CULTURALLY-SPECIFIC SUBSTANCE ABUSE PREVENTION FOR URBAN AMERICAN INDIAN YOUTH

在许多美国人中，许多可预防疾病的发病率和死亡率高得不成比例。 印第安人(Al)人口。有充分证据表明，Al成年人和青年与滥用 酒精、烟草和非法毒品延伸到不断增长的城市人口，他们现在占 阿尔人的总人口。青年AL报告的发病率更高，发病更早，后果更严重，但更少 与非本国同行相比，他们对物质使用危害的感知风险更高。为了阻止早发 在药物滥用和后果方面，已在几个国家的青年中开展了初级预防工作 美国地区。但项目并没有明确针对城市青年，使用严格的文化根基 预防方法。这项拟议的研究借鉴了项目组对肺炎病因的研究 在西南部城市的青年中使用物质进行翻译研究，以认识到 这些青年、社会和关系背景确定的显著风险和复原力因素使他们面临 物质及其在文化上适当的抗药性策略。这项研究的首要目标是创造 以7、8年级城市Al青少年为对象的基于文化的物质滥用预防干预研究 通过修改SAMHSA模式的普遍预防计划，使其保持真实。改编 将采用新兴的原则来调整计划以适应新的目标人群，以增加 文化契合度，同时保持对核心计划组成部分的忠诚度。干预将被改编，试点， 相应地进行评估、文化验证和修订。第二个目标是测试以下项目的可行性和有效性 一项随机对照试验(RCT)中的适应性物质滥用预防干预。生态发展 该理论为理解影响青年物质使用的关键因素提供了框架。参与式 将使用行动研究方法来调整干预措施，包括具有关键Al线人的焦点小组 (成人和青少年)，与最初干预措施的设计者合作并协调 该地区为印度城市居民提供最大的社会服务。RCT将在现有的 在城市学区注册的Al学生团体。由此产生的预防干预将解决 受健康差距严重影响的未得到充分服务的群体的需求，并增进对 有效的转化性研究战略，以适应不同种族青年的预防干预措施。

Morbidity and mortality rates of many preventable conditions are disproportionately high in many American Indian (Al) populations. Well documented health disparities for Al adults and youth related to abuse of alcohol, tobacco, and illicit drugs extend to the growing urban Al population, who now constitute over 60% of the total Al population. Al youth report higher rates, earlier onset, more severe consequences, yet less perceived risk of harm of substance use compared to their non-native counterparts. To thwart the early onset and aftermath of substance abuse, primary prevention efforts have been undertaken with Al youth in several U.S. regions. But programs have not explicitly targeted urban Al youth using rigorous culturally grounded prevention methods. The proposed study draws upon the project team's research on the etiology of substance use among Al youth of the urban southwest to conduct translational research that recognizes salient risk and resiliency factors identified by these youth, social and relational contexts that expose them to substances, and their culturally appropriate drug resistance strategies. The first aim of the study is to create a culturally grounded substance abuse prevention intervention targeting urban Al youth in 7th and 8th grades through a modification of a SAMHSA Model universal prevention program, keepin it REAL. The adaptation will employ emerging principles for adapting programs for new target populations in ways that increase cultural fit while maintaining fidelity to core program components. The intervention will be adapted, piloted, evaluated, culturally validated, and revised accordingly. A second aim is to test the feasibility and efficacy of the adapted substance abuse prevention intervention in a randomized control trial (RCT). Ecodevelopmental Theory provides the framework for understanding key influences on Al youths' substance use. Participatory action research methods will be used to adapt the intervention, including focus groups with key Al informants (adults and youth), working in collaboration with the designers of the original intervention and in coordination with the area's largest provider of social services to urban Indians. The RCT will be conducted in existing groups for Al students enrolled in urban school districts. The resulting prevention intervention will address the needs of an under-served group severely affected by health disparities, and advance knowledge on effective translational research strategies for adapting prevention interventions for ethnically diverse youth.