Un essai clinique randomis\u00e9 men\u00e9 aux \u00c9tats-Unis a \u00e9valu\u00e9 l\u2019efficacit\u00e9 de deux interventions virtuelles, culturellement adapt\u00e9es, visant \u00e0 r\u00e9duire l\u2019usage de substances psychoactives chez de jeunes adultes am\u00e9rindiens et natifs de l\u2019Alaska vivant en milieu urbain. Cette population est identifi\u00e9e comme pr\u00e9sentant des taux plus \u00e9lev\u00e9s de troubles li\u00e9s \u00e0 l\u2019usage de substances et de d\u00e9tresse psychologique que d\u2019autres groupes raciaux et ethniques, alors que peu de programmes fond\u00e9s sur des preuves existent sp\u00e9cifiquement pour elle, en particulier en milieu urbain.<\/p>\n
L\u2019\u00e9tude a recrut\u00e9 des participants \u00e0 l\u2019\u00e9chelle nationale entre le 1er d\u00e9cembre 2020 et le 27 octobre 2023. Les crit\u00e8res d\u2019\u00e9ligibilit\u00e9 incluaient : avoir entre 18 et 25 ans, r\u00e9sider en zone urbaine (hors r\u00e9serves et rancherias), s\u2019auto-identifier comme Am\u00e9rindien ou natif de l\u2019Alaska, ne pas pr\u00e9senter de trouble li\u00e9 \u00e0 l\u2019usage d\u2019opio\u00efdes, et parler anglais. Les participants ont rempli un questionnaire de base puis ont \u00e9t\u00e9 r\u00e9partis al\u00e9atoirement dans l\u2019un des deux dispositifs d\u2019intervention et suivis par enqu\u00eates \u00e0 3, 6 et 12 mois. Le suivi s\u2019est achev\u00e9 le 28 janvier 2025. L\u2019analyse a \u00e9t\u00e9 conduite en intention de traiter. Au total, 541 jeunes adultes ont \u00e9t\u00e9 inclus, majoritairement des femmes (451, soit 83,2 %), avec un \u00e2ge moyen de 22,1 ans.<\/p>\n
Les participants ont re\u00e7u soit trois ateliers du programme Traditions and Connections for Urban Native Americans (TACUNA) compl\u00e9t\u00e9s par un cercle de bien-\u00eatre, soit un atelier culturel d\u2019\u00e9ducation sur les opio\u00efdes et de sant\u00e9 et bien-\u00eatre (Health and Wellness Cultural, HWC), assimil\u00e9 aux soins usuels. Les questionnaires mesuraient en indicateur principal l\u2019usage d\u2019opio\u00efdes, d\u2019alcool et de cannabis, et, en indicateurs secondaires, les cons\u00e9quences de ces consommations, la sant\u00e9 mentale, le lien culturel et l\u2019influence des pairs.<\/p>\n
Dans les deux groupes (TACUNA et HWC), les r\u00e9sultats montrent une baisse de la fr\u00e9quence d\u2019usage du cannabis, une diminution des scores positifs de d\u00e9pistage de troubles li\u00e9s \u00e0 l\u2019usage de l\u2019alcool et du cannabis, ainsi qu\u2019une am\u00e9lioration des indicateurs relatifs au temps pass\u00e9 avec des pairs consommateurs d\u2019alcool et d\u2019opio\u00efdes prescrits. Des am\u00e9liorations ont \u00e9galement \u00e9t\u00e9 observ\u00e9es concernant la d\u00e9pression et l\u2019anxi\u00e9t\u00e9 cliniques, les cons\u00e9quences li\u00e9es \u00e0 l\u2019usage d\u2019alcool et de cannabis, et les normes per\u00e7ues des pairs concernant l\u2019usage d\u2019alcool, de cannabis, d\u2019opio\u00efdes prescrits et d\u2019h\u00e9ro\u00efne.<\/p>\n
Seuls les participants du groupe TACUNA ont toutefois pr\u00e9sent\u00e9 une diminution significative de la fr\u00e9quence et de la quantit\u00e9 d\u2019alcool consomm\u00e9, ainsi que de la quantit\u00e9 de cannabis consomm\u00e9e. Comparativement au groupe HWC, le groupe TACUNA a \u00e9galement rapport\u00e9 une r\u00e9duction plus importante du temps pass\u00e9 avec des pairs consommant du cannabis et de l\u2019h\u00e9ro\u00efne, ainsi qu\u2019une baisse plus marqu\u00e9e de l\u2019anxi\u00e9t\u00e9.<\/p>\n
Les auteurs concluent que ces deux interventions virtuelles, culturellement ancr\u00e9es, ont permis d\u2019atteindre des jeunes adultes am\u00e9rindiens et natifs de l\u2019Alaska en milieu urbain, population d\u00e9crite comme ayant un acc\u00e8s r\u00e9duit aux ressources, et d\u2019obtenir des r\u00e9ductions globales des cons\u00e9quences li\u00e9es \u00e0 l\u2019usage de substances. Les r\u00e9sultats sugg\u00e8rent un int\u00e9r\u00eat particulier pour des dispositifs en ligne, culturellement adapt\u00e9s, en pr\u00e9vention et r\u00e9duction des risques dans des populations autochtones urbaines, tout en montrant une efficacit\u00e9 diff\u00e9renci\u00e9e selon le type de programme, notamment pour la r\u00e9duction de la consommation d\u2019alcool et de cannabis et de certains troubles anxieux.(contenu r\u00e9sum\u00e9 en fran\u00e7ais par l’IA)\u00a0Lire la Suite<\/a><\/p>","protected":false},"excerpt":{"rendered":" Un essai clinique randomis\u00e9 men\u00e9 aux \u00c9tats-Unis a \u00e9valu\u00e9 l\u2019efficacit\u00e9 de deux interventions virtuelles, culturellement adapt\u00e9es, visant \u00e0 r\u00e9duire l\u2019usage de substances psychoactives chez de jeunes adultes am\u00e9rindiens et natifs 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