Addressing health disparities by providing evidence-based treatment in the Black Church

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The proposed administrative supplement will not alter the specific aims nor the central themes in the research strategy of this randomized clinical trial, however, the funds requested from the supplement will enhance recruitment of Black individuals who want to reduce their alcohol use, which was comprised due to COVID-19. Black/African-Americans use alcohol and illicit drugs at the same rates as their White counterparts but are much more likely to suffer negative substance related consequences. Moreover, they are less likely to initiate treatment when compared with other racial groups; and when they do, are significantly less likely to complete treatment or to be offered evidence-based treatments. Stigma, mistrust of the medical system, lack of health care coverage, complex pathways to care, lower socioeconomic status, and the scarcity of culturally informed treatment may all be factors underlying low treatment initiation and engagement. Thus, offering treatment in alternative settings, such as the Black Church, a highly trusted entity in Black communities, is a novel, and potentially highly disseminable strategy for improving both access to evidence-based treatments and alcohol treatment outcomes for this important population. We are requesting additional funds through the administrative supplement to aid in the initiation and retention of Black individuals’ in addiction treatment. Past participants of this clinical trial have expressed challenges in accessing treatment, so we have allocated a portion of the supplement to be utilized for transportation. We have also proposed to use bus passes to enable research team members to travel greater distances for recruitment and connections with community partners. These efforts will result in greater dissemination of information regarding the clinical trial. As indicated above, Black individuals also have lower retention rates in addiction treatment than their White counterparts. The largest portion of the requested supplement will be utilized to increase the effort of the project’s, Community Health Representative position. This role will serve as a direct contact for participants to interact with, and provide support and resources for individuals who may have challenges accessing treatment in either arm of the study. Lastly, funding for personal protective equipment (PPE) and risk mitigation strategies, such as air filters are included in this supplement to account for the anticipated increase of participants due to our enhanced efforts. Funds for the Church-based Health Advisor role will also be required for increased engagement. This vital role will continue to engage with participants as they complete the evidence based CBT4CBT modules in the Black Church arm of the study. Moreover, if the utilization of CBT4CBT in this novel setting coupled with enhanced efforts for recruitment and engagement is demonstrated to be effective, this would represent an inexpensive and disseminable strategy to address health disparities among Black individuals with alcohol use disorders in the United States.