A Mixed-Method Study on Transgender and Gender Diverse Adults’ Alcohol Use

关于跨性别和性别多样化成年人饮酒的混合方法研究

• 批准号: 10666199
• 负责人: Joseph R Cohen
• 金额: $ 22.99万
• 依托单位: UNIVERSITY OF WISCONSIN MILWAUKEE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10666199
• 关键词: Address; Adult; Age; Alcohol abuse; Alcohol consumption; Alcohols; Algorithms; Assessment tool; Attention; Child Abuse; Classification; Clinical; Clinical Protocols; Communities; Data; Data Analyses; Discrimination; Disparity; Drug usage; Ensure; Ethnic Origin; Event; Evidence Based Medicine; Face; Family; Foundations; Future; Gender; Gender Identity; General Population; Health Personnel; Health Services Accessibility; Heavy Drinking; Individual; Intervention; Interview; Knowledge; Life; Literature; Mental Health; Methodology; Methods; Minority; Minority Health Research; Modeling; National Institute on Alcohol Abuse and Alcoholism; Persons; Phase; Policy Maker; Population; Population Heterogeneity; Poverty; Prevention Research; Process; Provider; Public Health; Race; Recording of previous events; Research; Research Methodology; Risk; Risk Factors; Sampling; Screening procedure; Sex Orientation; Sexual Health; Shapes; Social status; Surveys; Testing; Translating; Translations; Violence; Vulnerable Populations; alcohol abuse therapy; alcohol availability; alcohol intervention; alcohol related problem; alcohol risk; alcohol use disorder; cisgender; cultural competence; drinking; effective intervention; ethnic minority; experience; gender diversity; gender minority; gender minority group; indexing; innovation; interest; intersectionality; lens; life history; marginalization; minority stress; minority stressor; multilevel analysis; nonbinary; novel; prevent; racial diversity; racial minority; resilience; resilience factor; response; risk prediction; stressor; theories; timeline; transgender; transgender men; transgender women; transphobia

Project Summary/Abstract Transgender and gender diverse (TGD) adults are at greater risk for alcohol use, alcohol-related problems, and alcohol use disorders relative to cisgender adults. Thus, having culturally-competent alcohol use assessments and interventions that effectively target salient risks within this population is critical from a public health perspective. Yet, despite increased attention on this vulnerable population, extant theory concerning alcohol risk and resilience within TGD populations suffers from numerous theoretical and methodological limitations. This includes (a) a narrow perspective of risk that fails to consider the incremental validity of different stressors facing TGD adults, (b) the operationalization of risk within racially homogeneous, White samples that may not capture risks and strengths relevant in racially, ethnically, and sexually diverse samples, and (c) reliance on quantitative approaches that fail to facilitate the translation of indices of alcohol use within TGD communities into clinical protocols. Addressing these limitations is the answer to laying the foundation for more culturally affirming and clinically useful models for explaining and intervening with alcohol use in TGD populations. Our study is consistent with NOT-MD-19-001, “Notice of Special Interest in Research on the Health of Sexual and Gender Minority (SGM) Populations.” The proposed study seeks to address these aims via a novel, mixed method research approach. In the first phase of the study, we will conduct secondary data analyses on a large, diverse sample of TGD adults (N=27,715; U.S. Transgender Survey) to examine which minority stress experiences in the empirical literature are robust predictors of alcohol use across gender identities (e.g., non-binary, trans men, trans women) and intersecting identities (e.g., race, ethnicity, sexual orientation). Our analytic plan will use a multi-level modeling approach (i.e., MAIHDA models) to better capture the influence of intersecting identities on risk, as well as an evidence-based medicine (EBM) approach to demonstrate the clinical utility and statistical fairness of an alcohol use risk algorithm informed by minority stress theory for TGD adults. In the second phase of the study, qualitative interviews will be conducted with 60 TGD, drinking adults, to gain perspectives on top-down minority stress theories tested in Phase I, as well as other salient risks, needs, and strengths missing from current conceptualizations of alcohol use within the TGD community. The sample will be stratified by gender identity, race, and ethnicity to ensure a representative perspective on the environmental events and dynamic processes most salient to TGD adults’ perspectives on problematic alcohol use. Collective findings from our study will inform an R34 application that focuses on developing a TGD-affirming alcohol intervention.

项目概要/摘要 跨性别和性别多样化 (TGD) 成年人饮酒、酒精相关问题和饮酒的风险更大 与顺性别成人相关的疾病。因此，进行适合文化的酒精使用评估和干预措施 从公共卫生的角度来看，有效针对这一人群中的突出风险至关重要。然而，尽管增加 对这一弱势群体的关注，关于 TGD 人群中酒精风险和恢复力的现有理论 受到许多理论和方法上的限制。这包括 (a) 狭隘的风险视角 考虑 TGD 成人面临的不同压力源的增量有效性，(b) 内部风险的操作化 种族同质的白人样本可能无法捕捉到与种族、族裔和种族相关的风险和优势 样本性别多样化，以及 (c) 依赖定量方法，无法促进性别指数的转化 TGD 社区内的饮酒情况纳入临床方案。解决这些限制是解决问题的答案 为更多文化肯定和临床有用的模型奠定基础，用于解释和干预酒精使用 TGD 人群。我们的研究与 NOT-MD-19-001 一致，“对研究特别感兴趣的通知” 性与性别少数群体 (SGM) 的健康。” 拟议的研究旨在通过一种新颖的混合方法研究方法来解决这些目标。在第一阶段 研究中，我们将对大量不同的 TGD 成年人样本（N=27,715；美国跨性别者）进行二次数据分析 调查）以研究实证文献中哪些少数人的压力经历是饮酒的有力预测因素 跨性别身份（例如，非二元性别、跨性别男性、跨性别女性）和交叉身份（例如，种族、族裔、性取向） 方向）。我们的分析计划将使用多级建模方法（即 MAIHDA 模型）来更好地捕获 交叉身份对风险的影响，以及循证医学（EBM）方法来证明 基于少数压力理论的 TGD 成人饮酒风险算法的临床实用性和统计公平性。 在研究的第二阶段，将对 60 名 TGD 饮酒的成年人进行定性访谈，以获得 对第一阶段测试的自上而下的少数压力理论的观点，以及其他显着的风险、需求和优势 TGD 社区当前对酒精使用的概念化中缺失了这一点。样本将按以下方式分层 性别认同、种族和民族，以确保对环境事件和动态有代表性的观点 处理最重要的是 TGD 成年人对有问题的饮酒的看法。我们研究的集体发现将 为专注于开发 TGD 确认酒精干预措施的 R34 应用程序提供信息。