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

项目摘要/摘要 尽管非法药物使用率相似，但拉美裔和非裔美国人使用服务的比率要低得多 只有不到8%的患有药物使用障碍的拉美裔和非裔美国人认为他们 物质使用是有问题的。这种差异表明，显然需要勾勒出动态和具体的 有助于在两个群体中使用和回收物质的过程。建议的项目将构建 一项公认的研究表明，负面情绪和渴望是两个最强的预测 短期药物使用和戒烟意向，这是康复的重要组成部分。歧视也是一种可靠的 压力和负面情绪的预测因子，但-尽管它在预测饮酒和 吸烟--在西班牙裔和非裔美国人的物质使用研究中很少被研究。 由于预期中的歧视，歧视还可能减少寻求物质使用的正式帮助 接受护理；此外，预期的歧视可能在农村地区被放大，那里的治疗选择是 有限，而且对隐私的担忧加剧。这些因素在西班牙裔美国人的实际应用中尚未被探索。 和非洲裔美国人，特别是在农村地区。因此，建议的长期目标是 该项目旨在阐明歧视、药物使用、戒烟意图和寻求帮助之间的联系 在农村拉美裔和非裔美国人中。为了实现这一目标，该项目将从生态 即时评估(EMA)方法，通过以下方式进行实时、即时评估 移动技术。完成此奖学金下的拟议项目将允许申请者 获得独一无二的研究和培训经验，而不是他们通常在 博士培训，并将这一理解应用于开发和评估适应文化的 干预计划，并可能影响健康差距政策的变化。具体来说，成功 这笔培训赠款的资金将导致完成上述项目和实现以下目标 申请者：1)获得关于推动拉美裔药物使用和回收的背景因素的知识，并 非洲裔美国人人口；2)在收集和实施方法方面获得知识 在物质使用研究中确定人与环境的相互作用(例如，EMA)3)获得高级统计 与我提议的研究计划相关的模型技能，以确定驱动差异的机制，以及 4)在赠款准备方面获得进一步的知识和技能。培训将主要在华盛顿大学进行。 内布拉斯加州-林肯、佛罗里达国际大学和南卡罗来纳医科大学。建议数 研究直接解决了NIDA战略目标的组成部分，因为它有助于“描述…的特征”社交， 影响吸毒和吸毒成瘾风险和复原力的环境因素和发展因素。

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.”