University of Washington, Indigenous Wellness Research Institute Director Division of Environmental Health and Land-Based Healing, Social Work & Public Health, Seattle, WA, United States of America.
Montana State University, Bozeman, MT, United States of America.
Contemp Clin Trials. 2023 Jan;124:107013. doi: 10.1016/j.cct.2022.107013. Epub 2022 Nov 16.
Colonial historical trauma and ongoing structural racism have impacted Indigenous peoples for generations and explain the ongoing health disparities. However, Indigenous peoples have been engaging in multilevel, clinical trial interventions with Indigenous and allied research scientists resulting in promising success. In this paper, National Institutes of Health funded scientists in the field of Indigenous health have sought to describe the utility and need for multilevel interventions across Indigenous communities (Jernigan et al., 2020). We posit limitations to the existing socioecological, multilevel frameworks and propose a dynamic, interrelated heuristic framework, which focuses on the inter-relationships of the collective within the environment and de-centers the individual. We conclude with identified calls for action within multilevel clinical trial research.
殖民历史创伤和持续存在的结构性种族主义已经影响了几代原住民，并解释了持续存在的健康差距。然而，原住民一直在与原住民和联盟研究科学家一起进行多层次的临床试验干预，这取得了有希望的成功。在本文中，美国国立卫生研究院资助的原住民健康领域的科学家试图描述多层次干预措施在原住民社区中的效用和需求（Jernigan 等人，2020 年）。我们认为现有的社会生态学多层次框架存在局限性，并提出了一个动态的、相互关联的启发式框架，该框架侧重于集体在环境中的相互关系，并将重点从个人身上转移开。最后，我们提出了多层次临床试验研究中需要采取的行动。
