A RCT of a Family-Centered Ojibwe Substance Abuse Prevention

 描述（由申请人提供）：本申请旨在为一项多保留随机对照试验（RCT）提供资金，该试验针对8-10岁的Anishinabe（Ojibwe）前青少年，他们的父母/照顾者以及日常影响目标儿童行为的大家庭成年人。Bii-Zin-Da-De-Dah（BZDDD）（倾听彼此）计划是爱荷华州加强家庭计划的第一个美国印第安人（AI）改编。现在是第三代，BZDDD已经适应了达科他州，拉科塔，普韦布洛和纳瓦霍文化，目前是加拿大公共卫生署资助的加拿大全国土著心理健康促进的中心部分。虽然BZDDD在基层非常受欢迎，并已适应多种文化，但从未对该方案减少青少年酗酒和吸毒的功效进行过大规模的实证评估。我们的总体目标是实施第四代BZDDD预防计划的RCT，该计划可以由其他北美土著文化跨文化复制，以减少早期青少年的药物使用并改善心理健康结果。这一目标将通过四个具体目标来实现：1）完成美国保留地14周BZDDD预防计划的最终调整; 2）实施BZDDD的RCT，以评估其延迟和/或预防青少年酗酒和吸毒的有效性;第三章通过评估社区中的污染和非正式传播，从经验上解决涉及土著文化的RCT的文化挑战，大家庭;和4）与我们的Anishinabe研究伙伴合作，制定一个持续预防的计划。使用意向治疗设计，随机对照试验将涉及255个治疗和255个等待控制家庭，他们居住在明尼苏达州和威斯康星州的五个Anishinabe保留地或附近。将有一个预测试和初步的后测试，随后的6，12，18，24，30和36个月的随访，从而评估目标儿童通过关键年的物质使用开始。拟议的RCT将留下一个以社区为基础、以家庭为中心的预防方案，该方案很容易融入现有的部落社会和卫生服务或学校环境。它也将成为适应其他土著文化的模板。

 DESCRIPTION (provided by applicant): This application seeks funding for a multi-reservation randomized controlled trial (RCT) of a popular, widely disseminated, substance abuse prevention program targeted at Anishinabe (Ojibwe) preadolescents aged 8-10 years, their parents/caretakers, and extended family adults who have daily influence over the target child's behaviors. The Bii-Zin-Da-De-Dah (BZDDD) (Listening to One Another) program was the first American Indian (AI) adaptation of the Iowa Strengthening Families Program. Now in its third generation, BZDDD has been adapted for Dakota, Lakota, Pueblo, and Navajo cultures and is currently the center piece of a Canadian national Indigenous mental health promotion funded by Public Health Agency of Canada. Although BZDDD has been extremely popular at the grassroots level and has been adapted to numerous cultures there has never been a large-scale empirical evaluation of the program's efficacy for reducing adolescent alcohol and drug use. Our overall goal is to implement a RCT of a fourth-generation BZDDD prevention program that can be replicated cross-culturally by other North American Indigenous cultures to decrease substance use among early adolescents and improve mental health outcomes. This goal will be accomplished through four specific aims: 1) Complete a final adaptation of the 14-week BZDDD prevention program for the U.S. reservations; 2) Implement a RCT of BZDDD to assess its efficacy for delaying and/or preventing adolescent onset of alcohol and drug use; 3) Empirically address cultural challenges for RCTs involving Indigenous cultures by evaluating contamination and informal diffusion in communities and extended families; and 4) Work with our Anishinabe research partners to develop a plan to sustain the prevention. Using intent to treat design, the RCT will involve 255 treatment and 255 waitlist control families who live on or near five Anishinabe reservations in Minnesota and Wisconsin. There will be a pretest and initial post-test, with subsequent 6, 12, 18, 24, 30, and 36 month follow-ups, thus evaluating the target children through the critical years of substance use initiation. The proposed RCT will leave behind an empirically-based, family-centered prevention program that is easily woven into existing tribal social and health services or school settings. It also will be a template for adaptation to other Indigenous cultures.