Pearce Margo E, Jongbloed Kate A, Richardson Chris G, Henderson Earl W, Pooyak Sherri D, Oviedo-Joekes Eugenia, Christian Wunuxtsin M, Schechter Martin T, Spittal Patricia M
School of Population and Public Health, University of British Columbia, Columbia, Canada.
Centre for Health Evaluation and Outcome Sciences, 588-1081 Burrard St., V6Z1Y6, Vancouver, BC, Canada.
BMC Public Health. 2015 Oct 29;15:1095. doi: 10.1186/s12889-015-2417-7.
Indigenous scholars have long argued that it is critical for researchers to identify factors related to cultural connectedness that may protect against HIV and hepatitis C infection and buffer the effects of historical and lifetime trauma among young Indigenous peoples. To our knowledge, no previous epidemiological studies have explored the effect of historical and lifetime traumas, cultural connectedness, and risk factors on resilience among young, urban Indigenous people who use drugs.
This study explored risk and protective factors associated with resilience among participants of the Cedar Project, a cohort study involving young Indigenous peoples who use illicit drugs in three cities in British Columbia, Canada. We utilized the Connor-Davidson Resilience Scale to measure resilience, the Childhood Trauma Questionnaire to measure childhood maltreatment, and the Symptom-Checklist 90-Revised to measure psychological distress among study participants. Multivariate linear mixed effects models (LME) estimated the effect of study variables on mean change in resilience scores between 2011-2012.
Among 191 participants, 92 % had experienced any form of childhood maltreatment, 48 % had a parent who attended residential school, and 71 % had been in foster care. The overall mean resilience score was 62.04, with no differences between the young men and women (p = 0.871). Adjusted factors associated with higher mean resilience scores included having grown up in a family that often/always lived by traditional culture (B = 7.70, p = 0.004) and had often/always spoken their traditional language at home (B = 10.52, p < 0.001). Currently knowing how to speak a traditional language (B = 13.06, p = 0.001), currently often or always living by traditional culture (B = 6.50, p = 0.025), and having recently sought drug/alcohol treatment (B = 4.84, p = 0.036) were also significantly associated with higher mean resilience scores. Adjusted factors associated with diminished mean resilience scores included severe childhood emotional neglect (B = -13.34, p = 0.001), smoking crack daily (B = -5.42, p = 0.044), having been sexual assaulted (B = 14.42, p = 0.041), and blackout drinking (B = -6.19, p = 0.027).
Young people in this study have faced multiple complex challenges to their strength. However, cultural foundations continue to function as buffers that protect young Indigenous people from severe health outcomes, including vulnerability to HIV and HCV infection.
长期以来，本土学者一直认为，研究人员必须确定与文化联系相关的因素，这些因素可能有助于预防艾滋病毒和丙型肝炎感染，并减轻年轻本土人群中历史创伤和终身创伤的影响。据我们所知，以前没有流行病学研究探讨过历史创伤和终身创伤、文化联系以及风险因素对年轻的城市吸毒本土人群恢复力的影响。
本研究探讨了雪松项目参与者恢复力的相关风险和保护因素，雪松项目是一项队列研究，涉及加拿大不列颠哥伦比亚省三个城市中使用非法药物的年轻本土人群。我们使用康纳-戴维森恢复力量表来测量恢复力，儿童创伤问卷来测量儿童期虐待情况，症状自评量表90修订版来测量研究参与者的心理困扰。多变量线性混合效应模型（LME）估计了研究变量对2011 - 2012年间恢复力得分平均变化的影响。
在191名参与者中，92%经历过任何形式的儿童期虐待，48%的父母曾就读于寄宿学校，71%曾在寄养机构生活过。总体恢复力平均得分为62.04，年轻男性和女性之间无差异（p = 0.871）。与较高平均恢复力得分相关的调整因素包括在一个经常/一直遵循传统文化生活的家庭中长大（B = 7.70，p = 0.004）以及在家中经常/一直说本民族传统语言（B = 10.52，p < 0.001）。目前会说本民族传统语言（B = 13.06，p = 0.001）、目前经常或一直遵循传统文化生活（B = 6.50，p = 0.025）以及最近寻求过毒品/酒精治疗（B = 4.84，p = 0.036）也与较高的平均恢复力得分显著相关。与较低平均恢复力得分相关的调整因素包括严重的儿童期情感忽视（B = -13.34，p = 0.001）、每天吸食快克可卡因（B = -5.42，p = 0.044）、遭受过性侵犯（B = 14.42，p = 0.041）以及狂饮（B = -6.19，p = 0.027）。
本研究中的年轻人在增强自身力量方面面临多重复杂挑战。然而，文化基础继续发挥缓冲作用，保护年轻本土人群免受严重健康后果的影响，包括易感染艾滋病毒和丙型肝炎。
