Substance Use Trajectories and Health Outcomes for Monoracial and Biracial Blacks

描述（由申请人提供）：建议的指导职业发展奖（K01）的总体目标是在成功的nih资助赞助商的指导下为我提供密集的研究职业发展培训，这将使我研究独立。提出的研究研究的中心阐明途径的物质使用在单种族和混血儿黑人青少年和年轻人。药物使用研究人员越来越多地引用追赶效应来解释黑人中一个自相矛盾的趋势，即青少年时期药物使用率较低并不意味着成年期药物使用率较低。虽然黑人青少年的药物使用率比白人青少年低得多，但到了成年早期，黑人的药物使用率赶上或超过了白人。这种追赶效应导致黑人出现不良社会和健康后果的比率很高。将黑人视为同质群体的规范做法阻碍了对追赶效应的理解。值得注意的是，在美国人口普查中，“黑人”包括非裔美国人、非洲人、加勒比黑人和混血儿黑人，但没有考虑可能影响药物使用的不同社会文化经历。因此，这种聚集很可能掩盖了重要的组间差异。事实上，我的初步研究表明，单一的物质使用轨迹完全不足以描述或预测在单种族和各种混血儿黑人亚群中发现的物质使用途径。除了我的初步发现外，没有研究检验过混血黑人青年的非聚集样本中物质使用轨迹的预测因素。因此，拟议的研究旨在解决这些知识差距。它将揭示哪些亚群体最容易受到追赶效应的影响，以及哪些因素是单种族和双种族黑人亚群体在从青春期过渡到青年期使用药物的关键决定因素。本研究拟采用两项具有全国代表性的研究数据：全国青少年健康纵向研究（Add Health）和全国美国人生活调查：21世纪应对压力（NSAL）。本K01旨在1)描述11至34岁期间单种族群体（黑人、西班牙裔和白人）和两个主要的双种族黑人亚群体（黑人-西班牙裔、黑人-白人）中香烟、酒精和大麻使用的发展轨迹，这是物质使用的高风险时期。此外，K01将评估社会经济地位、种族主义经历、个人/文化、家庭、同伴、学校和社区因素与单种族和双种族黑人青少年和年轻人的物质使用（横断面）和物质使用发展轨迹（纵向）之间的关系。拟议的研究是一个综合培训计划的组成部分，旨在提高我的研究技能；我在一个跨学科的专家导师团队的指导下开发了这个项目，他们将在我的K01研究中提供指导。这项拟议的研究推进了我的职业目标，即成为一名主要的独立研究员，专注于种族/少数民族，特别是黑人和混血儿青少年和年轻人之间的健康差异、流行病学、病因学和物质使用和依赖的预防。我在本K01的近期职业目标包括在发展科学、文化因素和健康差异方面发展更多的专业知识；掌握先进的方法论技能；根据我的初步发现进行研究；通过同行评议的文章传播我的发现；在国家会议上发言；准备一份拨款申请，让我的研究进入下一阶段。我将利用北卡罗来纳大学和杜克大学极其丰富的研究环境来实现这些目标；通过研讨会、定向阅读和课程作业获取知识；在我的赞助人和导师的指导下进行研究。拟议的研究代表了一个无与伦比的机会，以发展对特定的混血儿黑人亚群的物质使用途径的理解。此外，本研究将有助于了解黑人药物使用的病因、追赶效应和相关的健康差异，并加强预防工作。在本K01的最后阶段，我将提交一份R01提案，扩大调查范围，以检查所有非聚合的混血儿群体（例如，美国印第安人-白人，亚洲人-西班牙人），以确定是否如一些初步证据所表明的那样，混血儿是药物使用行为的一般风险因素，或者是否在某些混血儿群体中发现了药物使用的高风险，而在其他群体中则没有。此外，R01研究将检查在混血儿群体中物质使用轨迹的并发和长期的社会和健康相关性。

DESCRIPTION (provided by applicant): The overall aim of the proposed Mentored Career Development Award (K01) is to provide me with intensive research career development training under the guidance of successful NIH-funded sponsors that will lead me to research independence. The proposed research study centers on elucidating the pathways to substance use among monoracial and biracial Black adolescents and young adults. Increasingly, substance use researchers refer to the catch-up effect to explain a paradoxical trend among Blacks in which lower rates of substance use in adolescence do not predict lower rates of substance use in adulthood. Although Black adolescents use substances at substantially lower rates than their White peers, by young adulthood the rates of substance use among Blacks catch up to or surpass the rates of Whites. This catch-up effect contributes to high rates of adverse social and health outcomes among Blacks. Understanding the catch-up effect is hindered by the normative practice of treating Blacks as a homogeneous group. Notably, as used for the US Census, "Black" includes African Americans, Africans, Afro- Caribbean's, and biracial Blacks-but without regard for different sociocultural experiences that might affect substance use. Thus, such aggregation likely obscures important between-group differences. Indeed, my preliminary research suggests a single substance use trajectory is wholly inadequate for either describing or predicting the pathways to substance use found among monoracial and various biracial Black subgroups. Excluding my preliminary findings, no research has examined predictors of substance use trajectories among de-aggregated samples of biracial Black youth. Hence, the proposed study seeks to address these knowledge gaps. It will reveal which subgroups are most vulnerable to the catch-up effect and which factors are critical determinants of substance use among monoracial and biracial Black subgroups during the transition from adolescence to young adulthood. This study proposes to use data obtained from two nationally representative studies: National Longitudinal Study of Adolescent Health (Add Health) and National Survey of American Life: Coping with Stress in the 21st Century (NSAL). This K01 seeks to 1) describe the developmental trajectories of cigarette, alcohol, and marijuana use among the monoracial groups (Black, Hispanic, and White) and two major biracial Black subgroups (Black-Hispanic, Black-White) during ages 11 to 34 years, which is a high-risk period for onset of substance use. Further, the K01 will 2) assess the relationships among socioeconomic status, experiences of racism, and individual/cultural, family, peer, school, and neighborhood factors and substance use (cross-sectional) and developmental trajectories of substance use (longitudinal) among monoracial and biracial Black adolescents and young adults. The proposed study is an integral component to a comprehensive training program designed to enhance my research skills; I have developed this program with the direction of an interdisciplinary team of expert mentors who will provide guidance throughout my K01 research. The proposed study advances my career goal of becoming a leading independent researcher focused on health disparities and the epidemiology, etiology, and prevention of substance use and dependence among racial/ethnic minorities, especially Black and biracial adolescents and young adults. My immediate career objectives in this K01 include developing greater expertise in developmental science, cultural factors, and health disparities; acquiring advanced methodological skills; conducting research that builds on my preliminary findings; disseminating my findings via peer- reviewed articles; presenting at national meetings; and preparing a grant application that will move my research to its next phase. I will achieve these goals by capitalizing on the exceptionally rich research environments at UNC and Duke University; acquiring knowledge through workshops, directed readings, and coursework; and conducting research under the guidance of my sponsors and advisors. The proposed research represents an unparalleled opportunity to develop an understanding of the pathways to substance use for specific biracial Black subgroups. Further, this research will contribute to the understanding of the etiology of substance use, the catch-up effect, and related health disparities among Blacks, and enhance prevention efforts. In the final stages of this K01, I will submit a R01 proposal that expands the scope of the investigation to examine the full range of de-aggregated biracial groups (e.g., American Indian-White, Asian-Hispanic) to determine whether, as suggested by some preliminary evidence, biracialism is a general risk factor for substance use behaviors or whether high risk for substance use is found among some biracial groups but not in others. In addition, the R01 study will examine concurrent and longer- term social and health correlates of substance use trajectories among biracial groups.