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不成比例地高， 印第安人（Al）。有充分记录的与滥用兴奋剂有关的成人和青年的健康差异 酒精，烟草和非法药物延伸到不断增长的城市Al人口，他们现在占全国人口的60%以上。 总人口。青年人报告发病率较高，发病较早，后果较严重，但发病率较低。 与非本地同行相比，他们认为物质使用的危害风险。为了阻止早期发病 和药物滥用的后果，初级预防工作已与青年在几个 美国地区但是，这些项目并没有明确针对城市Al青年， 预防方法。拟议的研究借鉴了项目小组对 物质使用之间的城市西南青年进行转化研究，认识到 这些青年确定的突出风险和复原力因素，使他们面临的社会和关系背景， 药物及其文化上适当的耐药战略。研究的第一个目的是创造 针对城市Al青少年7年级和8年级的基于文化的药物滥用预防干预 通过修改SAMHSA模型通用预防计划，保持真实的。适应 将采用新兴的原则，以增加的方式，为新的目标人群调整方案， 文化契合度，同时保持对核心计划组成部分的忠诚度。将对干预措施进行调整、试点， 评估，文化验证，并进行相应的修改。第二个目的是测试以下方法的可行性和有效性： 在一项随机对照试验（RCT）中，采用了适应性药物滥用预防干预措施。生态发展 理论提供了一个框架，了解对铝青少年的物质使用的关键影响。参与性 行动研究方法将用于调整干预措施，包括与关键人工智能信息提供者的焦点小组 （成人和青年），与最初干预措施的设计者合作， 与该地区最大的城市印第安人社会服务提供商合作。RCT将在现有的 在城市学区注册的Al学生的团体。由此产生的预防干预措施将解决 受健康差距严重影响的得不到充分服务的群体的需要， 采取有效的转化研究战略，使预防干预措施适应不同族裔的青年。

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.