Mohatt Gerald V, Fok Carlotta Ching Ting, Henry David, Allen James
Center for Alaska Native Health Research (CANHR), University of Alaska Fairbanks, Fairbanks, AK, USA.
Am J Community Psychol. 2014 Sep;54(1-2):153-69. doi: 10.1007/s10464-014-9646-2.
The Elluam Tungiinun and Yupiucimta Asvairtuumallerkaa studies evaluated the feasibility of a community intervention to prevent suicide and alcohol abuse among rural Yup'ik Alaska Native youth in two remote communities. The intervention originated in an Indigenous model of protection, and its development used a community based participatory research process. Feasibility assessment aimed to assess the extent to which (1) the intervention could be implemented in rural Alaska Native communities, and (2) the intervention was capable of producing measurable effects. Scales maximally sensitive to change were derived from earlier measurement work, and the study contrasted implementation process and outcomes across the two communities. In one community, medium dose response effects (d = .30-.50), with dose defined as number of intervention activities attended, were observed in the growth of intermediate protective factors and ultimate variables. In the other community, medium dose effects were observed for one intermediate protective factor variable, and small dose effects were observed in ultimate variables. Differences across communities in resources supporting intervention explain these contrasting outcomes. Results suggest implementation in these rural Alaska settings is feasible when sufficient resources are available to sustain high levels of local commitment. In such cases, measureable effects are sufficient to warrant a prevention trial.
埃卢阿姆·通吉努恩(Elluam Tungiinun)和尤皮乌西姆塔·阿斯瓦尔图姆勒卡(Yupiucimta Asvairtuumallerkaa)研究评估了一项社区干预措施在阿拉斯加农村两个偏远社区预防Yup'ik阿拉斯加原住民青年自杀和酗酒问题的可行性。该干预措施源自一种本土保护模式,其开发采用了基于社区的参与性研究过程。可行性评估旨在评估:(1)该干预措施在阿拉斯加农村原住民社区实施的程度;(2)该干预措施能够产生可衡量效果的程度。对变化最敏感的量表源自早期的测量工作,该研究对比了两个社区的实施过程和结果。在一个社区,观察到中等剂量反应效应(d = 0.30 - 0.50,剂量定义为参加的干预活动数量),表现在中间保护因素和最终变量的增长方面。在另一个社区,观察到一个中间保护因素变量有中等剂量效应,最终变量有小剂量效应。支持干预的社区资源差异解释了这些不同的结果。结果表明,在阿拉斯加这些农村地区,如果有足够资源维持高水平的当地参与度,实施该干预措施是可行的。在这种情况下,可衡量的效果足以开展一项预防试验。