Understanding Racial Disparities in Teen Methamphetamine Use

尽管有大量的研究记录了美国青少年使用甲基苯丙胺的性质和程度，但相对较少的研究提供了与青少年使用甲基苯丙胺相关的风险和保护因素的全面描述。一个显著的疏漏是，缺乏对青少年使用甲基苯丙胺的种族差异进行深入研究的研究：美洲原住民青少年比非西班牙裔白人使用和滥用甲基苯丙胺的风险要大得多。有证据表明，使用冰毒与从事与感染艾滋病毒/艾滋病相关的静脉吸毒和无保护的性行为等行为的风险增加有关，这一事实进一步加剧了这一事实。事实上，疾病控制和预防中心的研究提供了证据，表明与非西班牙裔白人相比，美洲原住民感染艾滋病毒/艾滋病的风险更高。显然，我们对甲基安非他命使用/滥用在青少年中分布差异的认识和理解存在重要差距，需要进行研究，特别侧重于解释美国原住民和非西班牙裔白人青少年在甲基安非他命使用和甲基安非他命使用与暴露于艾滋病毒/艾滋病风险相关行为之间的“种族差距”。目前的研究，通过解决这些知识差距，将有助于理解为什么这种行为存在种族差异，并可以指导有针对性的干预和预防计划，解决美洲原住民和非西班牙裔白人青少年之间的健康差异。研究小组的长期目标是继续探索种族和经济分层如何产生健康差异，以减少基于种族和经济的差异。该应用程序的目的有三个：a)确定与甲基苯丙胺使用有关的社会风险和保护因素，以及那些有助于描述使用中具体种族/民族差异的因素；b)应用应力过程模型/一般应变理论来扩大我们对冰毒使用和使用种族差异的理解；c)探索冰毒使用与危险性行为之间的联系，以及种族如何成为潜在的调节因素。本应用程序的中心假设是，压力暴露的差异将预测个体和种族在冰毒使用，滥用和相关危险行为（静脉吸毒/无保护的性行为）方面的差异，个人和社会资源有助于缓和压力物质使用关联。该计划是通过追求以下两个具体目标来填补这一知识空白：a)利用压力过程模型/商品及服务税框架来确定与在蒙大拿州公立学校就读的男性和女性、非西班牙裔白人和美洲原住民青少年开始、使用和滥用/依赖冰毒有关的社会风险和保护因素；b)评估压力过程模型/GST框架作为预测风险性行为的解释，以及种族和冰毒使用作为调节因素的潜在作用。为了实现这些目标，将收集一波数据，包括对蒙大拿州三所高中的大约900名九年级和十年级男孩和女孩的目标样本使用自我管理的问卷。这项拟议的研究意义重大，因为它有望提供必要的基础知识，以便建立有效的干预和预防措施，旨在减少青少年印第安人白人在冰毒使用方面的差距，以及与艾滋病毒/艾滋病相关的危险行为。

Despite a voluminous number of studies documenting the nature and extent of teen methamphetamine use in the United States, relatively few studies have provided a comprehensive portrait of the risk and protective factors associated with adolescent meth use. One salient omission is the lack of studies that provide insight into the well-documented race gap in teen methamphetamine use: Native American teens are at much greater risk of use and abuse of methamphetamines than non-Hispanic whites. This fact is exacerbated by evidence that meth use is associated with a heightened risk of engaging in behaviors such as IV drug use and unprotected sexual practices that are correlated with contracting HIV/AIDS. Indeed, research from the Centers for Disease Control and Prevention provides evidence that Native Americans are at a heightened risk of contracting HIV/AIDS relative to non-Hispanic whites. Clearly, there are important gaps in our knowledge and understanding of why methamphetamine use/abuse is distributed differentially among adolescents, and there is a need for research that specifically focuses on explaining the "race-gap" between Native American and non Hispanic white teens in America with regards to both meth use and the associations between meth use and behaviors associated with risk of exposure to HIV/AIDS. The present study, by addressing these knowledge gaps, will facilitate understanding into why the race gap in such behavior exists and can direct targeted intervention and prevention programs that address such health disparities between Native American and non-Hispanic white teens. The long-term goal of the research team is to continue to explore how racial and economic stratification serves to produce health disparities, in order to reduce race and economic based disparities. The objective of this application is threefold: a) to identify the social risk and protective factors associated with both meth use generally and those factors that serve to delineate racial/ethnic differences in use specifically; b) to apply the stress process model/General Strain Theory to expand our understanding of both meth use and racial differences in use; and c) to explore the association between meth use and risky sexual behaviors and how race serves as a potential moderator. The central hvpothesis of this application is that differences in stress exposure will predict both individual and race-based variation in meth use, abuse, and related risky behaviors (IV drug use/unprotected sex) with personal and social resources serving to moderate the stresssubstance use association. The plan is to fill this knowledge gap by pursuing the following two specific aims: a) utilize the stress process modei/GST framework to identify the social risk and protective factors associated with the initiation, use, and abuse/dependence of meth use among both males and females, non-Hispanic whites and Native American adolescents who attend public schools in Montana; and b) evaluate the stress process modei/GST framework as an explanation for predicting risky sexual practices and the potential role of race and meth use as moderators. In order to accomplish these objectives, one wave of data will be collected, entailing the use of a self-administered questionnaire of a targeted sample of approximately 900 ninth and tenth grade boys and girls attending three high schools in Montana. The proposed research is significant because it is expected to provide fundamental knowledge necessary in order to construct efficacious interventions and prevention efforts designed to reduce the adolescent Native American-white race gap in meth use, and risky behaviors associated with HIV/AIDS.