Developing a Positive Approach to Substance Use Prevention in North American Indian Adolescents

项目摘要 酒精是许多土著居民健康差异的主要决定因素之一， 酒精导致的死亡率明显高于白人（73.8/10万vs. 27.5）， 因此，这是对土著青年最佳健康和福祉的关键威胁。土著青年生活在 美国和加拿大倾向于开始使用酒精、烟草和其他药物（ATOD）， 其他民族/种族群体，并倾向于更快地转向经常使用，导致ATOD的早期发作 紊乱尽管问题很严重，但仍然迫切需要采取有效措施， 针对美国和加拿大土著居民文化的预防方案。整体 本项目的目标是开发和获得关于可接受性，可行性和初始 Native PATHS（Positive Approaches to Reduce Harm from Substance Use）：减少物质使用危害的积极方法。原生路径是一个 针对五至八年级土著青年的以力量为基础的家庭预防方案， ATOD启动。本地路径的发展一直由我们在这个社区的形成工作指导， 采取行为经济学和积极心理学方法进行预防。在预防方面， 行为经济学理论的重点是减少ATOD的可用性，增加无ATOD 替代品和加强从从事无原子能机构的活动。在Native PATHS的活动 将与家庭合作，帮助建立无ATOD规则，限制ATOD在家中的物理可用性， 并加强青少年参与无ATOD活动。积极的心理干预（PPI） 增加积极情绪、生活满意度和幸福感。PPI将用于提高享受 从ATOD免费活动中获得，并提高生活满意度。本地路径在文化上与 北美原住民的健康观，从身体、心理和行为之间的平衡来描述健康， 生命的精神，情感和心理方面，这在医学轮的教导中表现出来。 我们将与部落合作伙伴合作，进一步调整我们的计划， 以文化上有意义的方式培养家庭和土著人的养育方式。拟议项目的总体目标将 1)在青年和家庭成员的参与下，最后确定土著人的道路，并进行公开试点 试验; 2）评估原生PATHS在减少ATOD启动和使用ATOD的意图方面的有效性。第三章 开始评估可能的作用机制/调节剂，包括未来的潜在介质 与等待名单相比， 对照组我们还将评估积极影响作为任何治疗效果的潜在调节剂，例如， 那些积极情感较高的人不太可能参与ATOD使用，也不太可能赞同意图 使用ATOD。

Project Summary Alcohol is one of the primary determinants of health disparity among many Indigenous populations with rates of alcohol-attributable mortality substantially higher than for Whites (73.8 per 100,000 vs. 27.5), and therefore, is a key threat to optimal health and well-being to Indigenous youth. Indigenous youth living in both the US and Canada tend to begin using alcohol, tobacco, and other drugs (ATOD) at earlier ages than most other ethnic/racial groups, and tend to move more quickly to regular use, resulting in earlier onset of ATOD disorders. Despite the severity of the problem, there continues to be an urgent unmet need for effective prevention programs that are culturally tailored to Indigenous populations of the US and Canada. The overall objective of this project is to develop and obtain preliminary data on the acceptability, feasibility, and initial efficacy of Native PATHS (Positive Approaches to reducing Harm from Substance Use). Native PATHS is a strengths-based, family prevention program for Indigenous youth in 5th-8th grade which focuses on delayed ATOD initiation. The development of Native PATHS has been guided by our formative work in this community, taking a behavioral economic and positive psychological approach to prevention. Applied to prevention, behavioral economic theory focuses on reducing the availability of ATOD and increasing ATOD-free alternatives and the reinforcement received from engaging in ATOD-free activities. Activities in Native PATHS will work with families to help with establishing ATOD-free rules, limit physical availability of ATOD in the home, and reinforce youths' participation in ATOD-free activities. Positive psychological interventions (PPIs) focus on increasing positive emotions, life satisfaction, and well-being. PPIs will be used to enhance the enjoyment received from ATOD-free activities and to improve life satisfaction. Native PATHS is culturally consistent with North American Indigenous views of health that describe health in terms of a balance between the physical, spiritual, emotional, and mental aspects of life, which is represented in the teachings of the Medicine Wheel. Collaboratively we will work together with our tribal partner on further adaptation of our program to include family and Indigenous ways of parenting in a culturally meaningful way. The overall goals proposed project will 1) finalize Native PATHS with participation from youth and family members in talking circles and an open pilot trial; 2) assess the effectiveness of Native PATHS in reducing ATOD initiation and intentions to use ATOD. 3) begin to evaluate the possible mechanisms/moderators of action including potential mediators future orientation and alternative reinfocer/activity engagement and reinforcement received, compared to a wait-list control group. We will also evaluate positive affect as a potential moderator of any treatment effect, such that those higher in positive affect will be less likely to engage in ATOD use and be less likely to endorse intentions to use ATOD.