Developing and validating a quantitative measure of daily intersectional stigma experiences for Black people with disabilities

制定并验证残疾黑人日常交叉耻辱经历的定量衡量标准

• 批准号: 10771704
• 负责人: Peng Wang
• 金额: $ 33.57万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-23 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10771704
• 关键词: Address; African American population; Age; Anxiety; Black Populations; Black race; Cardiovascular Diseases; Characteristics; Chronic; Communities; Diabetes Mellitus; Disabled Persons; Discrimination; Disparity; Domestic Violence; Empirical Research; Event; Feedback; Fostering; Future; Gender; Goals; Health; Intervention Studies; Interview; Literature; Measurement; Measures; Mediating; Mediator; Medical; Mental Depression; Mental Health; Methods; Minority Health Research; Mission; National Institute on Minority Health and Health Disparities; Observational Study; Outcome; Participant; Patient Self-Report; Perception; Persons; Phase; Pilot Projects; Population; Poverty; Prevalence; Probability; Psychometrics; Race; Reporting; Research; Research Design; Risk Behaviors; Sampling; Services; Shapes; Smoking; Social Processes; Social support; Socioeconomic Status; Source; Structure; Testing; Time; Transportation; Work; behavioral health; cognitive interview; cognitive process; cultural competence; diaries; disability; emotion regulation; experience; functional disability; health care availability; health disparity populations; health equity; health inequalities; help-seeking behavior; improved; insight; intersectionality; marginalization; marginalized population; member; minority health; minority health disparity; novel; physical conditioning; physical inactivity; pilot test; poor health outcome; prospective; psychological distress; psychosocial; psychosocial stressors; racism; recruit; response; sexual minority group; social; social determinants; social stigma; socioeconomics; stressor; theories; tool; women of color

PROJECT SUMMARY/ABSTRACT Black people with disabilities (PWD) disproportionately experience poor physical and behavioral health outcomes due to compounding socioeconomic challenges and stigma-related stressors. Intersectionality theory suggests that such magnified health inequities may be in part driven by intersectional stigma (i.e., experiences shaped by both racism and ableism), though few quantitative measures exist to capture this dynamic, multifaceted construct as it fluctuates over time and across contexts. To address this empirical gap, the proposed project will develop and validate a brief self-report measure of daily intersectional stigma experiences for Black PWD via a three-phase, multimethod approach. In Aim 1, we will generate an initial pool of items by drawing upon available literature, expert input, and feedback from Black PWD. In addition to consulting extant empirical research on ableism, racism, and their intersection, we will conduct semi-structured interviews with 20 Black PWD community members and 10 content experts. In Aim 2, we will refine this initial item pool by gathering feedback from Black PWD via an iterative process of cognitive interviewing and pilot testing. We will conduct an initial round of cognitive interviews with 20 Black PWD, followed by a 7-day pilot daily diary study and a second round of cognitive interviews with the same participants to further ascertain that the items adequately capture contextual and temporal variability in intersectional stigma experiences. In Aim 3, we will psychometrically evaluate the newly developed intersectional stigma measure by examining its scale structure and predictive validity in relation to stigma-relevant psychosocial outcomes using a probability-based sample of Black PWD recruited from the NORC AmeriSpeak panel. We will conduct a 2-week daily diary study with 200 Black PWD, who will complete the finalized intersectional stigma measure, along with measures of emotion regulation difficulties, psychological distress, perceived social support, connection with the disability and Black communities, and experiences of racism and ableism in isolation. We will examine the prevalence of intersectional stigma as a function of demographic and disability characteristics; additionally, we will investigate the concurrent and prospective associations between intersectional stigma and psychological distress, while also exploring potential mediators and moderators of these associations. Results from this project will provide a novel measurement tool for use in future observational and intervention research geared towards addressing the deleterious health impact of intersectional stigma for Black PWD. Findings will also yield valuable insights into the psychosocial consequences of intersectional stigma among a representative sample of Black PWD across the U.S., directly addressing NIMHD's priority in understanding the intersectional lived experiences of PWD from health disparity populations.

项目摘要/摘要 黑人残疾人（PWD）不成比例地经历身体和行为健康状况不佳 由于社会经济挑战和与耻辱有关的压力因素的复合，交叉性理论 表明，这种放大的健康不公平可能部分是由交叉污名驱动的（即，经验 受种族主义和能力主义的影响），尽管没有多少量化措施来反映这一动态， 多方面的结构，因为它随着时间和背景的变化而波动。为了解决这一经验差距， 拟议的项目将开发和验证一个简短的自我报告措施的日常交叉耻辱的经验 通过一个三阶段的多方法的方法，为黑色PWD。在目标1中，我们将通过以下方式生成一个初始项目池： 利用现有文献、专家意见和来自黑人残疾人的反馈。除了咨询现有的 关于体能歧视、种族主义及其交叉点的实证研究，我们将进行半结构化采访 20名黑人PWD社区成员和10名内容专家。在目标2中，我们将通过以下方式来细化这个初始项目池： 通过认知访谈和试点测试的迭代过程收集黑人PWD的反馈。我们将 对20名黑人残疾人进行第一轮认知访谈，然后进行为期7天的试验性每日日记研究 第二轮认知访谈，以进一步确定这些项目 充分捕捉跨部门的耻辱经验的上下文和时间的变化。在目标3中，我们 通过对新开发的交叉污名量表的结构进行心理测量学评价 和预测效度有关的耻辱相关的心理社会结果，使用基于概率的样本， 从NORC AmeriSpeak小组招募的黑人PWD。我们将进行为期2周的每日日记研究， 黑人残疾人，谁将完成最终确定的交叉耻辱措施，沿着的情绪措施 调节困难，心理困扰，感知社会支持，与残疾和黑人的联系 种族主义和残疾人歧视的经验。我们将研究 交叉污名作为人口统计学和残疾特征的函数;此外，我们将调查 交叉污名和心理困扰之间的并发和前瞻性关联， 也探索这些协会的潜在调解人和主持人。该项目的成果将提供 一种新的测量工具，用于未来的观察和干预研究，旨在解决 对黑人残疾人的交叉污名的有害健康影响。调查结果还将产生有价值的见解 在一个有代表性的黑人残疾人样本中， 在美国，直接解决NIMHD在理解交叉生活经验的优先事项， 来自健康差距人群的残疾人。