Fostering Resilience to Race-Based Stress: A Pilot Study

白色和黑色，土著和有色人种（BIPOC）之间的健康差距有据可查， 美国;这种现象部分是由歧视经历驱动的，是一个重要的 促进福祉和功能，包括在军人和退伍军人。慢性 种族主义压力具有心理和生理影响。歧视与增加 心理困扰，包括有色人种退伍军人（VOC）中PTSD的发病率较高，健康行为较差 降低了医疗保健的利用率。基于种族的压力也与增加的非稳态负荷（AL）有关， 是一个可测量的指标磨损和撕裂的身体由于慢性压力暴露， 更大的疾病负担和死亡率。认识到帮助挥发性有机化合物处理的干预需求未得到满足， 种族压力/创伤和赋权方案（RBSTE） 干预（Carlson，Endsley，Motley，Shawahin，&威廉姆斯，2018）。RBSTE是一个基于组的 一种将文化适应性的既有心理治疗技术与新的策略相结合的疗法 以促进VOC的复原力和赋权。最初的定性数据表明这种方法的前景， 但还没有系统的数据来确定RBST E是否实现了其目标， 加强应对和恢复福祉。拟开展的项目为先导性随机对照试验（RCT） 多模式纵向评估。参与者将从VA设施和周围招募 社区将在基线时对报告种族压力的VOC进行评估，排除的情况最少， 随机分组至两种治疗条件之一，然后在治疗后立即重新评估。的 治疗包括RBSTE和非特异性心理治疗对照，以现在为中心的治疗（PCT）， 旨在控制RBSTE的非特定方面，包括支持和参与全BIPOC 组这些干预措施将由一名训练有素的治疗师每周进行8次90分钟的小组会议， 视频会议。该项目的目的是（1）评估招募VOC进行RCT的可行性， （2）检查治疗内容的可接受性和适当性， 参与，以及参与者对提供者行为和态度的看法;（3）建立最佳的 量化心理和身体健康结果的战略，为未来的研究。因此，该项目将设置 评估科技教育区域局功效并最终执行的阶段。这一至关重要的计划， 研究将为管理种族压力的最佳做法提供指导， 目标是消除退伍军人和社区更广泛的健康差距。

Health disparities between White and Black, Indigenous and People of Color (BIPOC) are well documented in the United States; this phenomenon is driven in part by discrimination experiences and is an important contributor to well-being and functioning, including among military service members and Veterans. The chronic stress of racism has both psychological and physiological effects. Discrimination is associated with increased psychological distress, including higher rates of PTSD among Veterans of Color (VOC), poorer health behavior and decreased healthcare utilization. Race-based stress is also linked to increased allostatic load (AL), which is a measurable index of wear-and-tear on the body due to chronic stress exposure that is associated with greater disease burden and mortality. Recognizing the unmet need for interventions to help VOC process and cope with experiences of discrimination, the Race-based Stress/Trauma and Empowerment (RBSTE) intervention (Carlson, Endsley, Motley, Shawahin, & Williams, 2018) was developed. RBSTE is a group-based therapy that combines cultural adaptations of established psychotherapeutic techniques with novel strategies to foster resilience and empowerment for VOC. Initial qualitative data suggests the promise of this approach, but no systematic data are yet available to determine whether or not RBST E is achieving its goals of enhancing coping and restoring well-being. The proposed project is a pilot randomized controlled trial (RCT) with multi-modal longitudinal assessment. Participants will be recruited from VA facilities and the surrounding community. VOC who report race-based stress, with minimal exclusions, will be evaluated at baseline, randomized in groups to one of two therapy conditions and then re-evaluated immediately after treatment. The treatments include RBSTE and a non-specific psychotherapy control, Present Centered Therapy (PCT), designed to control for nonspecific aspects of RBSTE, including support and participation in an all-BIPOC group. The interventions will be delivered in 8 weekly 90-minute group sessions by a trained therapist using videoconferencing. The aims of the project are (1) to assess the feasibility of recruiting VOC for an RCT of this nature; (2) to examine the acceptability and appropriateness of treatment content, the feasibility of participation, and participant’s perceptions of provider behavior and attitudes; and (3) to establish the optimal strategy for quantifying mental and physical health outcomes for future studies. Thus, the project will set the stage for evaluation of RBSTE’s efficacy and ultimately implementation. This critically important program of research will provide guidance as to best practices for the management of race-based stress, with the ultimate goal of eliminating health disparities for Veterans and the community more broadly.