Pilot proof of concept exploring longitudinal links between minority stress, stress physiology dysregulation, and drug use in sexual minority adults

概念试点验证探索少数群体压力、压力生理失调和性少数成年人吸毒之间的纵向联系

• 批准号: 10800410
• 负责人: Ezemenari M Obasi
• 金额: $ 7.75万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-08 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10800410
• 关键词: Address; Adult; Affect; Alcohol consumption; Anxiety; Applications Grants; Behavioral; Biological; Biological Markers; Blood; Body mass index; Chronic; Chronic stress; Data; Development; Disclosure; Discrimination; Disparity; Drug Addiction; Drug usage; Economics; Environmental Risk Factor; General Population; Health; Heterosexuals; Hydrocortisone; Individual; Intervention; Lead; Lesbian Gay Bisexual; Link; Literature; Longitudinal Studies; Measures; Mediating; Mental Depression; Mentors; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Neurobiology; Outcome; Participant; Patient Self-Report; Pattern; Pharmaceutical Preparations; Physiological; Physiology; Pilot Projects; Play; Population; Population Heterogeneity; Populations at Risk; Prevention; Procedures; Process; Public Health; Race; Research; Research Personnel; Research Support; Risk; Risk Factors; Role; Sample Size; Sampling; Sex Orientation; Societies; Stress; Structure; Substance Use Disorder; Testing; Time; United States National Institutes of Health; Universities; addiction; allostasis; allostatic load; burden of illness; cancer prevention; career; cost; cytokine; drug use vulnerability; eligible participant; ethnic diversity; expectation; experience; feasibility testing; health disparity; health outcome disparity; high risk; homonegativity; hypothalamic-pituitary-adrenal axis; innovation; insight; interest; longitudinal design; minority stress; mortality; non-heterosexual; perceived discrimination; prevent; prospective; psychosocial stressors; recruit; resilience; resilience factor; sexual minority; sexual minority group; sexual minority health; sexual minority stress; social; social factors; stress reactivity; stressor

PROJECT SUMMARY/ABSTRACT Sexual minority (SM) adults are disproportionately affected by drug use and are at greater risk for substance use disorders than their heterosexual counterparts. One explanation for the high rates of drug use and substance use disorders among sexual minorities is that increased stress related to being a SM puts SM individuals at risk for drug use. Research demonstrates that chronic stress and subsequent activation of the hypothalamic-pituitary-adrenal axis lead to allostasis, or a state of sustained stability outside of normal functioning that is necessary to meet the demands of the chronic stressor(s). Overtime, allostasis leads to allostatic load, or the cumulative “wear and tear” on the body as a result of chronic stress. Moreover, allostatic load has been linked to both the initiation and trajectories of drug use. However, no research has examined allostatic load in the context of drug use outcomes among SMs. The purpose of the proposed research is to conduct a feasibility and proof-of-concept study to examine the relationships between SM stress (e.g., discrimination experiences, internalized homonegativity), allostatic load, and drug use. The specific aims are to (1) assess the feasibility of following a sample of 40 racially/ethnically-diverse SM adults over the course of 1 year to explore the links between minority stress, allostatic load, and drug use, (2) obtain estimates of effect size that will allow the investigators to determine the required sample size for a subsequent, fully-powered study, (3) begin to explore the temporal links between minority stress, allostatic load, and drug use, and (4) provide targeted mentoring of a new investigator by an established investigator. To meet these aims, we will recruit a racially/ethnically-diverse sample of SM adults in Houston, TX. Eligible participants will complete self-report measures, including minority stress and drug use, among others, in addition to biological measures collected via blood and anthropometrics (e.g., cytokines, BMI). This innovative study will be the first to explore the links between allostatic load and drug use in this population, which has demonstrated drug-use health disparities. Moreover, it will be the first study to comprehensively test the impact of minority stress on allostatic load among SM adults. Study results will be used to develop a subsequent NIH grant application to conduct a fully-powered, 2-year longitudinal study. In addition, results will help to inform the development of individually-tailored interventions to detect, prevent, and treat addiction in this at-risk population, which will help to lessen the disease burden of drug use and addiction. The proposed research addresses the Notice of Special Interest (NOT-MD-23-001) by leveraging the University of Houston’s HEALTH Center for Addictions Research and Cancer Prevention to conduct this innovative pilot study examining how biological, behavioral, and social/environmental factors contribute to SM health outcomes and health disparities, specifically drug use and addiction.

项目摘要/摘要 性少数（SM）成年人受药物使用的影响不成比例， 物质使用障碍比异性恋者多。吸毒率高的一个解释是 性少数群体的吸毒和药物使用障碍是与成为SM相关的压力增加 使SM个体面临吸毒的风险。研究表明，慢性压力和随后的 下丘脑-垂体-肾上腺轴的激活导致别稳态，或持续稳定的状态 在满足慢性应激源的需求所必需的正常功能之外。加班， 非稳态导致非稳态负荷，或由于慢性炎症对身体的累积“磨损”。 应力此外，非稳态负荷与药物使用的开始和轨迹都有关。 然而，没有研究检查非稳态负荷的背景下，药物使用的结果之间的SM。的 拟议研究的目的是进行一项可行性和概念验证研究， SM应力之间的关系（例如，歧视经历、内化同负性）、非稳态 负荷和药物使用。具体目标是：（1）评估跟踪40个样本的可行性 在1年的时间里，对种族/民族多样的SM成年人进行研究，以探索少数民族压力， 非稳态负荷和药物使用，（2）获得效应量的估计值，使研究人员能够确定 后续充分把握度研究所需的样本量，（3）开始探索时间联系 少数民族压力，非稳态负荷和药物使用之间的关系，以及（4）为新的 由一个既定的调查员。为了实现这些目标，我们将招募一个种族/民族多元化的 德克萨斯州休斯顿的SM成年人样本。合格的参与者将完成自我报告措施，包括 除其他外，除了通过血液和血液样本收集的生物措施外， 人体测量学（例如，细胞因子、BMI）。这项创新的研究将是第一个探索之间的联系， 这一人群的非稳态负荷和药物使用情况，显示了药物使用的健康差异。 此外，这将是第一个全面测试少数应力对非稳态负荷影响的研究 成年SM研究结果将用于开发随后的NIH拨款申请，以进行一项 为期2年的全面纵向研究。此外，研究结果将有助于了解 个体化的干预措施，以检测，预防和治疗这一高危人群的成瘾，这将 有助于减轻药物使用和成瘾造成的疾病负担。拟议的研究涉及《通知》 特别关注（NOT-MD-23-001），利用休斯顿大学健康中心， 成瘾研究和癌症预防进行这项创新的试点研究，研究如何 生物、行为和社会/环境因素有助于SM健康结果和健康 差异，特别是吸毒和吸毒成瘾。