Understanding Substance Use Risk among Sexual Minority Women

项目摘要 性少数女性（SMW;女同性恋、双性恋、其他非异性恋女性）的年龄 与异性恋女性相比，物质使用（SU）的风险增加。这一点尤其明显， 成年初期（18-25岁），法定最低工资人士吸食大麻和大量饮酒的风险高。这些 强烈的差异突出了理解和减少法定最低工资之间的SU的必要性。然而， 现有的研究阻碍了这方面的努力。首先，SMW中SU的研究几乎完全使用 横截面和半年纵向设计。虽然这些研究为 由于这些方法无法了解SMW中的SU风险，因此它们所能提供的关于SU风险的数据有限。 经验抽样方法（ESM）可以通过识别时间上接近的风险来促进我们的理解 SU的因素（例如，预测当天/次日SU的因素），并从相关因素中分离风险因素- 使法定最低工资的干预目标更为清晰。第二，法定最低工资被视为同质群体，因此， 对法定最低工资各组别的风险因素知之甚少（即，女同性恋，双性恋，同性恋，泛性恋）。这是一个关键 问题，因为1）初步证据表明，一个因素（性身份披露）与SU有关 为双性恋，但不是女同性恋，妇女; 2）一个子集的法定最低工资-那些有多性别吸引力的经验 理论上影响SU的独特压力源，以及3）共享的风险因素（例如同伴影响）可能会有差异 影响法定最低工资的分组。尽管存在风险，但没有为SMW量身定制的SU干预措施，强调了 需要确定如何调整SU干预措施，以解决其独特的风险因素。的目标 拟议的研究是：1）确定新兴成年人中有问题的大麻和酒精使用的风险因素 SMW; 2）描述SMW亚组的常见和独特风险因素;以及3）确定如何调整 SU干预SMW。这些目标将采用混合方法实现。第一阶段将包括 30-一项为期一天的ESM研究，研究对象是自称为女同性恋、双性恋、酷儿和泛性恋的新兴成年女性（60%）。 身份），并将侧重于识别SU的人内和人与人之间的风险因素，并描述常见的 以及法定最低工资亚组的独特风险因素。在第二阶段，我们将对60个阶段进行定性访谈， 1名参与者。访谈将侧重于SU的感知风险因素，SMW对ESM调查结果的解释， 以及如何使SU干预适应SMW。该奖项将为申请人提供SU培训 研究，ESM，定性/混合方法，以及西北大学研究所的干预发展 性和性别少数群体的健康和福祉-一个丰富的知识环境， 培训学者在性少数健康研究的理想资源。培训和研究活动 由本K 01资助将促进申请人的过渡到一个独立的研究者与程序， 翻译研究侧重于理解和减少影响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.