Prospective Cohort of Rural US LGBTQ Persons to Definitively Characterize Depression and Suicidal Ideation Burdens, Determinants, and Preferred Intervention Approaches

美国农村 LGBTQ 群体的未来群体，明确描述抑郁症和自杀意念负担、决定因素和首选干预方法

• 批准号: 10428079
• 负责人: Sarah Sutherlin-McIvor Murray
• 金额: $ 82.01万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10428079
• 关键词: Address; Adolescent; Adult; Affect; Age; Area; Baseline Surveys; Cities; Collaborations; Communication; Consultations; Country; Data; Depression and Suicide; Development; Discrimination; Distal; Enrollment; Ethnic Origin; Feeling suicidal; Female; Funding; Gays; General Population; Geography; Goals; Health; Heterogeneity; Heterosexuals; Institute of Medicine (U.S.); Intervention; Intervention Studies; Investigation; Lesbian Gay Bisexual Transgender Queer; Life Cycle Stages; Literature; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Mental disorders; Mental health promotion; Methods; Minority Health Research; Modeling; Outcome; Participant; Pathway interactions; Persons; Population; Population Programs; Procedures; Prospective cohort; Psychiatric epidemiology; Public Health Schools; Questionnaires; Race; Recommendation; Reporting; Research; Research Personnel; Risk Factors; Rural; Sample Size; Sampling; Services; Sexual Health; Sexual and Gender Minorities; Strategic Planning; Subgroup; Suicide; Suicide attempt; Suicide prevention; Surveys; Technology; Time; Trauma; United States; United States National Institutes of Health; Universities; base; cis-female; cis-male; cisgender; cognitive interview; cohort; depression prevention; epidemiology study; ethnic identity; evidence based guidelines; experience; experimental study; follow-up; gender minority community; gender minority group; gender minority health disparity; health disparity; high risk; improved; innovation; interest; men who have sex with men; metropolitan; minority stress; minority stressor; peer; preference; programs; prospective; protective factors; psychologic; racial and ethnic; rural area; rural counties; sexual minority female; sexual minority health; sexual minority male; social stigma; suicidal risk; therapy development; transfeminine; transmasculine; young adult

Mental health disparities affecting sexual and gender minority (SGM) persons are well documented and indicate a substantially greater burden of mental disorders and suicide among SGM as compared to their heterosexual, cisgender peers across the life course. The Institutes of Medicine (IOM) identified substantial gaps in research on these health disparities among SGM persons, particularly in the context of sustained stigma. Additionally, as highlighted in NIH’s 2021-2025 SGM Research Office Strategic Plan, limited data exists on SGM persons residing in rural contexts; though where data are available, they suggest higher rates of mental disorders for SGM outside of, as opposed to residing within, urban centers. Technology-delivered interventions addressing depression are being increasingly explored among the general population and hold promise for use among rural SGM communities, but they must take into account both the substantial heterogeneity of rural SGM persons and pervasive experiences of SGM-related stigma, discrimination, and trauma to be effective. This research team from the Department of Mental Health and Key Populations Program at Johns Hopkins University and the Programs, Research, & Innovation in Sexual Minority Health at Emory University will use online approaches to enroll 2000 SGM (500 each cisgender female and male sexual minorities, and 500 each transfeminine and transmasculine persons) from rural counties and small cities across the US to follow for 12 months with repeated questionnaires to: 1) determine whether classes of stigma, discrimination, and traumatic experiences vary across rural SGM subgroups and whether these exposure classes are associated with increased prevalent depression and suicide ideation or attempt; 2) determine whether these exposure classes are associated with incident depression or suicidal ideation or attempt across rural SGM groups; and, 3) compare the relative acceptability of various technology-delivered interventions for depression and suicide prevention tailored to address rural SGM persons’ experiences of stigma, discrimination, and trauma. This study will produce the first comprehensive investigation of rural SGM adults’ experiences of distal minority stressors and their relationship to prevalent mental health outcomes, as well as by what pathways they may predict incident depression, suicidal ideation and attempts. The study will also provide substantive evidence-based recommendations for the development or adaptation of technology- delivered interventions to address mental health among heterogenous rural SGM communities, and in so doing is responsive to NIH’s Notice of Special Interest on the Health of SGM Populations (NOT-MD-19-001).

影响性和性别少数群体的心理健康差异有充分的记录， 表明SGM中精神障碍和自杀的负担大大高于其 异性恋，顺性别的同龄人在整个生命过程中。医学研究所（IOM）发现， 关于SGM人群中这些健康差异的研究存在差距，特别是在持续的 耻辱此外，正如NIH的2021-2025年SGM研究办公室战略计划所强调的那样， 存在于居住在农村环境中的SGM人身上;尽管在有数据的地方，它们表明更高的比率， 精神障碍的SGM以外，而不是居住在城市中心。技术交付 针对抑郁症的干预措施正在越来越多地在普通人群中探索， 承诺在农村SGM社区中使用，但他们必须考虑到 农村SGM人群的异质性以及SGM相关污名化、歧视和 创伤是有效的。这个来自精神卫生和重点人群部门的研究小组 计划在约翰霍普金斯大学和计划，研究，在性少数群体的健康创新， 埃默里大学将使用在线方法招收2000名SGM（顺性别女性和男性各500名） 少数民族和变性人各500名）， 在美国各地进行为期12个月的重复问卷调查，以：1）确定是否有类别的 羞辱、歧视和创伤经历在农村SGM亚群中各不相同， 暴露类别与抑郁症和自杀意念或企图的增加有关; 2） 确定这些暴露类别是否与抑郁或自杀意念有关， 尝试在农村SGM组;和，3）比较各种技术提供的相对可接受性 针对农村SGM人员的抑郁和自杀预防经验采取干预措施， 耻辱、歧视和创伤。本研究将产生第一个全面的调查农村SGM 成年人对远端少数民族压力源的经历及其与普遍心理健康结果的关系， 以及通过什么途径他们可以预测抑郁症事件，自杀意念和企图。这项研究将 还为技术的开发或改造提供实质性的循证建议， 提供干预措施，以解决异质性农村SGM社区的心理健康问题， 这样做是对NIH关于SGM人群健康的特别关注通知（NOT-MD-19-001）的响应。