Elluam Tungiinun - Toward Wellness

描述（由申请人提供）：阿拉斯加原住民面临与酒精使用障碍和自杀相关的重大健康差异。Elluam Tungiinun是一个爱斯基摩语，可以翻译为“走向健康”。“Elluam Tungiinun（ET）是一种基于文化的预防性干预措施，旨在减少阿拉斯加土著Yup'ik爱斯基摩青年的自杀风险和共同病态的未成年饮酒。ET过程方法将其干预计划与阿拉斯加每个农村社区的当地需求和文化联系起来，通过一套密集的社区合作研究人员适应过程程序来服务。该提案旨在为在五个偏远的Yup'ik农村社区对239名12至18岁的青少年进行为期五年的ET干预CBPR预防试验提供资金。一个样本的159.in三个社区将测试有效性两年后，干预使用随机动态等待列表控制设计，沿着的保真度的ET情境化过程的方法干预模型。80个样本将在另外两个社区测试五年内影响的持久性和可持续性，我们在过去三年中与这些社区合作开发和试点ET干预措施。这项提案代表了与阿拉斯加土著人进行的为期15年的CPBR进程的下一阶段。 Elluam Tungiinun有三个具体目标： 具体目标1：通过使用随机分配的、交错的基线、动态等待列表控制设计与三个偏远的农村AN村庄在完成干预时对结果测量的影响对比来测试ET干预的有效性。 具体目标二：在三个社区测试实施教育技术工具箱本地情境化方法对教育技术干预模式的保真度，以及保真度对结果的影响。 具体目标3：在干预后第1年和第2年，在随机分配的社区1- 3，以及在制定和试行干预措施的社区4- 5，监测干预措施对成果措施影响的可持续性和持久性。 该项目的最终目标是为阿拉斯加原住民创造基于证据的预防做法。该项目对公共卫生的相关性有三个直接贡献。它旨在（1）减少不成比例地影响阿拉斯加原住民和美洲印第安人的公共卫生重要性的健康差异的最重要来源，（2）在与部落社区的健康相关研究中推进CBPR方法， 其他少数民族、社会经济地位低、医疗服务不足和农村人口，以及（3）加强对土著和其他少数民族群体健康预测因素的理解。

DESCRIPTION (provided by applicant): Alaska Natives face significant health disparities associated with alcohol use disorders and suicide. Elluam Tungiinun is a Yup'ik Eskimo term translatable as "towards wellness." Elluam Tungiinun (ET) is a culturally-based preventative intervention to reduce suicide risk and co-morbid underage drinking among Alaska Native Yup'ik Eskimo youth. The ET process approach contextualizes its intervention program to the local needs and culture of each rural Alaska community it serves through a set of intensive community co-researcher adaptation process procedures. This proposal seeks funding for a five-year CBPR prevention trial of the ET intervention with 239 youth, ages 12 through 18, in five rural, remote Yup'ik communities. A sample of 159.in three communities will test effectiveness two years post intervention using a randomized dynamic wait list control design, along with the fidelity of the ET contextualizing process approach to the intervention model. A sample of 80 will test durability and sustainability of impact over five years in two additional communities with whom we have worked in the past three years developing and piloting the ET intervention. This proposal represents the next stage in a 15-year CPBR process with Alaska Natives. Elluam Tungiinun has three specific aims: Specific Aim 1: Test the effectiveness of the ET intervention through contrasts of impact on outcome measures using a randomly assigned, staggered baseline, dynamic wait list control design with three remote, rural AN villages at completion of the intervention. Specific Aim 2: Test the fidelity of implementation of the ET toolbox local contextualization approach to the ET intervention model in three communities, and impact of fidelity on outcomes. Specific Aim 3: Monitor the sustainability and durability of intervention impact on outcome measures in randomly assigned communities 1- 3 at year 1 and 2 post intervention, and in communities 4- 5, where the intervention was developed and piloted, at year 1-5 post intervention. The ultimate goal of this project is to create evidence-based prevention practices for Alaska Natives. The project has three direct contributions to public health relevance. It seeks to (1) reduce the most significant source of health disparity of public health importance disproportionately affecting Alaska Natives and American Indians, (2) advance CBPR methods in health related research with tribal communities and other ethnic minority, low socioeconomic status, medically underserved, and rural populations, and (3) enhance understanding of factors predictive of health among indigenous and other ethnic minority groups.