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首页> 外文期刊>Prevention science: the official journal of the Society for Prevention Research >Multi-Level Cultural Intervention for the Prevention of Suicide and Alcohol Use Risk with Alaska Native Youth: a Nonrandomized Comparison of Treatment Intensity
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Multi-Level Cultural Intervention for the Prevention of Suicide and Alcohol Use Risk with Alaska Native Youth: a Nonrandomized Comparison of Treatment Intensity

机译：用于预防自杀和酒精使用风险的多级文化干预患者与阿拉斯加本地青年：治疗强度的非粗糙比较

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摘要

Suicide and alcohol use disorders are primary determinants of health disparity among Alaska Native people in contrast to the US general population. Qungasvik, a Yup'ik word for toolbox, is a strengths-based, multi-level, community/cultural intervention for rural Yup'ik youth ages 12-18. The intervention uses "culture as intervention" to promote reasons for life and sobriety in young people using local expertise, high levels of community direction, and community based staff. The intervention is grounded in local practices and adaptive to local cultural differences distinctive to rural Yup'ik communities. The current study compares the effectiveness of high-intensity intervention in one community (treatment), operationalized as a high number of intervention activities, or modules, implemented and attended by youth, contrasted to a lower intensity intervention in a second community (comparison) that implemented fewer modules. A Yup'ik Indigenous theory of change developed through previous qualitative and quantitative work guides intervention. In the model, direct intervention effects on proximal or intermediate variables constituting protective factors at the individual, family, community, and peer influences levels lead to later change on the ultimate prevention outcome variables of Reasons for Life protective from suicide risk and Reflective Processes about alcohol use consequences protective from alcohol risk. Mixed effects regression models contrasted treatment and comparison arms, and identified significant intervention effects on Reasons for Life (d = 0.27, p .05) but not Reflective Processes.
机译：自杀和酒精使用障碍是阿拉斯加本地人与美国一般人群相比的卫生差异的主要决定因素。 qugaSvik是一个用于工具箱的Yup'ik Word，是一个基于优势的，多级，社区/文化干预，为农村Yup'ik Youth 12-18岁。干预使用“文化作为干预”，促进使用当地专业知识，高水平的社区方向和社区工作人员的青少年生命和清醒的原因。干预措施在地方做法基础，适应当地文化差异与农村的yup'ik社区不同。目前的研究比较了一个社区（治疗）的高强度干预的有效性，作为大量干预活动，或由青年实施和参加的模块，与第二个社区（比较）的较低强度干预形成鲜明对比实现了更少的模块。通过以前的定性和定量工作指南干预制定了yup'ik土着变革理论。在模型中，对构成个人，家庭，社区和同行影响水平的保护因素的近端或中间变量的直接干预效应导致后来的终身预防结果变化，从自杀风险和反射过程中获得终身保护性的原因和关于酒精的反思过程利用保护性的后果免受酒精风险。混合效果回归模型对比治疗和比较臂，并确定了对寿命的原因的显着干预效果（D = 0.27，P <.05）但不是反射过程。

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