A Qualitative Analysis of Social and Behavioral Processes Associated with Self-Change in Drinking in an Existing Cohort of Black and White Emerging Adults

项目概要/摘要 在美国，新兴的成年人（EA，18-29岁）饮酒率高于 其他年龄组的人，与酒精有关的死亡人数和死亡率增加 于2019冠状病毒病大流行的首两年，约有25%的雇员离职。黑色的EA和EA 非四年制大学毕业生经历酒精使用的后果更大 并被NIAAA和美国确定为未充分研究的高优先级群体 医学研究所。在NIAAA的资助下，我们跟踪了一个以社区为基础的多元化队列， 自2017年以来，601名新生儿成年人（出生时的平均年龄= 22.5岁; 47%为白色，42%为黑人; 35%为 没有大学学位）。Beta项目的第一阶段是第一次仔细检查 行为经济学预测20年代中期的酒精使用轨迹， 编制了34份出版物，并支助了4项获得资助的二级赠款。我们最近完成 数据收集，并确定了新兴成年人的亚组，他们（1）减少了他们的 饮酒，因为成为参与研究，并报告一致的低风险饮酒超过 根据WHO分类，过去一年（N = 281）或（2）饮酒增加或相对 在整个研究过程中持续的高风险饮酒者（根据WHO的定义） 分类; N = 174）。拟议的R21将利用这些现有的子组， 来自每个亚组的参与者（50%的参与者将是黑人）查看 总结了他们在3.5年的参与过程中的个人饮酒轨迹， 父母研究，以促进与自我相关的潜在可改变因素的讨论， 改变或持续的危险饮酒，包括行为经济变量和 歧视除了了解参与者如何成功地改变 他们的饮酒，我们的采访和定性分析也将获得如何设计的见解 并传播预防和干预计划，以减少不同人群的酒精风险， 社区居住的新兴成年人。我们将获得关于首选干预内容的反馈， 方式和地点/地点。我们的团队包括新兴成人酒精滥用方面的专家， 成瘾和恢复，简短的干预措施，定性方法和文化适应， 酒精治疗的黑人美国人，因此非常适合成功地完成这些 目标，并利用其结果来开发和完善有效的，文化上知情的酒精 在社区环境中传播的潜力很大的预防方法， 随后的R 01应用。

PROJECT SUMMARY/ABSTRACT In the United States, emerging adults (EAs, ages 18-29) consume alcohol at higher rates than people in any other age group, and the number and rate of alcohol-related deaths increased approximately 25% during the first two years of the COVID-19 pandemic. Black EAs and EAs who are not graduates of four-year colleges experience greater consequences from alcohol use and have been identified as an understudied, high-priority group by both NIAAA and the US Institute of Medicine. Funded by NIAAA, we have followed a diverse community-based cohort of 601 emerging adults since 2017 (mean age at inception = 22.5; 47% White, 42% Black; 35% without a college degree). Phase one of Project BETA was the first to carefully examine behavioral economic predictors of alcohol use trajectories in the mid-twenties and has generated 34 publications and supported 4 funded secondary grants. We recently completed data collection and have identified subgroups of emerging adults who have (1) reduced their drinking since becoming involved with the study and report consistent low-risk drinking over the past year based on the WHO Classification (N = 281) or (2) increased drinking or been relatively persistent high-risk drinkers throughout the course of study (as defined by the WHO Classification; N = 174). The proposed R21 will leverage these existing subgroups by having 40 participants from each of these subgroups (50% of participants enrolled will be Black) view a summary of their individual drinking trajectories throughout their 3.5-year participation in the parent study to facilitate a discussion of potentially modifiable factors associated with self- change or persistent risky drinking, including behavioral economic variables and experiences of discrimination. In addition to gaining an understanding of how participants successfully changed their drinking, our interviews and qualitative analyses will also gain insights into how to design and disseminate prevention and intervention programs to reduce alcohol risk for diverse community-residing emerging adults. We will obtain feedback on preferred intervention content, modalities, and locations/venues. Our team includes experts in emerging adult alcohol misuse, addiction and recovery, brief interventions, qualitative methods, and cultural adaptation of alcohol treatments for Black Americans and is thus ideally suited to successfully complete these aims and to use the results to develop and refine effective, culturally informed alcohol prevention approaches with high potential for dissemination in community settings in a subsequent R01 application.