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

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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.