Abstract：
Prior research suggests that culturally aligned, accessible and lower-barrier interventions are well-placed to align with the needs of American Indian and Alaska Native (AI/AN) people with alcohol use disorder (AUD). Taking into account community members\' suggestions and the need for physical distancing during the COVID-19 pandemic, our team developed a protocol for virtual Harm Reduction Talking Circles (HaRTC) to incorporate these points. The aims of this 8-week, single-arm pilot were to initially document feasibility, acceptability, and outcomes associated with attendance at virtual HaRTC, which integrates the accessibility of virtual connection, a lower-barrier harm-reduction approach, and a culturally aligned intervention. Participants (N = 51) were AI/AN people with AUD (current or in remission) across 41 Tribal affiliations and 25 US states. After a baseline interview, participants were invited to attend 8, weekly virtual HaRTC sessions. At the baseline, midpoint and post-test assessments, we collected data on virtual HaRTC acceptability, cultural connectedness, quality of life, and alcohol outcomes. Of the 123 people approached, 63% were interested in and consented to participation. Participants attended an average of 2.1 (SD = 2.02) virtual HaRTC sessions, with 64% of participants attending at least one. On a scale from 1 to 10, participants rated the virtual HaRTC as highly acceptable (M = 9.3, SD = 1.9), effective (M = 8.4, SD = 2.9), culturally aligned (M = 9.2, SD = 1.5), helpful (M = 8.8, SD = 1.9), and conducted in a good way (M = 9.8, SD = 0.5). Although the single-arm study design precludes causal inferences, participants evinced statistically significant decreases in days of alcohol use and alcohol-related harm over the three timepoints. Additionally, both sense of spirituality, which is a factor of cultural connectedness, and health-related quality of life increased over time as a function of the number of HaRTC sessions attended. Virtual HaRTC shows initial feasibility and acceptability as a culturally aligned intervention for AI/AN people with AUD. Future randomized controlled trials will provide a test of the efficacy of this approach.
摘要：
先前的研究表明，在文化上是一致的，可获得和低障碍的干预措施处于有利位置，以符合美国印第安人和阿拉斯加原住民（AI/AN）酒精使用障碍（AUD）患者的需求。考虑到社区成员的建议和COVID-19大流行期间身体距离的需要，我们的团队开发了一个虚拟减害谈话圈子(HaRTC)的协议来整合这些要点.这8周的目标，单臂飞行员最初要记录可行性，可接受性,以及与虚拟HaRTC出勤相关的结果，它集成了虚拟连接的可访问性，低屏障减少伤害的方法，和文化上一致的干预。参与者（N=51）是41个部落成员和25个美国州的AUD（当前或缓解）的AI/AN人。在基线采访之后，参与者被邀请参加8次每周一次的虚拟HaRTC会议.在基线，中点和测试后评估，我们收集了有关虚拟HaRTC可接受性的数据，文化联系,生活质量,酒精的结果。在接近的123人中，63%的人有兴趣并同意参与。参与者平均参加了2.1(SD=2.02)次虚拟HaRTC会议，64％的参与者至少参加了一次。在1到10的范围内，参与者将虚拟HaRTC评为高度可接受（M=9.3，SD=1.9），有效(M=8.4，SD=2.9)，文化一致(M=9.2，SD=1.5)，有帮助（M=8.8，SD=1.9），并以良好的方式进行（M=9.8，SD=0.5）。尽管单臂研究设计排除了因果关系，参与者在3个时间点的饮酒天数和与酒精相关的伤害方面表现出统计学上显著的减少.此外,两种灵性的感觉，这是文化联系的一个因素，随着时间的推移,与健康相关的生活质量随着参加HaRTC会议次数的增加而增加。VirtualHaRTC显示了作为具有AUD的AI/AN人群的文化一致干预措施的初始可行性和可接受性。未来的随机对照试验将提供这种方法的有效性测试。
