Microaggressions and Hazardous Drinking among non-Latinx Black Individuals with Chronic Pain

项目总结/摘要 危险性饮酒和慢性疼痛都是非常普遍的，经常共病的公共卫生 对患者、提供者和医疗保健系统造成重大负担的疾病。1，2事实上， 患有慢性疼痛的黑人成年人更有可能报告更大的疼痛强度，增加对活动的回避 由于疼痛，与疼痛有关的更大的恐惧思维，以及在 当与非拉丁白色对照组相比时，他们的慢性疼痛经历的背景。3 -6 由于非拉丁裔黑人成年人的饮酒率较低，他们经历了更大的负面后果 (e.g.,酒精依赖症状和社会后果）饮酒比非拉丁裔白色成年人。 此外，与非拉丁裔白色人相比，酒精依赖的非拉丁裔黑人成年人 经常性和持续性酒精依赖的可能性增加。 物质使用和心理健康结果的模式使边缘化群体，如非拉丁裔， 黑人成年人，容易受到有问题的物质使用通过常见的种族/民族微侵略（MA）， 定义为因种族/族裔而侮辱或贬低他人的言语或非言语侮辱。 非拉丁裔黑人个体中的现有工作仅初步记录了MA对他们的负面影响。 有必要了解MA和酒精使用动机的纵向性质（即， 更大的酒精渴望，饮酒的意图，以及酒精使用的应对导向动机）和饮酒（即， 更多的酒精消费，更频繁的饮酒，以及饮酒带来的更多负面后果） 在非拉丁裔黑人成年人中，他们是患有慢性疼痛的危险饮酒者。拟议的研究项目 支持国家酒精滥用和酒精中毒研究所（NIAAA）的2017-2021年战略计划， 推进两个关键领域的研究。第一，目前的建议的目标是改进战略， 预防酒精滥用、酒精使用障碍和“高危”人群中酒精相关后果 这些条件（目标3）。其次，它通过以下方式增强了NIAAA支持的研究对公共卫生的影响： 重点关注美国最大的人口统计数据之一，这些数据显示了危险饮酒的差异（目标 5）。此外，该提案还有助于对健康差异和合并症的研究，这两种疾病是 NIAAA的交叉研究主题。 2

PROJECT SUMMARY/ABSTRACT Hazardous drinking and chronic pain are both highly prevalent and frequently comorbid public health conditions that exact a significant burden on patients, providers, and health care systems.1,2 Indeed, non-Latinx Black adults with chronic pain are more likely to report greater pain intensity, increased avoidance of activities due to pain, greater fearful thinking related to pain, and greater physical and psychological disability in the context of their chronic pain experience when compared their non-Latinx White counterparts.3-6 Despite there being lower rates of drinking among non-Latinx Black adults, they experience greater negative consequences (e.g., alcohol dependence symptoms and social consequences) for drinking than non-Latinx White adults.7 Additionally, compared to their non-Latinx White counterparts, alcohol-dependent non-Latinx Black adults have an increased likelihood of experiencing recurrent and persistent alcohol dependence.8 Minority stress-based models of substance use and mental health outcomes posit that marginalized groups, such as non-Latinx Black adults, are vulnerable to problematic substance use via common racial/ethnic microaggressions (MAs), defined as verbal or non-verbal indignities that insult or put down people because of their race/ethnicity.9 Extant work among non-Latinx Black individuals has only initially documented the negative impact of MAs on alcohol use.10 There is a need to understand the longitudinal nature of MAs and alcohol use motivation (i.e., greater alcohol craving, intention to drink, and coping-oriented motives for alcohol use) and drinking (i.e., greater alcohol consumption, greater frequency of drinking, and more negative consequences from drinking) among non-Latinx Black adults who are hazardous drinkers with chronic pain. The proposed research project supports the 2017-2021 strategic plan of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) by advancing research in two of the key areas. First, the current proposal has the goal of improving strategies to prevent alcohol misuse, alcohol use disorder, and alcohol-related consequences among an ‘at-risk’ population for these conditions (goal 3). Second, it enhances the public health impact of NIAAA-supported research, by focusing on one of the largest demographics in the US who demonstrate disparities in hazardous drinking (goal 5). Further, the proposal contributes to research on health disparities and comorbidities, which represent two of the cross-cutting research themes of NIAAA. 2