Pilot evaluation of a Lakota-centered lifespan mentoring program to reduce alcohol related problems and promote holistic wellbeing

项目摘要 美国印第安人（AI）的酒精相关问题（ARPs）发生率不成比例地高，包括 危险的酒精使用（例如，重度强化或暴饮）和酒精相关后果（ARC; 健康、安全、法律的和社会问题，包括伤害和死亡）与任何其他种族/族裔相比 在美国，ARPs也阻碍了整体幸福感（HWB;心理、情感、身体和精神健康） 在AI人群中。人工智能人群中的ARPs通常是代际的;植根于社会和结构 条件;并与文化身份的丧失/缺乏、社会孤立以及健康应对和生活的缺陷有关 skills.尽管越来越多的人了解与AI人群ARPs相关的病因学因素， 一些文化上定制的（通常是表面水平的），主要是以个人为重点的预防和治疗方案 在人工智能中，评估人工智能开发的、以文化为中心的人工智能项目的研究有限。 关注基础因素（例如，创伤、损失、孤立）。一个非常有前途的方法 减少人工智能中的ARPs并促进整体福祉是一个以文化为中心的指导计划， 该计划由Lakota领导的非营利组织Oaye Luta Okolakiciye（OLO）开发并正在实施。 OLO指导计划旨在促进拉科塔文化认同，社会联系和健康的应对 并通过同伴支持、文化沉浸、传统治疗和技能培训来学习技能。尽管其强大的 在人工智能人群中减少ARPs和促进HWB的潜力，以文化为中心的OLO指导 该计划尚未得到正式评估。拟议的项目旨在弥补这一差距， 全功率R 01我们组建了一个由拉科塔利益相关者组成的跨学科团队（例如，传统 知识管理者、长者和拉科塔卫生专业人员）和高度成就的行动导向型 研究人员领导这项工作。目标1（过程评估）包括记录OLO指导计划 通过审查所有OLO文档（例如， 操作手册）（目标1a）、与OLO指导计划利益相关者的访谈（目标1b）以及指导- 通过每周跟踪日志进行学员计划参与（目标1c）。目标2（成果评价）测试 假设OLO指导计划将积极影响中介结果（即，拉科塔文化 身份、社会联系、健康生活和应对技能）（目标2a）。由于缺乏征聘一名 足够大的样本，关于主要结果的信息（即，减少HAU/ARC，戒酒， 和整体幸福感）将主要用于描述性目的，以提供更严格的R 01 设计（目标2b）。使用匹配的导师-学员的反应，我们将研究如何感知的指导 过程影响中间成果（目标2c）。最后，我们将探讨学员计划参与度 影响结果（目标2d）。为了完成这些目标，学员（n=50）将完成基线、 测试和六个月的项目后调查。导师（n=10）还将完成即时后测。

Project Summary American Indians (AIs) experience disproportionately high rates of alcohol-related problems (ARPs) including hazardous alcohol use (e.g., HAU; heavy intensive or binge drinking) and alcohol-related consequences (ARC; health, safety, legal, and social problems including injury and death) as compared to any other racial/ethnic groups in the U.S.ARPs also hinder holistic well-being (HWB; mental, emotional, physical, and spiritual health) among AI peoples. ARPs among AI peoples is often intergenerational; rooted in social and structural conditions; and related to loss/lack of cultural identity, social isolation, and deficits in healthy coping and life skills. Despite an increasing understanding of etiological factors related to ARPs for AI peoples and a growing number of culturally tailored (often surface level), mostly individually-focused programs to prevent and treat ARPs among AIs, there is limited research evaluating AI-developed, culturally centered programs for AI people that focus on foundational factors (e.g., trauma, loss, isolation) underlying ARPs. A highly promising approach to reduce ARPs among AIs and promote holistic well-being is a culturally centered mentoring program that has been developed and is currently being implemented by a Lakota-led nonprofit, Oaye Luta Okolakiciye (OLO). The OLO mentoring program seeks to foster Lakota cultural identity, social connectedness, and healthy coping and like skills through peer support, cultural immersion, traditional healing and skills training. Despite its strong potential for reducing ARPs and promoting HWB among AI people, the culturally centered OLO mentoring program has not been formally evaluated. The proposed project seeks to address this gap in preparation for a fully powered R01. We have assembled an interdisciplinary team of Lakota stakeholders (e.g., Traditional Knowledge Keepers, Elders, and Lakota health professionals) and highly accomplished action-oriented researchers to lead this work. Aim 1 (Process Evaluation) includes documenting the OLO mentoring program processes, strengths, challenges, acceptability and feasibility via a review of all OLO documentation (e.g., operating manuals) (Aim 1a), interviews with OLO mentoring program stakeholders (Aim 1b), and mentor- mentee program engagement via weekly tracking logs (Aim 1c). Aim 2 (Outcome Evaluation) tests the hypothesis that the OLO mentoring program will positively impact intermediary outcomes (i.e., Lakota cultural identity, social connectedness, healthy life and coping skills) (Aim 2a). Given the lack of feasibility to recruit a large enough sample, information about primary outcomes (i.e., reductions in HAU/ARC, alcohol abstinence, and holistic well-being) will be collected primarily for descriptive purposes to inform a more rigorous R01 design (Aim 2b). Using matched mentor-mentee responses, we will examine how perceptions of the mentoring process impact intermediary outcomes (Aim 2c). Finally, we will examine how mentee program engagement impacts outcomes (Aim 2d). To complete these aims, mentees (n=50) will complete baseline, immediate-post- test, and six-month post program surveys. Mentors (n=10) will also complete an immediate post-test.