Elluam Tungiinun - Toward Wellness

描述(由申请者提供)：阿拉斯加原住民面临着与酒精使用障碍和自杀相关的严重健康差距。Elluam Tungiinun是爱斯基摩人的Yup‘ik术语，可翻译为“走向健康”。Elluam Tungiinun(ET)是一种基于文化的预防性干预措施，旨在降低阿拉斯加原住民尤皮克·爱斯基摩年轻人的自杀风险和共病未成年饮酒。ET过程方法通过一套密集的社区合作研究人员适应过程程序，将其干预计划与其服务的每个阿拉斯加农村社区的当地需求和文化联系起来。这项提案寻求资金，用于在五个偏远的尤皮克农村社区对239名12至18岁的青年进行为期五年的ET干预的CBPR预防试验。在三个社区的159个样本中，将使用随机动态等待名单控制设计以及ET情景过程方法对干预模型的保真度来测试干预两年后的有效性。一个80人的样本将在过去三年中与我们合作开发和试点ET干预的另外两个社区在五年内测试影响的持久性和可持续性。这项提议代表着与阿拉斯加原住民进行为期15年的CPBR进程的下一个阶段。 Elluam Tungiinun有三个具体目标： 具体目标1：在干预完成时，使用随机分配的、交错的基线、动态等待名单对照设计，通过对三个偏远农村AN村庄的影响对比，测试ET干预的有效性。 具体目标2：测试在三个社区实施ET工具箱本地情景方法对ET干预模式的保真度，以及保真度对结果的影响。 具体目标3：在干预后第1年和第2年，在随机分配的社区1-3和干预后2年，以及在制定和试点干预措施的社区4-5，在干预后1-5年，监测干预措施对结果衡量的可持续性和持久性。 该项目的最终目标是为阿拉斯加原住民创造以证据为基础的预防实践。该项目对公共卫生有三个直接贡献。它寻求(1)减少公共卫生重要性对阿拉斯加土著和美国印第安人造成不成比例影响的健康差距的最重要来源，(2)促进与部落社区的健康相关研究的CBPR方法，以及 (3)加强对土著和其他少数族裔群体健康预测因素的了解。

DESCRIPTION (provided by applicant): Alaska Natives face significant health disparities associated with alcohol use disorders and suicide. Elluam Tungiinun is a Yup'ik Eskimo term translatable as "towards wellness." Elluam Tungiinun (ET) is a culturally-based preventative intervention to reduce suicide risk and co-morbid underage drinking among Alaska Native Yup'ik Eskimo youth. The ET process approach contextualizes its intervention program to the local needs and culture of each rural Alaska community it serves through a set of intensive community co-researcher adaptation process procedures. This proposal seeks funding for a five-year CBPR prevention trial of the ET intervention with 239 youth, ages 12 through 18, in five rural, remote Yup'ik communities. A sample of 159.in three communities will test effectiveness two years post intervention using a randomized dynamic wait list control design, along with the fidelity of the ET contextualizing process approach to the intervention model. A sample of 80 will test durability and sustainability of impact over five years in two additional communities with whom we have worked in the past three years developing and piloting the ET intervention. This proposal represents the next stage in a 15-year CPBR process with Alaska Natives. Elluam Tungiinun has three specific aims: Specific Aim 1: Test the effectiveness of the ET intervention through contrasts of impact on outcome measures using a randomly assigned, staggered baseline, dynamic wait list control design with three remote, rural AN villages at completion of the intervention. Specific Aim 2: Test the fidelity of implementation of the ET toolbox local contextualization approach to the ET intervention model in three communities, and impact of fidelity on outcomes. Specific Aim 3: Monitor the sustainability and durability of intervention impact on outcome measures in randomly assigned communities 1- 3 at year 1 and 2 post intervention, and in communities 4- 5, where the intervention was developed and piloted, at year 1-5 post intervention. The ultimate goal of this project is to create evidence-based prevention practices for Alaska Natives. The project has three direct contributions to public health relevance. It seeks to (1) reduce the most significant source of health disparity of public health importance disproportionately affecting Alaska Natives and American Indians, (2) advance CBPR methods in health related research with tribal communities and other ethnic minority, low socioeconomic status, medically underserved, and rural populations, and (3) enhance understanding of factors predictive of health among indigenous and other ethnic minority groups.