Training in Equity and Structural Solutions in Addictions (TESSA)

项目摘要 成瘾及其治疗方面的不平等现象日益严重，对健康和社会构成普遍威胁。一个全球性的 流行病和大型社会运动，如#BlackLivesMatter，突出了种族主义的负面影响。 以及对成瘾和中心结构的歧视是不平等的根本原因。结构性种族主义已经 从根本上决定了美国对物质使用的反应。其他结构性因素，如政策和 教育、住房、刑事司法和医疗保健等制度加剧了不平等，助长了成瘾 不平等和不平等。然而，成瘾中的结构性因素，以及如何增加成瘾护理的公平性 以及结果，都被严重地忽视了。新一代成瘾健康服务学者 需要解决根植于结构的股权挑战。与NIDA的种族平等目标一致 倡议，下一代学者将需要在反种族主义和相关研究方法方面进行强有力的培训 可以改变加剧不平等的结构的领域(例如，政策和实施科学) 传统保健服务和成瘾方面的培训--具体内容和方法。作为国家总理 公立研究大学-拥有领先的卫生服务研究博士项目，是排名前十的医学 学校，国家认可的实施科学和卫生政策项目，是为数不多的几个项目之一 全国反种族主义中心-华盛顿大学(UW)可以很好地解决这些问题 培训需求。因此，华盛顿大学卫生系统和人口部和普通内务部 医学寻求NIDA资金建立成瘾公平和结构性解决方案培训(Tessa) 计划：1)招募11名对成瘾差异感兴趣的博士后和博士后学者，2)提供 专门的课程培养了对成瘾及其护理、政策、 实施科学和反种族主义；3)为TESA学者提供指导研究的机会 关于多学科研究团队的成瘾公平性，4)支持TESA学者开展研究 职业培训计划，以提高他们的技能，为他们的研究生涯做好准备；以及5)评估成功 使用明确的基准和预定义的结果对该计划进行评估。我们已经开发了Tessa程序 对学者进行17项核心能力培训，以解决反种族主义、政策和实施科学等问题 传统的健康服务和成瘾的内容和方法。如果我们继续训练成瘾学者 如果没有这种直接的多学科方法，我们很可能会看到进展缓慢，并错失了 改善公平，减少与成瘾有关的发病率、死亡率和痛苦。对特萨的投资 将导致新一代多元化、反种族主义和关注公平的成瘾研究学者，他们是 为开发和测试预防、治疗和康复的新战略做好最佳准备，并实施 通过公平和反种族主义的视角将有效的战略和政策融入现实世界，推动 NIDA的贯穿各领域的战略目标和种族平等倡议，以减少成瘾方面的耻辱和差距。

PROJECT ABSTRACT Inequity in addictions and their treatment are growing, ubiquitous threats to health and society. A global pandemic and large social movements, such as #BlackLivesMatter, have highlighted negative impacts of racism and discrimination for addictions and centered “structures as the root cause of inequities. Structural racism has fundamentally shaped responses to substance use in the U.S. Other structural factors, such as policies and systems like education, housing, criminal justice, and healthcare reinforce inequality and contribute to addictions disparities and inequities. However, structural factors in addictions, and how to increase equity in addictions care and outcomes, are grossly understudied. A new generation of addictions health services scholars is needed to address equity challenges rooted in structures. Consistent with the goals of NIDA’s Racial Equity Initiative, next generation scholars will need strong training in anti-racism and related research methods and fields that can alter structures that reinforce inequity (e.g., policy and implementation science) in addition to training in traditional health services and addictions-specific content and methodology. As the nation’s premier public university for research—home to a leading doctoral program in health services research, a top-ten medical school, nationally-recognized programs in implementation science and health policy, and one of only a handful of anti-racism centers in the nation—the University of Washington (UW) is well positioned to address these training needs. Thus, UW’s Department of Health Systems and Population and Division of General Internal Medicine seek NIDA funding to found the Training in Equity and Structural Solutions in Addictions (TESSA) Program to: 1) recruit 11 pre- and post-doctoral scholars with interest in addictions disparities, 2) deliver a specialized curriculum fostering a multidisciplinary understanding of addictions and their care, policy, implementation science, and anti-racism; 3) provide TESSA scholars mentored research opportunities focused on addictions equity in multidisciplinary research teams, 4) support TESSA scholars in developing research career training plans to enhance their skills and prepare them for research careers; and 5) evaluate the success of the program using explicit benchmarks and pre-defined outcomes. We have developed the TESSA program to train scholars in 17 core competencies addressing anti-racism, policy, and implementation science in addition to traditional health services and addictions content and methodology. If we continue to train addictions scholars without such a direct multidisciplinary approach, we are likely to see slow progress and missed opportunities to improve equity and reduce morbidity, mortality, and suffering associated with addictions. Investment in TESSA will result in a new generation of diverse, anti-racist and equity-focused addictions research scholars who are optimally prepared to develop and test novel strategies for prevention, treatment, and recovery, and implement effective strategies and policies into real-world settings through a lens of equity and anti-racism, advancing NIDA’s cross-cutting strategic goals and Racial Equity Initiative to reduce stigma and disparities in addictions.