Social stress and substance abuse disparities in sexual minority youth

性少数青少年的社会压力和药物滥用差异

• 批准号: 8384342
• 负责人: Mark Louis Hatzenbuehler
• 金额: $ 17.82万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8384342
• 关键词: Address; Adolescence; Adolescent; Adopted; Alcohol or Other Drugs use; Alcohols; American Medical Association; Area; Attitude; Award; Biological; Biological Factors; Biology; Bisexual; Buffers; Chronic; Cohort Studies; Communities; Complement; Crime; Data; Data Collection; Development; Discrimination; Disease; Economics; Environment; Epidemiologic Studies; Epidemiology; Equilibrium; Exhibits; Exposure to; Family; Gays; Goals; Guidelines; HIV; HIV Infections; Hate; Health; Heterosexuals; High Prevalence; Homosexuality; Hydrocortisone; Individual; Institute of Medicine (U.S.); Institution; Interdisciplinary Study; Intervention; Knowledge; Laboratories; Lesbian; Life Cycle Stages; Link; Longitudinal Studies; Low Prevalence; Measures; Mediating; Medical; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Minority; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Neighborhoods; Outcome; Pathway interactions; Physiological; Policies; Population; Process; Psychosocial Stress; Public Health; Reporting; Research; Research Priority; Research Project Grants; Resources; Risk; Risk Behaviors; Risk Factors; Sampling; Schools; Sex Orientation; Social Environment; Social Identification; Stigmata; Stress; Substance abuse problem; System; Testing; Time; Tobacco use; Training; Vulnerable Populations; Youth; base; biological adaptation to stress; bullying; career; contextual factors; cost; dehydroepiandrosterone; design; experience; health disparity; innovation; men; novel; peer; programs; prospective; research study; response; sexual minority; skills; social; social stigma; social stress; stressor; substance use prevention; symposium; young adult

DESCRIPTION (provided by applicant): Recent data indicate substantial health disparities in lesbian, gay, and bisexual (LGB) populations, including nearly twice the risk of substance use among LGB youths compared to their heterosexual peers. Additionally, young gay/bisexual men, already disproportionately burdened with HIV morbidity, are one of the only risk groups in which new HIV infection rates are increasing. A 2011 report on LGB health released by the Institute of Medicine (IOM) noted the dearth of research on the factors responsible for these disparities. This report identified the study of social ecological influences as a priority researc area, and emphasized the need for studies that adopt minority stress and life course perspectives in order to determine how the unique issues confronting LGB populations increase their risk for adverse health outcomes. This Mentored Research Scientist Development Award (K01) will provide the candidate with the protected time, training, and resources necessary to carry out these research priorities established in the IOM report. The goal of the Award is to develop an interdisciplinary research program focused on identifying modifiable social ecological factors that can explain and address health disparities among LGB youth. To accomplish his career goals and research objectives, the candidate requires training and mentorship in social epidemiology, biostatistical approaches to life course studies, and stress biology. This training will be accomplished through a combination of mentored research projects, courses, seminars, and conferences. The new skills that are acquired will enable the candidate to conduct innovative, high-impact research examining how and why the social environment surrounding LGB youth contributes to their increased risk for substance use and associated problems. The over-arching objectives of this research are: (1) to evaluate whether sexual minority stress measured at the social ecological level predicts substance use and HIV risk behaviors within LGB youth and explains sexual orientation-related disparities in these outcomes; (2) to identify modifiable contextual factors that protect LGB youth from engaging in substance use and HIV risk behaviors; and (3) to elucidate biological pathways that mediate the relationship between sexual minority stress, substance use, and HIV risk behaviors. This proposal uses a multi-method framework that draws on the strengths of two prospective cohort studies (the Growing Up Today Study and the National Longitudinal Study of Adolescent Health) that have followed LGB and heterosexual adolescents for over 15 years. These epidemiologic studies will be complemented by data collection in two studies that utilize experimental and experience-sampling designs. This research will address novel questions about social determinants of LGB health, their interplay with individual biological factors, and how these processes emerge over the life course. Moreover, the results will facilitate the development of structural, policy, and community-level interventions that reduce sexual orientation-related disparities in substance use and HIV risk behaviors, an important priority at NIDA. PUBLIC HEALTH RELEVANCE: Given the persistence of substantial health disparities in lesbian, gay, and bisexual (LGB) populations compared to heterosexuals, research into the underlying factors that can explain these disparities constitutes a critical area for public health Chronic exposure to sexual minority stress during adolescence may contribute to elevated rates of substance use and HIV risk behaviors among LGB youth, resulting in deleterious health outcomes as well as considerable economic and societal costs. The goal of this proposed research is to identify modifiable social determinants of substance use and HIV risk behaviors among LGB youth that can be used to develop public health interventions that reduce health disparities within this vulnerable population.

描述（由申请人提供）：最近的数据表明，在女同性恋、男同性恋和双性恋（LGB）人群中存在巨大的健康差异，包括LGB青年中物质使用的风险几乎是异性恋同龄人的两倍。此外，年轻的男同性恋/双性恋男子已经不成比例地承受着艾滋病毒发病率的负担，是艾滋病毒新感染率不断上升的唯一危险群体之一。医学研究所（IOM） 2011年发布的一份关于LGB健康的报告指出，对造成这些差异的因素缺乏研究。该报告将社会生态影响研究确定为优先研究领域，并强调需要采用少数群体压力和生命历程视角进行研究，以确定LGB人口面临的独特问题如何增加其不良健康结果的风险。指导研究科学家发展奖（K01）将为候选人提供受保护的时间、培训和必要的资源，以开展IOM报告中确定的这些研究重点。该奖项的目标是发展一个跨学科的研究项目，重点是确定可改变的社会生态因素，这些因素可以解释和解决LGB青年之间的健康差异。为了实现他的职业目标和研究目标，候选人需要在社会流行病学、生命历程研究的生物统计方法和压力生物学方面的培训和指导。该培训将通过指导研究项目、课程、研讨会和会议的组合来完成。获得的新技能将使候选人能够进行创新的，高影响力的研究，研究LGB青年周围的社会环境如何以及为什么会导致他们增加药物使用和相关问题的风险。本研究的主要目的是：(1)评估社会生态水平的性少数派压力是否能预测LGB青年的物质使用和艾滋病毒风险行为，并解释这些结果中与性取向相关的差异；(2)确定可改变的环境因素，保护LGB青年不从事药物使用和艾滋病毒风险行为；(3)阐明性少数派压力、物质使用和HIV风险行为之间的生物学途径。该提案采用了一个多方法框架，借鉴了两项前瞻性队列研究（“今日成长研究”和“全国青少年健康纵向研究”）的优势，这两项研究对LGB和异性恋青少年进行了超过15年的跟踪调查。这些流行病学研究将通过利用实验和经验抽样设计的两项研究收集数据加以补充。这项研究将解决关于LGB健康的社会决定因素，它们与个体生物因素的相互作用，以及这些过程如何在生命过程中出现的新问题。此外，研究结果将有助于制定结构性、政策和社区层面的干预措施，减少与性取向相关的药物使用差异和艾滋病毒风险行为，这是NIDA的一个重要优先事项。