Johns Hopkins University, Bloomberg School of Public Health, Center for American Indian Health, 415 N. Washington St., Baltimore, MD, 21231, USA.
Johns Hopkins University, Bloomberg School of Public Health, Center for American Indian Health, 415 N. Washington St., Baltimore, MD, 21231, USA.
Drug Alcohol Depend. 2021 Nov 1;228:109024. doi: 10.1016/j.drugalcdep.2021.109024. Epub 2021 Sep 4.
Early substance use disproportionately impacts Native American (Native) youth and increases their risk for future abuse and dependence. The literature urges for interventions to move beyond focusing on single risk behaviors (e.g. substance use) and instead have capacity to improve health risk behaviors co-occuring during adolescence, particularly among Native populations for whom few evidence-based interventions (EBI) exist. We evaluated the effectiveness of the Respecting the Circle of Life program (RCL) on risk and protective factors for early substance use. RCL is a culturally tailored EBI shown to improve sexual health outcomes among Native youth.
We conducted secondary analyses of data collected through a community-based randomized controlled trial of RCL evaluated among Native youth (ages 11-19) residing on a rural reservation between 2015-2020 (N = 534, 47.4 % male). We used linear regression, controlling for baseline age and sex, to test between study group differences in outcomes at 3-, 9-, and 12-month post-intervention. Models were stratified by sex and age (11-12, 13-14, and 15+ years of age) to examine differences within these subgroups.
Youth receiving RCL reported lower intention to use substances through 12-months follow-up (p = 0.006). Statistically significant improvements were also observed across peer, parent, and sexual partner risk and protective factors to delay substance use initiation, with notable differences among boys and participants ages 13-14.
RCL is a primary prevention, skills-based program effective in preventing risks for substance use. This evaluation underscores the value in developing programs that influence concurrent adolescent risk behaviors, especially for Native communities who endure multiple health disparities.
早期物质使用对美国原住民（Native）青年的影响不成比例，增加了他们未来滥用和依赖的风险。文献敦促干预措施不仅仅关注单一的风险行为（例如物质使用），而是要有能力改善青少年时期同时发生的健康风险行为，特别是在几乎没有基于证据的干预措施（EBI）的原住民群体中。我们评估了尊重生命之环计划（RCL）对早期物质使用的风险和保护因素的有效性。RCL 是一种经过文化调整的 EBI，已被证明可以改善原住民青年的性健康结果。
我们对 2015 年至 2020 年间在农村保留地居住的 11-19 岁原住民青年（N=534，47.4%为男性）进行了基于社区的随机对照试验收集的数据进行了二次分析。我们使用线性回归，控制基线年龄和性别，在 3、9 和 12 个月的干预后测试研究组之间的结果差异。模型按性别和年龄（11-12、13-14 和 15+岁）分层，以检查这些亚组内的差异。
接受 RCL 的青年在 12 个月的随访中报告了较低的物质使用意向（p=0.006）。在推迟物质使用开始的同伴、父母和性伴侣风险和保护因素方面也观察到了显著的改善，男孩和 13-14 岁的参与者之间存在显著差异。
RCL 是一种预防为主、基于技能的计划，可有效预防物质使用风险。这项评估强调了开发能够影响青少年同时发生的风险行为的计划的价值，特别是对于那些面临多种健康差距的原住民社区。
