil (Strong Men), in a randomized controlled trial through the following Aims: Aim 1: Adapt CETA and associated implementation strategies for young AI men, age 18-26 years, resulting in the Hastóí Bidziil (Strong Men) intervention. Hypothesis: Standard delivery of CETA will require modifications for cultural and gendered specific delivery of CETA for maximum community impact. Aim 2: Determine the effectiveness of Hastóí Bidziil for reducing SU among N=160 AI men (ages 18-26) using a randomized controlled trial design. Hypothesis: Hastóí Bidziil will reduce SU among young adult males enrolled in the intervention arm of the randomized controlled trial. Aim 3: Explore mediators and moderators of Hastóí Bidziil, guided by the Indigenist Ecological Systems Model, to inform a precision approach to implementation. Hypothesis: Program effectiveness will be driven by several moderating and mediating factors which will help inform how best to scale, implement, and tailor the program if proven effective. This project synergizes with CIRCLE's aims of advancing Indigenous and allied leadership, understanding heterogeneous patterns of SU to further a precision public health approach to SU prevention, and building on Indigenous sources of strength. Our focus also aligns with recent NIDA funding priorities particularly focused on reducing drug use inequities.