Impact of minority stress on cardiovascular disease risk and resilience

7.项目摘要/摘要 本项目是对NOT-MD-19-001关于性健康和性行为健康研究特别关注的通知的响应 性别少数(SGM)人口。少数性别人群患心血管疾病的风险增加 疾病(CVD)发病率和死亡率。具体地说，行为风险因素监测系统的数据表明 与顺性人相比，少数性别人群患心肌梗死的风险是顺性人的两倍多。 并报告了更严重的抑郁，缺乏运动，身体质量指数(BMI)升高，以及更难获得 到医疗保健，所有这些都会增加心血管疾病的风险。此外，许多性别少数人服用荷尔蒙，这 可能会进一步增加他们患心血管疾病的风险。根据少数群体压力理论，偏见和偏见的负面影响 歧视是心血管疾病风险差异的一个因素。尽管之前的研究发现了 在性别、少数民族压力和自我报告的心理健康较差之间，少数民族压力对身体的影响 健康结果，包括心血管疾病风险，尚未在性别少数群体中进行检查。这样做的目的是 研究旨在加深我们对少数民族压力和韧性如何影响心血管疾病风险的理解。在一个既定的 在美国三个城市(N=390)的纵向、多地点的性别少数群体队列中，我们的目标是：(1) 确定少数民族压力与心理健康和心血管疾病风险的关联；(2)确定社会压力的影响 关于精神健康和心血管疾病风险的支持、获得护理和认同感发展；以及(3)确定可修改的 可能影响少数民族应激与心理健康和心血管疾病风险关系的弹性因素 健康差距人口。除了结构化访谈和生态瞬时评估(EMA) 在基线和两年的随访中，我们将收集两周的客观测量结果 血压、睡眠和体力活动。这项拟议的研究将提供迄今为止最好的证据 指导研究人员和临床医生制定干预措施，以减少少数性别人群的心血管疾病差异 并促进他们的长期健康和福祉。

7. PROJECT SUMMARY/ABSTRACT This project is responsive to NOT-MD-19-001 Notice of Special Interest in Research on the Health of Sexual and Gender Minority (SGM) Populations. Gender minority populations are at increased risk for cardiovascular disease (CVD) morbidity and mortality. Specifically, Behavioral Risk Factor Surveillance System data suggest that, compared to cisgender people, gender minorities are at more than double the risk for myocardial infarction and report greater depression, physical inactivity, and elevated body mass index (BMI), as well as poorer access to healthcare, all of which increase CVD risk. Further, many gender minority individuals take hormones, which may further increase their risk of CVD. According to minority stress theory, the negative impact of prejudice and discrimination is one contributor to CVD risk disparities. Although previous studies have found associations between gender minority stress and poorer self-reported mental health, the impact of minority stress on physical health outcomes, including CVD risk, has not been examined in gender minority populations. The goal of this study is to advance our understanding of how minority stress and resilience affect CVD risk. In an established longitudinal, multisite cohort of gender minority individuals in three U.S. cities (N=390), we aim to: (1) determine the association of minority stress with mental health and CVD risk; (2) determine the impact of social support, access to care, and identity development on mental health and CVD risk; and (3) identify modifiable resilience factors that may influence the relationship of minority stress to mental health and CVD risk in this health disparity population. In addition to structured interviews and Ecological Momentary Assessments (EMA) of stress and resilience at baseline and 2-year follow-up, we will collect 2-week bursts of objective measurements of blood pressure, sleep and physical activity. The proposed research will provide the best evidence to date to guide researchers and clinicians working to develop interventions to reduce CVD disparities in gender minority populations, and promote their long-term health and wellbeing.