Understanding Substance Use Risk among Sexual Minority Women

项目摘要 性少数民族妇女(SMW；女同性恋者、双性恋者和其他非异性恋妇女)基本上处于 与异性恋女性相比，使用药物(SU)的风险更高。这一点在以下方面尤为明显 初成年(18-25岁)，SMW吸食大麻和大量饮酒的风险很高。这些 巨大的差距突显了理解和减少SMW中的SU的必要性。然而，它的局限性在于 现有的研究阻碍了这方面的努力。首先，对SMW中的SU的研究几乎只使用了 横截面和半年一次的纵向设计。虽然这些研究为 要了解SMW中的SU风险，这些方法所能提供的关于SU风险的数据有限。 经验抽样方法(ESM)可以通过识别临时性近端风险来提高我们的理解 SU的因素(例如，预测相同/次日SU的因素)和从相关因素中分离风险因素- 从而使SMW的干预目标更加明确。第二，SMW被视为同质群体，所以我们 对SMW亚群(即女同性恋者、双性恋者、同性恋者、双性恋者)的风险因素知之甚少。这是一个关键的 问题是，1)初步证据表明，一个因素(性身份披露)与SU有关 对于双性恋，但不是女同性恋者；2)SMW的子集-那些具有多性别吸引力的人-体验 理论上认为影响SU的独特应激源，以及3)共同的风险因素(例如，同伴影响)可能存在差异 SMW的影响亚群。尽管存在风险，但没有针对SMW量身定做的SU干预措施，突显出 需要确定如何调整SU干预措施以解决其独特的风险因素。世界银行的目标是 建议的研究是：1)确定新兴成年人中有问题的大麻和酒精使用的危险因素 SMW；2)描述SMW各亚组的共同和独特的风险因素；以及3)确定如何适应 苏对SMW的干预。这些目标将使用混合方法来实现。第一阶段将包括 对自我认同的女同性恋者、双性恋者、同性恋者和泛性恋者的30天ESM研究(60% 身份)，并将重点确定SU的人内和人与人之间的风险因素，并描述共同的 和SMW亚组独特的危险因素。在第二阶段，我们将对60阶段进行定性访谈 1名参与者。访谈将集中在SU的感知风险因素，SMW对ESM调查结果的解释， 以及适应SMW的SU干预的方法。该奖项将为申请人提供SU方面的培训 西北大学研究所的研究、ESM、定性/混合方法和干预发展 对于性和性别少数群体的健康和福祉-丰富的智力环境 培训少数性别性健康研究学者的理想资源。培训和研究活动 由K01提供的资金将促进申请人向独立调查员的过渡，该计划将 翻译研究的重点是了解和减少影响SMW的SU差异。

Project Summary Sexual minority women (SMW; lesbian, bisexual, other non-heterosexual women) are at substantially increased risk for substance use (SU) compared to heterosexual women. This is particularly evident in emerging adulthood (ages 18-25), when SMW are at high risk for cannabis and heavy alcohol use. These robust disparities highlight the need to understand and reduce SU among SMW. However, the limitations of existing research hinder efforts to do so. First, research on SU among SMW has almost exclusively used cross-sectional and semi-annual longitudinal designs. While these studies provide a foundation for understanding SU risk among SMW, these methods are limited in the data they can provide about SU risk. Experience sampling methods (ESM) can advance our understanding by identifying temporally proximal risk factors for SU (e.g., factors predicting same/next-day SU) and disentangling risk factors from correlates — resulting in clearer intervention targets for SMW. Second, SMW are treated as a homogeneous group, so we know little about risk factors for subgroups of SMW (i.e., lesbian, bisexual, queer, pansexual). This is a critical problem because 1) preliminary evidence suggests that one factor (sexual identity disclosure) is linked to SU for bisexual, but not lesbian, women; 2) a subset of SMW—those with multi-gender attractions—experience unique stressors theorized to impact SU, and 3) shared risk factors (e.g. peer influences) may differentially impact subgroups of SMW. Despite their risk, there are no SU interventions tailored for SMW, highlighting the need to determine how to adapt SU interventions to address their unique risk factors. The goals of the proposed study are to: 1) identify risk factors for problematic cannabis and alcohol use among emerging adult SMW; 2) delineate common and unique risk factors for subgroups of SMW; and 3) determine how to adapt a SU intervention for SMW. These goals will be met using a mixed methods approach. Phase 1 will consist of a 30-day ESM study of self-identified lesbian, bisexual, queer, and pansexual emerging adult women (60 per identity) and will focus on identifying within- and between-person risk factors for SU and delineating common and unique risk factors for subgroups of SMW. In Phase 2, we will conduct qualitative interviews with 60 Phase 1 participants. Interviews will focus on perceived risk factors for SU, SMW’s interpretations of ESM findings, and ways to adapt a SU intervention for SMW. This award will provide the applicant with training in SU research, ESM, qualitative/mixed-methods, and intervention development at Northwestern University’s Institute for Sexual and Gender Minority Health and Wellbeing – a rich intellectual environment with abundant resources ideal for training scholars in sexual minority health research. The training and research activities funded by this K01 will facilitate the applicant’s transition to an independent investigator with a program of translational research focused on understanding and reducing SU disparities affecting SMW.