Discovering Our Story, to develop the Chemawa Journey of Transformation

发现我们的故事，发展 Chemawa 转型之旅

• 批准号: 10573319
• 负责人: Teresa A Evans-Campbell
• 金额: $ 63.79万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10573319
• 关键词: Address; Affect; African American population; Age; Age Years; Alaska Native; Alcohol consumption; Alcohols; American Indians; Behavioral; Chlamydia; Coitus; Collaborations; Communities; Data; Disparity; Drug usage; Elderly; Epidemic; Ethnic Origin; Event; Evidence based program; Family; Future Generations; General Population; Gonorrhea; HIV; Health; Heart; High Prevalence; High School Student; Indigenous; Individual; Intervention; Lead; Leadership; Marijuana; Mediating; Metaphor; Methods; Modeling; Motivation; Native-Born; Opioid; Oral; Pain; Pathway interactions; Pattern; Pharmaceutical Preparations; Population; Population Programs; Poverty; Predisposition; Prevention; Primary Prevention; Process; Public Health; Quasi-experiment; Race; Randomized; Recording of previous events; Reproductive Health; Research; Research Infrastructure; Research Personnel; Risk; Risk Factors; Risk Reduction; Safe Sex; Schools; Self Efficacy; Sexual Health; Sexually Transmitted Diseases; Stress and Coping; Students; Substance abuse problem; Sustainable Development; Syphilis; Teenagers; Testing; Tobacco; Tobacco use; Training; Tribal School; Tribes; United States; Universities; Unsafe Sex; Waiting Lists; Washington; Youth; alcohol prevention; alcohol use initiation; behavior change; community based participatory research; cost; cost effective; digital; experience; health disparity; heroin use; high school; intervention effect; leadership development; multidisciplinary; native youth; opioid misuse; peer; positive youth development; programs; response; sex; sexual risk behavior; skills; smoking prevalence; social; stem; substance use; substance use prevention; syndemic; therapy development

Substance use and sexual health risk are increasingly prevalent, costly, and deadly -- fueling a synergistic epidemic in the United States (US) that disproportionately affects American Indian and Alaska Native (AIAN) communities. AIAN youth are at the heart of the AIAN health crisis. AIAN youth are disproportionately affected by many of these historical, structural, social, and behavioral factors that contribute to significant health disparities including high alcohol, tobacco, opiate and other drug (ATOD) use and sexual and reproductive health risks (SRH; ATOD-SHR). The overall mean age of tobacco use, alcohol use, and marijuana initiation for AIANs is much younger (11.5 years) than the general population, with AIAN youth having the highest prevalence of smoking and the earliest age of first use of ATOD. Alarmingly, more that 20% of Native high school students who used a prescription pain med without a prescription also used heroin in the past 30 days. Substance use is one of the most significant risk factors for unprotected sex and AIAN youth have the earliest age of first sexual intercourse. AIANs under 25 years of age have three times the rate of chlamydia, gonorrhea, and syphilis compared to White youth. Taken together, these ATOD-SHR disparities underscore the urgent need for interventions that simultaneously target ATOD and SHR among AI teens. While there is a paucity of research addressing the ATOD-SRH prevention needs of AIAN youth in general, there is even less information available on ATOD-SRH-related disparities for the nearly 1 out of 10 AIAN youth attending the 183 tribal day or boarding schools nationwide. To address this crisis and the dearth of evidence-based programs for this population, the proposed study, prepared in response to PAR-17-496, involves a 5-year RO1 to test the preliminary efficacy of the Chemawa Journey of Transformation–Native Youth Health Leadership Program (CHJ) which is an adapted and expanded version of the Discovering Our Story intervention, a 2010 SAMSHA- identified best practice AIAN strengths-based comprehensive substance use and health risk prevention and health leadership program for AIAN youth. The CJOT emphasizes a holistic, positive youth approach that incorporates storytelling with traditional archetypes and responsibilities as both a process and metaphor for guiding AIAN youth through behavioral change. The CJOT is a culturally-centered experiential 8-week (10 sessions) school-based positive youth health leadership development intervention to prevent ATOD use and SHR among AIAN youth (ages 13-16). The program involves a 2-month intervention (3 individual sessions + 10 sessions) + 5 booster sessions including digital storytelling training + 1 community event (digital and oral storytelling premiere) that targets behavior change relative storytelling and a youth-led storytelling event.

物质使用和性健康风险越来越普遍，昂贵和致命-助长了协同效应。 美国（US）的一种流行病，不成比例地影响美洲印第安人和阿拉斯加原住民（AIAN） 社区. AIAN青年处于AIAN健康危机的核心。AIAN青年 不成比例地受到许多这些历史，结构，社会和行为因素的影响， 严重的健康差异，包括酗酒、吸烟、鸦片和其他药物的使用以及性行为 和生殖健康风险（SRH; ATOD-SHR）。吸烟、饮酒和吸烟的总体平均年龄 AIAN的大麻启蒙比一般人群年轻得多（11.5岁），AIAN青年 吸烟率最高，首次使用ATOD的年龄最早。令人震惊的是，超过20%的 在没有处方的情况下使用处方止痛药的本地高中生中， 过去30天。药物使用是无保护性行为的最重要风险因素之一， 第一次性交的最早年龄。25岁以下的AIAN衣原体感染率是其他人的三倍， 淋病和梅毒相比，白色青年。总的来说，这些ATOD-SHR差异强调了 迫切需要同时针对AI青少年中的ATOD和SHR进行干预。虽然有一个 由于缺乏研究来解决一般AIAN青年的ATOD-SRH预防需求， 关于参加183届全国艾滋病毒/艾滋病联合会的近十分之一的青少年中与ATOD-SRH有关的差距的现有资料 部落日校或寄宿学校为了解决这一危机和缺乏基于证据的计划， 针对PAR-17-496，拟定的研究涉及5年RO 1，以测试 Chemawa转型之旅-土著青年健康领导计划的初步效果 (CHJ)这是2010年SAMSHA“发现我们的故事”干预措施的改编和扩展版本- 已确定的最佳做法AIAN基于优势的全面药物使用和健康风险预防， AIAN青年健康领导方案。CJOT强调全面、积极的青年方法， 将讲故事与传统的原型和责任结合起来，作为一个过程和隐喻， 通过行为改变引导AIAN青年。CJOT是一个以文化为中心的体验式8周（10 以学校为基础的积极的青年健康领导力发展干预，以防止ATOD的使用， AIAN青年（13-16岁）的SHR。该计划包括为期2个月的干预（3个单独的会议+10 会议）+ 5次助推会议，包括数字讲故事培训+ 1次社区活动（数字和口头 讲故事首映），目标是改变行为相对讲故事和青年主导的讲故事活动。