Drug Use, Ethnicity, and Help Seeking among Rural Youth

说明(申请人提供)：在关于少数民族人群行为健康治疗需求的文献中，对生活在贫困、种族多元化的农村地区的13至21岁吸毒青年的关注很少。我们提出了一个为期两年的多方法人种学项目，以考察背景对新墨西哥州西南部拉美裔和白人青年吸毒活动的影响以及行为卫生保健的途径。该地区农村和经济不景气的特点可能会加剧吸毒者和他们的社会支持所经历的社会、经济和心理压力，并加剧行为保健需求。这项拟议的研究将确定西班牙裔和白人农村青年在需求、寻求帮助的过程和服务利用的决定因素方面的关键差异。这项研究的总体目标是提供形成性研究，以支持发展与文化相关的、高质量的农村青年护理。我们的民族志方法结合了半结构化访谈、照片语音方法和焦点小组。我们将在新墨西哥州西南部四个农村县的提供者、吸毒青年及其社会支持中实施这一方法。我们的方法将评估(1)社会支持，(2)关于药物使用的社区规范和价值观，(3)正式和非正式的治疗系统，以及(4)更广泛的社会、政策和监管背景如何影响这个农村地区的行为健康问题和寻求治疗的体验。我们的三个具体目标是：(1)检查行为健康提供者概念化(A)西班牙裔和白人农村吸毒青年的诊断、治疗和转诊需求的方式，以及(B)社会、法规和政策背景对这些青年的毒品使用和治疗服务的影响；(2)研究拉美裔和白人农村吸毒青年及其社会支持是如何概念化的：(A)当地青年中的吸毒问题，(B)对吸毒的心理社会和背景影响，(C)正规和非正规护理部门对吸毒问题的适当治疗，以及(D)需要具体的治疗资源；(3)考察拉美裔和白人农村吸毒青年在积极寻求治疗时的求助过程及其社会支持，记录护理障碍和克服障碍的战略。这项研究将为不同种族背景下农村青年的药物使用和治疗问题提供新的数据，这对于制定有效的公共卫生预防和干预计划至关重要。这些数据将包括关于社会文化因素的信息，这些因素影响不同族裔的人寻求和完成治疗的方式和原因，此外还详细描述了社会支持、社区环境和机构动态如何牵涉到农村青年的求助过程。这项研究还将为未来以社区为基础的关于新墨西哥州西南部青少年吸毒和行为保健的参与性研究奠定基础。

DESCRIPTION (provided by applicant): In the literature on the behavioral health treatment needs of minority populations, very little attention is given to drug-using youth, ages 13 to 21, living in impoverished, ethnically diverse, rural regions. We propose a two-year multi-method ethnographic project to examine contextual influences on the drug use activities and the pathways to behavioral health care for Hispanic and White youth in southwestern New Mexico. The rural and economically depressed character of this region may intensify social, financial, and psychological stress experienced by drug-using youth and their social supports, and exacerbate behavioral health care needs. This proposed research would identify critical differences in needs, help-seeking processes, and determinants of service utilization for Hispanic and White rural youth. The study's overall goal is to provide formative research that will support the development of culturally relevant, quality care for rural youth. Our ethnographic approach combines semi-structured interviews, Photovoice methods, and focus groups. We will implement this approach among providers, drug-using youth, and their social supports in four rural southwestern New Mexico counties. Our approach will assess how (1) social supports, (2) community norms and values regarding drug use, (3) formal and informal treatment systems, and (4) broader social, policy, and regulatory contexts influence the experience of behavioral health problems and treatment-seeking in this rural area. Our three specific aims are: (1) to examine the ways in which behavioral health providers conceptualize (a) the diagnostic, treatment, and referral needs of Hispanic and White rural drug-using youth, and (b) the effect of social, regulatory, and policy contexts on drug use and treatment services for these youth; (2) to examine the ways in which Hispanic and White rural drug-using youth and their social supports conceptualize (a) drug use problems among local youth, (b) psychosocial and contextual influences on drug use, (c) appropriate treatment for drug use problems in formal and informal sectors of care, and (d) need for specific treatment resources; and (3) to examine the help-seeking processes of Hispanic and White rural drug-using youth and their social supports as the youth actively engage in treatment-seeking, documenting both barriers to care and strategies for overcoming impediments. This study will provide new data on drug use and treatment issues for rural youth in ethnically diverse settings, which are essential to designing effective public health prevention and intervention programs. This data will include information on sociocultural factors that influence how and why people of different ethnicities seek and complete treatment, in addition to richly detailed descriptions of how social supports, community contexts, and institutional dynamics are implicated in the help-seeking processes of rural youth. This study also will lay the groundwork for future community-based participatory research on youth drug use and behavioral health care in southwestern New Mexico.