Examining the Stress Processes Relating Ethnicity and Sex to Substance Misuse and Services Outcomes (ESPRESSO)

检查种族和性别与药物滥用和服务结果相关的压力过程 (ESPRESSO)

• 批准号: 10361501
• 负责人: Micah Johnson
• 金额: $ 17.65万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-15 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10361501
• 关键词: 18 year old; Address; Adolescence; Adolescent; Adopted; Awareness; Caring; Cessation of life; Communities; Computer software; Coupled; Criminal Justice; Data; Data Analyses; Databases; Development; Diagnosis; Diagnostic Services; Drug Courts; Drug usage; Equation; Ethnic Origin; Ethnic group; Etiology; Exposure to; Female; Florida; Fostering; Foundations; Gender; Goals; Health; Health Services; Health Services Accessibility; Hybrids; Imprisonment; Individual; Intervention; Interview; Justice; Knowledge; Life; Link; Longitudinal Studies; Manuscripts; Measures; Mediating; Mediation; Mentors; Methodology; Methods; Minor; Minority; Minority Groups; Minority Health Research; Minority Women; Mission; Modeling; Monitor; National Institute of Drug Abuse; Occupational; Outcome; Ozone; Paper; Participant; Pathway interactions; Pattern; Perception; Population; Prevention; Process; Protocols documentation; Psychometrics; Publishing; Qualitative Methods; Race; Recommendation; Research; Research Activity; Resources; Risk; Risk Assessment; Risk Factors; Sampling; Science; Services; Sex Differences; Sociology; Source; Strategic Planning; Stress; Stress Tests; Substance Use Disorder; Surveys; System; Technology; Testing; Training; Translational Research; Trauma; Underserved Population; United States; Violence; base; behavioral health; clinical diagnosis; community center; design; diagnostic criteria; disorder prevention; disparity reduction; ethnic difference; ethnic disparity; experience; health disparity; health disparity populations; high risk sexual behavior; implementation science; improved; innovation; insight; instrumentation; juvenile justice system; longitudinal database; longitudinal design; novel; person centered; protective factors; psychological outcomes; racial and ethnic; racial and ethnic disparities; recidivism; screening; service delivery; sex; sex disparity; stressor; substance misuse; substance use prevention; substance use treatment; theories; treatment disparity; treatment services

PROJECT SUMMARY The proposed project quantitatively and qualitatively investigates and disseminates the mechanisms underlying potential racial/ethnic and sex differences in risk for substance use disorder (SUD) and disparities in SUD treatment services among justice-involved adolescents (JIA). JIA are a critically underserved population who are especially vulnerable to SUD. Certain ethnic groups and females in the juvenile justice system are predisposed to harsher consequences of substance misuse and are more prone to suffer from undiagnosed SUDs. The cascade of care is a novel framework for investigating unmet treatment needs. The stress process model hypothesizes that disparities occur due to unequal distribution of stressors and resources, offering a major pathway linking race/ethnicity and sex to disparities at the cascade checkpoints. The study will synergize transdisciplinary theory and methodology through integrating a) a sociological theory of health disparities—the stress process model, b) a novel framework for measuring unmet treatment needs–the cascade of care, c) advanced quantitative methods –mediation analysis in structural equation modeling, and d) innovatory qualitative approaches–hybrid thematic analysis with cutting-edge technologies. The specific research aims are to 1) investigate if stress and resources mediate racial/ethnic and sex differences in substance misuse (SM) patterns; 2) test if stress and resources mediate ethnic and sex disparities in referral to SUD screening, diagnosis with SUD, treatment initiation and treatment completion; and 3) qualitatively explore how stress and resources relate to ethnic and sex disparities in SUD services and post-release outcomes. The study employs mediation analysis in structural equation modeling to analyze a statewide longitudinal database of 100,000 JIA from the third largest juvenile justice population in the United States. To uncover deeper insights into the statistical findings, the project conducts and analyzes in-depth interviews and surveys among 60 individuals who experienced SM and incarceration as minors. Hybrid thematic analysis will be employed to fuse the quantitative and qualitative data. These aims serve to fulfil NIDA’s mission to advance science on the etiology of SM, improve SUD prevention and treatment, and advance research on minorities, females, and other populations facing disproportionate consequences of misuse. To complete the research aims, an extensive training plan directed by a network of expert mentors who are leaders in the field will be executed. The training aims are to develop expertise in SUD services delivery in criminal justice systems; mediation analysis in SEM, psychometrics, censored data, and longitudinal design; interviewing methods in health research and analysis with the ATLAS.ti software; stress instrumentation; and implementation and translational science. These training and subsequent research activities are a major step towards developing and testing culturally appropriate, sex-responsive, and trauma-informed SUD risk assessment protocols and disparity reduction interventions that innovate SUD screening and treatment delivery in juvenile justice systems.

项目摘要 拟议的项目定量和定性地研究并传播了基础机制 潜在的种族/族裔和性别差异在药物使用障碍（SUD）和SUD差异的风险上 涉及正义的青少年（JIA）中的治疗服务。贾是一个非常服务不足的人口 特别容易受到SUD的影响。少年司法系统中的某些种族和女性是 易于滥用物质的伤害后果，更容易遭受未诊断的痛苦 泡沫。级联护理是研究未满足治疗需求的新型框架。压力过程 模型假设分布是由于压力源和资源的不等分配而发生的，提供了 将种族/民族和性别与级联检查站的差异联系起来的主要途径。该研究将协同作用 通过整合a）健康差异的社会学理论 - 跨学科理论和方法论 - 压力过程模型，b）测量未满足治疗需求的新型框架 - 级联护理，c） 先进的定量方法 - 结构方程模型中的测为分析，d）创新 定性方法 - 使用尖端技术的杂化主题分析。具体研究目的 到1）调查压力和资源媒体竞赛/种族和性别差异是否存在 （SM）模式； 2）测试压力和资源媒体种族和性别分布是否在转介到SUD筛查中， 具有SUD，治疗计划和治疗完成的诊断； 3）定性探讨压力和 资源与SUD服务和释放后结果中的种族和性别分布有关。学习员工 结构方程模型中的调解分析，分析了全州范围的100,000 JIA纵向数据库 来自美国第三大少年司法人口。揭示更深入的洞察力 统计发现，该项目在60个人中进行和分析进行了深入的访谈和调查 他经历了SM和未成年人的演变。混合主题分析将被雇用以融合 定量和定性数据。这些目的有助于实现NIDA的使命，以推进病因学科学 SM，改善预防和治疗的SM，并提高对少数民族，女性和其他的研究 面临滥用不成比例的后果的人群。为了完成研究的目的 由专家导师网络指导的培训计划将被执行。培训 目的是在刑事司法系统中发展SUD服务提供专业知识； SEM中的调解分析， 心理计量学，公民数据和纵向设计；健康研究和分析中的访谈方法 使用Atlas.ti软件；压力仪器；以及实施和转化科学。这些 培训和随后的研究活动是在文化上发展和测试的主要步骤 适当，性响应和创伤性的SUD风险评估方案和降低差异 少年司法系统中创新的SUD筛查和治疗交付的干预措施。