Reducing Alcohol Use among Black Men: Barbershop SBIRT

摘要--项目3 不健康饮酒被认为是美国十大公共健康问题之一。 大量饮酒与整体健康状况较差有关，它造成了约8.8万人死亡和250万人死亡 美国每年损失的潜在寿命年数2暴露于社会劣势的男性，如黑人 生活贫困的男性更有可能饮酒更多。3-5实际上，在阿肯色州，一个高饮酒率的州 在不健康饮酒方面，收入低于3.5万美元的黑人男性更有可能报告酗酒 (每天4杯或更多)，在狂饮时喝更多的饮料。6此外， 对黑人男性来说，不健康的饮酒可能更糟糕。报告大量饮酒的黑人男性 经常经历更严重的健康后果和更负面的社会后果 7-11筛查、短暂干预和转诊治疗(SBIRT)是一种循证的、 为高危个人提供早期干预服务的多层次综合公共卫生方法 对于危险饮酒，以及及时转介到对那些有药物滥用的人进行更强化的治疗 12-14在初级保健和急救环境中都有效地实施了SBIRT 15。 然而，护理方面的结构性障碍(即保险地位、有文化能力的服务、种族主义和 歧视等)可能会阻碍黑人男性获得不健康饮酒的循证护理 位于医疗环境中。16考虑到与不健康相关的死亡和发病率增加的风险 生活在贫困中的黑人饮酒，加上不健康带来的更有害的健康后果 黑人男性饮酒，通过将护理落实到社区来改善平等获得循证护理的机会 迫切需要黑人男性更有可能访问的设置。 因此，这项拟议的混合类型2语用有效性-实施试验的目标是：1)测试 先前开发的基于证据的SBIRT干预(理发店谈话)对低收入者的有效性 2)产生必要的科学证据，将SBIRT传播到“现实世界” 设置。这项研究的数据将进一步加深我们对如何降低饮酒风险的理解 贫困黑人的发病率和死亡率。数据还将提高我们对战略的理解 这可以改进循证护理模式在非临床环境中的实施；因此，扩大 将循证护理延伸到需求最高的社区。

SUMMARY – PROJECT 3 Unhealthy drinking is considered one of the top 10 public health concerns in the United States.1 Not only has heavy drinking been linked to poorer overall health, it is responsible for about 88,000 deaths and 2.5 million years of potential life lost in the United States each year.2 Men exposed to social disadvantage, such as Black men living in poverty, are more likely to consume more alcohol.3–5 Indeed, in Arkansas, a state with high rates of unhealthy drinking, Black men who make less than $35,000 are more likely to report heavy drinking (4 or more drinks a day) and consume more drinks when binge drinking.6 Further, the negative impacts of unhealthy drinking may be worse for Black men. Black men who report consuming large amounts of alcohol often experience more severe health outcomes and more negative social consequences when compared to other ethnic groups.7–11 Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based, multilevel, integrated, public health approach to the delivery of early intervention services for individuals at risk for risky drinking, and the timely referral to more intensive treatment for those who have substance abuse disorders.12–14 SBIRTs have been effectively implemented in both primary care and emergency care settings15. However, structural barriers to care (i.e., insurance status, culturally competent services, racism and discrimination, etc.) may impede Black men's access to evidence-based care for unhealthy drinking located in medical settings.16 Given the increased risk for mortality and morbidity associated with unhealthy drinking among Black men living in poverty, coupled with the more harmful health consequences of unhealthy drinking for Black men, improving equitable access to evidence-based care by implementing care into community settings that Black men are more likely to access is urgently needed. Thus, the goals of this proposed Hybrid Type 2 pragmatic effectiveness-implementation trial are to: 1) test the effectiveness of a previously developed, evidence-based SBIRT intervention (Barbershop Talk) for low income African American men; and 2) generate the scientific evidence needed to disseminate SBIRTs to “real world” settings. Data from this study will further our understanding on how to reduce the risk of alcohol attributable morbidity and mortality among Black men living in poverty. Data will also improve our understanding of strategies that can improve implementation of evidence-based care models in non-clinical settings; thus, extending the reach of evidence-based care to communities with the highest need.