Parental Influences on Tobacco Use among Sexual Minority Young Adults in a New Market and Policy Landscape

项目概要/摘要 青年期（YA）是从事危险行为（包括烟草使用）和建立生活方式的关键时期 对健康有长期影响。近几十年来，美国的烟草使用情况发生了变化， 香烟的使用加上替代烟草产品（ATP;电子香烟，雪茄， 无烟烟草、水烟）。不断变化的烟草政策环境进一步加剧了这些复杂性， 多烟草使用的增加。这些产品的使用对弱势亚群体，包括性行为， 少数民族。确定传统和ATP使用中性取向差异的机制至关重要 为减少使用和差距的干预提供信息。然而，在机制方面存在很大差距， 解释了这些差异。YA烟草使用的重要预测因素是父母的行为和心理健康问题， 这可能对性少数的YAs产生特别强烈的影响，考虑到社区和社会的多样性， 在这段时间里，烟草的使用。这个F32应用程序的目的是促进博士罗姆的成就，她的职业生涯 目标-建立一个独立的研究计划，致力于阐明健康风险的多层次决定因素 弱势青少年和青少年群体的行为，并为预防和减少此类行为的干预措施提供信息 行为。该提案利用罗姆博士现有的技能和经验，并提供1）高级培训 多层次行为理论，健康差异和干预研究; 2）指导支持她的专业 发展;和3）指导和独立研究的资源，以推进以下交叉点的新研究：a） 特别脆弱的人群--性少数青年; B）解释性取向的多层次机制 YA烟草使用的差异;以及c）传统和ATP的使用，与当今不断发展的烟草高度相关 上下文更具体地说，培训将直接提高技能和专业知识博士。 研究的目的是：1）检查性取向（区分异性恋，双性恋和男同性恋/女同性恋）与 青年男女使用传统和ATPs的变化; 2）记录 男性和女性性少数与异性恋青少年的育儿行为和烟草使用;以及3）识别 父母教养行为对性少数人群烟草使用行为影响的中介变量和调节变量， 异性恋青年拟议的研究利用了发展框架，社会认知理论和少数民族 压力理论和多种研究方法，包括一年的纵向调查设计和定性访谈。 最终，这项提案将推动一个有前途的年轻研究人员的高影响力的职业生涯，并告知以家庭为基础的 采取干预措施，在迅速变化的烟草格局中减少烟草使用中的性取向差异。

PROJECT SUMMARY/ABSTRACT Young adulthood (YA) is a critical period for engaging in risk behaviors, including tobacco use, and establishing lifestyles with long-term health implications. The landscape of tobacco use in the US has changed in recent decades, with decreases in cigarette use coupled with increases in the use of alternative tobacco products (ATPs; electronic cigarettes, cigars, smokeless tobacco, hookah). These complexities are further compounded by an evolving tobacco policy context and increases in polytobacco use. The use of these products disproportionately impacts vulnerable subgroups, including sexual minority YAs. Identifying mechanisms accounting for sexual orientation disparities in traditional and ATP use is critical for informing interventions to reduce use and disparities. However, there is a substantial gap regarding the mechanisms that explain these disparities. Important predictors of YA tobacco use are parenting behaviors and mental health problems, which may have particularly strong influences for sexual minority YAs, given the multitude of community and social impacts on tobacco use during this time. This F32 application aims to catalyze Dr. Romm’s achievement of her career goal – to establish an independent research program devoted to elucidating multilevel determinants of health-risk behaviors among vulnerable adolescent and YA populations and inform interventions to prevent and reduce such behaviors. This proposal capitalizes on Dr. Romm’s existing skills and experience, and provides 1) training in advanced multilevel behavioral theories, health disparities, and intervention research; 2) mentored support for her professional development; and 3) resources for mentored and independent research to advance novel research at the intersection of: a) a particularly vulnerable population – sexual minority YAs; b) multilevel mechanisms that explain sexual orientation disparities in YA tobacco use; and c) use of both traditional and ATPs, highly relevant within today’s evolving tobacco context. More specifically, the training will directly enhance the skills and expertise Dr. Romm requires to execute the 3 research aims, to: 1) examine sexual orientation (distinguishing heterosexual, bisexual, and gay/lesbian) in relation to changes in use of traditional and ATPs among YA men and women; 2) document differential associations between parenting behaviors and tobacco use among male and female sexual minority versus heterosexual YAs; and 3) identify mediators and moderators of the impact of parenting behaviors on tobacco use behaviors among sexual minority versus heterosexual YAs. The proposed research leverages a developmental framework, sociocognitive theory and minority stress theory, and multiple research methods, including a 1-year longitudinal survey design and qualitative interviews. Ultimately, this proposal will advance a high-impact career of a promising young investigator and inform family-based interventions to reduce sexual orientation disparities in YA tobacco use within the rapidly evolving tobacco landscape.