Intertribal Talking Circle for the Prevention of Substance Abuse in Native Youth

描述(申请人提供)：美国印第安人中的药物滥用(AI)是一个严重的健康差距，并导致许多危及生命和致命的问题，如事故、慢性肝病、肝硬变、凶杀和自杀。在人工智能青少年中发现的高药物滥用比率被认为与各种环境和历史因素有关。这些问题包括贫困、历史创伤、跨文化压力以及部落和家庭角色的变化。很少有针对青少年早期AI物质滥用的评估项目。部落社区必须积极参与方案的制定和实施，以确保预防方案的文化相关性和可持续性。该项目建议评估一项课后药物滥用预防干预措施--部落间谈话圈(ITC)，目标是三个人工智能社区的六年级人工智能青年：明尼苏达州的Ojibwe/Chippewa、俄克拉何马州的Choctaw和北卡罗来纳州的Lumbee。将采用以社区为基础的参与性研究方法，在文化和技术上适应国贸中心。一项双条件对照研究将评估ITC在增加AI青年原住民自立能力同时减少AI青年物质使用参与方面的效果。还提出了成人培训方案第二级干预研究，以培训来自三个区域部落的部落人员，了解如何在研究期后将部落间对话圈干预作为部落方案实施。有效性将通过一项比较ITC干预和等待名单控制(WLC)条件的小型部分交叉随机试验来确定。进程评价的重点将是国贸中心今后的采纳和执行情况，以及可持续适应的建议。该项目还将建设人工智能能力，以解决健康差距，因为经验丰富的土著调查人员将指导三名初级土著调查人员。

DESCRIPTION (provided by applicant): Substance abuse among American Indians (AI) is a critical health disparity and accounts for many life- threatening and deadly problems such as accidents, chronic liver disease, cirrhosis, homicide, and suicide. The high rate of substance abuse found among AI adolescents is believed to be associated with a variety of environmental and historical factors. These include poverty, historical trauma, bi-cultural stress, and changing tribal and family roles. There are few evaluated programs addressing early adolescent AI substance abuse. Tribal communities must be actively engaged in program development and implementation to ensure cultural relevance and sustainability of prevention programs. This project proposes to evaluate an after-school substance abuse prevention intervention, the Intertribal Talking Circle (ITC), targeting 6th grade AI youth in three AI communities: Ojibwe/Chippewa in Minnesota, Choctaw in Oklahoma, and Lumbee in North Carolina. A community-based participatory research approach will be used to culturally and technologically adapt the ITC. A two-condition controlled study will evaluate the efficacy of the ITC to increase AI youth Native self- reliance while decreasing AI youth substance use involvement. An adult training program second level intervention study is also proposed to train tribal personnel from the three regional tribes on how to implement the Intertribal Talking Circle intervention as a tribl program beyond the study period. Effectiveness will be determined by a small partial cross-over randomized trial comparing ITC intervention to a Wait-List Control (WLC) condition. Process evaluations will focus on the future adoption and implementation of the ITC, and recommendations for sustainable adaptations. The project will also build AI capacity to address health disparities, as experienced Native investigators will mentor three Junior Native Investigators.