D'Amico Elizabeth J, Dickerson Daniel L, Brown Ryan A, Johnson Carrie L, Klein David J, Agniel Denis
RAND Corporation, 1776 Main St., Santa Monica, CA 90401, United States of America.
UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior David Geffen School of Medicine, 11075 Santa Monica Blvd., Ste. 200, Los Angeles, CA 90025, United States of America.
J Subst Abuse Treat. 2020 Apr;111:86-99. doi: 10.1016/j.jsat.2019.12.011. Epub 2019 Dec 28.
To date, few programs that integrate traditional practices with evidence-based practices have been developed, implemented, and evaluated with urban American Indians/Alaska Natives (AI/ANs) using a strong research design. The current study recruited urban AI/AN teens across northern, central, and southern California during 2014-2017 to participate in a randomized controlled trial testing two cultural interventions that addressed alcohol and other drug (AOD) use. Adolescents were 14-18 years old (inclusive), and either verbally self-identified as AI/AN or were identified as AI/AN by a parent or community member. We tested the added benefit of MICUNAY (Motivational Interviewing and Culture for Urban Native American Youth) to a CWG (Community Wellness Gathering). MICUNAY was a group intervention with three workshops that integrated traditional practices with motivational interviewing. CWGs were cultural events held monthly in each city. AI/AN urban adolescents (N = 185) completed a baseline survey, were randomized to MICUNAY + CWG or CWG only, and then completed a three- and six-month follow-up. We compared outcomes on AOD use, spirituality, and cultural identification. Overall, AOD use remained stable over the course of the study, and we did not find significant differences between these two groups over time. It may be that connecting urban AI/AN adolescents to culturally centered activities and resources is protective, which has been shown in other work with this population. Given that little work has been conducted in this area, longer term studies of AOD interventions with urban AI/AN youth throughout the U.S. are suggested to test the potential benefits of culturally centered interventions.
迄今为止,很少有将传统做法与循证实践相结合的项目,针对美国城市印第安人/阿拉斯加原住民(AI/ANs),运用强大的研究设计进行开发、实施和评估。本研究在2014年至2017年期间,招募了加利福尼亚州北部、中部和南部的城市AI/AN青少年,参与一项随机对照试验,测试两种针对酒精和其他药物(AOD)使用的文化干预措施。青少年年龄在14至18岁之间(含14岁和18岁),要么口头自我认定为AI/AN,要么由父母或社区成员认定为AI/AN。我们测试了“MICUNAY(城市美国本土青少年的动机性访谈与文化)”相对于“社区健康聚会(CWG)”的额外益处。MICUNAY是一种小组干预措施,包括三个将传统做法与动机性访谈相结合的工作坊。CWG是在每个城市每月举办一次的文化活动。185名城市AI/AN青少年完成了基线调查,被随机分为MICUNAY + CWG组或仅CWG组,然后完成了三个月和六个月的随访。我们比较了两组在AOD使用、灵性和文化认同方面的结果。总体而言,在研究过程中AOD使用情况保持稳定,随着时间推移,我们没有发现这两组之间存在显著差异。或许将城市AI/AN青少年与以文化为中心的活动和资源联系起来具有保护作用,这在针对该人群的其他研究中已得到证实。鉴于该领域开展的工作较少,建议在美国各地对城市AI/AN青少年进行AOD干预的长期研究,以测试以文化为中心的干预措施的潜在益处。