Allen James, Charles Billy, Fok Carlotta Ching Ting, Lee KyungSook, Grogan-Kaylor Andrew, Rasmus Stacy
Department of Family Medicine and Biobehavioral Health and Memory Keepers Medical Discovery Team-American Indian and Rural Health Equity, University of Minnesota Medical School, Duluth Campus, Minneapolis, Minnesota, USA.
Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska, USA.
Am J Community Psychol. 2023 Mar;71(1-2):184-197. doi: 10.1002/ajcp.12621. Epub 2022 Oct 10.
We examined the effectiveness of the Qungasvik (Tools for Life) intervention in enhancing protective factors as a universal suicide and alcohol prevention strategy for young people ages 12-18 living in highly affected rural Alaska Native communities. Four communities were assigned to immediate intervention or to a dynamic wait list. Outcomes were analyzed for 239 young people at four time points over two years of community intervention. Outcomes assessed two ultimate variable protective factors buffering suicide and alcohol risk, and three intermediate variable protective factors at the individual, family, and community level. Dose dependent intervention effects were associated with growth in ultimate but not intermediate variables. This evaluation of the Qungasvik intervention provides support for the effectiveness of its Indigenous strategies for suicide and alcohol misuse prevention in this rural Alaska Native setting. Though findings did not provide support for a theory of change where growth in ultimate variables is occasioned through effects on intermediate variables, research designs focused on young people who enter intervention at lower levels of preexisting protection hold promise for better understanding of intervention change processes. The Qungasvik intervention is responsive to an acute public health need for effective rural Alaska Native suicide and alcohol risk prevention strategies.
我们考察了“昆加斯维克（生活工具）”干预措施作为一种通用的自杀和酒精预防策略，对于生活在受影响严重的阿拉斯加原住民农村社区、年龄在12至18岁的年轻人增强保护因素方面的有效性。四个社区被分配到立即干预组或动态候补名单组。在为期两年的社区干预中，在四个时间点对239名年轻人的结果进行了分析。结果评估了两个缓冲自杀和酒精风险的最终变量保护因素，以及在个人、家庭和社区层面的三个中间变量保护因素。剂量依赖性干预效果与最终变量而非中间变量的增长相关。对“昆加斯维克”干预措施的这项评估为其在阿拉斯加原住民农村地区预防自杀和酒精滥用的本土策略的有效性提供了支持。尽管研究结果并未支持一种通过对中间变量的影响导致最终变量增长的变革理论，但针对在既有保护水平较低时进入干预的年轻人的研究设计，有望更好地理解干预的变化过程。“昆加斯维克”干预措施满足了阿拉斯加原住民农村地区对有效的自杀和酒精风险预防策略的迫切公共卫生需求。
