A Community Trial To Prevent Inhalant Use In Alaska

描述（由申请人提供）：提出了一项为期三年的可行性研究，该研究将评估综合社区预防模式的实施情况，以在四个社区中对抗吸入剂使用和相关问题，这些社区中有不同比例的阿拉斯加原住民（尤皮克人、特林吉特人和因纽特人）、高加索人和其他人群。这一综合模式结合了三个干预组成部分：社区动员，为社区实施以吸入剂为重点的预防战略做好准备；采取环境战略，减少商业场所和家庭中可吸入产品的可得性，办法是让社区参与行动，限制青少年获得社区中青少年正在吸入的合法产品，并以替代可吸入产品的改性或非溶剂型供应品为替代品；以学校为基础的技能培训项目针对学龄前儿童，以提高认知和行为技能，以抵制吸入剂的使用。本研究关注(a)制定和实施社区可接受的社区吸入剂预防模型，(b)评估其实施质量和与成功实施相关的因素，以及(c)评估被认为介导吸入剂使用干预效果的近端结果的变化，并确定可能解释近端结果变化的因素。还将审查在目标人口的合作率、数据收集专门知识和可用性、数据有效性和可靠性以及成本方面收集高质量结果数据的可行性。由于向阿拉斯加州提供的一笔数额巨大的联邦赠款于2003年结束，在同意参加这项研究的每个社区都建立了以社区为基础的预防药物滥用联盟。这些联盟中的每一个都实施了药物滥用预防计划，并参与了预防评估。本研究将在现有能力的基础上开展吸入剂预防工作。由社区参与和协作、赋权、知识和社区变革组成的参与式行动研究原则将指导本研究，并在评估中采用定性和定量方法。

DESCRIPTION (provided by applicant): A three-year feasibility study is proposed that will assess the implementation of an integrated community prevention model to combat inhalant use and related problems among pre- and early adolescents in four communities with varying proportions of Alaskan Natives (Yupik, Tlingit, and Inupiat), Caucasians, and other populations. This comprehensive model combines three intervention components: community mobilization to prepare the community to implement inhalant-focused prevention strategies; environmental strategies to decrease availability of inhalable products in commercial establishments and homes by engaging communities in actions to restrict youth access to legal products that are being inhaled by youth in the community and to substitute altered or non-solvent-based supplies that are alternatives to inhalable products; and school-based skill training programs targeting pre-adolescents to increase cognitive and behavioral skills to resist the use of inhalants. The study concerns (a) developing and implementing community-acceptable community inhalant prevention model, (b) assessing its implementation quality and factors associated with successful implementation, and (c) assessing changes in proximal outcomes believed to mediate intervention effects in inhalant use, and identifying factors that may explain proximal outcome changes. The feasibility of collecting quality outcome data in terms of cooperation rates of target population, data collection expertise and availability, data validity and reliability, and cost will also be examined. As a result of a large federal grant to the State of Alaska that ended in 2003, community-based substance abuse prevention coalitions have been established in each of the communities that have agreed to participate in the study. Each of these coalitions has implemented substance abuse prevention programs, and they have been involved in prevention evaluations. The present study will build upon this existing capacity to implement an inhalant prevention effort. Participatory action research (PAR) principles consisting of community participation and collaboration, empowerment, knowledge, and community change will guide this research, which will employ qualitative and quantitative methods in the assessment.