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.

中文翻译：

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“我死去的朋友比手指和脚趾还多”：年轻黑人男孩和男性对暴力和药物使用预防的服务利用需求和偏好


年轻黑人男性 (YBM) 不成比例地面临着青少年暴力 (YV) 和药物滥用障碍的最严重形式和后果，但他们不太可能获得并保留这些高风险行为的服务。调查服务使用差异和减少障碍的干预提供模式的作用至关重要；了解 YBM 的服务需求和偏好也很重要。本研究探讨了涉及暴力和药物滥用的 YBM 以及来自种族和经济多元化社区的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，我们还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和促进高暴力环境中黑人男孩的公平方面的潜在好处和缺点。对 16 名 YBM（从试点研究的 300 名参与者中选出）和 7 名服务提供者（四名女性，三名男性）进行了单独访谈。数据分析采用了生态系统现象学变体理论 (PVEST) 指导下的解释性描述 (ID) 方法。出现了四个主题：（1）旋转门和暴力历史； （2）暴力的好处：“你对我做什么，我对你做什么”； (3) 对暴力和药物使用预防计划的积极和消极看法； (4) 需要注重公平和消除障碍的数字健康干预措施。我们的研究结果确定了 YBM 在个人和社区层面使用的回避机制，并强调了现有基于社区的计划和数字干预措施作为减轻护理障碍的关键工具的看法。 这项研究还证实，即使在项目丰富的城市，也普遍存在关键服务差距和项目吸收问题。因此，强调在高度暴力和药物使用环境中需要与 YBM 共同设计以公平为中心的干预措施。