Emezue Chuka N, Dan-Irabor Dale, Anakwe Adaobi, Froilan Andrew P, Dunlap Aaron, Karnik Niranjan S, Julion Wrenetha A
Rush University Medical Center, Chicago, IL, USA.
University of Missouri-Kansas City, USA.
J Interpers Violence. 2025 Apr;40(7-8):1668-1698. doi: 10.1177/08862605241262256. Epub 2024 Aug 9.
Young Black men (YBM) disproportionately face the most severe forms and consequences of youth violence (YV) and substance use disorders, but are less likely to access and be retained in services for these high-risk behaviors. Investigating service uptake disparities and the role of barrier-reducing intervention delivery models is essential; so is understanding the service needs and preferences of YBM. This study explores the experiences of violence-involved and substance-disordered YBM and service providers working with them from racially and economically diverse communities, focusing on their service needs and preferences. Additionally, we examine the potential benefits and drawbacks of digital health interventions in addressing crucial structural barriers to service access and promoting equity for Black boys in high-violence environments. Individual interviews were conducted with 16 YBM (selected from a larger pool of 300 participants from a pilot study) and 7 service providers (four females, three males). Data analysis utilized an Interpretive Description (ID) approach guided by the Phenomenological Variant of Ecological Systems Theory (PVEST). Four themes emerged: (1) Revolving Doors and Histories of Violence; (2) Benefits of Violence: "You Do Something to Me, I Do Something to You"; (3) Positive and Negative Perceptions of Violence and Substance Use Prevention Programs; and (4) Need for Equity-Focused and Barrier-Mitigating Digital Health Interventions. Our findings identified avoidance mechanisms utilized by YBM at both individual and community levels and highlighted perceptions of existing community-based programs and digital interventions as crucial tools for mitigating barriers to care. This study also confirms the prevalence of critical service gaps and program uptake issues, even in cities with abundant programs. Thus emphasizing the need for equity-focused interventions co-designed with and for YBM in high-violence and substance use contexts.
年轻黑人男性（YBM）不成比例地面临着青少年暴力（YV）和物质使用障碍的最严重形式及后果，但他们获得针对这些高风险行为的服务并持续接受服务的可能性较小。调查服务获取方面的差异以及减少障碍的干预交付模式所起的作用至关重要；了解年轻黑人男性的服务需求和偏好同样重要。本研究探讨了涉及暴力和有物质使用障碍的年轻黑人男性以及来自种族和经济多样化社区且与他们合作的服务提供者的经历，重点关注他们的服务需求和偏好。此外，我们研究了数字健康干预措施在解决服务获取的关键结构性障碍以及促进高暴力环境中黑人男孩公平性方面的潜在利弊。对16名年轻黑人男性（从一项试点研究的300名参与者中挑选）和7名服务提供者（4名女性，3名男性）进行了个人访谈。数据分析采用了以生态系统理论的现象学变体（PVEST）为指导的诠释性描述（ID）方法。出现了四个主题：（1）旋转门与暴力史；（2）暴力的益处：“你对我做了什么，我就对你做什么”；（3）对暴力和物质使用预防项目的积极和消极看法；（4）对以公平为重点且减少障碍的数字健康干预措施的需求。我们的研究结果确定了年轻黑人男性在个人和社区层面使用的回避机制，并强调了对现有社区项目和数字干预措施的看法，认为它们是减轻护理障碍的关键工具。本研究还证实了关键服务差距和项目接受问题的普遍存在，即使在有大量项目的城市也是如此。因此强调了在高暴力和物质使用背景下与年轻黑人男性共同设计并为其设计以公平为重点的干预措施的必要性。
