# Examining the Stress Processes Relating Ethnicity and Sex to Substance Misuse and Services Outcomes (ESPRESSO)

> **NIH NIH K01** · UNIVERSITY OF SOUTH FLORIDA · 2024 · $176,469

## Abstract

PROJECT SUMMARY
The proposed project quantitatively and qualitatively investigates and disseminates the mechanisms underlying
potential racial/ethnic and sex differences in risk for substance use disorder (SUD) and disparities in SUD
treatment services among justice-involved adolescents (JIA). JIA are a critically underserved population who
are especially vulnerable to SUD. Certain ethnic groups and females in the juvenile justice system are
predisposed to harsher consequences of substance misuse and are more prone to suffer from undiagnosed
SUDs. The cascade of care is a novel framework for investigating unmet treatment needs. The stress process
model hypothesizes that disparities occur due to unequal distribution of stressors and resources, offering a
major pathway linking race/ethnicity and sex to disparities at the cascade checkpoints. The study will synergize
transdisciplinary theory and methodology through integrating a) a sociological theory of health disparities—the
stress process model, b) a novel framework for measuring unmet treatment needs–the cascade of care, c)
advanced quantitative methods –mediation analysis in structural equation modeling, and d) innovatory
qualitative approaches–hybrid thematic analysis with cutting-edge technologies. The specific research aims
are to 1) investigate if stress and resources mediate racial/ethnic and sex differences in substance misuse
(SM) patterns; 2) test if stress and resources mediate ethnic and sex disparities in referral to SUD screening,
diagnosis with SUD, treatment initiation and treatment completion; and 3) qualitatively explore how stress and
resources relate to ethnic and sex disparities in SUD services and post-release outcomes. The study employs
mediation analysis in structural equation modeling to analyze a statewide longitudinal database of 100,000 JIA
from the third largest juvenile justice population in the United States. To uncover deeper insights into the
statistical findings, the project conducts and analyzes in-depth interviews and surveys among 60 individuals
who experienced SM and incarceration as minors. Hybrid thematic analysis will be employed to fuse the
quantitative and qualitative data. These aims serve to fulfil NIDA’s mission to advance science on the etiology
of SM, improve SUD prevention and treatment, and advance research on minorities, females, and other
populations facing disproportionate consequences of misuse. To complete the research aims, an extensive
training plan directed by a network of expert mentors who are leaders in the field will be executed. The training
aims are to develop expertise in SUD services delivery in criminal justice systems; mediation analysis in SEM,
psychometrics, censored data, and longitudinal design; interviewing methods in health research and analysis
with the ATLAS.ti software; stress instrumentation; and implementation and translational science. These
training and subsequent research activities are a major step towards developi...

## Key facts

- **NIH application ID:** 10770515
- **Project number:** 5K01DA052679-04
- **Recipient organization:** UNIVERSITY OF SOUTH FLORIDA
- **Principal Investigator:** Micah Johnson
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $176,469
- **Award type:** 5
- **Project period:** 2021-03-15 → 2024-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10770515

## Citation

> US National Institutes of Health, RePORTER application 10770515, Examining the Stress Processes Relating Ethnicity and Sex to Substance Misuse and Services Outcomes (ESPRESSO) (5K01DA052679-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10770515. Licensed CC0.

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