Project BrEAtHe (Brothers, Reclaiming, Emotional, Awareness, Tranquility, Healing & Ex-istence): Disrupting Racism-related Stress, Trauma, & Problematic Substance Use in Young Adult Black Men

BrEAtHe 项目（兄弟、重获新生、情感、意识、安宁、治愈

• 批准号: 10288430
• 负责人: Susan Gaylord
• 金额: $ 31.98万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10288430
• 关键词: Accidental Injury; Address; Affect; Affective; African American; Age; Alcohol consumption; Alcohols; Awareness; Behavioral; Breathing; Brothers; COVID-19; Cessation of life; Chronic; Chronic stress; Connecticut; Conscious; Development; Disadvantaged; Disease; Dropout; Effectiveness; Emotional; Exhibits; Feedback; Focus Groups; Funding; Future; Gender; Group Interviews; Health; Home; Homicide; Hybrids; Impulsivity; Informal Social Control; Institutes; Intervention; Investigation; Learning; Link; Marijuana; Measures; Mediator of activation protein; Meditation; Men' s Role; Methods; Mobile Health Application; Modality; Morbidity - disease rate; National Institute of Drug Abuse; Neighborhoods; North Carolina; Numbness; Outcome; Overdose; Participant; Pathway interactions; Physiological; Police; Population; Prevention Research; Prevention trial; Preventive; Process; Regulation; Risk; Risk Factors; Rural; Sample Size; Science; Self Medication; Specificity; Stress; Substance Addiction; Suicide; Testing; Theft; Time; Training; Trauma; Universities; Violence; acceptability and feasibility; alcohol and other drug; base; behavioral health; biological adaptation to stress; black men; boys; coping; design; dysphoria; emotion dysregulation; experience; feasibility testing; healing; health disparity; heart rate variability; improved; innovation; innovative technologies; instructor; male; marijuana use; mindfulness-based stress reduction; mobile computing; mortality; negative affect; neighborhood disadvantage; novel; post intervention; prevent; preventive intervention; racism; recruit; reduced substance use; skills; stress reactivity; stress symptom; stressor; substance abuse prevention; substance use; symptomatology; theories; trauma symptom; usability; young adult

PROJECT SUMMARY/ABSTRACT COVID-19 and upticks in U.S. racialized violence are stealing our collective breaths and brewing a potent mix, or syndemic of stress, trauma, and negative affect – key risk factors for behavioral health disparities. Behavioral health disparities among Black males are well-documented and known to erupt during young adulthood (ages 18-29) when this population exhibits steep escalations in problematic substance use (e.g., marijuana and alcohol). Many young adult Black males also reside in disadvantaged neighborhoods settings with conditions like high violence, alcohol, and other drug activity linked to substance use. While we know that Black males residing in disadvantaged neighborhoods are disproportionately impacted by racism (i.e., racial profiling by police and citizens) and that racism is a risk for self-medicating with alcohol and marijuana, few substance use interventions have been adapted to target this culturally-relevant stressor or related trauma symptoms. Mindfulness-based stress reduction (MBSR) interventions featuring meditation and breathing space training have been shown to reduce maladaptive stress response, trauma symptoms, and substance use, principally by improving self-regulation (i.e., affect and physiological). Yet, a fundamental lag exists in the cultural adaptation of established MBSR interventions and exploration of new modalities for delivering them to Black males. As a result, less is known about their feasibility, acceptability, or probable effectiveness in this disparity population. Successful MBSR interventions require participant home practice and deployment of acquired skills in real-world settings. Integrating mobile technologies, especially ones providing ‘real-time’ feedback, could further enhance MBSR interventions’ impacts on substance use mitigation among young adult Black males by providing supportive nudges in moments and settings when racism-related stress and trauma symptoms likely peak. Adapted, mobile technology-assisted MBSR interventions will likely be more acceptable by young adult Black males when they are developed with their input and address culturally relevant stress, trauma, and the gender norms (e.g., boys don’t cry) often encouraging males to regulate negative affect by pushing it out of conscious awareness. Our theory-driven central hypothesis, is that preventive interventions aimed at modulating racism-related stress response, trauma symptoms, and affect regulation especially in ‘real-time’ will reduce problematic substance use progression among young adult Black males. This R34 application proposes the following aims to be carried out among 18-29 year-old Black males in Durham, NC and Hartford, CT – settings with strikingly similar neighborhood disadvantage: 1) To culturally adapt a validated instructor-led, group-based and mobile technology-assisted, MBSR intervention; 2) To pilot test and assess the feasibility/acceptability of a culturally adapted instructor-led, group-based and mobile technology-assisted, MBSR intervention; 3) To identify preliminary effect sizes and mediators to determine sample size and power for a larger fully scaled mobile technology-assisted, instructor-led, group-based MBSR intervention.

项目概要/摘要 COVID-19 和美国种族暴力事件的增加正在夺走我们的集体呼吸，并酝酿着一种强有力的混合， 或压力、创伤和负面影响的综合症——行为健康差异的关键风险因素。 黑人男性之间的行为健康差异有据可查，并且众所周知，这种差异在年轻时就会爆发 成年期（18-29 岁），该人群在有问题的物质使用方面表现出急剧升级（例如， 大麻和酒精）。许多年轻的成年黑人男性也居住在弱势社区环境中 患有严重暴力、酗酒和其他与药物使用相关的药物活动等情况。虽然我们知道 居住在弱势社区的黑人男性受到种族主义（即种族歧视）的影响尤为严重。 警察和公民的分析），并且种族主义是用酒精和大麻自我治疗的风险，很少有人 物质使用干预措施已针对这种文化相关的压力源或相关创伤进行了调整 症状。以冥想和呼吸空间为特色的基于正念的减压 (MBSR) 干预措施 训练已被证明可以减少适应不良的压力反应、创伤症状和物质使用， 主要是通过改善自我调节（即情感和生理）。然而，存在根本性的滞后 对已建立的 MBSR 干预措施进行文化调整，并探索将其实施的新模式 黑人男性。因此，人们对其可行性、可接受性或可能的有效性知之甚少。 人口差距。成功的 MBSR 干预措施需要参与者家庭练习和部署 在现实世界中获得技能。集成移动技术，尤其是提供“实时”的技术 反馈，可以进一步增强 MBSR 干预措施对减少年轻人物质使用的影响 黑人男性在遭受种族主义相关压力和创伤的时刻和环境中提供支持性推动 症状可能达到顶峰。经过调整的、移动技术辅助的 MBSR 干预措施可能会更容易被接受 年轻的成年黑人男性在他们的投入和解决文化相关压力的情况下得到发展， 创伤和性别规范（例如男孩不哭）经常鼓励男性通过以下方式调节负面影响： 将其排除在意识之外。我们理论驱动的中心假设是，预防性干预措施 旨在调节与种族主义相关的应激反应、创伤症状和影响调节，尤其是在 “实时”将减少年轻黑人男性中有问题的物质使用进展。这个R34 申请提出了在北卡罗来纳州达勒姆 18-29 岁黑人男性中实施以下目标 和康涅狄格州哈特福德——具有惊人相似的邻里劣势的环境：1) 在文化上适应经过验证的 由讲师指导、基于小组和移动技术辅助的 MBSR 干预； 2) 进行试点测试和评估 适应文化、由讲师主导、基于小组和移动技术辅助的可行性/可接受性， 正念减压干预； 3) 确定初步效应大小和中介因素，以确定样本大小和功效 进行更大规模、全面的移动技术辅助、讲师指导、基于小组的 MBSR 干预。