A lifecourse approach to evaluating the effect of structural stigma on cancer risk factors among sexual minorities

评估结构性耻辱对性少数群体癌症危险因素影响的生命全程方法

• 批准号: 10672329
• 负责人: Alice Guan
• 金额: $ 3.95万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10672329
• 关键词: Adolescence; Adolescent; Adult; Alcohol consumption; Area; Attitude; Biostatistical Methods; Cancer Burden; Communities; Competence; Complex; County; Data; Data Analyses; Data Set; Dimensions; Disparity; Elderly; Environment; Epidemiologic Methods; Epidemiologist; Ethnic Origin; Exposure to; Gays; Gender; Geography; Goals; Health; Health behavior; Heterosexuals; High Prevalence; Household; Individual; Institutional Policy; Knowledge; Lesbian Gay Bisexual; Life Cycle Stages; Literature; Longitudinal Studies; Malignant Neoplasms; Measures; Mediation; Mentorship; Methodology; Methods; National Longitudinal Survey of Adolescent to Adult Health; Neighborhoods; Obesity; Outcome; Overweight; Pathway interactions; Policies; Population; Race; Research; Respondent; Risk; Risk Factors; Same-sex; Sampling; Sex Orientation; Socioeconomic Status; Statutes and Laws; Subgroup; Time; Tobacco use; Training; Update; cancer health disparity; cancer prevention; cancer risk; career; contextual factors; density; emerging adult; experience; intersectionality; longitudinal dataset; marginalization; marginalized community; marginalized population; minority engagement; prevent; public health research; racial minority; sexual identity; sexual minority; sexual minority female; sexual minority group; sexual minority health; skills; social; social determinants; social factors; social group; social stigma; structural determinants; theories; trend

Project Summary Sexual minorities have been found to have an increased burden of several cancer risk factors, including tobacco use, alcohol consumption and obesity. Over the last decade, there has been substantial advancement in the identification of social and contextual factors related to sexual minority health, and exposure to structural stigma has been implicated as a potential explanatory factor this disparity. Thus, intervening on factors related to structural stigma could be a promising approach for reducing the burden of cancer risk factors among this highly marginalized community. Evidence suggests that effects of exposure to stigma during adolescence could be different than stigma in later years, and prior studies that have attempted to examine these lifecourse effects. However, this research has major gaps. First, these studies were not nationally representative. Second, they did not explicitly use lifecourse methods to evaluate these effects. Thus, our study proposes to explore the effects of lifecourse exposure to structural stigma on tobacco use, heavy alcohol consumption, and being overweight or obese using a nationally representative dataset. The goal of this proposal is to evaluate lifecourse effects of exposure to structural stigma on sexual minority engagement in cancer risk factors. Using publicly available administrative datasets, we will update and refine a previously constructed state-level measure of structural stigma that was created in 2011 by including more granular county-level components that have been demonstrated to be important for the health of sexual minorities (aim 1). Using data from four waves of the National Longitudinal Study of Adolescent to Adult Health, we will apply this updated measure to evaluate the effects of life-course exposure to structural stigma on cancer risk factors among sexual minorities (aim 2). Finally, we will estimate the intersectional effects of exposure to structural stigma by gender, race/ethnicity, and socioeconomic status (aim 3). The interdisciplinary training environment for this proposal will provide the applicant an opportunity to enhance methodological skills, build research competency, and augment content expertise in order to become an expert in the intersection of cancer prevention and sexual minority health.

项目摘要 研究发现，性少数群体的几种癌症风险因素的负担增加，包括 吸烟、饮酒和肥胖。在过去的十年里， 在确定与性少数群体健康有关的社会和背景因素，以及暴露于结构性疾病方面， 成见被认为是造成这种差异的一个潜在因素。因此，干预有关因素 结构性耻辱可能是减少癌症风险因素负担的一种有前途的方法， 高度边缘化的社区。有证据表明，在青春期接触耻辱的影响， 可能与晚年的耻辱感不同，先前的研究试图检查这些生命过程， 方面的影响.然而，这项研究有很大的差距。首先，这些研究不具有全国代表性。 其次，他们没有明确使用生命过程方法来评估这些影响。因此，我们的研究建议， 探索生命周期暴露于结构性耻辱对烟草使用、酗酒和 超重或肥胖的数据。 这项建议的目的是评估暴露于结构性耻辱对性行为的生命过程的影响。 少数人参与癌症风险因素。使用公开的管理数据集，我们将更新 并完善之前构建的国家级结构性耻辱措施，该措施于2011年由 包括更细粒度的县级组成部分，这些组成部分已被证明对健康很重要， 性少数群体（目标1）。使用四波全国青少年纵向研究的数据， 成人健康，我们将应用这一更新的措施，以评估生命过程中暴露于结构性疾病的影响， 性少数群体对癌症风险因素的污名化（目标2）。最后，我们将估计交叉点 按性别、种族/族裔和社会经济地位分列的遭受结构性污名的影响（目标3）。的 本提案的跨学科培训环境将为申请人提供一个提高 方法技能，建立研究能力，并增加内容专业知识，以成为专家 癌症预防和性少数群体健康的交叉点。

项目成果

Commentary: Racism and structural violence: Interconnected threats to health equity.

评论：种族主义和结构性暴力：对健康公平的互连威胁。

• DOI: 10.3389/fpubh.2022.958436
• 发表时间: 2022
• 期刊: FRONTIERS IN PUBLIC HEALTH
• 影响因子: 5.2
• 作者: Abdiwahab, Ekland;Guan, Alice;Hong, Cindy;Gomez, Scarlett Lin
• 通讯作者: Gomez, Scarlett Lin

Patient and physician perspectives on treatments for low-risk prostate cancer: a qualitative study.

• DOI: 10.1186/s12885-023-11679-4
• 发表时间: 2023-12-05
• 期刊: BMC CANCER
• 影响因子: 3.8
• 作者: Guan, Alice;Santiago-Rodriguez, Eduardo J.;Chung, Benjamin I.;Shim, Janet K.;Allen, Laura;Kuo, Mei-Chin;Lau, Kathie;Loya, Zinnia;Brooks, James D.;Cheng, Iona;Derouen, Mindy C.;Frosch, Dominick L.;Golden, Todd;Leppert, John T.;Lichtensztajn, Daphne Y.;Lu, Qian;Oh, Debora;Sieh, Weiva;Wadhwa, Michelle;Cooperberg, Matthew R.;Carroll, Peter R.;Gomez, Scarlett L.;Shariff-Marco, Salma
• 通讯作者: Shariff-Marco, Salma

Understanding the Predictors of Low Take-Up of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): A Nationwide Longitudinal Study.

• DOI: 10.1007/s10995-023-03728-y
• 发表时间: 2023-10
• 期刊: MATERNAL AND CHILD HEALTH JOURNAL
• 影响因子: 2.3
• 作者: Guan, Alice;Batra, Akansha;Seligman, Hilary;Hamad, Rita
• 通讯作者: Hamad, Rita

Factors that influence treatment decisions: A qualitative study of racially and ethnically diverse patients with low- and very-low risk prostate cancer.

• DOI: 10.1002/cam4.5405
• 发表时间: 2023-03
• 期刊: Cancer medicine
• 影响因子: 4

Asian American/Pacific Islander and Hispanic Ethnic Enclaves, Neighborhood Socioeconomic Status, and Hepatocellular Carcinoma Incidence in California: An Update.

• DOI: 10.1158/1055-9965.epi-21-1035
• 发表时间: 2022-03
• 期刊: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
• 作者: Sangaramoorthy M;Yang J;Guan A;DeRouen MC;Tana MM;Somsouk M;Thompson CA;Gibbons J;Ho C;Chu JN;Cheng I;Gomez SL;Shariff-Marco S
• 通讯作者: Shariff-Marco S