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

美国黑人明显地遭受着一系列健康差距的困扰，这是由于长期的 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人 在普通人群中，黑人饮酒者有酒精使用障碍(AUD)的比率是相似的，为1.5 一百万患有澳元的美国黑人。黑人因饮酒而遭受更多的负面后果，例如 疾病、伤害、刑事法律介入和社会问题。恢复是一个动态的行为过程 变革导致在功能、目标和福祉方面的稳定改善。NIAAA进一步亮点 随着AUD症状的缓解以及大量饮酒的停止，患者的病情得到了恢复。恢复支持服务 恢复社区组织的目标是建立恢复资本。然而，到目前为止，几乎没有做出什么努力来 考虑群体内的复苏，而不是跨群体的复苏。“以页边为中心”的方法 强调需要审查种族主义和小型化人口的经验。这项拟议的研究旨在 为黑人男性和女性提供先进的恢复途径和支持服务听从这一呼吁。它是直接的 响应RFA-AA-21-001关于澳大利亚人健康差距的强调，与 RFA的目标是推进了解文化的措施和干预措施，增加获得AUD服务的机会，使 服务更具吸引力，并评估以证据为基础的做法。我们这样做的重点是黑人男性 处于澳元恢复期的妇女。因此，我们的目标是迭代地使用定量和定性的方法来捕获和 评估与异种黑人人口中澳元恢复有关的问题，与黑人- 底特律的多数恢复社区组织。具体地说：(1)使用定性方法与黑色 人口以(A)定义AUD恢复路径；(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的社区指标 随着澳元的恢复。(2)用定量的方法描述和评估澳元回收的提供情况 恢复社区组织在匹配需求方面提供的支助服务，阶段 康复和其他客户和社区特征，按种族/族裔分列。(三)务实作为 以AIMS 1和AUD恢复人群为基础的随机对照试验，与 照常治疗组加用面对面的康复支持服务，以确定加用 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)。这项拟议的研究将使人们能够深入了解复苏对 黑人男性和女性，如何衡量它，以及我们如何推进黑人的复苏之旅 患有澳元的美国人。这一结果将对黑人个人本身、治疗提供者具有重要意义 对于患有AUD的黑人，以及需要更好地理解其含义和 不同种类的美国人口的需求。

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.