Cardiovascular Health of Sexual and Gender Minorities in the Hispanic Community Health Study/Study of Latinos (SGM HCHS/SOL)

项目摘要/摘要 西班牙裔/拉丁裔性和性别少数群体(SGM)是美国SGM中增长最快的种族群体。 心血管疾病(CVD)是拉美裔/拉美裔美国人发病和死亡的主要原因。SGM 心血管疾病(CVD)风险方面的不平等早在成年时就已被发现；少数人 压力已被认为是一种潜在的调节因素。然而，少数少数族裔参加了特别大会 研究排除了对性取向、性别认同和种族的交叉点的检查。 我们提出了一项具有成本效益的辅助研究，该研究将利用父母西班牙裔的现有数据 社区健康研究/拉丁美洲人研究(HCHS/SOL)，同时收集关于性取向、性别的新数据 身份、污名、歧视、压力、应对、社会支持和心血管疾病风险。建议的研究恰逢其时。 因为HCHS/SOL参与者将于11月开始第三次面对面访问(V3) 2019年。在这项研究中，我们将(1)检验性取向和性别认同对心血管疾病风险的影响 在V3的所有HCHS/SOL参与者中(~9300)；(2)来自性取向和性别的示范路径 在1：2匹配的SGM和SGM亚队列中，通过污名、歧视和压力对心血管疾病风险的认同 V3的非SGM参与者(~1680)；以及(3)检查耻辱/歧视对性别的影响 V3中次队列参与者的定向和心血管疾病风险关系。数据分析将遵循以下几点 从LGBT少数民族压力模型衍生的概念模型，在该模型中，过度的耻辱歧视 SGM导致少数人应激，从而增加心血管疾病的风险。在这个模型中，应对和社会支持起到了 减轻少数族裔压力对心血管疾病风险的影响的弹性因素。横截面和纵向 回归模型和结构方程模型将被用来检验这些关系。理解 在西班牙裔/拉丁裔SGM中，污名诱导的应激对心血管疾病风险的影响具有重大意义 制定针对特定文化的心血管疾病风险降低战略。研究结果将被用来在 确定拉美裔/拉美裔文化优势，为家庭和社区的适应和测试提供信息 接受干预。 。

Project Summary/Abstract Hispanic/Latino sexual and gender minorities (SGM) are the fastest growing ethnic group of SGM in the U.S. Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among Hispanic/Latinos. SGM inequities in cardiovascular disease (CVD) risk have been identified as early as young adulthood; and minority stress has been identified as a potential moderator. Yet, small numbers of ethnic minority participants in SGM studies have precluded examination of the intersections of sexual orientation, gender identity, and ethnicity. We propose a cost-effective ancillary study that will leverage existing data from the parent Hispanic Community Health Study/Study of Latinos (HCHS/SOL) while collecting new data on sexual orientation, gender identity, stigma, discrimination, stress, coping, social support, and CVD risk. The proposed study is timely because HCHS/SOL participants will be scheduled for their third in-person visits (V3) starting in November 2019. In this study, we will (1) examine the influence of sexual orientation and gender identity on CVD risk among all HCHS/SOL participants at V3 (~9300); (2) model pathways from sexual orientation and gender identity to CVD risk through stigma, discrimination, and stress among a 1:2 matched sub-cohort of SGM and non-SGM participants at V3 (~1680); and (3) examine the influence of stigma/discrimination on sexual orientation and CVD risk relationships among sub-cohort participants at V3. Data analysis will follow a conceptual model derived from the LGBT Minority Stress Model in which excess stigma discrimination against SGM leads to minority stress that increases CVD risk. In this model, coping and social support serve as resilience factors that mitigate the impact of minority stress on CVD risk. Cross-sectional and longitudinal regression models as well as structural equation models will be used to test these relationships. Understanding the influence of stigma-induced stress on CVD risk among Hispanic/Latino SGM has significant implications for the development of culturally-specific CVD risk reduction strategies. Study findings will be used to build on identified Hispanic/Latino cultural strengths to inform adaptation and testing of family and community acceptance interventions. .