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

推进黑人男性和女性酒精使用障碍的康复途径和支持服务

• 批准号: 10372433
• 负责人: SHARON REIF
• 金额: $ 65.95万
• 依托单位: BRANDEIS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-15 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10372433
• 关键词: Address; Age; Alcohol consumption; Alcohols; American; Americas; Asian population; Birth; Black American; Black Populations; Black race; COVID-19; Capital; Cellular Phone; Cessation of life; Characteristics; Client; Communities; County; DSM-V; Diagnosis; Disease; Disease remission; Employment; Environment; Ethnic Origin; Evidence based practice; Female; Future; General Population; Goals; Health Insurance; Heavy Drinking; Heterogeneity; Imprisonment; Individual; Injury; Intervention; Knowledge; Legal; Life Expectancy; Low income; Maps; Measures; Methods; Michigan; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Pathway interactions; Personal Satisfaction; Persons; Pharmaceutical Preparations; Population; Population Group; Probability; Process; Provider; Qualitative Methods; Quality of life; Race; Randomized Controlled Trials; Recording of previous events; Recovery; Recovery Support; Reporting; Research Personnel; Role; Self Efficacy; Services; Social Problems; Survival Rate; Symptoms; Telephone; Time; Work; alcohol availability; alcohol consequences; alcohol services; alcohol use disorder; base; behavior change; black men; black women; burden of illness; community organizations; digital; effectiveness evaluation; experience; health care availability; health disparity; high risk; improved functioning; maladaptive behavior; male; racial disparity; racism; service intervention; social determinants; socioeconomic disparity; stem; treatment as usual; urban setting

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.

美国黑人显然遭受着一系列健康差异的困扰，这些差异源于长期的种族歧视历史。 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 与一般人群相比，黑人饮酒者患有酒精使用障碍 (AUD) 的比例相当，为 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、刑事法律卷入和社会问题。恢复是一个动态的行为过程 变化会导致功能、目标和福祉的稳定改善。 NIAAA 进一步强调 康复指的是 AUD 症状的缓解以及酗酒的停止。康复支持服务 恢复社区组织旨在建立恢复资本。然而，迄今为止，还没有做出什么努力 考虑人群内部而不是跨群体的恢复。 “以边缘为中心”的方法 强调需要审查种族化和少数群体人口的经历。这项拟议的研究旨在 为黑人男女提供先进的康复途径和支持服务，我们注意到这一呼吁。就是直接 响应 RFA-AA-21-001 强调澳元人口的健康差异，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，使 服务更具吸引力，并评估基于证据的实践。我们这样做的重点是黑人和 澳元复苏中的女性。因此，我们的目标是迭代地使用定量和定性方法来捕获和 与黑人合作，评估与异质黑人群体中澳元复苏相关的问题 底特律的多数恢复社区组织。具体来说：（1）对 Black 使用定性方法 人口 (a) 确定澳元复苏路径； (b) 评估和完善恢复域的衡量标准（例如， 人际关系、生活环境）； (c) 识别并绘制可能促进或干扰的社区指标 随着澳元的复苏。 （2）采用定量方法描述和评估澳元回收的提供情况 康复社区组织在满足需求、康复阶段等方面提供的支持服务 按种族/民族划分的康复情况以及其他客户和社区特征。 （三）开展务实工作 基于目标 1 和 2 的随机对照试验，针对黑人澳元恢复人群，与 像往常一样进行治疗，并提供现场康复支持服务，以确定附加治疗的有效性 电话+数字康复支持服务干预（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深入了解恢复对健康的意义 黑人男性和女性，如何衡量，以及我们如何推进黑人的康复之旅 美国人用澳元。结果将对黑人本身、治疗的提供者有意义 拥有澳元的黑人，以及需要更好地理解澳元的含义和政策的研究人员和政策制定者 不同的美国人口的需求。