Brief Intervention for Substance Using Native Youth

针对吸毒的本土青少年的简短干预

• 批准号: 8109165
• 负责人: John R., RN, PHD, FAAN Lowe
• 金额: $ 62.81万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8109165
• 关键词: Adolescent; Alcohol abuse; Alcohol or Other Drugs use; Attention; Behavior Therapy; Cherokee Indian; Clinical Trials; Development; Drug usage; Effectiveness; Elderly; Ensure; Ethnic group; Evaluation; Feedback; Gender; General Population; Goals; Intervention; Life; Mediator of activation protein; Minority; Native Americans; Not Hispanic or Latino; Oklahoma; Older Population; Paper; Participant; Pharmaceutical Preparations; Phase; Population; Process; Publishing; Questionnaires; Randomized; Randomized Clinical Trials; Readiness; Recruitment Activity; Reporting; Research; Research Project Grants; Risk; Sampling; Schools; Screening procedure; Self Efficacy; Students; Substance abuse problem; Target Populations; Teenagers; Testing; Time; Training; Treatment outcome; Tribal School; Youth; aged; alcohol intervention; base; brief advice; brief intervention; brief motivational intervention; college; design; drinking; high risk; high school; innovation; motivational enhancement therapy; native youth; post intervention; public health priorities; racial and ethnic; response; self reliance; treatment effect; treatment response

DESCRIPTION (provided by applicant): "Brief Intervention for Substance Using Native Youth" is a 5-year research project designed to develop and test a school-based, brief motivational intervention for substance using, Native American high school students. Motivational Interviewing (MI) is a behavioral treatment for substance use problems that has already shown efficacy in some populations. Clinical trials support the effectiveness of MI with adults and older adolescents with substance use problems. However, MI clinical trials to date have been limited by (a) insufficient ethnic/racial diversity of samples (i.e., almost every MI RCT published to date has focused on predominantly non-Hispanic white samples), (b) lack of attention to non-treatment seeking populations, (c) no direct examination of putative mechanisms of change, and (d) no direct examination of how culture-related variables may influence treatment response. MI's effectiveness for minority populations, and especially Native American populations, has received scant research attention, and remains unknown. Moreover, Native American youth, compared to youth from other racial/ethnic backgrounds, are at especially high risk for drug use and drinking, which makes them particularly susceptible to the development of substance use problems. The primary goal of the proposed study is to conduct a clinical trial evaluating a culturally congruent, school-based motivational interviewing intervention targeting substance use among Native American high school students. The development phase of the project (6 months) will focus on (a) adapting our assessment and intervention materials in order to ensure cultural and developmental congruency with our target population, (b) training staff in conducting MI assessment and intervention with developmental and cultural sensitivity, and (c) collaborating with school and tribal representatives in the planning and implementation the clinical trial phase of the project. Clinical trial participants will be recruited from three predominantly Native American public high schools located in Oklahoma. A school-wide paper-and-pencil substance use screening questionnaire will be used to select a sample of "high risk substance users" (n = 480), who will be randomly assigned to one of three treatment conditions: (1) brief advice and a personalized feedback report alone (BA+PFR; n = 160), (2) brief advice, a personalized feedback report, and motivational interviewing (BA+PFR+MI; n =160), or (3) brief advice, a personalized feedback report, motivational interviewing, and a 6-months post- intervention booster session (BA+PFR+MI+BOOST; n =160). Participants will be evaluated at study entry, and at 3-, 6-, 9-, and 12-month follow-ups. We hypothesize Native American high school students who receive motivational interviewing will demonstrate significantly greater post-intervention reductions in substance use and substance- related negative consequences than their counterparts who do not receive MI (i.e., BA+PFR participants). We also hypothesize adolescents who receive the booster session will demonstrate significantly greater and longer-lived substance use reductions than adolescents who do not receive the booster. A secondary aim is to examine mechanisms of change (i.e., mediators) associated with MI response. We hypothesize pre-to post-intervention changes in perceived readiness to change, perceived importance of change, and self-efficacy will predict participants' response to intervention. Our third aim is to explore gender and Native American-specific cultural variables (Cherokee self- reliance & Native American ethnic identity) as moderators of the differential effectiveness of MI; this aim is specifically designed as a preliminary evaluation of the gender and cultural invariance of our school-based MI intervention. We believe our proposed study is significant and innovative, and represents an important next step in the development of cross-culturally effective, brief, and school- based interventions for drug use and drinking among teenagers. PUBLIC HEALTH RELEVANCE: The proposed project evaluates the efficacy of a motivational interviewing intervention for reducing drug and alcohol use problems among Native American high school students. Native American adolescents are a public health priority, as they are at greater risk than adolescents from other ethnic/cultural groups for the development of long-term substance use problems. The proposed project is intended to test the effectiveness of an empirically supported substance abuse intervention that is accessible and transportable across settings and cultures, with this high risk and underserved group.

描述（由申请人提供）：“对土著青少年物质使用的简短干预”是一个为期 5 年的研究项目，旨在开发和测试针对美国土著高中生物质使用的基于学校的简短动机干预。动机访谈 (MI) 是一种针对药物滥用问题的行为治疗方法，已在某些人群中显示出有效性。临床试验支持 MI 对有药物滥用问题的成人和老年青少年的有效性。然而，迄今为止的 MI 临床试验受到以下因素的限制：(a) 样本的民族/种族多样性不足（即，迄今为止发布的几乎所有 MI RCT 都主要关注非西班牙裔白人样本），(b) 缺乏对非治疗寻求人群的关注，(c) 没有直接检查假定的变化机制，以及 (d) 没有直接检查文化相关变量如何影响治疗反应。 MI 对少数族裔，尤其是美洲原住民的有效性，很少受到研究关注，并且仍然未知。此外，与其他种族/族裔背景的青年相比，美洲原住民青年吸毒和饮酒的风险特别高，这使他们特别容易出现药物滥用问题。 拟议研究的主要目标是进行一项临床试验，评估针对美国原住民高中生物质使用的文化一致性、基于学校​​的动机访谈干预措施。该项目的开发阶段（6 个月）将侧重于（a）调整我们的评估和干预材料，以确保与目标人群的文化和发展一致性，（b）培训工作人员进行具有发展和文化敏感性的 MI 评估和干预，以及（c）与学校和部落代表合作规划和实施项目的临床试验阶段。临床试验参与者将从位于俄克拉荷马州的三所以美国原住民为主的公立高中招募。将使用全校纸笔物质使用筛查问卷来选择“高风险物质使用者”样本（n = 480），他们将被随机分配到三种治疗条件之一：（1）仅简短建议和个性化反馈报告（BA + PFR；n = 160），（2）简短建议，个性化反馈报告和动机访谈（BA + PFR + MI；n = 160），或（3） 简短的建议、个性化反馈报告、动机性访谈以及干预后 6 个月的强化课程 (BA+PFR+MI+BOOST；n =160)。参与者将在研究开始时以及 3、6、9 和 12 个月的随访时接受评估。 我们假设接受动机性访谈的美国原住民高中生在干预后的物质使用和与物质相关的负面后果方面将比未接受 MI 的高中生（即 BA+PFR 参与者）显着减少。我们还假设，与未接受加强治疗的青少年相比，接受加强治疗的青少年将表现出显着更大且更长寿命的物质使用减少。第二个目的是检查与 MI 反应相关的变化机制（即调节因素）。我们假设干预前和干预后感知变革准备度、感知变革重要性和自我效能的变化将预测参与者对干预的反应。我们的第三个目标是探索性别和美洲原住民特有的文化变量（切罗基人的自力更生和美洲原住民的种族认同）作为 MI 差异有效性的调节因素；这一目标是专门设计的，旨在对我们基于学校的 MI 干预措施的性别和文化不变性进行初步评估。我们相信，我们提出的研究具有重要意义和创新性，代表着针对青少年吸毒和饮酒制定跨文化、有效、简短和基于学校的干预措施的重要下一步。 公共卫生相关性：拟议项目评估动机访谈干预对于减少美国原住民高中生吸毒和酗酒问题的有效性。美洲原住民青少年是公共卫生的优先事项，因为他们比其他种族/文化群体的青少年面临更大的长期药物使用问题的风险。拟议的项目旨在测试基于经验的药物滥用干预措施的有效性，这种干预措施对于高风险和服务不足的群体来说是可以跨环境和文化使用和转移的。