Ethnic Differences in the Effects of COVID on the Substance Use Behavior of Emerging Adults

摘要 关于新冠肺炎对以下人群的不利心理社会影响，人们知之甚少 已经面临着巨大的健康差距。夏威夷原住民和其他太平洋岛民(诺皮人)，他们是 夏威夷和其他太平洋岛屿的土著居民面临着严重的健康差距，而这一差距往往被忽视 因为诺皮人在国家研究中与低风险的亚洲群体相结合。与亚洲人相比， 诺皮族人因癌症和心血管疾病而死亡和发病的风险明显较高。在……里面 此外，诺皮人中烟草和其他物质的使用率远远高于亚洲人。这 一项提案旨在检查病毒传播前后物质使用行为的种族差异 新冠肺炎横跨亚洲人和诺皮人，指的是白人。此外，我们还将测试一款新型号， 试图解释COVID后新兴人群物质使用量潜在增加的机制 成年人(18-29岁)。受压力应对、自我治疗和成人成长理论的启发 (EA)，模型的中心假设是COVID后财务困境、EA压力、感知 歧视、孤独/社会孤立、与COVID相关的焦虑和负面生活事件会导致 在新兴成年人中普遍存在压力和较差的心理健康，这反过来会导致 物质使用(烟草、酒精、大麻和非法药物)。我们假设诺皮会表现出更高的 暴露在COVID后的财务困境、EA压力、COVID相关焦虑、孤独和消极生活中 事件，这最终将导致诺皮人使用更多的物质。我们的团队可以接触到一群 来自夏威夷的新兴成年人(N=2335人；55%女性；45%亚洲人，20%诺皮人，24%白人，11%其他人)， 最初是作为专注于烟草控制的研究的一部分招募的。尽管烟草是焦点，但这项研究 收集了关于其他药物使用行为、精神健康症状和EA属性的广泛数据， 这可以与冠状病毒感染后的变化进行比较。我们已经收集了4波冠状病毒感染前的数据 每隔6个月进行一次队列调查。第四波数据收集于2020年1月完成，大约 两个月前，夏威夷州停止了所有非必要的活动，以应对大流行，包括 旅游业是夏威夷经济的支柱。旅游业的减少和企业的关闭导致了 夏威夷的经济是美国受影响最严重的地区之一。目前的研究计划恢复后新冠肺炎 从队列中收集额外6波的数据。六波中的第一波即将在#年下水。 2021年2月至3月--上一次COVID前调查约一年后--使用机构资金。这个 目前的提案寻求继续每6个月收集一次数据，再收集5次。跨越四波Pre- 在收集COVID数据时，我们保留了89%的基线样本，几乎所有人都表示有兴趣 继续参与这项研究。综上所述，这项研究对于寻求提高对 该机制为检验COVID相关的健康差距和创新概念模型提供了新的思路。

ABSTRACT Little is known about the adverse psychosocial impact of COVID-19 on demographic groups that are already facing significant health disparities. Native Hawaiian and other Pacific Islanders (NHOPI), who are indigenous to Hawaii and other Pacific Islands, face significant health disparities, which often get overlooked because of NHOPI being combined with low-risk Asian groups in national studies. Compared with Asians, NHOPI are at markedly higher risk for mortality and morbidity due to cancer and cardiovascular disease. In addition, tobacco and other substance use prevalence among NHOPI is much higher than among Asians. This proposal seeks to examine ethnic differences in substance use behavior before and after the spread of COVID-19 across Asians and NHOPI, with reference to Whites. In addition, we will test a new model that attempts to explain the mechanisms of the potential increase in substance use post-COVID among emerging adults (18-29 year olds). Informed by the theories of stress-coping, self-medication, and emerging adulthood (EA), the central postulate of the model is that post-COVID increases in financial distress, EA stress, perceived discrimination, loneliness/social isolation, COVID-related anxieties, and negative life events result in increased generalized stress and poorer mental health among emerging adults, which in turn results in increased substance use (tobacco, alcohol, marijuana, and illicit drugs). We hypothesize that NHOPI will show higher exposure to post-COVID financial distress, EA stress, COVID-related anxieties, loneliness, and negative life events, which will eventually lead to higher substance use among NHOPI. Our team has access to a cohort of emerging adults (N=2335; 55% women; 45% Asian, 20% NHOPI, 24% White, 11% Other) from Hawaii, originally recruited as part of research focused on tobacco control. Despite the tobacco focus, the study collected extensive data on other substance use behavior, mental health symptomatology, and EA attributes, which may be compared against post-COVID changes. We have collected 4 waves of pre-COVID data from the cohort in 6-month intervals. The 4th wave of data collection was completed in January 2020, approximately two months before the state of Hawaii halted all non-essential activities in response to the pandemic, including tourism, a mainstay of Hawaii’s economy. The decreased tourism and closure of businesses have resulted in Hawaii’s economy being one of the worst affected in the U.S. The current study plans to resume post-COVID data collection from the cohort for additional 6 waves. The first of the 6 waves is about to be launched in February-March 2021—approximately 1 year after the last pre-COVID survey—using institutional funds. The current proposal seeks to continue data collection every 6 month for 5 more waves. Across the 4 waves of pre- COVID data collection, we retained 89% of the baseline sample, almost all of whom have expressed interest for continued participation in the study. In sum, this study is significant for seeking to advance knowledge about the mechanisms of COVID-related health disparities and innovative for testing a new conceptual model.