A RCT of a Family-Centered Ojibwe Substance Abuse Prevention

 描述(由申请人提供)：本申请寻求资助一项广受欢迎、广泛传播的药物滥用预防计划的多保留随机对照试验(RCT)，该计划针对8-10岁的Anishinabe(Ojibwe)青少年、他们的父母/照顾者以及对目标儿童的行为有日常影响的大家庭成年人。Bii-Zin-Da-de-Dah(BZDDD)(相互倾听)计划是爱荷华州加强家庭计划的第一个美国印第安人(AI)改编计划。BZDDD现已进入第三代，已适应达科他州、拉科塔州、普韦布洛和纳瓦霍文化，目前是加拿大公共卫生局资助的加拿大国家土著精神健康促进项目的中心。尽管BZDDD在基层非常受欢迎，并适应了多种文化，但从未对该方案在减少青少年酗酒和吸毒方面的效果进行大规模的经验性评估。我们的总体目标是实施第四代BZDDD预防计划的RCT，该计划可被其他北美土著文化跨文化复制，以减少早期青少年的药物使用并改善心理健康结果。这一目标将通过四个具体目标来实现：1)完成针对美国保留地的为期14周的BZDDD预防计划的最终调整；2)实施BZDDD随机对照试验，以评估其在延迟和/或防止青少年开始酗酒和吸毒方面的有效性；3)通过评估社区和大家庭中的污染和非正式传播，从经验上应对涉及土著文化的随机对照试验的文化挑战；以及4)与我们的Anishinabe研究伙伴合作，制定一项持续预防的计划。使用意向治疗设计，RCT将涉及255个治疗和255个等待名单对照家庭，他们住在明尼苏达州和威斯康星州的五个Anishinabe保留地或附近。将进行前测和初始后测，随后进行6个月、12个月、18个月、24个月、30个月和36个月的随访，从而评估目标儿童在开始使用药物的关键年份。拟议的RCT将留下一个以经验为基础、以家庭为中心的预防计划，很容易融入现有的部落社会和卫生服务或学校环境。它还将成为适应其他土著文化的模板。

 DESCRIPTION (provided by applicant): This application seeks funding for a multi-reservation randomized controlled trial (RCT) of a popular, widely disseminated, substance abuse prevention program targeted at Anishinabe (Ojibwe) preadolescents aged 8-10 years, their parents/caretakers, and extended family adults who have daily influence over the target child's behaviors. The Bii-Zin-Da-De-Dah (BZDDD) (Listening to One Another) program was the first American Indian (AI) adaptation of the Iowa Strengthening Families Program. Now in its third generation, BZDDD has been adapted for Dakota, Lakota, Pueblo, and Navajo cultures and is currently the center piece of a Canadian national Indigenous mental health promotion funded by Public Health Agency of Canada. Although BZDDD has been extremely popular at the grassroots level and has been adapted to numerous cultures there has never been a large-scale empirical evaluation of the program's efficacy for reducing adolescent alcohol and drug use. Our overall goal is to implement a RCT of a fourth-generation BZDDD prevention program that can be replicated cross-culturally by other North American Indigenous cultures to decrease substance use among early adolescents and improve mental health outcomes. This goal will be accomplished through four specific aims: 1) Complete a final adaptation of the 14-week BZDDD prevention program for the U.S. reservations; 2) Implement a RCT of BZDDD to assess its efficacy for delaying and/or preventing adolescent onset of alcohol and drug use; 3) Empirically address cultural challenges for RCTs involving Indigenous cultures by evaluating contamination and informal diffusion in communities and extended families; and 4) Work with our Anishinabe research partners to develop a plan to sustain the prevention. Using intent to treat design, the RCT will involve 255 treatment and 255 waitlist control families who live on or near five Anishinabe reservations in Minnesota and Wisconsin. There will be a pretest and initial post-test, with subsequent 6, 12, 18, 24, 30, and 36 month follow-ups, thus evaluating the target children through the critical years of substance use initiation. The proposed RCT will leave behind an empirically-based, family-centered prevention program that is easily woven into existing tribal social and health services or school settings. It also will be a template for adaptation to other Indigenous cultures.