A Behavioral Intervention to Reduce Psychological Distress Symptoms among Black Gender Minority Women Experiencing Chronic Stigma

一项减少少数黑人心理困扰症状的行为干预 遭受慢性羞辱的妇女 项目概要：美国的黑人性别少数群体（GM）妇女面临着几乎普遍的 慢性污名化的经历（即，（一）与人交往，与人交往，与人交往; 与顺性别同龄人相比，心理困扰症状的患病率不成比例。心理 痛苦的症状，特别是创伤后应激（PTS）和抑郁症状，可以是高度衰弱的 传统的护理途径受到广泛的医疗保健获取和参与障碍的阻碍， 黑人GM女性这些障碍包括准备不足的医疗保健提供者，缺乏健康保险，医疗保健， 不信任，以及医疗保健环境中的高歧视率和受害率， 与黑人转基因女性中PTS和抑郁症状严重程度增加相关。相反，应对 和转基因社区的联系已被证明可以减轻心理困扰症状的严重程度 黑人GM女性因此，需要在文化上知情的社区干预措施来抵消沉重的负担 消除医疗保健障碍，解决这一人群的心理困扰症状。研究 这一应用的目标是，首先，制定一个文化知情的社区为基础的干预， 社区成员的指导（通过焦点小组和剧院测试; N=20），以减少慢性疾病的影响 污名暴露对黑人转基因者心理困扰症状（PTS和抑郁症状）的影响 妇女其次，我们将进行概念验证试验（N=40），以确定可行性和初步 由此产生的干预效果。调查结果将为干预优化提供信息，以改善症状 管理这个群体。拟议的研究在开发和评估证据方面发挥着至关重要的作用- 基于干预措施，以改善黑人转基因妇女的心理困扰症状管理。到 完成拟议的研究，我提出了一个研究和培训计划，促进我过渡到一个 独立的，以病人为导向的研究生涯，专门从事症状科学和文化上适当的 症状管理的干预措施，很容易在现实世界中实施。研究训练 目标将通过密切的跨学科指导和精心挑选的教学活动来实现， 出席会议，应用研究经验，手稿和赠款提案准备（即，R-- 系列）。此外，我将通过获得干预设计方面的临床和研究培训来实现这些目标， 实施和评估;转基因人的心理困扰治疗;以及研究伦理和 特别是针对弱势群体的管理。培训计划利用得到良好支持的 埃默里大学的基础设施，以及国家和机构的机会，以确保教学， 体验式和专业化的个人指导。 1

A Behavioral Intervention to Reduce Psychological Distress Symptoms among Black Gender Minority Women Experiencing Chronic Stigma PROJECT SUMMARY: Black gender minority (GM) women in the United States face a nearly universal experience of chronic stigma (i.e., enacted, anticipated, and structural stigma), associated with a disproportionate prevalence of psychological distress symptoms compared to cisgender peers. Psychological distress symptoms, specifically post-traumatic stress (PTS) and depressive symptoms, can be highly debilitating and traditional pathways to care are impeded by widespread barriers to healthcare access and engagement for Black GM women. Such barriers include underprepared healthcare providers, lack of health insurance, medical mistrust, and high rates of discrimination and victimization within healthcare settings, which have been associated with increased PTS and depressive symptom severity among Black GM women. Conversely, coping and GM community connection have been shown to decrease psychological distress symptom severity among Black GM women. Thus, culturally informed community-based interventions are needed to offset the high burden of barriers to healthcare and address psychological distress symptoms among this population. The research objectives of this application are to first, develop a culturally informed community-based intervention with guidance from community members (via focus groups and theater testing; N=20) to reduce the effect of chronic stigma exposure on psychological distress symptoms (PTS and depressive symptoms) among Black GM women. Second, we will conduct a proof-of-concept trial (N=40) to determine the feasibility and preliminary efficacy of the resulting intervention. Findings will inform intervention optimization to improve symptom management for this group. The proposed study plays an essential role in developing and evaluating evidence- based interventions to improve psychological distress symptom management among Black GM women. To accomplish the proposed research, I propose a research and training program facilitating my transition to an independent, patient-oriented research career, specializing in symptom science and culturally appropriate interventions for symptom management that are easily implemented in real-world settings. Research and training aims will be accomplished through close interdisciplinary mentorship and carefully selected didactic activities, conference attendance, applied research experiences, and manuscript and grant proposal preparation (i.e., R- series). Additionally, I will achieve these goals by obtaining clinical and research training in intervention design, implementation, and evaluation; psychological distress treatment among GM people; and research ethics and management specific to engaging vulnerable populations. The training plan leverages the well-supported infrastructure at Emory University, as well as national and institutional opportunities to ensure didactic, experiential, and specialized individual instruction. 1