African American communities are disproportionately impacted by the adverse consequences of substance use problems (SUPs). Despite similar rates of use, African Americans experience more severe social, health, and criminal related costs than Whites. Significant disparities in the treatment of SUPs have been found with African Americans reporting poorer access and quality of care than Whites. Less than 25% of African Americans who are in need of treatment actually obtain care for SUPs. African Americans, however, are more likely to seek help for SUPs from churches than Whites. Historically and presently, the Black church has served as a trusted haven where help is sought, support is dispensed, and hope is restored. Black churches are often the first and only point of contact for many African Americans with SUPs. Black churches can facilitate the early detection of SUPs, shape social norms and stigma regarding treatment, and establish linkages to formal services. Strategic partnerships between Black churches and formal providers can significantly impact improved access and care for SUPs, yet such partnerships are woefully rare. One major barrier is the mere lack of training. Churches may not recognize serious SUPs or when formal treatment is indicated given that screening and referral is not typically practiced, not due to a lack of interest but of capacity. A more formalized process is needed that considers the kinds of conditions and types of collaboration that churches would be willing to engage in, including screening, brief intervention, and referral to treatment (SBIRT). Black churches may be well-suited to implement SBIRT interventions given their wealth of human and physical capital, expertise in empowering and mobilizing people, and shared experience of SUPs'deleterious effects on the community. This proposed study's faith-based partner, West Angeles Church of God in Christ, with over 24,000 congregants, is one of the largest Black """"""""mega-churches"""""""" in the nation. Situated in the South Los Angeles, West Angeles has extensive interfaces with health, social welfare, and community organizations, providing more than 80 programs for the enhancement of the community. Recognizing that the needs of the community are too vast to be met by any one institution, West Angeles desires to help build the capacity of other churches to engage in similar collaborative relationships. West Angeles leads the Faith- based Community Collaborative, a network of over 300 local Black churches. The Collaborative will serve as a kind of case study for generating knowledge on the development of an intervention aimed at enhancing churches'engagement in collaborative practices such as SBIRT that are tailored to the cultural, spiritual, and local needs of the faith community. The proposed research has the following specific aims: (1) Describe the practices of Black churches in addressing SUPs (2) Identify factors associated with Black churches'engagement and receptivity to SBIRT interventions (3) Develop a preliminary protocol to enhance Black churches'implementation of SBIRT interventions

Public Health Relevance

Project Narrative African Americans experience significant disparities in the negative impact of substance use problems and in accessing and obtaining quality substance abuse treatments. Less than 25% of Africans Americans who are in need of treatment actually obtain care for substance use problems. The proposed research would lay the groundwork for the development of a preliminary intervention aimed at enhancing Black churches'implementation of screening, brief intervention, and referral to treatment (SBIRT). The implementation of SBIRT, a successful public health approach to substance use problems, within church settings may provide a potentially powerful avenue to address unmet need for treatment.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Exploratory/Developmental Grants (R21)
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Study Section
Special Emphasis Panel (ZMD1-PA (07))
Program Officer
Dankwa-Mullan, Irene
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Rand Corporation
Santa Monica
United States
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Wong, Eunice C; Derose, Kathryn P; Litt, Paula et al. (2018) Sources of Care for Alcohol and Other Drug Problems: The Role of the African American Church. J Relig Health 57:1200-1210