Kipiyecipakiciipe "coming home": Establishing clinical cultural neuroscience as a tool for understanding the role of traditional cultural engagement in mitigating substance misuse and disorder

项目总结 尽管几十年来，美国印第安人(AI)人群中的物质使用障碍(SOD)方面的不平等现象仍然存在 意识和研究。到目前为止，在SUD研究的不同领域的进展有(1) 强调基于社区和以文化为基础的研究方法在人工智能中的重要性 (2)显示了临床神经科学在解决SUD方面的作用的前景。将这些合并为 通过临床文化神经科学的方法是该领域缺少的一环，该领域有很大的希望 在人工智能和未得到充分服务的人群中推进SUD差异研究，以及神经科学 对SUD和更广泛的恢复的理解。该方案结合了基于社区的参与式 研究(CBPR)和临床神经科学方法，以更好地描绘大脑过程 对于受传统文化参与(TCE)影响的南方共同市场而言，这一点非常重要。这项研究旨在利用 多模式神经成像技术作为一种使用OBJECT探测TCE的方法前景广阔 大脑结构和功能的标记物。将与合作伙伴合作完成TCE的概念化 来自肖尼部落(ST)。这种伙伴关系对目前的项目至关重要，因为文化包括广泛的 人类经历的一种类别，对一群人来说是共同的，通常与种族、民族、 地理分布和宗教。这种复杂性使得我们很难分析文化的影响 并有意义地将三氯乙烯纳入疾病和治疗模式。最近，健康方面的进展 人工智能社区差异研究将TCE的特征概念化 健康的社会决定因素(SDH)，以描述SUD的具体风险和复原力因素。此外，TCE 已经被支持作为对SUD的保护和治疗。 科技咨询机构认识到，历史遗失和文化习俗退化的影响是 SUD的流行情况，并致力于以社区参与为中心发展循证 利用和整合传统文化知识和习俗的干预和预防工作。 Kipiyeecipsakiciipe是ST合作伙伴选择的肖尼语单词，代表着 推进三氯乙烯的科学研究，以缓解南部地区的差异。肖尼族成年人的社区顾问委员会 将监督这项研究的设计、实施和解释。将使用三个阶段的方法 以提供对TCE作为保护性SDH的多层次理解。第一阶段将由目标为重点的小组组成 在提炼特定于ST的TCE概念化时，为行为提供深层的概念有效性 三氯乙烯神经探头及刺激物。第二阶段将检查三氯乙烯的神经探针和神经行为 在CAB定义的不同程度TCE的个体中，SUD的认知风险因素。 第三阶段将把结果扩展到患有SUD和健康对照的个体样本。这项研究将提供一个 在其他少数族裔群体中研究类似的文化因素以促进健康公平的框架。

PROJECT SUMMARY Inequities in substance use disorders (SUDs) among American Indian (AI) populations persist despite decades of awareness and research. Advancements in heretofore separate areas of SUD research have (1) underscored the importance of community based and culturally grounded research approaches in AI populations and (2) shown the promise of clinical neuroscience's role in addressing SUD. Merging these approaches through clinical-cultural neuroscience is a missing link in the field which holds large promise for advancing both SUD disparities research in AIs and underserved populations, and the neuroscientific understanding of SUD and recovery more broadly. This proposal integrates Community Based Participatory Research (CBPR) and clinical-neuroscience approaches to better delineate the brain processes that are important for SUD and that are impacted by traditional cultural engagement (TCE). The study aims to leverage the large promise of multimodal neuroimaging techniques as a method for probing TCE using objective markers of brain structure and function. Conceptualization of TCE will be done in collaboration with partners from the Shawnee Tribe (ST). This partnership is critical to the current project as culture comprises a broad category of human experiences common to a group of people and is often conflated with race, ethnicity, geographic distribution, and religion. This complexity has made it difficult to parse the influence of cultural factors and meaningfully incorporate TCE into disease and treatment models. Recently, advances in health disparities research among AI communities have conceptualized features of TCE under the framework of social determinants of health (SDH) to delineate specific risk and resilience factors for SUD. Furthermore, TCE has been supported as protective against and as treatment for SUD. The ST recognizes the impact of historical loss and degradation of cultural practices as a key factor in the prevalence of SUD and is committed to centering community engagement in developing evidence-based intervention and prevention efforts informed by and integrating traditional cultural knowledge and practices. Kipiyeecipsakiciipe “coming home” is a Shawnee word chosen by the ST partners to represent the effort of advancing the science of TCE in mitigating SUD disparities. A community advisory board of Shawnee adults will oversee the design, implementation, and interpretation of the study. A three phased approach will be used to provide a multi-level understanding of TCE as a protective SDH. Phase 1 will consist of focus groups aimed at refining a conceptualization of TCE specific to the ST to provide deep conceptual validity for behavioral probes and stimuli for neural probes of TCE. Phase 2 will examine neural probes of TCE and neurobehavioral and cognitive risk factors for SUD across individuals with varying degrees of TCE as defined by the CAB. Phase 3 will extend results to a sample of individual with SUD and healthy controls. This study will provide a framework for studying analogous cultural factor across other racial minority groups to advance health equity.