Development and Implementation of a Culturally Centered Opioid Prevention Intervention for American Indian/Alaska Native Young Adults in California

项目总结/摘要 美国印第安人/阿拉斯加原住民（AI/AN）受阿片类药物流行病的影响不成比例。他们 阿片类药物使用障碍（OUD）和药物过量死亡的诊断率最高。COVID- 19大流行极大地改变了卫生保健环境中提供卫生干预措施的方式， 我们不得不改变我们新的阿片类药物使用预防干预城市AI/AN新兴成年人虚拟在 大流行的开始。尽管我们已经成功地从28个州招募到了我们的员工， 研究并让这些人完成调查，我们遇到了保留的挑战， 随着疫情的发展，在线研讨会。随着COVID-19发病率开始下降，我们新兴的成年人 人口开始更多地重新参与娱乐，社会，教育和就业活动， 参加和保留讲习班的人数减少。因此，我们再次转向提高可行性， 和交付能力的预防和连接的城市土著美国人（TACUNA），通过减少我们的 讲习班1小时，认识到现实的变焦疲劳和忙碌和积极的生活方式，我们的研究 人口该补助金的目的是在父母补助金的范围内，但通过以下方式扩大补助金： 为我们提供了一个独特的机会来分析和比较虚拟1小时 与我们最初计划的2小时工作坊。我们有158名参与者被分配到 2-小时TACUNA节目。这一补充将使我们能够获得额外的50名参与者的1小时 TACUNA程序，所以我们可以在这个新的条件下获得总N= 75。目标1。评估 TACUNA的虚拟1小时版本和TACUNA的2小时版本对父母的主要结果 3个月、6个月和12个月补助金：开始使用类阿片和酒精及其他药物， 大麻，以及相关的后果;与使用阿片类药物、酒精和其他药物的同龄人在一起的时间， 和同伴使用的普遍性。目标2.检查总体参与率和保留率是否不同 在虚拟的1小时塔丘纳和2小时塔丘纳之间。目标3：检查是否存在差异 虚拟1小时TACUNA和2小时TACUNA之间的定量和定性满意度， 混合方法分析这是第一个研究，以评估影响程序的变化，不得不作出 由于COVID-19大流行，特别是通过比较阿片类药物，酒精和大麻的结果， 接受1小时虚拟TACUNA研讨会的AI/AN新兴成年人与接受2小时虚拟TACUNA研讨会的成年人相比 工作坊.有很大的潜力来证明TACUNA如何能够满足部落多样化的需求 居住在城市和其他非保留区的AI/AN新兴成年人的异质人口 这项研究还将提供有关参与者如何看待这两个版本的关键信息 这些虚拟研讨会使用混合方法的方法。

PROJECT SUMMARY/ABSTRACT American Indian/Alaska Native (AI/AN) people are disproportionately affected by the opioid epidemic. They have the highest rates of diagnosis for opioid use disorders (OUD) and deaths from drug overdose. The COVID- 19 pandemic dramatically changed how health interventions are delivered within the healthcare setting, and we had to change our new opioid use prevention intervention for urban AI/AN emerging adults to virtual at the beginning of the pandemic. Although we have been successful in recruiting individuals from 28 states into our study and having these individuals complete surveys, we have encountered challenges with retention in the online workshops as the pandemic has progressed. As COVID-19 rates began to decrease, our emerging adult population began to re-engage more with recreational, social, education, and employment activities, and participation and retention in the workshops decreased. We thus pivoted once again to increase both feasibility and deliverability of Traditions and Connections for Urban Native Americans (TACUNA) by decreasing our workshops to 1-hour, recognizing realities of zoom fatigue and the busy and active lifestyles of our study population. The aims of this supplement are within scope of the parent grant, yet expand the grant by providing us with a unique opportunity to analyze and compare benefits of deliverability of the virtual 1-hour workshops with our originally planned 2-hour workshops. We have 158 participants who were assigned to the 2-hour TACUNA program. This supplement will allow us to obtain an additional 50 participants for the 1-hour TACUNA program, so we can obtain a total N= 75 in this new condition. Aim 1. Assess differences between the virtual 1-hour version of TACUNA and the 2-hour version of TACUNA on the main outcomes of the parent grant at 3-, 6- and 12-months: initiation and escalation of opioid use and alcohol and other drug use, such as marijuana, and related consequences; time spent around peers who use opioids and alcohol and other drugs, and perceived prevalence of peer use. Aim 2. Examine whether overall participation and retention differs between the virtual 1-hour TACUNA and 2-hour TACUNA. Aim 3. Examine whether there are differences on both quantitative and qualitative satisfaction between the virtual 1-hour TACUNA and 2-hour TACUNA using a mixed methods analysis. This is the first study to evaluate effects of procedural changes that had to be made due to the COVID-19 pandemic, specifically by comparing opioid, alcohol and cannabis outcomes for urban AI/AN emerging adults who receive 1-hour virtual TACUNA workshops compared to those who receive 2-hour workshops. There is great potential to demonstrate how TACUNA can meet the needs of the tribally-diverse and heterogeneous population of AI/AN emerging adults residing in urban and other non-reservation areas throughout the U.S. This study will also provide critical information on how participants view the two versions of these virtual workshops using a mixed methods approach.