Discrimination, Substance Use, and Cultural Buffers among AI/AN College Students

描述（由申请人提供）：美洲印第安人和阿拉斯加原住民（AI/ANs）面临着与毒品和酒精有关的重大健康差异，特别是在药物使用障碍率和相关的负面健康后果方面。拟议的研究将考虑一个社会层面的因素，即种族歧视，如何可能导致这些差异，同时也审查文化缓冲的保护作用（即参与传统活动、传统精神、人工智能/人工智能身份）。种族歧视与种族/少数民族群体中较高的药物使用率有关（例如，Pascoe & Smart Richman, 2009; Whitbeck, Hoyt, McMorris, Chen, & Stubben, 2001）， 40%的AI大学生报告说，在过去的学年中，他们是公开的种族歧视的受害者（例如，被辱骂，骚扰；Perry, 2002）。尽管这些统计数据令人担忧，但在AI/AN大学生中，歧视与物质使用之间的关系尚未得到探讨，而且之前关于AI/AN大学生中歧视与物质使用的研究是横断面的，因此无法进行因果分析。本土主义者压力-应对模型（Walters, Simoni, and Evans-Campbell, 2002）认为文化缓冲缓和了歧视与物质使用之间的正相关关系。为了为文化定制的物质使用干预奠定基础，本研究将(1)横断面和前瞻性地研究歧视与物质使用之间的关系，以及(2)在西南大城市的两所大专院校就读的AI/AN大学生（18-44岁）中测试文化缓冲的调节作用。在研究的第一部分，343名AI/A学生将完成一份在线问卷，测量歧视、物质使用和文化缓冲。结构方程模型将用于计算歧视、物质使用和假定的调节因子之间关系的效应大小。在研究的第二部分，报告每月至少经历几次歧视的在线问卷参与者将被邀请参加一个为期21天的每日日记可行性研究，测量歧视、物质使用和文化缓冲（N=40）。利用多层次模型，可以探索歧视与物质使用之间的因果关系，并测试文化缓冲的调节作用。研究结果将有助于更细致地了解导致人工智能/人工智能之间健康差异的因素，并为未来的预防和干预研究和临床工作奠定基础。

DESCRIPTION (provided by applicant): American Indians and Alaska Natives (AI/ANs) face significant drug- and alcohol-related health disparities, particularly in terms of substance use disorder rates and related negative health consequences. The proposed study will consider how one societal-level factor, racial discrimination, may contribute to these disparities, while also examining the protective effects of cultural buffers (i.e., participation in traditional activities traditional spirituality, AI/AN identity). Racial discrimination has been associated with higher rates of substance use among racial/ethnic minority groups (e.g., Pascoe & Smart Richman, 2009; Whitbeck, Hoyt, McMorris, Chen, & Stubben, 2001), and 40% of AI college students report being a victim of overt racial discrimination in the past school year (e.g., called names, harassed; Perry, 2002). Despite the concerning nature of these statistics, the association between discrimination and substance use has not been explored among AI/AN college students, and previous research on discrimination and substance use among AI/ANs has been cross-sectional, thereby precluding causal analyses. The Indigenist Stress-Coping Model (Walters, Simoni, and Evans-Campbell, 2002) posits that cultural buffers temper the positive relationship between discrimination and substance use. To lay the groundwork for culturally-tailored substance use interventions, the proposed study will (1) cross-sectionally and prospectively examine the relationship between discrimination and substance use, and (2) test moderating cultural buffers among AI/AN college students (ages 18-44) attending two post-secondary institutions in a large Southwestern city. In the first part of the study, 343 AI/A students will complete an online questionnaire measuring discrimination, substance use, and cultural buffers. Structural equation modeling will be used to calculate effect sizes for the relationship between discrimination, substance use, and presumed moderators. For the second part of the study, online questionnaire participants who report experiencing discrimination at least a few times a month will be invited to participate in a 21-day daily diary feasibility study measuring discrimination, substance use, and cultural buffers (N=40). Using multi-level modeling, causal links between discrimination and substance use can be explored, and the moderating effects of cultural buffers will also be tested. Findings will contribute to a more nuanced understanding of factors that contribute to health disparities among AI/ANs and lay the groundwork for future prevention and intervention research and clinical efforts. PUBLIC HEALTH RELEVANCE: American Indians and Alaska Natives (AI/ANs) experience significant substance-related health disparities (e.g., high rates of substance use disorders), and discrimination is one societal-level factor that may contribute to these disparities. The proposed study will examine day-to-day relationships between discrimination and substance use and the protective effects of cultural factors (e.g., spirituality) among AI/AN college students, and in so doing, lay the groundwork for culturally-tailored substance use interventions to reduce substance- related health disparities.