Talking Circle for Native American Youth Living Well (A Yo Li)

摘要/总结美洲原住民持续的心理健康危机表现在非常严重的 高比率的精神，情绪和行为健康障碍，如焦虑，压力，抑郁，物质 使用和自杀在美国土著青年年轻的10。COVID-19对老年人的毒性已经达到 美国原住民社区尤其困难，部落长老和母语使用者的损失已经造成了严重的影响。 对美洲原住民世代相传的语言和传统的文化纽带造成了无法估量的损失 给年轻人。COVID-19大流行加剧了所有年龄段的美洲原住民的痛苦， 他们报告了一些最高比例的心理困扰，包括抑郁，焦虑，生活 压力源、物质使用（酒精、毒品、商业烟草使用）和自杀早在大流行之前。的 2019冠状病毒病对美洲原住民社区的破坏，加上最近和长期的 种族主义和对美洲土著人的犯罪，对土著人的心理健康产生了令人震惊的影响。 美国青年即使在大流行之前，美国土著青年的自杀死亡人数也在30岁至40岁之间。 15-19岁是非西班牙裔白人的两倍多。对于一些美洲原住民社区来说，自杀是 是10-14岁青少年的主要死因。此外，美洲原住民青年开始饮酒， 在较年轻的年龄（约11岁），并在较高的比率比所有其他物质和商业烟草， 种族群体。对于已经在挣扎的人口来说，COVID-19大流行是灾难性的，增加了 美国原住民青年自杀和其他心理健康疾病的风险已经很高。因此， 迫切需要改善美国土著青年心理、情感和行为健康结果。到 为了满足这一迫切需求，我们的总体目标是利用经验证明，高效，学校 基于，谈话圈干预，以促进心理，情绪，和行为健康的地理 不同的（农村与城市）美国土著青年。这项研究，“美国土著青年生活谈话圈” Well（A Yo Li）”采用基于社区的调查研究（CBPR）的方法来评估谈话圈 有效性，与俄克拉荷马州的切罗基部落的联合基托瓦乐队（UKB）合作， 成员生活在两个不同的地理区域，农村和城市。UKB部落语言中的“A Yo Li” 意思是“青春”谈话圈干预将作为课后计划在每个学校实施， 参与学校。课外活动是谈话圈干预的理想场所。课后 在许多美国原住民社区，家长、学生和教师都喜欢这些项目，因为它们 为青少年在正常的课余时间提供有组织的教育机会和活动， 父母/监护人仍然忙碌工作或其他责任。根据我们KB部落的偏好 合作伙伴，道德考虑，所有的学生最终都会接受干预，从而控制 条件是waitlist-control。

Abstract/Summary The ongoing mental health crisis among Native Americans manifests in extraordinarily high rates mental, emotional, and behavioral health disorders such as anxiety, stress, depression, substance use, and suicide in Native American youth as young as 10. The virulence of COVID-19 for older people has hit Native American communities particularly hard, and the loss of Tribal Elders and Native speakers has taken an incalculable toll on the cultural ties of language and tradition that flow from Elder Native American generations to the young. The COVID-19 pandemic has exacerbated the suffering of Native American people of all ages, who reported some of the highest rates of psychological distress that include depression, anxiety, life stressors, substance use (alcohol, drugs, commercial tobacco use), and suicide long before the pandemic. The devastation of Native American communities from COVID-19, coupled with both a recent and long history of racism and crimes against Native American people, has had an alarming effect on the mental health of Native American youth. Even before the pandemic, suicide fatalities for Native American youth between the ages of 15–19 was more than double that of non-Hispanic whites. For some Native American communities, suicide is the leading cause of death for youth ages 10-14. Moreover, Native American youth begin to use alcohol, other substances and commercial tobacco at younger ages (around the age of 11), and at higher rates, than all other ethnic groups. For a population already struggling, the COVID-19 pandemic is calamitous, increasing the already high risk for suicide and other mental health disorders of Native American youth. Thus, interventions to improve Native American youth mental, emotional, and behavioral health outcomes are urgently needed. To meet this urgent need, our overarching objective is to leverage the empirically proven, highly effective, school based, Talking Circle Intervention to promote the mental, emotional, and behavioral health of geographically diverse (rural vs. urban) Native American youth. This study, “Talking Circle for Native American Youth Living Well (A Yo Li)” uses a Community Based Participatory Research (CBPR) approach to evaluate Talking Circle effectiveness, partnering with the United Keetoowah Band (UKB) of Cherokee Tribe in Oklahoma, with members living in two geographically diverse areas, rural and urban. “A Yo Li” in the UKB tribal language means “youth”. The Talking Circle Intervention will be implemented as an after-school program in each of the participating schools. After-school programs are an ideal setting for the Talking Circle intervention. After-school programs are preferred by parents, students, and teachers in many Native American communities, as they provide structured, educational opportunities and activities for youth after regular school hours, while parents/guardians are still busy with work or other responsibilities. Based upon the preference of our UKB tribal partners, and ethical considerations, all students will eventually receive the intervention, thus the control condition is waitlist-control.