Talking Circle for Native American Youth Living Well (A Yo Li)

摘要/综述美国原住民中持续的心理健康危机异常突出 高比例的精神、情绪和行为健康障碍，如焦虑、压力、抑郁、物质 使用新冠肺炎，并在10岁的美洲原住民青年中自杀。微博对老年人的毒力已经打击 美洲原住民社区尤其艰难，部落长老和说原住民的人的流失使 对美洲原住民老一辈人流传下来的语言和传统的文化纽带造成了无法估量的损失 为年轻人干杯。新冠肺炎的流行加剧了各个年龄段的美洲原住民的痛苦， 世卫组织报告的一些心理苦恼发生率最高，包括抑郁、焦虑、生活 压力源、物质使用(酒精、毒品、商业烟草使用)和自杀早在大流行之前很久。这个 新冠肺炎对美洲原住民社区的破坏，再加上最近和长期的 种族主义和针对美洲原住民的罪行对原住民的心理健康产生了令人震惊的影响 美国青年。即使在大流行之前，美国原住民年龄段年轻人的自杀死亡人数 15比19的比例是非西班牙裔白人的两倍多。对于一些美洲原住民社区来说，自杀是 是10-14岁青少年的主要死因。此外，美洲原住民青年开始饮酒，其他 较年轻(约11岁)的物质和商业烟草，其比率高于所有其他 种族群体。对于一个已经在苦苦挣扎的人来说，新冠肺炎的大流行是灾难性的，增加了 美国原住民青年自杀和其他精神健康障碍的风险已经很高。因此，干预措施 改善美洲原住民青年的心理、情感和行为健康状况是当务之急。至 满足这一迫切需求，我们的首要目标是利用经验证明的、高度有效的学校 以谈话圈为基础的干预，以促进地理上的心理、情感和行为健康 多样化的(乡村和城市)美洲原住民青年。这项名为《美洲原住民青年生活的谈话圈》的研究 《Well(A Yo Li)》使用基于社区的参与性研究(CBPR)方法来评估谈话圈 有效性，与俄克拉荷马州切诺基部落的联合基托瓦乐队(UKB)合作，与 成员生活在两个地理位置不同的地区，农村和城市。UKB部落语言中的“A YO Li” 意思是“青春”。Talking Circle干预将作为一项课后计划在每个 参与的学校。课外项目是开展Talking Circle干预活动的理想场所。课外活动 在许多美洲原住民社区，家长、学生和老师都更喜欢这些项目，因为他们 在正常上课时间以外为青年提供有系统的教育机会和活动，同时 父母/监护人仍然忙于工作或其他责任。基于我们UKB部落的偏好 伙伴，以及伦理方面的考虑，所有的学生最终都会受到干预，从而控制 条件是等待列表-控制。

Abstract/Summary The ongoing mental health crisis among Native Americans manifests in extraordinarily high rates mental, emotional, and behavioral health disorders such as anxiety, stress, depression, substance use, and suicide in Native American youth as young as 10. The virulence of COVID-19 for older people has hit Native American communities particularly hard, and the loss of Tribal Elders and Native speakers has taken an incalculable toll on the cultural ties of language and tradition that flow from Elder Native American generations to the young. The COVID-19 pandemic has exacerbated the suffering of Native American people of all ages, who reported some of the highest rates of psychological distress that include depression, anxiety, life stressors, substance use (alcohol, drugs, commercial tobacco use), and suicide long before the pandemic. The devastation of Native American communities from COVID-19, coupled with both a recent and long history of racism and crimes against Native American people, has had an alarming effect on the mental health of Native American youth. Even before the pandemic, suicide fatalities for Native American youth between the ages of 15–19 was more than double that of non-Hispanic whites. For some Native American communities, suicide is the leading cause of death for youth ages 10-14. Moreover, Native American youth begin to use alcohol, other substances and commercial tobacco at younger ages (around the age of 11), and at higher rates, than all other ethnic groups. For a population already struggling, the COVID-19 pandemic is calamitous, increasing the already high risk for suicide and other mental health disorders of Native American youth. Thus, interventions to improve Native American youth mental, emotional, and behavioral health outcomes are urgently needed. To meet this urgent need, our overarching objective is to leverage the empirically proven, highly effective, school based, Talking Circle Intervention to promote the mental, emotional, and behavioral health of geographically diverse (rural vs. urban) Native American youth. This study, “Talking Circle for Native American Youth Living Well (A Yo Li)” uses a Community Based Participatory Research (CBPR) approach to evaluate Talking Circle effectiveness, partnering with the United Keetoowah Band (UKB) of Cherokee Tribe in Oklahoma, with members living in two geographically diverse areas, rural and urban. “A Yo Li” in the UKB tribal language means “youth”. The Talking Circle Intervention will be implemented as an after-school program in each of the participating schools. After-school programs are an ideal setting for the Talking Circle intervention. After-school programs are preferred by parents, students, and teachers in many Native American communities, as they provide structured, educational opportunities and activities for youth after regular school hours, while parents/guardians are still busy with work or other responsibilities. Based upon the preference of our UKB tribal partners, and ethical considerations, all students will eventually receive the intervention, thus the control condition is waitlist-control.