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）：“对使用物质的土著青年的简短干预”是一个为期5年的研究项目，旨在开发和测试以学校为基础的，对使用物质的美国土著高中学生的简短动机干预。动机访谈（MI）是一种针对物质使用问题的行为治疗方法，已经在一些人群中显示出疗效。临床试验支持MI对有药物使用问题的成年人和年长青少年的有效性。然而，迄今为止，MI临床试验受到以下限制：（a）样本的种族/人种多样性不足（即，迄今为止发表的几乎所有MI RCT都主要关注非西班牙裔白色样本），（B）缺乏对非寻求治疗人群的关注，（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对少数民族人群，特别是美洲原住民人群的有效性，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，美洲土著青年吸毒和酗酒的风险特别高，这使他们特别容易出现吸毒问题。 这项研究的主要目标是进行一项临床试验，评估一种文化上一致的，以学校为基础的动机性访谈干预，针对美国土著高中生的物质使用。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，以确保与我们的目标人群的文化和发展一致性，（B）培训工作人员进行MI评估和干预，具有发展和文化敏感性，以及（c）与学校和部落代表合作规划和实施该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主要为美洲原住民的公立高中招募。将使用全校范围的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），这些人将被随机分配到三种治疗条件之一：（1）简单建议和单独的个性化反馈报告（BA+PFR; n = 160），（2）简要建议，个性化反馈报告和动机访谈（BA+PFR+MI; n =160），或（3）简短建议、个性化反馈报告、动机访谈和6个月干预后加强治疗（BA+PFR+MI+BOOST; n =160）。将在研究入组时以及3个月、6个月、9个月和12个月随访时对受试者进行评价。 我们假设接受动机访谈的美国原住民高中生在物质使用和物质相关的负面后果方面的干预后减少比没有接受MI的学生要大得多（即，BA+PFR参与者）。我们还假设，接受助推器的青少年将比未接受助推器的青少年表现出更大和更长的物质使用减少。第二个目的是检查变化机制（即，与MI反应相关的介质）。我们假设干预前到干预后的变化，在感知的变化准备，感知的变化的重要性，和自我效能将预测参与者的干预反应。我们的第三个目标是探索性别和美洲原住民特定的文化变量（切罗基自力更生和美洲原住民种族认同）作为MI差异有效性的调节因素;这一目标是专门设计的，作为我们以学校为基础的MI干预的性别和文化不变性的初步评估。我们相信我们提出的研究是重要的和创新的，代表了跨文化有效的，简短的，以学校为基础的青少年吸毒和饮酒干预措施发展的重要下一步。 公共卫生相关性：拟议的项目评估的动机面试干预的有效性，以减少美国原住民高中生的药物和酒精使用问题。美洲原住民青少年是公共卫生的优先事项，因为他们比其他族裔/文化群体的青少年更容易出现长期使用药物的问题。拟议的项目旨在测试经验支持的药物滥用干预措施的有效性，这种干预措施可以在不同环境和文化中使用和运输，具有高风险和服务不足的群体。