Reducing Alcohol Use among Black Men: Barbershop SBIRT

摘要-项目3 不健康的饮酒被认为是美国十大公共卫生问题之一。 大量饮酒与整体健康状况较差有关，它导致约88，000人死亡，250万人死亡。 在美国每年损失的潜在寿命年数。2处于社会不利地位的男性，如黑人， 生活在贫困中的男性更有可能消费更多的酒精。3 -5事实上，在阿肯色州，一个高比率的州， 收入低于35，000美元的黑人男性更有可能报告酗酒 （每天4杯或更多），并在狂饮时消耗更多的饮料。6此外， 不健康的饮酒对黑人来说可能更糟。报告大量饮酒的黑人男性 相比之下，通常会经历更严重的健康后果和更负面的社会后果。 7 -11筛查、短期干预和转诊治疗（SBIRT）是一项基于证据的， 为高危人群提供早期干预服务的多层次、综合性公共卫生方法 对于危险饮酒，并及时转介给那些滥用药物的人进行更深入的治疗， 12 -14 SBIRT在初级保健和紧急护理环境中都得到了有效实施15。 然而，护理的结构性障碍（即，保险状况，文化上合格的服务，种族主义和 歧视等）可能会阻碍黑人男性获得基于证据的不健康饮酒护理 16鉴于与不健康饮食有关的死亡和发病风险增加， 生活在贫困中的黑人男性饮酒，再加上不健康的饮食对健康造成的更有害的后果， 黑人男性饮酒，通过将护理纳入社区，改善公平获得循证护理的机会 黑人更有可能进入的环境是迫切需要的。 因此，本文提出的混合型第二类语用有效性-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）对低收入人群的有效性 非裔美国人; 2）产生向“真实的世界”传播SBIRTs所需的科学证据 设置.这项研究的数据将进一步加深我们对如何降低酒精所致风险的理解。 贫困黑人男性的发病率和死亡率。数据还将改善我们对战略的理解 这可以改善非临床环境中循证护理模式的实施;因此， 向最需要的社区提供循证护理。

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.