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

行为干预对减轻黑人性别群体心理困扰症状的作用 遭受慢性耻辱的女性 项目摘要：美国黑人性别少数(GM)女性面临几乎普遍的 慢性污名的经历(即，发生的、预期的和结构性的污名)，与 与顺性同龄人相比，心理困扰症状的发生率不成比例。心理学 痛苦症状，特别是创伤后应激(PTS)和抑郁症状，可能会使人非常虚弱 传统的护理途径因普遍存在的医疗保健获取和参与障碍而受阻 通用汽车的黑人女性。这些障碍包括准备不足的医疗保健提供者，缺乏医疗保险，医疗 不信任，以及医疗保健环境中的高歧视和高受害率，这些一直是 与黑人转基因女性的PTS增加和抑郁症状严重程度有关。相反，应对 和转基因社区的联系被证明可以降低 通用汽车的黑人女性。因此，需要以文化为基础的社区干预措施来抵消沉重的负担。 消除医疗保健方面的障碍，解决这一人群的心理困扰症状。这项研究 这个应用程序的目标是首先，开发一种基于文化的社区干预措施 社区成员的指导(通过焦点小组和剧院测试；N=20)，以减少慢性病的影响 污名暴露对黑人转基因人群心理困扰症状(PTS和抑郁症状)的影响 女人。第二，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。研究结果将为改善症状的干预优化提供信息 这个群体的管理。拟议的研究在发展和评估证据方面起着至关重要的作用- 基于干预措施，改善黑人转基因女性的心理困扰症状管理。至 为了完成建议的研究，我提出了一个研究和培训计划，帮助我过渡到 独立的、以患者为中心的研究生涯，专门从事症状科学和文化方面的研究 可在真实环境中轻松实施的症状管理干预措施。研究和培训 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，准备手稿和赠款提案(即，R- 系列)。此外，我将通过接受干预设计的临床和研究培训来实现这些目标， 实施和评估；转基因患者的心理痛苦治疗；以及研究伦理和 针对弱势群体的具体管理。该培训计划利用了得到良好支持的 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， 体验式的、专业化的个别化教学。 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