SUBSTANCE USE AND DISORDERED WEIGHT BEHAVIORS IN SEXUAL MINORITY YOUTH CONTEXTS

说明(由申请人提供)：性少数青少年(SMY；即男/女同性恋、双性恋或质疑)比他们的异性恋同龄人更有可能使用物质(例如，烟草、酒精、大麻)和从事无序的体重行为(例如，排泄)。这些健康差距出现在青春期早期，并使SMY面临患癌症、心血管疾病、与物质相关的伤害和障碍、饮食失调和肥胖的不成比例的风险。Smy可能会使用物质和紊乱的体重行为来缓解压力。这些行为也有可能被采纳和维持，因为它们有助于通过遵守感知的性少数物质使用和身体形象规范与SMY同龄人建立联系。这些压力和社会化途径的运作可能取决于SMY所遍历的不同社会环境，以及这些环境提供安全、连通性、结构和健康的健康行为规范的能力。然而，缺乏考察SMY中促进健康的环境的特征和活动的实证研究。尽管有限的研究表明，正式组织的支持环境的存在可能会防止负面影响和社会性，但对于这种支持环境如何以及为什么具有保护作用，或者这些保护作用是否也会延伸到物质使用和紊乱的体重行为，还缺乏理解。在计划中的K01研究中，我将使用前瞻性纵向调查数据和生态瞬时评估(EMA)技术来调查环境中的特征和活动，以缓解少数群体的压力，防止SMY中的物质使用和体重失调行为。数据将来自(1)今日成长研究--一个由16,000多名青少年和年轻人组成的全国性队列--评估背景特征、压力、物质使用和体重失调行为之间的总体联系；以及(2)从SMY服务组织招募的60名SMY队列，通过波士顿地区的受访者驱动抽样技术，研究SMY穿越的环境的动态及其与少数族裔压力、物质使用和体重失调行为的时间联系。为了促进这样的研究，我必须接受基于社区的参与性研究(CBPR)和预防科学、EMA研究设计和分析以及各种纵向统计方法(例如，具有密集纵向数据的有限混合建模)方面的培训，以分析背景互动和健康行为之间的联系。与SMY一起进行的CBPR可以通过生成关于造成健康差距的背景因素的详细信息，通过在SMY中培养领导技能和自我效能感，并通过加强SMY服务组织内的社会支持基础设施，来促进可持续的积极变化。拟议的研究将为预防干预确定可修改的背景水平的杠杆点，并将我定位为预防科学家的职业。

DESCRIPTION (provided by applicant): Sexual minority youth (SMY; i.e., gay/lesbian, bisexual, or questioning) are more likely to use substances (e.g., tobacco, alcohol, marijuana) and engage in disordered weight behaviors (e.g., purging) than their heterosexual peers. These health disparities emerge in early adolescence and place SMY at disproportionate risk for developing cancer, cardiovascular disease, substance-related injuries and disorders, eating disorders, and obesity. SMY may engage in substance use and disordered weight behaviors to mitigate stress. It is also possible that these behaviors are adopted and maintained because they help to build connections with SMY peers though conformity to perceived sexual minority substance use and body image norms. The operation of these stress and socialization pathways is likely contingent on the diverse social settings SMY traverse and the capacity of settings to provide safety, connectedness, structure, and salubrious health behavior norms. However, there is a dearth of empirical research examining characteristics and activities of settings that promote health in SMY. Although limited research suggests that the presence of formally organized support settings may protect against negative affect and sociality, there is a lack of understanding of how and why such support settings have a protective effect or whether these protective effects will also extend to substance use and disordered weight behaviors. In the planned K01 research I will use prospective longitudinal survey data and ecological momentary assessment (EMA) techniques to investigate characteristics and activities in settings that mitigate minority stress and protect against substance use and disordered weight behaviors among SMY. Data will come from (1) the Growing Up Today Study -- a national cohort of over 16,000 adolescents and young adults -- to assess overall associations between contextual characteristics, stress, and substance use and disordered weight behaviors; and (2) a cohort of 60 SMY recruited from SMY-serving organizations and via respondent-driven sampling techniques in the Boston area to examine the dynamics of the settings SMY traverse and their temporal connections to minority stress, substance use, and disordered weight behaviors. To facilitate such research, I must gain training in community-based participatory research (CBPR) and prevention science, EMA study design and analysis, and diverse longitudinal statistical methods (e.g., finite mixture modeling with intensive longitudinal data) for analyzing the connections between contextual interactions and health behaviors. CBPR with SMY can promote sustainable positive change by generating detailed information about the contextual factors contributing to health disparities, by building the leadership skills and feelings of self-efficacy in SMY, and by bolstering social support infrastructure within SMY-serving organizations. The proposed research will identify modifiable contextual-level leverage points for preventive interventions and position me for a career as a prevention scientist.