Substance Use Trajectories and Health Outcomes for Monoracial and Biracial Blacks

建议的指导职业发展奖（K 01）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，这将使我能够独立研究。这项拟议的研究集中在阐明单一和双胞胎黑人青少年和年轻人使用物质的途径。 越来越多的物质使用研究人员提到追赶效应来解释黑人中的一个矛盾趋势，即青少年时期物质使用率较低并不能预测成年后物质使用率较低。虽然黑人青少年使用物质的比率大大低于他们的白色同龄人，但到了成年初期，黑人使用物质的比率赶上或超过了白人。这种追赶效应导致黑人的不良社会和健康后果发生率很高。 将黑人视为一个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、非洲-加勒比人和非裔黑人，但没有考虑可能影响物质使用的不同社会文化经历。因此，这种汇总可能掩盖了组间的重要差异。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身黑人和各种单身黑人亚群中发现的物质使用途径。除了我的初步研究结果，没有研究检查药物使用轨迹的预测因素之间的非聚集样本的birthwestern黑人青年。因此，拟议的研究旨在解决这些知识差距。它将揭示哪些亚群最容易受到追赶效应的影响，哪些因素是从青春期向青年期过渡期间，单亲和双胞胎黑人亚群使用药物的关键决定因素。 本研究建议使用两项全国代表性研究的数据：国家青少年健康纵向研究（添加健康）和美国生活全国调查：应对21世纪的压力（NSAL）。本K 01旨在：1）描述11至34岁期间单一种族群体（黑人、西班牙裔和白色）和两个主要的双种族黑人亚组（黑人-西班牙裔、黑人-白色）吸烟、饮酒和大麻使用的发展轨迹，这是开始使用药物的高风险时期。此外，K 01将2）评估社会经济地位之间的关系，种族主义的经验，和个人/文化，家庭，同龄人，学校，和邻里因素和物质使用（横截面）和物质使用（纵向）的发展轨迹之间的关系。 拟议的研究是一个综合培训计划，旨在提高我的研究技能的一个组成部分;我已经开发了这个程序与专家导师的跨学科团队的方向谁将在我的K 01研究提供指导。这项拟议的研究推进了我的职业目标，成为一名领先的独立研究人员，专注于健康差距和流行病学，病因学，以及预防种族/少数民族，特别是黑人和双性恋青少年和年轻人之间的物质使用和依赖。我在这个K 01的直接职业目标包括发展更多的专业知识在发展科学，文化因素和健康差距;获得先进的方法技能;进行研究，建立在我的初步发现;通过同行评议的文章传播我的发现;在全国会议上提出;并准备一个赠款申请，将我的研究进入下一阶段。我将通过以下方式实现这些目标：充分利用杜克大学和杜克大学极其丰富的研究环境;通过研讨会、定向阅读和课程学习获取知识;在赞助商和顾问的指导下开展研究。 拟议的研究代表了一个无与伦比的机会，以发展对特定的birthalmic Black亚组的物质使用途径的理解。此外，这项研究将有助于了解物质使用的病因，追赶效应，以及黑人之间的相关健康差异，并加强预防工作。在本K 01的最后阶段，我将提交一份R 01提案，扩大调查范围，以检查所有非聚合生物群（例如，美国印第安白人，亚洲西班牙裔），以确定是否，如一些初步证据所示，biracialism是物质使用行为的一般风险因素，或者是否在一些biracialism群体中发现物质使用的高风险，而不是在其他人中。此外，R 01研究将审查双胞胎群体中物质使用轨迹的同时和长期社会和健康相关性。

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.