Advancing intersectional discrimination measures for health disparities research

项目概要/摘要 在交叉性框架的指导下，健康差异研究人员记录了 社会地位和位置（SSP）多个轴的交叉点，特别是种族/民族，性别， 性取向为了从确定到干预这种交叉健康差异， 需要进行研究，检查潜在的机制。许多研究表明， 单一健康差异人群中感知歧视的影响。定量方法 对歧视在造成跨部门健康差距方面的作用的评估仍处于初级阶段， 然而.我们的团队成员最近推出了交叉歧视指数（InDI），以解决 这个差距。该指数包括三个衡量已实施的（日常和重大）歧视和预期歧视的指标; 这些无归因措施询问“因为你是谁”而遭受虐待的经历。这些 措施显示出跨部门健康差异研究的希望，但需要进一步验证 交叉群体和语言。此外，删除属性的提议是有争议的， 直接比较。因此，本研究旨在（1）认知和（2） 心理测量评估交叉歧视指数（InDI）在英语和西班牙语和（3） 确定是否应包括属性。研究目的将依序借鉴三部原著 收集的数据来源：（a）英语和西班牙语定性认知访谈（n=50），样本 有目的地招募交叉SSP（性别，性取向，种族/民族，社会经济 身份、年龄、出生地）;（B）西班牙语定量调查（n=500; 50% SGM）;和（c）英语定量调查 调查（n=3000），按人种/种族（黑人、拉丁裔、白色）、SGM状态和性别进行配额抽样。的 这项研究的主要成果将是对预期的、日常的和经过验证的主要歧视的双语测量 使用严格的定性、定量和混合方法，对多个健康差异人群进行分析。这 预期成果将通过加强测量来支持NIMHD的健康差异科学优先事项 消除人口健康研究中的歧视现象，从而更好地了解歧视对健康的影响 差距。

PROJECT SUMMARY/ABSTRACT Guided by intersectionality frameworks, health disparities researchers have documented health disparities at the intersection of multiple axes of social status and position (SSP), particularly race/ethnicity, gender, and sexual orientation. To advance from identifying to intervening upon such intersectional health disparities, studies that examine underlying mechanisms are required. Much research demonstrates the negative health impacts of perceived discrimination within single health disparity populations. Quantitative approaches to assessing the role of discrimination in generating intersectional health disparities remain in their infancy, however. Members of our team recently introduced the Intersectional Discrimination Index (InDI) to address this gap. The InDI comprises three measures of enacted (day-to-day and major) and anticipated discrimination; these attribution-free measures ask about experiences of mistreatment “because of who you are.” These measures show promise for intersectional health disparities research but require further validation across intersectional groups and languages. Additionally, the proposal to remove attributions is controversial and no direct comparison has been conducted. Therefore, this study aims to (1) cognitively and (2) psychometrically evaluate the Intersectional Discrimination Index (InDI) in English and Spanish and (3) determine whether attributions should be included. Study aims will draw on three original sequentially collected sources of data: (a) Qualitative cognitive interviews in English and Spanish (n=50) with a sample purposively recruited across intersecting SSP (gender, sexual orientation, race/ethnicity, socio-economic status, age, nativity); (b) a Spanish quantitative survey (n=500; 50% SGM); and (c) an English quantitative survey (n=3000), with quota sampling by race/ethnicity (Black, Latinx, White), SGM status, and gender. The study's key deliverable will be bilingual measures of anticipated, day-to-day, and major discrimination validated for multiple health disparity populations using rigorous qualitative, quantitative, and mixed methods. This expected outcome will support NIMHD priorities for Health Disparities Science by strengthening measurement of discrimination in population health research, thereby improving understanding of how it contributes to health disparities.