Advancing Recovery Pathways and Support Services for Alcohol Use Disorders among Black Men and Women

美国黑人显然遭受着一系列的健康差距，这些差距是由长期的种族歧视造成的。 结构性不平等和种族主义。尽管美国黑人饮酒的可能性略低于美国黑人， 在一般人群中，患有酒精使用障碍（AUD）的黑人饮酒者的比例相当，占1.5 百万美国黑人持有澳元黑人因饮酒而遭受更多负面后果，例如 疾病，伤害，刑事法律参与和社会问题。恢复是一个动态的行为过程 变革导致功能、目的和福祉的稳定改善。NIAAA进一步强调 恢复为AUD症状缓解以及停止大量饮酒。恢复支持服务 恢复社区组织旨在建立恢复资本。然而，迄今为止， 考虑人口群体内部而不是群体之间的复苏。“以边缘为中心”的方法 强调需要审查种族化和少数群体化人口的经验。这项研究旨在 为黑人男女提供先进的康复途径和支持服务。它直接 响应RFA-AA-21-001，强调AUD人群的健康差异，与 RFA的目标是推进文化知情的措施和干预措施，增加获得AUD服务的机会， 服务更具吸引力，并评估循证实践。我们这样做的重点是黑人男子， 女性在AUD复苏。因此，我们的目标是迭代地使用定量和定性方法来捕获和 评估与异质性黑人人群中AUD恢复相关的问题，与黑人- 底特律的多数康复社区组织具体来说：（1）使用定性方法， 群体以（a）定义AUD恢复途径;（B）评估和改进恢复域的测量（例如， （c）确定和绘制可能促进或干扰社区发展的社区指标 澳元复苏。(2)使用定量方法描述和评估澳元回收的规定 康复社区组织在满足需要方面提供的支助服务， 按种族/族裔分列的康复和其他客户和社区特征。(3)开展务实 基于目标1和目标2的随机对照试验，使用黑色AUD恢复人群，与 治疗照常组与人恢复支持服务，以确定增加的有效性 电话+数字恢复支持服务干预（即，提供智能手机和指导/支持， 在线恢复活动）。拟议的研究将使人们能够深入了解恢复意味着什么， 黑人男女，如何衡量，以及我们如何推进黑人的恢复之旅 美国AUD结果将是有意义的黑人个人本身，供应商谁治疗 拥有澳元的黑人，以及需要更好地理解澳元含义的研究人员和决策者， 满足美国人口的多样化需求。

Black Americans demonstrably suffer from a range of health disparities rising from a long history of structural inequities and racism. Although Black Americans are slightly less likely to drink alcohol than the general population, the rate of Black drinkers with alcohol use disorders (AUD) is comparable, representing 1.5 million Black Americans with AUD. Blacks suffer more negative consequences due to alcohol use such as illnesses, injuries, criminal-legal involvement, and social problems. Recovery is a dynamic process of behavior change leading to stable improvements in functioning, purpose and well-being. NIAAA further highlights recovery as remission from AUD symptoms as well as cessation of heavy drinking. Recovery support services and recovery community organizations aim to build recovery capital. Yet, to date little effort has been made to consider recovery within population groups rather than across groups. A “centering in the margins” approach emphasizes the need to examine experiences of racialized and minoritized populations. This proposed study to advance recovery pathways and support services for Black men and women heeds that call. It is directly responsive to RFA-AA-21-001 in its emphasis on health disparities in AUD populations, intersecting with the RFA goals to advance culturally-informed measures and interventions, increase access to AUD services, make services more appealing, and evaluate evidence-based practices. We do this with a focus on Black men and women in AUD recovery. We thus aim to iteratively use quantitative and qualitative methods to capture and assess questions related to AUD recovery in a heterogenous Black population, in partnership with a Black- majority recovery community organization in Detroit. Specifically: (1) Use qualitative methods with a Black population to (a) define AUD recovery pathways; (b) assess and refine a measure of recovery domains (e.g., relationships, living environment); and (c) identify and map community indicators that may facilitate or interfere with AUD recovery. (2) Use quantitative methods to describe and assess the provision of AUD recovery support services provided by the recovery community organization in terms of matching to needs, stage of recovery and other client and community characteristics, by race/ethnicity. (3) Conduct a pragmatic randomized controlled trial that builds on Aims 1 and 2 with a Black AUD recovery population, compared to a treatment as usual group with in-person recovery support services, to determine the effectiveness of an added phone+digital recovery support service intervention (i.e., provision of smartphones and guidance/support for online recovery activities). The proposed study will enable a deep understanding of what recovery means to Black men and women, how it can be measured, and how we can advance recovery journeys of Black Americans with AUD. The results will be meaningful to Black individuals themselves, providers who treat Blacks who have AUD, and to researchers and policymakers who need to better understand the meaning and needs of a heterogenous US population.