Chukka Auchaffi' Natana: The Weaving Healthy Families Program to Promote Wellness and Resilience and Prevent Alcohol and Other Drug Abuse and Violence

项目摘要 酗酒和滥用其他药物以及家庭暴力是新冠肺炎的次要健康影响和风险 美洲原住民(NA)健康差距导致死亡率的因素。考虑到文化上的差距- 解决新冠肺炎的这些次要影响的扎根计划-AOD在家庭中的滥用和暴力- 迫切需要测试数字增强的和可持续的社区基础的有效性 干预措施。家长研究的长期目标是促进健康和健康，同时预防 以及减少NA家庭中的AOD滥用和暴力。本副刊将对此进行扩展，以解决 新冠肺炎促进可获得性、可持续性和数字化参与的次要健康影响 辅助干预。采用基于社区的参与式研究方法(CBPR)，总体目标 建议的父母奖的一部分是使用阶梯楔形试验设计(SWTD)来测试 以社区为基础的“编织健康家庭计划(WHF)”，它将预防、减少和推迟 新冠肺炎的次级健康影响，即在促进复原力的同时，在家庭中使用AOD和暴力 和健康(包括心理健康)在全国成年人和青年中。《补编》的目标1是 检查新冠肺炎的次级健康影响，即AOD滥用、IPV以及家庭功能， 和心理/身体健康。我们的工作假设是，新冠肺炎施加的更大压力将 加剧AOD滥用、IPV和家庭冲突，但WHF计划将改善这些次级健康 效果。我们继续使用父母赠款的SWTD，其中组(即175个MBCI家庭)是随机的 指定了他们接受干预的顺序。我们在新冠肺炎上检查了性别差异，使用 以性为调节变量，了解性是否以及如何调节新冠肺炎的次级健康影响 以及WHF项目按性别的不同效果。我们还整合了解释性的顺序混合- 方法设计通过30-50名定性访谈对新冠肺炎的社会行为影响进行评估 女户主。补编的目标2是评价#年的可持续性和可行性 WHF计划包含mHealth组件，通过使用短信发送来 增强经过调整的循证服务的覆盖范围、访问渠道、参与度、效率、质量和可持续性 干预。我们的工作假设是，包含用于调查和会话的短信 在WHF计划期间和之后的提醒、参与和心理教育将提高覆盖范围， 计划的准入、参与度、效率、质量和可持续性。我们使用母基金的CFIR和 用于定性和定量评价影响的解释性序贯混合设计 通过短信增强参与方式。这项研究与增刊很相配。 由于数字增强的世界卫生基金会计划直接解决了新冠肺炎的二次健康影响，在 特别是AOD滥用、暴力和家庭冲突，以及健康和精神健康。

Project Summary Alcohol and other drug (AOD) abuse and family violence are secondary health effects of COVID-19 and risk factors for the Native American (NA) health disparities that drive mortality rates. Given the gap in culturally- grounded programs to address these secondary effects of COVID-19—AOD abuse and violence in families— there is a critical need to test the efficacy of digitally enhanced and sustainable community-based interventions. The long-term goal of the parent research is to promote health and wellness, while preventing and reducing AOD abuse and violence in NA families. The supplement will extend this to address the secondary health effects of COVID-19 promoting access, sustainability, and engagement with a digitally assisted intervention. Using community-based participatory research methods (CBPR), the overall objectives of the proposed parent award are to use a stepped-wedge trial design (SWTD) to test the efficacy of the community-based, “Weaving Healthy Families program (WHF)”, which will prevent, reduce, and postpone the secondary health effects of COVID-19, namely AOD use and violence in families while promoting resilience and wellness (including mental health) among NA adults and youth. Objective 1 of the Supplement is to examine the secondary health effects of COVID-19, namely AOD abuse, IPV, as well as family functioning, and mental/physical health. Our working hypothesis is that the greater stress imposed by COVID-19 will worsen AOD abuse, IPV, and family conflict, but the WHF program will ameliorate these secondary health effects. We continue to use the parent grant's SWTD where groups (i.e. 175 MBCI families) are randomly assigned the order in which they receive the intervention. We examine the sex differences for COVID-19, using sex as a moderator to understand whether and how sex moderates the secondary health effects of COVID-19 and the differential effect of the WHF program by sex. We also integrate the explanatory sequential mixed- methods design to evaluate socio-behavioral impacts of COVID-19 through 30-50 qualitative interviews with female heads of household. Objective 2 of the Supplement is to evaluate the sustainability and feasibility of the WHF program with the inclusion of the mHealth component through the use of SMS text messaging to enhance the reach, access, engagement, efficiency, quality, and sustainability of the adapted evidence-based intervention. Our working hypothesis is that the inclusion of SMS text messages for survey and session reminders, engagement, and psychoeducation during and after the WHF program will improve the reach, access, engagement, efficiency, quality, and sustainability of the program. We use the parent grant's CFIR and the explanatory sequential mixed-methods design to evaluate the impact of qualitative and quantitative engagement methods enhanced with SMS text messaging. This research is well-matched to the supplement as the digitally enhanced WHF program directly addresses the secondary health effects of COVID-19, in particular AOD abuse, violence and family conflict, as well as health and mental health.