Caring for Our Generations: Supporting Native Mothers and Their Families

西北部美洲印第安人是一个严重缺乏研究和服务的群体，在伊尔斯克，他们存在多种健康问题，包括怀孕期间和怀孕后母亲健康状况不佳。生活在美国的印第安人 西北地区的产妇不良和急躁的结局比率很高。这项申请是对RFA HHS-2009-HIS-NARCHV-O001的回应，涉及一个为期4年的发展项目，以探索母亲的健康行为、母亲的药物使用、孕期和怀孕后使用药物的风险因素，以及支持健康的母亲行为的保护因素。研究结果将有助于研究小组为居住在西北部的美国印第安人母亲设计一项文化上合适且可行的干预计划。这项研究以现有的初步流行病学和监测数据以及部落支助为基础，提出了五个创新和重要的目标。首先，我们将进行定性的形成性研究，涉及4个焦点群体和25个关键信息访谈，访谈对象为18-55岁的母亲、土著保健提供者、 老年/传统治疗师和土著青年(15-25岁)。第二，我们将对100名美国印第安人社区成员进行有组织的调查采访。有了这些INTEN/IEW数据，我们将建立与配偶健康结果、保护性健康行为、孕期和孕后使用药物的风险因素以及对母亲的社会支持相关的初步基线数据。第三，我们将开发和实施以文化为基础的干预措施，以西北地区的成年美国印第安人母亲为目标。第四，我们将把调查结果翻译和传播给部落，并为社区成员和服务提供者准备翻译材料。第五，在整个研究过程中，我们将努力扩大Lummi部落卫生诊所的研究基础设施，并提高部落社区的研究能力。

Northwest American Indians are a drastically understudied and underserved group, at ilsk for multiple health problems induding poor maternal health during and after pregnancy. American Indians living in the Northwest have very high rates of poor maternal and irtfant outcomes. This application, in response to RFA HHS-2009-HIS-NARCHV-O001, involves a 4-year developmental project to explore matemal health behaviors, maternal substance use, risk factors for substance use during and after pregnancy, and protective factors that support healthy matemal behaviors. Findings will assist the research team in designing a culturally appropriate and feasible intervention program for American Indian mothers living in the Northwest. Building upon existing preliminary epidemiological and surveillance data as well as tribal support, this study proposes five innovative and significant aims. First, we will conduct qualitative formative research involving 4 focus groups and 25 key infomiant interviews with mothers aged 18-55, Native health providers, elder/traditional healers, and Native youth (aged 15-25). Second, we will conduct structured survey interviews with 100 American Indian community members. With these inten/iew data, we will establish preliminary baseline data related to matemal health outcomes, protective health tjehaviors, risk factors for substance use during and after pregnancy, and social support for mothers. Third, we will develop and manualize a culturally-based intervention targeting adult American Indian mothers in the Northwest. Fourth, we will translate and disseminate the findings to the tribe and prepare translational materials for community members and service providers. Fifth, throughout the course ofthe study, we will work to expand the research infrastructure at Lummi Tribal Health Clinic and to increase research capacity in the tribal community.