Hitting Close to Home: A Multi-Method Investigation of Neighborhood Characteristics and Drinking Motives on Alcohol-Related Health Disparities

项目总结/摘要 与美国黑人相比，美国黑人在与酒精有关的健康问题上承担的负担更大。 他们的白色同行，1代表一个重大的公共卫生问题。因此，消除健康 差异和实现健康公平是NIH健康人倡议的主要目标之一。 现有的研究在理解卫生不公平的广泛因素方面取得了进展，现有的模型 物质使用的差异不能充分解释黑人成年人中与酒精相关的后果的差异。 解释这些差异的一个有希望的方法是检查一个人的邻里环境 以及它与酒精使用的关系和相关后果。4，5现存的文献将特定的社区联系起来， 特性（例如，酒精出口和酒类商店密度6，7和邻里分散度5）同样重要 酒精使用的贡献者。然而，现有的关于邻里环境与 黑人成年人的物质使用提供了相互矛盾的证据，表明社区特征 最重要的是，8，9强调必须使用新的方法来确定突出的因素， 个人的环境，可能有助于不同的酒精相关的结果。此外，更多的研究 需要确定将环境特征与酒精结果联系起来的行动机制， 饮酒动机通常被认为是一种潜在的途径。生活在不同社区的成年人可能 饮酒的原因不同，这可能会不同地影响他们的饮酒量和后果 经验丰富。因此，目前的建议力求采用定性和定量方法， 邻里和社区层面的因素，可能会影响酒精的结果在黑人成年人。具体 目的包括（1）识别邻域特征（例如，邻里关系混乱和剥夺） 作为酒精结果的保护性或风险因素（即，酒精消费和酒精相关 结果）在黑人成年人和（2）调查邻里特征之间的关联 和酒精使用结果以及酒精动机如何解释这种关系。研究结果将有 对未来的健康差异研究具有重要意义， 机制驱动的公共卫生战略、预防和干预工作以及政策影响。的 申请人将获得以下方面的培训：（1）了解种族相关疾病的病因和治疗方法 酒精和物质使用的差异，（2）定性，定量和分析方法，（3）科学 写作和研究传播;（4）社区参与和跨学科方法。最后， 通过拟议的研究和培训计划，申请人将发展必要的技能和专业知识， 为种族健康差异领域做出实质性贡献，符合申请人的强烈愿望 成为一名独立的临床科学家，解决物质使用领域的健康不公平问题。

PROJECT SUMMARY/ABSTRACT Black Americans bear a disproportionately greater burden of alcohol-related health problems when compared to their White counterparts,1 representing a significant public health concern. Accordingly, eliminating health disparities and achieving health equity is one of the leading goals of the NIH Healthy People Initiative.2 Although existing research has made progress in understanding broad contributors to health inequities, existing models of substance use fail to adequately explain disparities in alcohol-related consequences among Black adults.3 One promising approach to explaining these disparities is the examination of one’s neighborhood environment and its relation to alcohol use and related consequences.4,5 Extant literature has linked specific neighborhood characteristics (e.g., alcohol outlet and liquor store density6,7 and neighborhood disadvantage5) as important contributors to alcohol use. Yet, existing research on the relationship between neighborhood context and substance use among Black adults provides conflicting evidence on which neighborhood characteristics are most important,8,9 highlighting the necessity of using novel approaches to identify salient factors within individuals’ environments that may contribute to differential alcohol-related outcomes. Moreover, more research is needed to identify mechanisms of action that associate environmental characteristics with alcohol outcomes, and drinking motives are often theorized as a potential pathway. Adults living in different neighborhoods may drink for different reasons, which may differentially influence their alcohol consumption and consequences experienced. Thus, the current proposal seeks to use both qualitative and quantitative approaches to identify neighborhood- and community-level factors that may influence alcohol outcomes among Black adults. Specific aims include (1) identifying neighborhood characteristics (e.g., neighborhood disorganization and deprivation) that serve as protective or risk factors for alcohol outcomes (i.e., alcohol consumption and alcohol-related consequences) among Black adults and (2) investigating the association between neighborhood characteristics and alcohol use outcomes and how alcohol motives may explain this relationship. Study findings will have important implications for future health disparities research and are crucial for the development of effective, mechanistically driven public health strategies, prevention and intervention efforts, and policy implications. The applicant will gain training in (1) understanding the etiology of and treatment approaches for race-related disparities for alcohol and substance use, (2) qualitative, quantitative, and analytical methodology, (3) scientific writing and research dissemination, and (4) community-engaged and interdisciplinary approaches. Ultimately, through the proposed research and training plan, the applicant will develop the skills and expertise necessary to make a substantive contribution to the field of racial health disparities, aligning with the applicant’s strong desire to become an independent clinical scientist addressing health inequities in the substance use field.