NIDA REI: Research on Neurocognitive Mechanisms Underlying the Impact of Structural Racism on the Substance Use Trajectory (R61/R33 Clinical Trial Optional)

Funding Opportunity Description Purpose: This Funding Opportunity Announcement (FOA) invites clinical research applications that are exploratory/developmental in nature, and seek to parse the complex effects of structural racism, and investigate its impact on neurocognition, with an emphasis on reducing Substance Use Disorder (SUD) risk and informing preventative interventions. Background: The NIH is committed to supporting health equity research to 1) improve minority health and reduce health disparities in the United States and 2) remove the barriers to advancing health disparities research (for more information, see: NIH's statement on ending structural racism and the NIH/NIMHD Strategic Plan). In alignment with this NIH-wide effort, NIDA established the Racial Equity Initiative (REI), with goals that include promoting racial equity in NIDA’s research portfolio. Among the actions taken by NIDA, which were informed by internal and external meetings and listening sessions, the Institute has committed to a significant increase in funding for research to address disparities in outcomes related to drug use and HIV. The REI funding opportunity announcements seek to advance equity by supporting research and research training efforts that are consistent with NIDA’s mission and with best practices for conducting research with racial and ethnic minority populations. Numerous health inequities, stemming from structural racism or the macro-level conditions that limit opportunities, resources, power, and well-being of individuals and populations based on racial or ethnic minority and other statuses, shape every phase of the substance use trajectory. Evidence from sociology, anthropology, and ethnic studies underscore the need to integrate social determinants of health into our understanding of substance use. Health disparities related to substance use outcomes must be contextualized within the conditions in which people are born, grow, live, work, and age. Contexts known to introduce inequities include family income and education, employment, housing, neighborhood-level characteristics, and exposure to violence. For example, redlining and residential segregation resulted in systemic neighborhood disinvestment, and consequent inequities in social determinants such as exposure to environmental toxins and psychosocial stressors associated with risk for SUD; such contextual factors need to be incorporated into neurocognitive theories on SUD and mental health. A more comprehensive understanding of the impact of structural racism can inform the development of novel interventions for preventing and treating SUD at the systems- and individual-level. To address the above need, REI has developed an integrated suite of funding opportunities focused on racial equity, with an emphasis on community-engaged research. One of the goals of this initiative is to better understand the neurocognitive mechanisms underlying the impact of structural racism on the substance use trajectory. By dissecting the impact of racism at the neurocognitive level, future mechanistic studies will be better equipped to disentangle the influence of structural factors from biological variables. In the long-term, novel advances may be achievable in multiple domains, not limited to 1) understanding factors that modulate risk for transition from recreational/medical use to compulsive use; 2) understanding risk for substance use during adolescence; 3) development of improved SUD treatment and secondary prevention interventions at the individual level. Research Objectives: This funding announcement invites exploratory mechanistic research seeking to parse the complex effects of structural racism and investigate its impact on neurocognition, with an emphasis on reducing SUD risk and informing preventative interventions. Applications are strongly encouraged to incorporate a multidimensional and intersectional approach to understanding structural racism, including but not limited to factors such as income inequality, homeownership inequity, employment inequity, education inequity, incarceration inequity, area deprivation, food insecurity, and neighborhood segregation. In addition to neuroscience/psychology, all applications are expected to incorporate expertise as needed from fields including but not limited to epidemiology, intervention science, community-engaged research, sociology, and/or ethnic studies. Applications are expected to justify how study variables are connected to structural racism. The proposed neurocognitive mechanisms are expected to be relevant to the development of preventative interventions (including prevention of substance use initiation, escalation, and development of an SUD), but applications are not required to propose an intervention per se. Topics of interest include, but are not limited to: Development and application of assessment tools towards capturing multidimensional socio-environmental influences that minimize participant burden and increase inclusion of underserved racial and ethnic minority groups Application of sophisticated analytical methods to investigate multivariate and/or non-linear relationships within large, complex socio-environmental datasets (e.g., testing non-linear dynamics involving structural factors and individual characteristics) Identification of novel mediating pathways linking the experience of structural inequities and racism (including effects of stigmatization and discrimination) to neurocognition pertaining to SUD risk (e.g., brain-gut interactions, CNS-immune and CNS-endocrine system interactions, epigenetic modifications) Secondary analysis of large longitudinal datasets (e.g., Adolescent Brain Cognitive DevelopmentSM(ABCD), HEALthy Brain and Child Development (HBCD)) to examine causal pathways between exposure to structural racism and psychophysiological or neurobiological risks that may affect the onset or course of substance use Identification of the neurocognitive mechanisms through which protective factors (e.g., support from and connections with racial and ethnic minority community) moderate the influence of racism, specifically those that could inform development of novel interventions Investigation of the neurocognitive effects of structural or interpersonal interventions designed to address the impacts of racism Development of novel interventions targeting the neurocognitive level that modulate behavior and/or cognition relevant to the intersection of SUD and racism