The role of momentary acute discrimination and cultural resilience in polysubstance use among adults from communities of color

短暂的严重歧视和文化复原力在有色人种社区成年人使用多种物质中的作用

• 批准号: 10585788
• 负责人: Jimi Huh
• 金额: $ 75.1万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585788
• 关键词: Acculturation; Acute; Address; Adult; Adverse effects; Affect; African American population; Alcohols; Asian Americans; Attention; Black, Indigenous, People of Color; COVID-19 pandemic; Cellular Phone; Cessation of life; Cigarette; Color; Communities; Coping Skills; Data; Discrimination; Disparity; Ecological momentary assessment; Electronic Nicotine Delivery Systems; Electronic cigarette; Environment; Ethnic Origin; Etiology; Event; Focus Groups; Future; Gender; Health; Hispanic Americans; Immigration; Individual; Inequity; Intercept; Intervention; Life Expectancy; Logistic Regressions; Marijuana; Measurement; Measures; Methods; Minority Groups; Modeling; Nature; Outcome; Pacific Islander; Pain; Participant; Personal Satisfaction; Persons; Phase; Play; Police; Policies; Population; Process; Public Health; Questionnaires; Race; Racial injustice; Recovery; Reporting; Research; Resources; Risk; Role; Stress; Structural Racism; Subgroup; Substance Addiction; Testing; Time; Tobacco use; United States; Variant; addiction; adult of color; aged; assessment application; combustible cigarette; comorbidity; coping; coping mechanism; design; digital; experience; hate crimes; health disparity; high risk; improved; infection rate; intersectionality; microaggression; novel; pandemic disease; pandemic impact; people of color; perceived discrimination; polysubstance use; post-pandemic; prevent; prospective; psychologic; racial population; racism; recruit; resilience; resilience factor; response; smartphone application; social; social stress; social stressor; stress management; stressor; substance use; theories

ABSTRACT. Structural and social inequities have historically impacted the health and wellbeing of Black, Indigenous and Persons of Color (BIPOC) in the United States, resulting in health disparities that were exacerbated by the COVID-19 pandemic, which coincided with a surge of discriminatory events and hate crimes targeting minority groups. Emerging research shows that substance use, especially polysubstance use (PSU), is increasing as a means to cope with the range of stressors and psychological consequences among BIPOC adults. The extent to which PSU as a maladaptive coping process unfolds and accumulates in the current context of the pandemic and racial injustice to perpetuate and potentially expand addiction-related disparities is unknown. Furthermore, the impact of coping responses, resources and resilience factors on these processes has not been extensively studied in all BIPOC subgroups. In the current proposal, we aim to capture the nature of daily variation in acute perceived discrimination and to examine how these variations influence PSU, with emphasis on evaluating predictors of resilience to stress. This information is critical to inform the design of context-sensitive interventions tailored to momentary circumstances in addition to person-level variables to prevent maladaptive coping strategies, including PSU. Building on our current user-centered, smartphone Ecological Momentary Assessment (EMA) app, we propose to conduct an exploratory-sequential mixed methods study. In Aim 1, we will use 6-9 focus groups (FGs; N~70) to better understand discrimination experience and coping resources in the context of intersectionality of race/ethnicity and gender in relation to PSU to inform context-sensitive EMA, refined during a pilot EMA phase. Subsequently, BIPOC adults who co- use 2+ substances (N=270) will be recruited through targeted digital ads, and will complete 7-day EMA every 3 months over 4 waves. In Aim 2, a cross-over, within-subject, repeated measure, observational EMA design will be used, and multi-level logistic regression models will be developed to determine the within-person effects of perceived discrimination on PSU and identify the underlying mechanisms. In Aim 3, we will model the prospective association between changes in discrimination and PSU using the multi-wave EMA data to examine the longitudinal effects of perceived discrimination contexts on changes in PSU among BIPOC adults. IMPACT. To the best of our knowledge, this is the first multi-wave EMA study that uses a social-ecological framework and a novel, culturally appropriate, real-time assessment design to determine the impact of day-to- day discrimination and PSU in BIPOC adults. We expect our study to uncover micro-temporal etiologies of PSU disparities across BIPOC adults that will inform future targeted interventions to ameliorate the effects of acute perceived discrimination on PSU and reduce addiction-related burdens disproportionately affecting BIPOC, an urgent aspect of post-pandemic recovery.

摘要。结构性和社会不平等在历史上影响了黑人的健康和福祉， 土著和有色人种（BIPOC）在美国，导致健康差距， 2019冠状病毒病大流行加剧了这一问题，与此同时，歧视性事件和仇恨激增 针对少数群体的犯罪。新的研究表明，物质使用，特别是多种物质的使用， (PSU)，越来越多地作为一种手段，以科普各种压力和心理后果， BIPOC成人。PSU作为一种适应不良的应对过程，在多大程度上在 目前流行病和种族不公正的背景下， 差异是未知的。此外，应对措施、资源和复原力因素对这些问题的影响 在所有BIPOC亚组中，尚未对过程进行广泛研究。在目前的提案中，我们的目标是捕捉 急性感知歧视的日常变化的性质，并研究这些变化如何影响 PSU，重点是评估压力恢复力的预测因素。此信息对于告知 除了个人层面的干预措施外，还设计了针对瞬时情况的对背景敏感的干预措施 变量，以防止适应不良的应对策略，包括PSU。基于我们目前以用户为中心的理念， 智能手机生态瞬时评估（EMA）应用程序，我们建议进行探索性的顺序 混合方法研究在目标1中，我们将使用6-9个焦点小组（FG; N~70）来更好地理解歧视 在种族/族裔和性别相互交织的情况下， PSU通知上下文敏感的EMA，在EMA试点阶段进行改进。后来，BIPOC的成年人谁共同- 使用2+物质（N=270）将通过有针对性的数字广告招募，并将每3天完成7天EMA 4个月以上的浪在目标2中，交叉、受试者内、重复测量、观察性EMA设计 将使用，并将开发多水平逻辑回归模型，以确定人内效应 对PSU的感知歧视，并确定潜在的机制。在目标3中，我们将对 使用多波EMA数据， 研究BIPOC成年人之间的PSU变化的感知歧视的背景下的纵向影响。 冲击据我们所知，这是第一个使用社会生态学的多波EMA研究。 框架和一个新颖的，文化上适当的，实时评估设计，以确定每天的影响， BIPOC成人中的日间歧视和PSU。我们希望我们的研究能够揭示 BIPOC成年人之间的PSU差异将为未来有针对性的干预措施提供信息，以改善 对PSU的严重歧视并减轻与成瘾相关的负担，不成比例地影响 BIPOC是大流行后恢复的一个紧迫方面。