The Role of Discrimination in Substance Use and Help Seeking among Hispanics and African Americans

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PROJECT SUMMARY/ABSTRACT Despite similar rates of illicit substance use, Hispanics and African-Americans utilize services at far fewer rates than Whites, and less than 8% of Hispanics and African-Americans with substance use disorder perceive their substance use as problematic. Such disparities demonstrate the clear need to outline the dynamic and specific processes that contribute to substance use and recovery among both populations. The proposed project builds on well-established research suggesting that negative affect and craving are the two strongest predictors of short-term substance use and intention to quit, a vital component of recovery. Discrimination is also a reliable predictor of stress and negative affect, but — despite its potentially critical role in predicting alcohol use and smoking — has been infrequently examined in substance use research with Hispanics and African-Americans. Discrimination may also reduce formal help seeking for substance use due to anticipated discrimination in receiving care; further, anticipated discrimination may be magnified in rural areas where treatment options are limited, and privacy concerns are heightened. These factors are unexplored in substance use with Hispanic and African-American populations, particularly in rural areas. Therefore, the long-term goal of the proposed project is to elucidate the linkages between discrimination, substance use, intentions to quit, and help seeking among rural Hispanics and African-Americans. To achieve this, the project will build from ecological momentary assessment (EMA) methods, which conducts real-time, “in-the-moment” assessments through mobile technology. Completing the proposed project under this fellowship award will allow the applicant to acquire unique research and training experiences beyond those that they would normally obtain in their doctoral training and apply this understanding to the development and evaluation of culturally adapted intervention programs, and potentially influence health disparity policy changes. Specifically, successful funding of this training grant will result in completion of the above project and the following goals of the applicant: 1) acquire knowledge on the contextual factors driving substance use and recovery in Hispanic and African-American populations; 2) gain knowledge in the collection and implementation of methodologies for determining person-in-context interactions in substance use research (e.g., EMA) 3) obtain advanced statistical skills in models relevant to my proposed research program of identifying mechanisms that drive disparities, and 4) attain further knowledge and skills in grant preparation. Training will primarily take place at the University of Nebraska-Lincoln, Florida International University, and the Medical University of South Carolina. The proposed research directly addresses components of NIDA’s strategic goals, in that it helps “characterize the…social, environmental, and developmental factors that mediate risk and resilience for drug use and addiction.”