Intertribal Talking Circle for the Prevention of Substance Abuse in Native Youth

描述（由申请人提供）：美国印第安人（AI）的药物滥用是一个严重的健康差距，并导致许多威胁生命和致命的问题，如事故、慢性肝病、肝硬化、杀人和自杀。在AI青少年中发现的高药物滥用率被认为与各种环境和历史因素有关。这些因素包括贫困、历史创伤、双重文化压力以及不断变化的部落和家庭角色。很少有针对青少年早期人工智能药物滥用的评估项目。部落社区必须积极参与项目的开发和实施，以确保预防项目的文化相关性和可持续性。本项目旨在评估一项课后药物滥用预防干预措施，即部落间谈话圈（ITC），目标是三个人工智能社区的六年级人工智能青少年：明尼苏达州的Ojibwe/Chippewa，俄克拉荷马州的Choctaw和北卡罗来纳州的Lumbee。以社区为基础的参与性研究方法将用于在文化和技术上调整贸易中心。一项双条件对照研究将评估ITC在提高AI青少年原生自立能力的同时减少AI青少年物质使用的有效性。本文还提出了成人培训项目二级干预研究，培训三个区域部落的部落人员在研究期后如何将部落间谈话圈干预作为一个部落项目来实施。有效性将通过一项比较ITC干预与等候名单对照（WLC）条件的小型交叉随机试验来确定。进程评价将侧重于未来国际贸易中心的采用和实施，以及可持续适应的建议。该项目还将建立人工智能能力，以解决健康差距问题，因为经验丰富的土著调查员将指导三名初级土著调查员。

DESCRIPTION (provided by applicant): Substance abuse among American Indians (AI) is a critical health disparity and accounts for many life- threatening and deadly problems such as accidents, chronic liver disease, cirrhosis, homicide, and suicide. The high rate of substance abuse found among AI adolescents is believed to be associated with a variety of environmental and historical factors. These include poverty, historical trauma, bi-cultural stress, and changing tribal and family roles. There are few evaluated programs addressing early adolescent AI substance abuse. Tribal communities must be actively engaged in program development and implementation to ensure cultural relevance and sustainability of prevention programs. This project proposes to evaluate an after-school substance abuse prevention intervention, the Intertribal Talking Circle (ITC), targeting 6th grade AI youth in three AI communities: Ojibwe/Chippewa in Minnesota, Choctaw in Oklahoma, and Lumbee in North Carolina. A community-based participatory research approach will be used to culturally and technologically adapt the ITC. A two-condition controlled study will evaluate the efficacy of the ITC to increase AI youth Native self- reliance while decreasing AI youth substance use involvement. An adult training program second level intervention study is also proposed to train tribal personnel from the three regional tribes on how to implement the Intertribal Talking Circle intervention as a tribl program beyond the study period. Effectiveness will be determined by a small partial cross-over randomized trial comparing ITC intervention to a Wait-List Control (WLC) condition. Process evaluations will focus on the future adoption and implementation of the ITC, and recommendations for sustainable adaptations. The project will also build AI capacity to address health disparities, as experienced Native investigators will mentor three Junior Native Investigators.