Trauma Screening, brief intervention and referral among AI/AN adults

创伤事件是生活在美国的成年人生活中常见的事件。在经历过创伤事件的人中，大约四分之一的人随后将达到创伤后应激障碍(PTSD)的全部标准；另有四分之一的人将经历部分创伤后应激障碍，并伴有严重程度的损害。创伤后应激障碍与不良的健康后果有关。包括与其他行为健康障碍、身体健康障碍和服务利用率增加的显著共病。对创伤和创伤相关疾病，包括美洲印第安人和阿拉斯加原住民的创伤后应激障碍(AI/ANS)的了解明显较少。有证据表明，AI/AN社区和临床样本中的创伤暴露和创伤相关疾病的比率高于普通美国人口。医疗保健环境为检测创伤相关疾病提供了丰富的机会。经历创伤事件的人中，有很高比例的人因创伤相关后遗症而遭受或存在的伤害而接受保健服务，甚至在事件发生多年后也是如此。提出的概念是科罗拉多大学丹佛大学美国印第安人和阿拉斯加原住民健康差异中心(P60)拨款续期内的两个相关研究项目之一。这项研究项目建立在现有研究的基础上，这些研究检查了人工智能/AN人群在初级保健环境中的行为健康筛查和检测。利用基于社区的参与式方法，拟议的研究项目将使主要利益攸关方参与考虑、开发和试点为两个独特的人工智能/AN群体提供服务的地点的AI/AN成人创伤系统筛查，具体做法如下：1)与主要利益攸关方合作，考虑和制定系统筛查创伤的方法，然后转介受影响的个人在两个AI/AN医疗保健环境中进行干预；以及2)试点创伤筛查和转诊，然后评估未来在这两个环境中进行大规模试验的可接受性和可行性。

Traumatic events are common occurrences in the lives of adults living in the United States. Roughly one quarter of those who experience a traumatic event will subsequently meet full criteria for posttraumatic stress disorder (PTSD); another quarter will experience partial PTSD with significant levels of Impairment. PTSD is related to adverse health outcomes. Including significant comorbidity with other behavioral health disorders, physical health disorders, and increased service utilization. Significantly less is known about trauma and trauma-related disorders including PTSD in American Indian and Alaska Native people (AI/ANs). Evidence suggests higher rates of trauma exposure and trauma-related disorders in AI/AN community and clinical samples than the general United States population. The health care setting offers a rich opportunity for the detection of trauma-related disorders. A high proportion of those experiencing a traumatic event receive health care services for injuries sustained or present for trauma-related sequelae even years after the event. The concept proposed is one of two related research projects within a renewal of the American Indian and ALaska Native Health Disparities center (P60) grant of the University of Colorado Denver. This research project builds upon existing studies examing behavioral health screening and detection in primary care settings for AI/AN people. Using a community based participatory approach, the proposed research project will engage key stakeholders In the consideration, development, and piloting of systematic screening for trauma among AI/AN adults at sites serving two unique AI/AN groups through the following specific alms: 1) Work with key stakeholders to consider and develop means to systematically screen for trauma then refer affected Individuals for intervention in two AI/AN health care settings; and 2) Pilot trauma screening and referral then assess the acceptability and feasibility of a future large scale trial in both settings.