Identifying the Effects of Race-Related Stressors on Laboratory- Induced Stress and Craving among African Americans with Alcohol Use Disorder

项目总结/摘要 拟议的K23指导以患者为导向的研究职业发展奖的主要目的是 为候选人（Delisa Brown博士）提供获得必要知识和技能的机会， 成为专注于酒精使用障碍（AUD）和健康差异的独立调查员。种族有关 压力（RRS）在美国的非洲裔美国人（AA）中很常见，并且与增加的风险有关。 发展AUD。研究表明，突出的文化因素，如积极的种族认同，可能会有所帮助 减轻RRS的负面影响。然而，很少有研究集中在RRS和AUD上， 缺乏对AA人群中AUD的敏感的循证治疗。鉴于缺乏科学的 鉴于RRS在患有AUD的AA患者中的作用的现有信息，拟议的研究将采用 良好控制的人类实验室范例来识别主观的（渴望，压力），生理的（心率， 皮肤电传导），以及对个性化图像线索的神经内分泌（皮质醇）反应性（即，RRS， 酒精和中性）在患有AUD的AA个体（N = 60）中。种族认同与 对RRS线索的反应性将被检查，以进一步为这一高度不足的领域提供科学信息，并支持 对AA和其他少数群体AUD的文化敏感治疗的未来发展。 生态瞬时评估（EMA）将用于获得关于酒精渴望，影响， 以及暴露于RRS后的饮酒模式。从这个项目中获得的数据将提供新的知识 和见解，以前所未有的方式让我们了解RRS和AUD之间的联系。的 候选人组建了一个由经验丰富的全国知名调查人员组成的导师团队， 他们带来了AUD、健康差异、人体实验室范例、EMA、临床试验 和治疗发展。现场导师和顾问包括苏迪·巴克博士、科琳·哈利迪博士和 MUSC的Erin麦克卢尔。场外导师和顾问包括密歇根大学的Kathleen Burlew博士 辛辛那提和拉吉塔·辛哈博士在耶鲁大学。拟议的项目将提供指导，正式 课程作业，实践数据收集和职业发展机会，以确保候选人 实现以下职业目标：1）提高对AUD的基础病理生理学的认识， 经历RRS的非裔美国人，2）发展新技能，以告知AUD治疗的文化适应， 3)提高对少数种族/族裔进行酒精研究的能力，4）获得新的培训， EMA方法和数据分析，以及5）通过手稿写作，会议 演示文稿和赠款写作。该项目与NIAAA的少数民族健康和健康差异密切相关 消除健康差距和增加来自代表性不足的国家的训练有素的科学家人数的倡议 酒精研究领域的背景。

PROJECT SUMMARY / ABSTRACT The primary aim of the proposed K23 Mentored Patient-Oriented Research Career Development Award is to provide the candidate (Dr. Delisa Brown) the opportunity to acquire the knowledge and skills necessary to become an independent investigator focused on alcohol use disorder (AUD) and health disparities. Race-related stress (RRS) is common among African Americans (AA) in the U.S. and is associated with increased risk of developing AUD. Research suggests that salient cultural factors, such as positive racial identity, may help mitigate the negative effects of RRS. However, little research has focused on RRS and AUD, and culturally sensitive, evidence-based treatments for AUD among AA populations are lacking. Given the dearth of scientific information available on the effects of RRS among AA individuals with AUD, the proposed study will employ a well-controlled human laboratory paradigm to identify the subjective (craving, stress), physiological (heart rate, galvanic skin conductance), and neuroendocrine (cortisol) reactivity to personalized imagery cues (i.e., RRS, alcohol, and neutral) among AA individuals (N = 60) with AUD. The relationship between racial identity and reactivity to RRS cues will be examined to further inform the science in this highly understudied area, and support the future development of culturally sensitive treatments for AA and other minoritized populations with AUD. Ecological momentary assessment (EMA) will be used to obtain real-time information on alcohol craving, affect, and drinking patterns following exposure to RRS. The data obtained from this project will provide new knowledge and insights to inform our understanding of the link between RRS and AUD in ways not previously possible. The candidate has assembled a mentorship team of experienced and nationally renowned investigators with a history of collaboration who bring expertise in AUD, health disparities, human laboratory paradigms, EMA, clinical trials, and treatment development. On-site mentors and consultants include Drs. Sudie Back, Colleen Halliday, and Erin McClure at MUSC. Off-site mentors and consultants include Dr. Kathleen Burlew at the University of Cincinnati and Dr. Rajita Sinha at Yale University. The proposed project will provide the mentorship, formal coursework, hands-on data collection, and career development opportunities needed to ensure the candidate achieves the following career goals: 1) enhance knowledge of the underlying pathophysiology of AUD among African Americans experiencing RRS, 2) develop new skills to inform cultural adaptions of treatments for AUD, 3) increase competence in conducting alcohol research with racial/ethnic minorities, 4) obtain new training in EMA methods and data analysis, and 5) increase scholarly productivity through manuscript writing, conference presentations, and grant writing. This project aligns closely with NIAAA’s Minority Health and Health Disparities Initiative to eliminate health disparities and increase the number of well-trained scientists from underrepresented backgrounds in the field of alcohol research.