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

项目概要/摘要 COVID-19和美国种族化暴力的上升正在偷走我们的集体呼吸，并酝酿着一个强大的组合， 或压力、创伤和负面影响的综合征--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是有据可查的，并且在年轻时爆发 成年期（18-29岁），当这一人群表现出问题物质使用的急剧升级（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 与高暴力，酒精和其他与药物使用有关的药物活动有关的条件。虽然我们知道 居住在弱势社区的黑人男性不成比例地受到种族主义的影响（即，种族 警察和公民的分析），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被调整，以针对这种文化相关的应激源或相关创伤 症状以冥想和呼吸空间为特色的正念减压（MBSR）干预 训练已被证明可以减少适应不良的应激反应、创伤症状和物质使用， 主要是通过改进自我调节（即，影响和生理）。然而，一个基本的滞后存在于 对已建立的正念减压疗法进行文化适应，并探索新的模式， 黑人男性因此，对它们的可行性、可接受性或在这方面可能的有效性知之甚少。 人口差距。成功的正念减压疗法需要参与者在家练习， 在现实世界中获得的技能。整合移动的技术，尤其是提供“实时” 反馈，可以进一步加强MBSR干预措施对年轻人物质使用缓解的影响 黑人男性通过在种族主义相关的压力和创伤的时刻和环境中提供支持性的轻推， 症状可能会达到高峰。适应性的、移动的技术辅助的正念减压疗法干预可能更容易被接受 年轻的成年黑人男性，当他们与他们的投入和解决文化相关的压力， 创伤和性别规范（例如，男孩不哭）经常鼓励男性调节负面影响， 把它推到意识之外。我们的理论驱动的中心假设是， 旨在调节种族主义相关的压力反应，创伤症状，特别是在 “实时”将减少年轻成年黑人男性中有问题的物质使用进展。R34 一项申请提出了在北卡罗来纳州达勒姆的18-29岁黑人男性中实施以下目标 和哈特福德，CT -设置与惊人相似的邻里劣势：1）为了适应文化验证 以导师为主导，以小组为基础，以移动的技术为辅助的正念减压疗法干预; 2）进行试点测试和评估， 一种适应文化的、由农民主导的、以群体为基础的、以移动的技术为辅助的、 MBSR干预; 3）确定初步效应量和中介变量，以确定样本量和功效 一个更大的完全规模的移动的技术辅助的，以小组为基础的MBSR干预。

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.