Montana State University, Bozeman, MT, USA.
Spark Ideas, LLC, Venice, CA, USA.
Am J Community Psychol. 2019 Sep;64(1-2):72-82. doi: 10.1002/ajcp.12354. Epub 2019 Jul 10.
Studies have documented serious disparities in drug and alcohol-related morbidity and mortality among American Indians and Alaska Natives (AI/ANs) compared to other ethnic groups in the U.S. despite high rates of abstinence in these groups. Further complicating these health disparities are barriers to accessing evidence-based treatments that are culturally appropriate and acceptable. As part of a research program to promote health equity in rural communities, we developed an academic-community partnership to create a culturally grounded intervention for adults with substance use disorder (SUD) residing on a rural AI reservation. We describe the early phases of our long-term Community Based Participatory Research project and report findings from the first study we conducted. This key informant interview study consisted of in-depth qualitative interviews with 25 tribal members knowledgeable about substance use and recovery on the reservation. The goal was to understand social norms and cultural conceptualizations of substance use to inform the development of a sustainable, community-driven intervention. Participants reported that a holistic approach to recovery that emphasizes spiritual, cultural, and interpersonal harmony and connectedness was important to the community and would be necessary for the intervention to succeed. They also emphasized the need for a multi-level intervention targeting individuals, families, and the community as a whole. Through this initial study, we not only gained valuable information that will be used to guide future research and treatment efforts, but we also strengthened our partnership and built trust with the community. In this manuscript we tell the story of the development of our project and describe our shared vision for future directions.
研究表明，与美国其他族裔相比，美洲印第安人和阿拉斯加原住民（AI/ANs）在药物和酒精相关的发病率和死亡率方面存在严重差异，尽管这些群体的禁欲率很高。进一步使这些健康差距复杂化的是，这些群体在获得文化上适当和可接受的循证治疗方面存在障碍。作为促进农村社区健康公平研究计划的一部分，我们建立了一个学术-社区伙伴关系，为居住在农村 AI 保留地的有药物使用障碍（SUD）的成年人创建了一种基于文化的干预措施。我们描述了我们长期社区参与式研究项目的早期阶段，并报告了我们进行的第一项研究的结果。这项关键知情人访谈研究包括对保留地内 25 名了解药物使用和康复情况的部落成员进行深入的定性访谈。目标是了解药物使用的社会规范和文化概念，为制定可持续的、社区驱动的干预措施提供信息。参与者报告说，强调精神、文化和人际和谐与联系的康复整体方法对社区很重要，干预措施要取得成功是必要的。他们还强调需要针对个人、家庭和整个社区的多层次干预措施。通过这项初步研究，我们不仅获得了宝贵的信息，这些信息将用于指导未来的研究和治疗工作，而且还加强了我们与社区的伙伴关系并建立了信任。在本文中，我们讲述了我们项目的发展过程，并描述了我们对未来方向的共同愿景。
