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 酒精和其他药物（AOD）滥用和家庭暴力是COVID-19的次要健康影响， 美国原住民（NA）健康差异的因素，推动死亡率。考虑到文化上的差距- 针对COVID-19-AOD滥用和家庭暴力的这些次要影响的基础计划- 迫切需要测试数字化增强和可持续的社区为基础的 干预措施。父母研究的长期目标是促进健康和健康，同时预防 并减少新来港定居人士家庭的滥用及暴力。该补编将扩展这一点，以解决 COVID-19的次级健康影响促进了数字化的可及性、可持续性和参与 协助干预。使用基于社区的参与性研究方法（CBPR）， 建议的父母奖是使用阶梯楔形试验设计（SWTD）来测试的有效性， 以社区为基础的“编织健康家庭方案"，将预防、减少和推迟 COVID-19的次级健康影响，即家庭中使用AOD和暴力，同时促进复原力 和健康（包括心理健康）在NA成人和青年。补编的目标1是 研究COVID-19对健康的继发性影响，即滥用AOD、IPV以及家庭功能， 心理/身体健康。我们的工作假设是，COVID-19造成的更大压力将 恶化AOD滥用，IPV和家庭冲突，但WHF计划将改善这些次级健康 方面的影响.我们继续使用父母补助金的SWTD，其中各组（即175个MBCI家庭）随机 分配他们接受干预的顺序。我们研究了COVID-19的性别差异，使用 性别作为调节因素，以了解性别是否以及如何调节COVID-19的继发性健康影响 以及世界遗产基金会方案对性别的不同影响。我们还整合了解释性的顺序混合- 方法设计，通过30-50个定性访谈评估COVID-19的社会行为影响， 女户主。补编的目标2是评价 世界卫生基金会计划，通过使用短信， 提高适应性循证教育的覆盖面、可及性、参与度、效率、质量和可持续性， 干预我们的工作假设是，包括短信的调查和会话 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， 访问，参与，效率，质量和计划的可持续性。我们使用父母补助金的CFIR， 解释性序贯混合方法设计评价定性和定量的影响 通过短信增强参与方式。这项研究是很好地匹配的补充 由于数字化增强的WHF计划直接解决了COVID-19的继发性健康影响， 特别是虐待、暴力和家庭冲突，以及健康和心理健康。

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.