National Institute on Minority Health and Health Disparities, R21MD017454
9/27/22 - 5/31/24
Patricia Cavazos-Rehg, PhD (Washington University in St. Louis)
Other Project Staff
Carolyn E. Sartor, PhD (Co-PI); Nicholas C. Jacobson, PhD (Site PI/Co-I)
African American adults are disproportionately exposed to stressors, such as racial discrimination, that increase risk for problem drinking and are more likely than White adults to experience alcohol-related illness, injuries, and negative social consequences. African Americans report experiencing everyday race-related discriminatory events involving intentional acts of racism or subtle degrading, excluding, or negating acts, known as racial microaggressions, as frequently as daily. Although the link between racial discrimination and drinking behaviors has been documented, the timing and modifiers of the effects remain largely unknown. In the proposed study, we will assess racial microaggressions as antecedents to alcohol use among African American young adults via ecological momentary assessment (EMA) to capture the association at a granular level during the peak developmental period of risk for heavy alcohol use. The study is built on two core premises: (1) More accurate understanding of African American young adults’ daily, real world experiences with racial microaggressions and their impact on drinking behaviors is critical to inform an R01 level, ecological momentary intervention to reduce alcohol use among this high-risk group; and (2) the effectiveness of such an intervention hinges on its usability and acceptability in the target population. To address Aim 1, establishment of the EMA design, we will recruit via social media  African American adults aged 18 to 25 who engage in regular alcohol use to complete surveys assessing the nature and frequency of racial microaggressions and alcohol use. Thirty survey participants (10 each from the lowest, middle, and highest thirds of the racial microaggression frequency distribution) will take part in usability testing to refine EMA design, including sampling periods, number of items, and frequency of prompts, and to establish the minimum frequency of racial microaggression experiences for valid use of the EMA. [In Aim 2, we will recruit a new sample of 100 participants] to complete a 21-day intensive, repeated, and brief smartphone-based EMA study to track alcohol use and instances of racial microaggressions. We will investigate both the within- and between- subject effects of racial microaggressions on alcohol use behaviors utilizing multilevel-modeling approaches to detect lagged (e.g., next day) as well as same day effects. For Exploratory Aim 3, we will investigate buffering and exacerbating effects of potential protective factors [assessed in Aim 2 baseline surveys] (e.g., adaptive coping strategies, racial socialization) and risk factors, (e.g., history of trauma, socioeconomic disadvantage) on alcohol use reported via EMAs. Achieving the study’s goal of identifying how racial microaggressions lead to drinking behaviors will uncover novel targets to spur the development of innovative focused prevention and intervention strategies for hazardous alcohol use among African American young adults, in keeping with NIAAA’s Strategic Plan for Fiscal Years 2022-2026 of promoting health equity.
Public Health Relevance
African American adults are disproportionately exposed to alcohol-related risk factors and experience high levels of alcohol-related illness, injuries, and negative social consequences, making the identification of prevention and intervention targets for this population a crucial public health aim. Racial discrimination has been linked to problem drinking among African Americans, but the impact of everyday race-related discriminatory events, known as racial microaggressions, and possible buffers against their effects on day-to- day drinking behaviors have yet to be identified. The submitted project implements an ecological momentary assessment (EMA) to track race-related microaggression experiences and drinking behaviors in real time among African American adults in the peak period of risk for problem drinking (ages 18-25) to evaluate associations between racial microaggressions and alcohol use in this high-risk group.