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.

项目摘要/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，非双性恋) 出生时被指定为女性的性少数群体患大麻使用障碍(CUD)的风险比 异性恋女性。令人震惊的是，性少数族裔女性和性别多样化的CUD比率正在上升 个人(SMWGD)以及异性恋女性，SMWGD中增长更快，导致 CUD的差距越来越大。这突显了在这两个群体中进行CUD研究的迫切需要。 检查事件级风险流程可以近乎实时地澄清风险因素和CU的时间顺序。 然而，生态瞬时评估(EMA)研究，包括我们自己的研究，提供了两种不同的证据 CU的风险因素集合：与增加积极影响相关的风险因素(积极强化；例如， 增强动机、社会用途)和减少负面影响(负面强化；例如，应对 动机，单独使用)。SMWGD还经历独特的正面和负面加固风险因素(例如， 铜与SMWGD；少数应激)。为混合证据提供了一个潜在的解释，我们的初步研究 结果和药物使用的多阶段模型表明，这两组危险因素可能与 CUD的不同阶段，当CUD症状消失或轻微时，阳性强化最相关 当CUD症状变得更加严重时，负强化成为主导。我们建议 实证检验一个包含多阶段模型和SMWGD独特风险因素的理论模型。 我们将使用测量突发设计，每半年5次，为期14天的EMA(每天2次调查)， 使我们能够检查风险因素对CU的事件级影响作为长期函数的变化(即， 每半年)CUD症状的变化。我们将包括SMWGD和异性恋女性，允许我们 找出两组共同风险因素对CU影响的异同，确定是否 CU轨迹的差异导致了CUD的差异，并确定了SMWGD的独特风险因素。 R01的目的是增进SMWGD和异性恋者对CUD的了解 女性，重点是随着CUD的发展，风险因素和CU之间的事件级关联如何变化。 我们将使用测量突发设计，400名SMWGD和200名异性恋女性(年龄在18-25岁) 每周至少吸食大麻。拟议的研究将实现三个具体目标：1)确定 随着CUD的发展，事件水平的危险因素对CU的影响；2)共同事件影响的差异检验 SMWGD和异性恋女性CU的水平危险因素，以及3)CU是否存在差异 SMWGD和异性恋妇女的发展轨迹导致了CUD发展的差异。这个 拟议的研究将为提高对异性恋妇女的现有CUD干预措施的有效性提供信息 并确定在对SMWGD的干预中应针对哪些风险因素。这项拟议的研究发表在 响应NOT-MD-19-001和NIDA的优先事项，以了解影响SMWGD的物质使用差异。