The Impact of Racism on Trajectories of Substance Use, Mental Health and Legal System Contact from Adolescence to Young Adulthood

种族主义对从青春期到青年期的药物使用、心理健康和法律系统接触轨迹的影响

• 批准号: 10620362
• 负责人: MARINA TOLOU-SHAMS
• 金额: $ 72.55万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-15 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10620362
• 关键词: Adolescence; Adolescent; Adolescent Risk Behavior; Adolescent and Young Adult; Adult; Age; Caregivers; Complex; Criminal Justice; Data; Data Reporting; Development; Discrimination; Disparity; Distress; Economics; Enrollment; Equity; Ethnic Origin; Family; Future; Gender; HIV/STD; Health; Health system; Individual; Inequality; Inequity; Intercept; Intervention; Interview; Justice; Legal; Legal system; Life Cycle Stages; Longitudinal Studies; Measurement; Measures; Mental Health; Outcome; Participant; Patient Self-Report; Population; Public Health; Race; Reproductive Health; Research; Risk; Risk Assessment; Risk Behaviors; Risk Factors; Sampling; Science; Services; Sexism; Sexual Health; Shapes; Socioeconomic Status; Structural Racism; Subgroup; System; Time; Woman; Youth; adjudication; adolescent substance use; behavioral health; convict; court; ethnic minority; ethnoracial; ethnoracial minority; experience; follow up assessment; health care availability; health disparity; health inequalities; indexing; intergenerational; juvenile justice system; lens; longitudinal dataset; minority children; multidisciplinary; primary outcome; prospective; protective factors; psychiatric symptom; public health research; racial disparity; racial minority; racism; recidivism; service utilization; sex; structural determinants; substance misuse; substance use; theories; traumatic stress; treatment services; young adult

PROJECT SUMMARY Data consistently demonstrate alarming racial disparities among youth and adults impacted by the legal system, and multiple studies have documented that justice-impacted youth have substantially higher rates of psychiatric needs, substance use and HIV/STI risk behaviors than youth who have not had juvenile legal system contact. However, research elucidating the impact of structural, cultural and individual racism on the health and legal outcomes and disparities of justice-impacted ethnoracial minoritized youth and families is nascent. This study will advance the science in structural racism and discrimination (SRD) and its influence on public health and legal inequities by leveraging an existing statewide longitudinal dataset from Project EPICC as well as following up with 300 previously enrolled youth and caregivers (N=300 dyads or 600 participants total) to conduct once annual follow-up assessments and life course interviews. Informed by Ecodevelopmental Theory, Project EPICC followed 401 youth and an involved caregiver (55% ethnoracial minoritized youth) for two years starting from the time of first ever youth contact with the juvenile legal system. Data are available on the longitudinal trajectories of substance use, psychiatric symptoms, HIV/STI risk behaviors and recidivism and the multiple contributing risk and protective influences (individual, family and extrafamilial) on youth trajectories. Project EPICC-2 will expand the Ecodevelopmental Framework to study the longitudinal impact of structural racism and discrimination on trajectories of ethnoracial minoritized youth’s substance use, psychiatric, sexual and reproductive health and legal outcomes during adolescence and into young adulthood. Using statewide administrative data, we will expand original primary outcomes to include substance use and psychiatric services utilization to understanding more about direct influence of structural racism and discrimination on justice-impacted young adult healthcare services access and equity. Annual life course interviews with a stratified random subsample of 50 young adults and 50 caregivers will provide a more nuanced qualitative and contextual understanding of the impact of structural racism on adolescent, young adult and family experiences and trajectories. EPICC-2 will leverage an existing longitudinal dataset, pre-existing relationships with a large sample of justice-impacted families, an ecodevelopmental and intersectional (race, ethnicity, sex, gender, socioeconomic status) framework, an intergenerational approach and an accomplished multidisciplinary study team to answer critically important questions in the field of adolescent and young adult health disparities.

项目摘要 数据始终显示出受法律影响的青年和成年人的惊人种族差异 系统，多项研究表明，受司法影响的青年的比率要高得多 与少年合法的年轻人相比，精神科需求，药物使用和HIV/STI风险行为 系统联系。但是，研究阐明了结构，文化和个人种族主义对 健康，法律成果以及受司法影响的民族少数青年和家庭的差异是 新生。这项研究将推进结构性种族主义和歧视（SRD）的科学及其对 通过利用项目EPICC的现有全州纵向数据集来利用公共卫生和法律不平等 以及跟进300名先前入学的青年和看护人（n = 300名二元或600名参与者 总共进行一次年度随访评估和生活课程访谈。由生态发育告知 理论，EPICC项目遵循401名青年和一名参与的照顾者（55％的民族少数年轻人） 从有史以来第一次与青少年法律体系接触的时候开始了两年。数据可用 物质使用，精神症状，艾滋病毒/性传播感染行为和累犯和累犯的纵向轨迹 对青年的多重造成风险和受保护的影响（个人，家庭和家族） 轨迹。 EPICC-2项目将扩大生态发育框架，以研究 结构性种族主义和歧视种族化的青年使用物质的轨迹， 青少年并成年期间的精神病，性和生殖健康以及法律成果。 使用全州管理数据，我们将扩展原始主要结果以包括物质使用和 精神病服务利用更多地了解结构种族主义的直接影响和 歧视正义影响的年轻成人医疗服务访问和公平。年度生活课程 对50名年轻人和50名看护人的分层随机子样本进行的访谈将提供更多 细微的定性和上下文理解结构种族主义对青少年，年轻人的影响 以及家庭经验和轨迹。 EPICC-2将利用现有的纵向数据集，预先存在 与大量受司法影响家庭的关系，一个生态发展和交叉（种族， 种族，性别，性别，社会经济地位）框架，一种代际方法和成就 多学科学习团队在青少年和年轻人领域回答至关重要的问题 健康分布。