Developing and evaluating a culturally grounded Mother-Daughter intervention to promote protective factors and reduce early substance use among Apache girls

项目摘要 这项研究、开发和评估了一种基于文化基础的母女干预措施，以促进 保护因素，减少阿帕奇女孩的早期药物使用和相关的性风险， 解决了美国印第安人(AI)女性早期药物使用开始出现危险的上升趋势 针对性别的、文化驱动的方法。国家和部落的数据显示：1)女孩的药物使用正在追赶 或超过男孩；2)女孩使用物质的原因不同于男孩；3)对健康的影响更大 对女孩有害；4)保护因素方法似乎比减少风险策略更有效 人工智能社区。这项研究的主要目标是测试一种新颖的、有文化根基的 母女干预，挖掘母系文化资产，加强保护，降低风险 阿帕奇女孩过渡期间早期使用药物及相关不安全性行为的因素 一直到青春期。干预变化的目标调解人基于WMAT-JHU团队的强大路线 研究，包括：积极的产妇(母亲和其他女性照料者)监测和参与， 母女沟通与女儿积极的文化认同、情绪调节和积极 同龄人组选择。这项研究的三个主要目的是：1)定性地收集社区态度， 关于早期药物使用和性危险行为的保护性因素和危险因素的信念和行为 阿帕奇女性。通过30次深度采访和10个焦点小组，或者直到达到饱和，我们将 深入了解：与女孩发展积极的文化和社区有关的信仰和做法 身份认同；文化、家庭和社区力量，促进女孩在青春期期间的积极过渡； 女孩与其母亲和其他成年女性照顾者之间的保护性关系的特点； 以及女孩使用药物和性冒险行为的其他决定因素。2)设计具有文化内涵的 对8至11岁的青春期前女孩及其母亲/女性进行扎实的“母女”干预 照顾者。干预将由训练有素的阿帕奇行为健康干预者提供。3) 评估干预措施的可行性、可接受性和初步效果，包括40名母亲-- 女儿夫妇和相关的女性照顾者(即祖母、阿姨)。这项提议是非常重要的 考虑到年轻人早期使用药物和性危险行为的威胁性组合，意义重大 人工智能女孩的代际周期意外怀孕和不良的行为健康结果。这项研究 将应用强有力的证据证明亲子策略可以防止青少年使用药物 开发一种新颖的母女干预方法。如果研究目标实现，我们将产生一种性别- 建立在阿帕奇文化和母系保护因素基础上的特定代际干预措施，以减少早期 阿帕奇女孩的药物使用和相关的性危险行为，对其他土著女孩也有影响 社区。

Project Summary This study, Developing and evaluating a culturally grounded “Mother-Daughter” intervention to promote protective factors and reduce early substance use and associated sexual risk among Apache girls, addresses a dangerous upturn in early substance use initiation among American Indian (AI) females through a gender-specific, culturally driven approach. National and tribal data show: 1) girls’ substance use is catching up or exceeding boys’; 2) girls use substances for different reasons than boys; 3) health effects are more deleterious for girls; and 4) protective factor approaches appear more effective than risk reduction strategies in AI communities. The primary goal of this research is to test the feasibility of a novel, culturally grounded mother-daughter intervention that taps matrilineal cultural assets to enhance protective and reduce risks factors for early substance use and associated unsafe sexual behaviors among Apache girls as they transition through puberty. Targeted mediators of intervention change are based on a strong line of WMAT-JHU team research, and include: positive maternal (mother and other female caregiver) monitoring and involvement, mother-daughter communication and daughter’s positive cultural identity, emotional regulation, and positive peer group selection. This study’s three primary aims are: 1) To qualitatively gather community attitudes, beliefs and practices about protective and risk factors for early substance use and sexual risk behaviors among Apache females. Through 30 in-depth interviews and 10 focus groups, or until saturation is reached, we will obtain insights on: beliefs and practices related to girls’ development of positive cultural and community identity; cultural, familial and community strengths that promote girls’ positive transition through puberty; characteristics of protective relationships between girls and their mothers and other adult female caregivers; and other determinants of girls’ substance use and sexual risk-taking behaviors. 2) To design a culturally grounded “mother-daughter” intervention for pre-pubescent girls ages 8 to 11 and their mothers/ female caregivers. The intervention will be delivered by trained Apache behavioral health interventionists. 3) To assess the feasibility, acceptability, and preliminary effectiveness of the intervention with n=40 mother- daughter dyads and associated female caregivers (i.e., grandmothers, aunties). This proposal is highly significant given the threatening combination of early substance use and sexual risk behaviors among young AI girls on intergenerational cycles of unintended pregnancy and poor behavioral health outcomes. The study will apply strong evidence that parent-child strategies can prevent adolescent substance use to the development of a novel mother-daughter intervention. If study aims are achieved, we will produce a gender- specific intergenerational intervention built on Apache cultural and matrilineal protective factors to reduce early substance use and related sexual risk behaviors among Apache girls, with import to other indigenous communities.