Fostering Resilience to Race-Based Stress: A Pilot Study

培养对种族压力的适应能力：一项试点研究

• 批准号: 10579114
• 负责人: Ariel J Lang
• 金额: --
• 依托单位: VA SAN DIEGO HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-10-01 至 2024-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10579114
• 关键词: Acute; Address; Aftercare; Atmosphere; Attitude; Black, Indigenous, People of Color; Caring; Chronic; Chronic stress; Clinical; Color; Communities; Data; Discrimination; Evaluation; Exclusion; Fostering; Future; Goals; Health; Health behavior; Human Resources; Human Rights; Individual; Institutional Racism; Intervention; Link; Measurable; Measurement; Mental Health; Military Personnel; Nature; Occupational; Outcome; Participant; Perception; Personal Satisfaction; Physiological; Physiology; Pilot Projects; Population; Post-Traumatic Stress Disorders; Practice Management; Preparation; Process; Provider; Psyche structure; Psychotherapy; Race; Randomized; Randomized Controlled Trials; Reporting; Research; Research Misconduct; Resources; Role; Shoulder; Stress; Techniques; Therapeutic; Time; Training; Trauma; United States; Veterans; Videoconferencing; allostatic load; base; burden of illness; coping; efficacy testing; emotion regulation; emotional distress; empowerment; experience; functional restoration; health care availability; health care service utilization; health disparity; high risk; improved; indexing; innovation; intervention effect; military service; military veteran; mortality; multimodality; novel strategies; participant retention; people of color; perceived discrimination; physical conditioning; programs; provider behavior; psychologic; psychological distress; psychosocial; racial and ethnic; racial discrimination; racism; randomized trial; recruit; resilience; service member; socioeconomic disadvantage; socioeconomic disparity; sound; stress management; stressor; therapy design; trial comparing

Health disparities between White and Black, Indigenous and People of Color (BIPOC) are well documented in the United States; this phenomenon is driven in part by discrimination experiences and is an important contributor to well-being and functioning, including among military service members and Veterans. The chronic stress of racism has both psychological and physiological effects. Discrimination is associated with increased psychological distress, including higher rates of PTSD among Veterans of Color (VOC), poorer health behavior and decreased healthcare utilization. Race-based stress is also linked to increased allostatic load (AL), which is a measurable index of wear-and-tear on the body due to chronic stress exposure that is associated with greater disease burden and mortality. Recognizing the unmet need for interventions to help VOC process and cope with experiences of discrimination, the Race-based Stress/Trauma and Empowerment (RBSTE) intervention (Carlson, Endsley, Motley, Shawahin, & Williams, 2018) was developed. RBSTE is a group-based therapy that combines cultural adaptations of established psychotherapeutic techniques with novel strategies to foster resilience and empowerment for VOC. Initial qualitative data suggests the promise of this approach, but no systematic data are yet available to determine whether or not RBST E is achieving its goals of enhancing coping and restoring well-being. The proposed project is a pilot randomized controlled trial (RCT) with multi-modal longitudinal assessment. Participants will be recruited from VA facilities and the surrounding community. VOC who report race-based stress, with minimal exclusions, will be evaluated at baseline, randomized in groups to one of two therapy conditions and then re-evaluated immediately after treatment. The treatments include RBSTE and a non-specific psychotherapy control, Present Centered Therapy (PCT), designed to control for nonspecific aspects of RBSTE, including support and participation in an all-BIPOC group. The interventions will be delivered in 8 weekly 90-minute group sessions by a trained therapist using videoconferencing. The aims of the project are (1) to assess the feasibility of recruiting VOC for an RCT of this nature; (2) to examine the acceptability and appropriateness of treatment content, the feasibility of participation, and participant’s perceptions of provider behavior and attitudes; and (3) to establish the optimal strategy for quantifying mental and physical health outcomes for future studies. Thus, the project will set the stage for evaluation of RBSTE’s efficacy and ultimately implementation. This critically important program of research will provide guidance as to best practices for the management of race-based stress, with the ultimate goal of eliminating health disparities for Veterans and the community more broadly.

白人和黑人、土著人和有色人种（BIPOC）之间的健康差距在