Enhancing the Role of Black Churches in Addressing Substance Use Problems

描述(由申请者提供)：项目摘要/摘要非裔美国人社区受到药物使用问题(SUP)不良后果的不成比例的影响。尽管使用率相似，但非裔美国人比白人面临更严重的社会、健康和犯罪相关成本。在SUP的治疗方面发现了显著的差异，非裔美国人报告说，他们比白人获得更差的机会和更差的护理质量。在需要治疗的非裔美国人中，只有不到25%的人真正得到了初级保健医生的护理。然而，非裔美国人比白人更有可能向教会寻求帮助。历史上和现在，黑人教会一直是一个值得信赖的避风港，在那里人们寻求帮助，分发支持，恢复希望。黑人教堂往往是许多有SUP的非裔美国人的第一个也是唯一的接触点。黑人教会可以帮助及早发现SUP，形成有关治疗的社会规范和污名，并建立与正规服务的联系。黑人教会和正规提供者之间的战略伙伴关系可以显著影响改善对SPS的获取和护理，但这种伙伴关系非常罕见。一个主要的障碍就是缺乏培训。教会可能不承认严重的SUP，或者当表明有正式治疗时，因为通常不进行筛查和转介，不是因为缺乏兴趣，而是因为缺乏能力。需要一个更正式的程序，考虑教会愿意参与的合作条件和类型，包括筛查、短暂干预和转介治疗(SBIRT)。黑人教会可能非常适合实施SBIRT干预措施，因为它们拥有丰富的人力和物质资本，在赋权和动员人们方面的专业知识，以及共同经历的SUP对社区的有害影响。这项拟议的研究以信仰为基础的合作伙伴西洛杉矶基督上帝教会，拥有超过24,000名会众，是美国最大的黑人“巨型教堂”之一。西洛杉矶位于洛杉矶南部，与健康、社会福利和社区组织有着广泛的联系，提供了80多个加强社区的计划。西洛杉矶认识到社区的需求太大，任何一个机构都不能满足，因此希望帮助其他教会建立参与类似合作关系的能力。西洛杉矶领导着基于信仰的社区合作组织，这是一个由300多个当地黑人教堂组成的网络。协作将作为一种案例研究，以产生关于制定干预措施的知识，旨在加强教会对协作实践的参与，例如为信仰社区的文化、精神和当地需求量身定做的SBIRT。拟议的研究有以下具体目的：(1)描述黑人教会在解决SPS问题上的做法(2)确定与黑人教会对SBIRT干预措施的参与度和接受度相关的因素(3)制定初步协议以加强黑人教会实施SBIRT干预措施 公共卫生相关性：项目叙述非裔美国人在药物使用问题的负面影响以及在获得和获得高质量的药物滥用治疗方面存在显著差异。在需要治疗的非洲裔美国人中，只有不到25%的人真正得到了药物使用问题的治疗。拟议的研究将为制定初步干预措施奠定基础，旨在加强黑人教会实施筛查、短暂干预和转介治疗(SBIRT)。在教会环境中实施SBIRT，这是解决物质使用问题的一种成功的公共卫生方法，可能会为解决未得到满足的治疗需求提供一个潜在的强有力的途径。

DESCRIPTION (provided by applicant): Project Summary/Abstract African American communities are disproportionately impacted by the adverse consequences of substance use problems (SUPs). Despite similar rates of use, African Americans experience more severe social, health, and criminal related costs than Whites. Significant disparities in the treatment of SUPs have been found with African Americans reporting poorer access and quality of care than Whites. Less than 25% of African Americans who are in need of treatment actually obtain care for SUPs. African Americans, however, are more likely to seek help for SUPs from churches than Whites. Historically and presently, the Black church has served as a trusted haven where help is sought, support is dispensed, and hope is restored. Black churches are often the first and only point of contact for many African Americans with SUPs. Black churches can facilitate the early detection of SUPs, shape social norms and stigma regarding treatment, and establish linkages to formal services. Strategic partnerships between Black churches and formal providers can significantly impact improved access and care for SUPs, yet such partnerships are woefully rare. One major barrier is the mere lack of training. Churches may not recognize serious SUPs or when formal treatment is indicated given that screening and referral is not typically practiced, not due to a lack of interest but of capacity. A more formalized process is needed that considers the kinds of conditions and types of collaboration that churches would be willing to engage in, including screening, brief intervention, and referral to treatment (SBIRT). Black churches may be well-suited to implement SBIRT interventions given their wealth of human and physical capital, expertise in empowering and mobilizing people, and shared experience of SUPs' deleterious effects on the community. This proposed study's faith-based partner, West Angeles Church of God in Christ, with over 24,000 congregants, is one of the largest Black "mega-churches" in the nation. Situated in the South Los Angeles, West Angeles has extensive interfaces with health, social welfare, and community organizations, providing more than 80 programs for the enhancement of the community. Recognizing that the needs of the community are too vast to be met by any one institution, West Angeles desires to help build the capacity of other churches to engage in similar collaborative relationships. West Angeles leads the Faith- based Community Collaborative, a network of over 300 local Black churches. The Collaborative will serve as a kind of case study for generating knowledge on the development of an intervention aimed at enhancing churches' engagement in collaborative practices such as SBIRT that are tailored to the cultural, spiritual, and local needs of the faith community. The proposed research has the following specific aims: (1) Describe the practices of Black churches in addressing SUPs (2) Identify factors associated with Black churches' engagement and receptivity to SBIRT interventions (3) Develop a preliminary protocol to enhance Black churches' implementation of SBIRT interventions PUBLIC HEALTH RELEVANCE: Project Narrative African Americans experience significant disparities in the negative impact of substance use problems and in accessing and obtaining quality substance abuse treatments. Less than 25% of Africans Americans who are in need of treatment actually obtain care for substance use problems. The proposed research would lay the groundwork for the development of a preliminary intervention aimed at enhancing Black churches' implementation of screening, brief intervention, and referral to treatment (SBIRT). The implementation of SBIRT, a successful public health approach to substance use problems, within church settings may provide a potentially powerful avenue to address unmet need for treatment.