Project BrEAtHe (Brothers, Reclaiming, Emotional, Awareness, Tranquility, Healing & Ex-istence): Disrupting Racism-related Stress, Trauma, & Problematic Substance Use in Young Adult Black Men

项目摘要/摘要 新冠肺炎和美国种族主义暴力事件的增加偷走了我们的集体呼吸，正在酝酿一种强有力的组合， 或压力、创伤和负面情绪的共同作用--行为健康差异的关键风险因素。 黑人男性的行为健康差异是有据可查的，而且已知在年轻时爆发 成年期(18-29岁)当这一群体表现出问题物质使用急剧上升时(例如， 大麻和酒精)。许多年轻的成年黑人男性也居住在弱势社区环境中 有高度暴力、酒精和其他与药物使用有关的毒品活动的情况。虽然我们知道 居住在弱势社区的黑人男性受到种族主义(即种族歧视)的影响不成比例 警察和公民的侧写)，种族主义是用酒精和大麻自我治疗的风险，很少有人 物质使用干预措施已被调整，以针对这种与文化相关的应激源或相关创伤 症状。以冥想和呼吸空间为特色的正念减压(MBSR)干预 训练已被证明可以减少适应不良的压力反应、创伤症状和药物使用， 主要是通过改善自我调节(即，情感和生理)。然而，一个根本性的滞后存在于 已建立的MBSR干预措施的文化适应和探索将其提供给 黑人男性。因此，人们对它们的可行性、可接受性或可能的有效性知之甚少 贫富差距人口。成功的MBSR干预需要参与者家庭实践和部署 在现实世界环境中获得技能。整合移动技术，尤其是提供“实时”服务的技术 反馈，可以进一步加强MBSR干预措施在年轻人减少药物使用方面的影响 黑人男性在与种族主义相关的压力和创伤时，通过在时刻和环境中提供支持性的推动 症状可能达到顶峰。适应的、移动技术辅助的MBSR干预可能会更容易被接受 年轻的成年黑人男性在发展他们的投入并解决与文化相关的压力时， 创伤和性别规范(例如，男孩不哭)经常鼓励男性通过以下方式来调节负面影响 把它推向有意识的状态。我们的理论驱动的中心假设是，预防性干预 旨在调节与种族主义相关的应激反应、创伤症状和影响调节，特别是在 “实时”将减少年轻成年黑人男性中有问题的物质使用进展。这辆R34 应用程序建议在北卡罗来纳州达勒姆的18-29岁黑人男性中开展以下目标 和康涅狄格州哈特福德-有着惊人相似的社区劣势的环境：1)在文化上适应一个经过验证的 讲师指导、小组和移动技术辅助的MBSR干预；2)试行测试和评估 文化适应、讲师指导、小组为基础和移动技术辅助的可行性/可接受性， MBSR干预；3)确定初步效应大小和中介因素以确定样本量和威力 更大规模的移动技术辅助、讲师指导、基于小组的MBSR干预。

PROJECT SUMMARY/ABSTRACT COVID-19 and upticks in U.S. racialized violence are stealing our collective breaths and brewing a potent mix, or syndemic of stress, trauma, and negative affect – key risk factors for behavioral health disparities. Behavioral health disparities among Black males are well-documented and known to erupt during young adulthood (ages 18-29) when this population exhibits steep escalations in problematic substance use (e.g., marijuana and alcohol). Many young adult Black males also reside in disadvantaged neighborhoods settings with conditions like high violence, alcohol, and other drug activity linked to substance use. While we know that Black males residing in disadvantaged neighborhoods are disproportionately impacted by racism (i.e., racial profiling by police and citizens) and that racism is a risk for self-medicating with alcohol and marijuana, few substance use interventions have been adapted to target this culturally-relevant stressor or related trauma symptoms. Mindfulness-based stress reduction (MBSR) interventions featuring meditation and breathing space training have been shown to reduce maladaptive stress response, trauma symptoms, and substance use, principally by improving self-regulation (i.e., affect and physiological). Yet, a fundamental lag exists in the cultural adaptation of established MBSR interventions and exploration of new modalities for delivering them to Black males. As a result, less is known about their feasibility, acceptability, or probable effectiveness in this disparity population. Successful MBSR interventions require participant home practice and deployment of acquired skills in real-world settings. Integrating mobile technologies, especially ones providing ‘real-time’ feedback, could further enhance MBSR interventions’ impacts on substance use mitigation among young adult Black males by providing supportive nudges in moments and settings when racism-related stress and trauma symptoms likely peak. Adapted, mobile technology-assisted MBSR interventions will likely be more acceptable by young adult Black males when they are developed with their input and address culturally relevant stress, trauma, and the gender norms (e.g., boys don’t cry) often encouraging males to regulate negative affect by pushing it out of conscious awareness. Our theory-driven central hypothesis, is that preventive interventions aimed at modulating racism-related stress response, trauma symptoms, and affect regulation especially in ‘real-time’ will reduce problematic substance use progression among young adult Black males. This R34 application proposes the following aims to be carried out among 18-29 year-old Black males in Durham, NC and Hartford, CT – settings with strikingly similar neighborhood disadvantage: 1) To culturally adapt a validated instructor-led, group-based and mobile technology-assisted, MBSR intervention; 2) To pilot test and assess the feasibility/acceptability of a culturally adapted instructor-led, group-based and mobile technology-assisted, MBSR intervention; 3) To identify preliminary effect sizes and mediators to determine sample size and power for a larger fully scaled mobile technology-assisted, instructor-led, group-based MBSR intervention.