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距的主要决定因素之一 酒精可归因性死亡率大大高于白人(73.8/10万比27.5)，以及 因此，这是对土著青年最佳健康和福祉的关键威胁。住在这两个地方的土著青年 美国和加拿大往往比大多数人更早开始使用酒精、烟草和其他药物(ATOD) 其他人种/种族群体，倾向于更快地转向常规使用，导致更早出现ATOD 精神错乱。尽管这一问题十分严重，但仍然存在尚未得到满足的对有效 为美国和加拿大的土著居民量身定做的预防计划。整体而言 该项目的目标是开发和获得关于可接受性、可行性和初步的初步数据 当地路径的有效性(减少药物使用危害的积极方法)。本机路径是 针对5-8年级土著青少年的基于优势的家庭预防计划，重点是延迟 ATOD启动。原生路径的发展一直受到我们在这个社区的形成工作的指导， 采取行为经济学和积极心理学的方法进行预防。应用于预防， 行为经济学理论侧重于减少ATOD的可获得性，增加ATOD的无效性 替代方案和从事不含ATOD的活动所获得的加强。原生路径中的活动 将与家庭合作，帮助建立无ATOD的规则，限制ATOD在家中的实际可用性， 并加强青少年对无兴奋剂活动的参与。积极的心理干预(PPI)侧重于 增加积极的情绪、生活满意度和幸福感。我们会采用私人投资意向书，以加强市民的享受。 从不含ATOD的活动中获得，并提高生活满意度。本机路径在文化上与 北美土著的健康观点，描述健康是指身体健康， 生命的精神、情感和精神方面，这在药轮的教义中得到了体现。 我们将与我们的部落合作伙伴共同努力，进一步调整我们的计划，包括 家庭和土著以具有文化意义的方式养育子女。建议项目的总体目标将是 1)最终确定原生路径，让青年和家庭成员参与谈话圈并进行开放试点 试验；2)评估本地路径在减少ATOD发起和使用ATOD意图方面的有效性。3) 开始评估可能的行动机制/主持人，包括未来的潜在调解人 与等待名单相比，已收到定向和替代增援/活动参与和增援 对照组。我们还将评估作为任何治疗效果的潜在调节因素的积极影响，例如 那些积极情绪较高的人将不太可能使用ATOD，也不太可能支持意图 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.