ADOLESCENT AMERICAN INDIAN MULTISECTOR HELP INQUIRY

尽管美国印第安青年中毒品和其他共同发生的心理健康问题的发生率很高，但我们对他们的服务利用率知之甚少。 他们的医疗保健系统（印第安人医疗服务）与其他联邦和州的计划分开发展。 虽然他们有资格获得国家资助的服务，但政治阻力、难以获得医疗补助报销以及缺乏保留地服务阻碍了城市和保留地青年的差异化。 AIM-HI（青少年美洲印第安人多部门帮助调查）研究将收集4年期间（从青春期到青年期）关于城市和保留地美洲印第安人青年的服务使用和药物使用信息。 样本都来自亚利桑那州，提供稳定的国家资助的服务，但一个生活在盐河Pima-Marvila部落的土地和城市凤凰城的其他。 该项目将在第一年访问1，000名青年，从1，000名青年中抽取400名进行深入的纵向访问，并对600名青年门户服务提供者进行调查。 将在以下方面研究多部门服务的使用情况：毒品/酒精和精神卫生等专业部门;儿童福利、教育、少年司法和初级保健等非专业部门;由父母、亲戚和朋友组成的非正规部门;以及土著治疗师的传统部门。本研究将达到三个目的：1.检验两个服务使用假设：a）青少年使用服务的药物或共病问题是由他们的需要，他们的易感特征，和服务使能特征;他们的需要，认为网关供应商;和这些网关供应商的资源，服务连接，和服务知识。和B）在控制基线环境因素和需求后，获得和利用更广泛和更深入的服务来解决其药物使用和相关行为问题的美国印第安青年不太可能出现功能受损和药物滥用、滥用或依赖。 2.为了检验一个假设的后果，服务报销：使用专业物质使用服务是积极相关的可用性和可访问性的医疗补助和管理式医疗报销这些服务。 3.记录：（a）药物滥用和其他问题的普遍性、严重性和持续时间，以及保护和风险因素;（B）多部门服务结构及其互补或补充关系;（c）障碍与服务结构变化之间的关系。 AIM-HI的影响力因以下因素而加速：美洲印第安人社区代表的参与;其PI与乔治沃伦布朗社会工作学院心理健康服务研究中心和布德尔美洲印第安人研究中心的联系;以及该领域主要研究人员的合作。

Despite high rates of drug and other co-occurring mental health problems among American Indian youths, we know little about their service utilization. Their health care system (The Indian Health Service) developed separately from other federal and state programs. Although they are eligible to receive state-funded services, political resistance, difficulty in accessing Medicaid reimbursement, and lack of on-reservation services impede access differentially for urban and reservation-based youths. The AIM- HI (Adolescent American Indian Multisector Help Inquiry) study will collect service use and drug-use information over a 4-year period (from adolescence to young adulthood) on urban and reservation-based American Indian youths. The samples are both from Arizona, providing stability in state financed services, yet one lives on the Salt River Pima-Maricopa Tribal lands and the other in urban Phoenix. The project will interview 1,000 youths in Year 1, sample 400 of the 1,000 for intensive longitudinal interviewing, and survey 600 of these youths' gateway service providers. Multisector service use will be studied in the specialty sectors of drug/alcohol and mental health; the nonspecialty sectors of child welfare, education, juvenile justice, and primary health; the informal sector comprised of parents, relatives and friends; and the traditional sector of Native healers. The study will achieve three aims: 1. To test two service use hypotheses: a) Youths' use of services for their drug or comorbid problems is determined by their need, their predisposing characteristics, and service enabling characteristics; their need as perceived by gateway providers; and those gateway providers' resources, service connections, and service knowledge. and b) After controlling for baseline environmental factors and needs, American Indian youths who have accessed and utilized more extensive and intensive services for their drug use and related behavioral problems will be less likely to have impaired functioning and substance misuse, abuse or dependence. 2. To test a hypothesis concerning the consequences of service reimbursement: The use of specialty substance-use services is positively associated with the availability and accessibility of Medicaid and managed care reimbursement to those services. 3. To document: a) the prevalence, severity and duration of substance abuse and other problems, as well as the protective and risk factors, b) The multisector configurations of services and their complementary or supplementary relationships; and c) The relationship between barriers and changes in the configurations of services. AIM-HI's impact is accelerated by the participation of American Indian community representatives; the association of its PIs with the George Warren Brown School of Social Work's Center for Mental Health Services Research, and the Buder Center for American Indian Studies; and the collaboration of key researchers in the field.