Testing a multistage model of risk factors for cannabis use utilizing a measurement burst design among sexual minority women, sexual minority gender diverse individuals, and heterosexual women

利用突发测量设计在性少数女性、性少数性别多样化个体和异性恋女性中测试大麻使用风险因素的多阶段模型

• 批准号: 10711584
• 负责人: CHRISTINA DYAR
• 金额: $ 71.52万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10711584
• 关键词: Address; Affect; Age; Bisexual; Data; Development; Disparity; Ecological momentary assessment; Education; Emotions; Event; Growth; Heterosexuals; Individual; Intervention; Lesbian; Measurement; Modeling; National Institute of Drug Abuse; Negative Reinforcements; Perception; Population; Positive Reinforcements; Process; Research; Risk; Risk Factors; Sampling; Severities; Sexual and Gender Minorities; Stress; Surveys; Symptoms; Testing; Theoretical model; Time; Woman; assigned female at birth; coping; design; disorder risk; experience; gender diversity; high risk; marijuana use; marijuana use disorder; minority stress; negative affect; nonbinary; positive emotional state; queer; recruit; response; risk sharing; sexual minority; sexual minority women; social; social stigma; substance use; theories; young adult

PROJECT SUMMARY/ABSTRACT Sexual minority women (e.g., lesbian, bisexual, queer women) and gender diverse (e.g., non-binary) sexual minorities assigned female at birth are at elevated risk for cannabis use disorder (CUD) compared to heterosexual women. Alarmingly, rates of CUD are increasing for sexual minority women and gender diverse individuals (SMWGD) as well as heterosexual women, with more rapid increases among SMWGD leading to growing disparities in CUD. This highlights the urgent need for CUD research in both populations. Examining event-level risk processes clarifies the temporal order of risk factors and CU in near-real time. However, ecological momentary assessment (EMA) studies, including our own, provide mixed evidence for two sets of risk factors for CU: risk factors related to increasing positive affect (positive reinforcement; e.g., enhancement motives, social use) and decreasing negative affect (negative reinforcement; e.g., coping motives, solitary use). SMWGD also experience unique positive and negative reinforcement risk factors (e.g., CU with SMWGD; minority stress). Providing a potential explanation for mixed evidence, our preliminary results and the multistage model of substance use suggest these two sets of risk factors may be relevant at different stages of CUD, with positive reinforcement most relevant when CUD symptoms are absent to mild and negative reinforcement becoming dominant when CUD symptoms become more severe. We propose to empirically test a theoretical model that incorporates the multistage model and unique risk factors for SMWGD. We will use a measurement burst design, with 5 semi-annual bursts of 14-days of EMA (2 surveys per day), allowing us to examine changes in event-level effects of risk factors on CU as a function of longer-term (i.e., semi-annual) changes in CUD symptoms. We will include SMWGD and heterosexual women, allowing us to identify similarities and differences in effects of shared risk factors on CU for these two groups, determine if differences in CU trajectories contribute to CUD disparities, and identify unique risk factors for SMWGD. The purpose of this R01 is to advance our understanding of CUD among SMWGD and heterosexual women, with a focus on how event-level associations between risk factors and CU change as CUD develops. We will use a measurement burst design, with 400 SMWGD and 200 heterosexual women (age 18-25) who use cannabis at least weekly. The proposed study will accomplish three specific aims: 1) identify changes in the effects of event-level risk factors on CU as CUD develops, 2) test for differences in effects of shared event- level risk factors on CU for SMWGD and heterosexual women, and 3) determine if differences in CU trajectories for SMWGD and heterosexual women contribute to disparities in the development of CUD. The proposed study will inform efforts to increase efficacy of existing CUD interventions for heterosexual women and determine which risk factors should be targeted in interventions for SMWGD. The proposed study is in response to NOT-MD-19-001 and NIDA priorities to understand substance use disparities affecting SMWGD.

项目总结/摘要 性少数群体妇女（例如，女同性恋、双性恋、同性恋妇女）和性别多样性（例如，非二进制） 出生时被指定为女性的性少数群体患大麻使用障碍（CUD）的风险高于 异性恋女性令人震惊的是，性少数女性和性别多样化的CUD率正在增加 个人（SMWGD）以及异性恋妇女，SMWGD中的增长速度更快， 在CUD中的差距越来越大。这突出表明迫切需要在这两个人群中进行CUD研究。 检查事件级风险过程澄清了风险因素和CU的时间顺序接近实时。 然而，生态瞬时评估（EMA）研究，包括我们自己的研究，提供了两个混合的证据 CU的风险因素集：与增加积极影响相关的风险因素（积极强化;例如， 增强动机，社会使用）和减少负面影响（负面强化;例如，应对 动机，单独使用）。SMWGD还经历独特的正强化和负强化风险因素（例如， CU与SMWGD;少数应激）。为混合证据提供了一个可能的解释，我们的初步研究结果显示， 结果和物质使用的多阶段模型表明，这两组风险因素可能是相关的， CUD的不同阶段，当CUD症状不存在至轻度时，正强化最相关 当CUD症状变得更严重时，负强化成为主导。我们建议 实证检验的理论模型，结合多阶段模型和独特的风险因素SMWGD。 我们将使用测量突发设计，每半年进行5次14天EMA突发（每天2次调查）， 允许我们检查风险因素对CU的事件水平影响的变化作为长期的函数（即， 半年一次）的CUD症状变化。我们将包括SMWGD和异性恋妇女，使我们能够 确定这两组中共同风险因素对CU影响的相似性和差异，确定是否 CU轨迹的差异导致CUD差异，并确定SMWGD的独特风险因素。 本R 01的目的是促进我们对SMWGD和异性恋之间CUD的理解 妇女，重点是如何事件水平之间的关联风险因素和CU的变化，作为CUD的发展。 我们将使用测量突发设计，400名SMWGD和200名异性恋女性（年龄18-25岁）， 至少每周使用大麻。拟议的研究将实现三个具体目标：1）确定 随着CUD的发展，事件水平风险因素对CU的影响，2）测试共享事件影响的差异- SMWGD和异性恋妇女CU水平的风险因素，以及3）确定CU的差异是否 SMWGD和异性恋妇女的发展轨迹导致了CUD发展的差异。的 拟议的研究将为提高异性恋女性现有CUD干预措施的有效性提供信息 并确定在SMWGD干预措施中应针对哪些风险因素。拟议研究载于 响应NOT-MD-19-001和NIDA优先事项，以了解影响SMWGD的物质使用差异。