A Structural Approach to Understanding and Addressing Suicidality among Transgender and Gender Nonconforming College Students

理解和解决跨性别和性别不合格大学生自杀行为的结构性方法

• 批准号: 10673852
• 负责人: Sarah Ketchen Lipson
• 金额: $ 15.35万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-20 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10673852
• 关键词: Accounting; Address; Adolescent and Young Adult; Affect; Age; Age of Onset; Boston; Caring; Cause of Death; Client; Code; Collaborations; Counseling; Data; Databases; Development; Discrimination; Disparity; Disparity population; Dropout; Enrollment; Epidemiology; Evaluation; Exclusion; Exposure to; Feedback; Feeling suicidal; Female; Funding; Future; Gender; Gender Identity; Health Insurance; Hormone replacement therapy; Housing; Individual; Institution; Institutional Policy; Insurance Coverage; Intake; Intervention; Interview; Investigation; Knowledge; Lead; Life; Link; Longitudinal Surveys; Measures; Mediating; Mediation; Mediator; Mental Health; Mental Health Services; Mental disorders; Mentors; Mentorship; Methods; Modeling; Names; National Institute of Mental Health; Natural experiment; Outcome; Pediatric Hospitals; Personal Satisfaction; Phase; Policies; Policy Analysis; Population; Positioning Attribute; Preparation; Provider; Public Health; Public Health Schools; Qualitative Research; Recommendation; Recording of previous events; Records; Reporting; Research; Research Design; Research Personnel; Research Support; Resources; Risk; Sampling; Schools; Services; Stigmatization; Structure; Students; Suicide; Suicide attempt; Surveys; Symptoms; Time; Training; United States National Institutes of Health; Universities; Variant; austin; career; cisgender; college; experience; falls; gender nonconforming; health care settings; health disparity; health service use; higher education; interest; male; multi-component intervention; multiphase optimization strategy; novel; professor; prospective; psychosocial; public health intervention; sensitivity training; sex; sex assigned at birth; skills; social stigma; structural determinants; suicidal; suicidal risk; theories; therapy development; transgender; treatment center; undergraduate student; university student

PROJECT SUMMARY Dr. Lipson's career objective is to become a leading mental health disparities researcher, contributing novel evidence about structural determinants of disparities in adolescent and young adult populations, specifically for transgender and gender nonconforming (TGNC) individuals (those who have a gender identity that differs from assigned sex at birth or does not fit the male-female binary). Dr. Lipson is particularly interested in mental health disparities among college students, which include ~70% of adolescents and young adults nationwide. Though TGNC students represent just 3-4% of all undergraduates, they account for ~15% of reported suicide attempts. The proposed K01 focuses on how exposure to structural stigma, in the form of 6 campus policies, is associated with suicidality and mental health service utilization among TGNC college students. This K01 includes 3 specific aims, each requiring further training and expert mentorship: Aims 1 and 2 leverage the natural experiment in which students have low/no exposure to campus policies in the pre-period (before arriving in fall of the 1st undergraduate year). In Aim 1, Dr. Lipson will apply her K01 training in causal inference to compare changes suicidal ideation and attempts between TGNC and cisgender students on campuses with and without structural stigma. In Aim 2, Dr. Lipson will analyze a national database of counseling center records to assess how structural stigma is associated with treatment dropout by TGNC and cisgender students. Supported by her K01 training in qualitative research, in Aim 3, Dr. Lipson will conduct interviews with TGNC students and counseling center directors. This formative research will be in accordance with the preparation phase of the Multiphase Optimization Strategy (MOST), a principled framework for optimizing/evaluating interventions. The preparation phase will inform development and evaluation of future interventions to address structural stigma and its underlying mechanisms. With her K01 research and training, Dr. Lipson will have the skills, knowledge, and evidence to lead intervention evaluation and effectively collaborate on intervention teams. At the end of the K01, she will be prepared to proceed with subsequent phases of MOST, for which she will seek R01 funding. As an assistant professor at the Boston University School of Public Health (BUSPH), Dr. Lipson is opportunely positioned to accomplish the proposed research and achieve her overall career objectives. Her mentors from BUSPH, Boston Children's Hospital/Harvard, and Rutgers University bring interdisciplinary expertise in: TGNC health disparities (Dr. Austin), causal inference (Dr. Lin), qualitative research (Dr. Jernigan), intervention development and evaluation (Dr. Stein), and suicide epidemiology (Dr. Gradus). NIH has designated TGNC as a disparity population, yet there remain large gaps in knowledge that undermine development of public health interventions, including evidence to support implementation of protective policies. With regard to TGNC suicidality, NIMH has specifically highlighted a need to consider transition periods that may heighten risk. Beginning college (the focus of Aims 1 and 2) is a significant life transition that coincides with age of onset for many lifetime mental disorders. The proposed research will strengthen the public health impact of NIMH-supported research (Strategic Objective 4) and address a critical barrier by advancing knowledge of how campus structural stigma is associated with TGNC suicidality. This evidence can be used to inform policy change and create more inclusive services to meet the needs of a growing population of TGNC students nationwide.

项目总结

项目成果

Changes in the prevalence and sociodemographic correlates of eating disorder symptoms from 2013 to 2020 among a large national sample of U.S. young adults: A repeated cross-sectional study.

• DOI: 10.1002/eat.23709
• 发表时间: 2022-06
• 期刊: INTERNATIONAL JOURNAL OF EATING DISORDERS
• 影响因子: 5.5
• 作者: Romano, Kelly A.;Lipson, Sarah K.;Beccia, Ariel L.;Quatromoni, Paula A.;Gordon, Allegra R.;Murgueitio, Jose
• 通讯作者: Murgueitio, Jose

More Than Inconvenienced: The Unique Needs of U.S. College Students During the COVID-19 Pandemic.

• DOI: 10.1177/1090198120969372
• 发表时间: 2021-03
• 期刊: Health education & behavior : the official publication of the Society for Public Health Education
• 作者: Lederer AM;Hoban MT;Lipson SK;Zhou S;Eisenberg D
• 通讯作者: Eisenberg D

Trends in college student mental health and help-seeking by race/ethnicity: Findings from the national healthy minds study, 2013-2021.

• DOI: 10.1016/j.jad.2022.03.038
• 发表时间: 2022-06-01
• 期刊: Journal of affective disorders
• 影响因子: 6.6
• 作者: Lipson SK;Zhou S;Abelson S;Heinze J;Jirsa M;Morigney J;Patterson A;Singh M;Eisenberg D
• 通讯作者: Eisenberg D

Mental health service use in a national sample of college students with co-occurring depression or anxiety and substance use.

• DOI: 10.1016/j.dadr.2022.100025
• 发表时间: 2022-03
• 期刊: Drug and alcohol dependence reports
• 作者: Auty, Samantha G;Lipson, Sarah K;Stein, Michael D;Reif, Sharon
• 通讯作者: Reif, Sharon

Neighbourhood income and physical distancing during the COVID-19 pandemic in the United States.

• DOI: 10.1038/s41562-020-00998-2
• 发表时间: 2020-12
• 期刊: Nature human behaviour
• 影响因子: 29.9
• 作者: Jay J;Bor J;Nsoesie EO;Lipson SK;Jones DK;Galea S;Raifman J
• 通讯作者: Raifman J