Effects of Marriage Recognition on Substance Abuse and Health for Women

婚姻认可对女性药物滥用和健康的影响

• 批准号: 9456502
• 负责人: Laurie Anne Drabble
• 金额: $ 7.48万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-25 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9456502
• 关键词: Address; Alcohol or Other Drugs use; Alcohols; Attenuated; Bisexual; Climate; Color; Communities; Data; Data Collection; Development; Discrimination; Employment; Ensure; Ethnic Origin; Factor Analysis; Fostering; Funding; Future; Goals; Health; Health Services Accessibility; Health Status; Heterosexuals; Housing; Individual; Institute of Medicine (U.S.); Intervention; Interview; Knowledge; Laws; Legal; Lesbian; Link; Marriage; Marriage and Family; Measures; Mediator of activation protein; Mental Depression; Methods; Minority; NIH Program Announcements; Outcome; Participant; Patient Self-Report; Policies; Population; Population Heterogeneity; Positioning Attribute; Predictive Value; Preventive Intervention; Property; Psychometrics; Psychosocial Factor; Race; Recruitment Activity; Religion and Spirituality; Research; Research Design; Research Methodology; Research Personnel; Respondent; Risk; Risk Behaviors; Rural; Sample Size; Sampling; Seeds; Sexual Health; Sexual and Gender Minorities; Social support; Societal Factors; Source; Stress; Structure; Subgroup; Substance abuse problem; Surveys; Testing; Time; Validation; Woman; Women' s Health; Work; base; design; ethnic difference; ethnic diversity; ethnic identity; ethnic minority population; experience; hazardous drinking; health disparity; improved; innovation; intersectionality; minority health; novel; population based; population survey; psychological distress; racial and ethnic; racial difference; racial diversity; resilience; same-sex marriage; sexual minority; social; stressor; success; volunteer

Project Summary/Abstract Sexual minority women (SMW; lesbian, bisexual) experience substantial health disparities, including significantly higher rates of hazardous drinking, depression, and poor self-reported health compared to heterosexual women. However, there is a dearth of research examining resiliency factors and how these factors might vary by race/ethnicity among SMW. The Institute of Medicine (IOM) challenged researchers to examine factors that foster resilience among SMW including examining differences by race and ethnicity and exploring the positive impact on sexual minority (SM) health of the legal recognition of same-sex marriage. Studies have found strong associations between supportive policies, such as marriage recognition, and improved health outcomes among sexual minorities. However, there are gaps in understanding specific psycho-social factors may explain the impact of policies on SM health outcomes. To address these gaps in knowledge, we will draw on minority stress, intersectionality, and social-ecological frameworks and a mixed-methods research design to identify and assess factors that underlie the effect of marriage recognition on health and to examine relationships between these factors and three health outcomes among SMW: hazardous drinking, depression, and poor general health. Several key innovations ensure the success and high impact of this project. First, the proposed project leverages innovative methods from a currently funded project (R01 DA036606; Drabble & Trocki, multiple-PIs), which uses respondent-driven sampling (RDS) based on population-based "seeds" from the National Alcohol Survey (NAS) to collect data nationwide from a large and diverse population of approximately 1000 SMW. Second, by creating measures to describe how marriage recognition may influence health, our study contributes to the sparse but urgently needed research on resiliency among SMW. Third, the study contributes to emerging understanding of the impact of marriage recognition on health outcomes, with a special focus on differences in risk by race/ethnicity and how such risks may be attenuated by other risk/protective factors at individual, interpersonal, community, and sociopolitical levels. Finally, the study capitalizes on the recent historic national change in laws that now recognize same-sex marriage in all states, affording a timely opportunity to develop and test new scales designed to investigate how marriage recognition influences health outcomes among racially and ethnically diverse SMW. To do so, we will test the following aims: 1) Develop new measures to assess factors that underlie the impact of marriage recognition, using in-depth qualitative interviews with approximately 32 diverse SMW. 2) Assess the psychometric properties of the new measures among approximately 500-600 SMW, using item analysis and confirmatory factor analysis. 3) Examine the predictive value of these novel SMW-specific measures on hazardous drinking, depression and self-reported health, with specific focus on racial/ethnic differences. We will merge new data with previously collected data, which include rich demographic, risk and resiliency data from the same participants. Findings will be used in future studies with population-based and volunteer samples to inform prevention and intervention strategies aimed and building resiliency and reducing health disparities among SMW.

项目摘要/摘要 性少数群体妇女(SMW；女同性恋者、双性恋者)经历着巨大的健康差距，包括显著更高的 与异性恋女性相比，危险饮酒、抑郁和自我报告的健康状况较差的比率。然而，还有 缺少研究复原力因素，以及这些因素如何在法定最低工资中因种族/民族而不同。这个 医学研究所(IOM)要求研究人员检查促进SMW复原力的因素，包括 按种族和民族考察差异并探索法律对性少数群体(SM)健康的积极影响 对同性婚姻的认可。研究发现，婚姻等支持性政策之间存在很强的关联 承认，并改善了性少数群体的健康结果。然而，在具体的理解上存在差距。 心理-社会因素可以解释政策对SM健康结果的影响。为了解决这些知识上的差距，我们 将利用少数群体压力、交叉性和社会生态框架以及混合方法的研究设计 确定和评估婚姻认可对健康的影响的因素，并审查 这些因素和SMW的三个健康后果：危险饮酒、抑郁和总体健康状况不佳。几个 关键的创新确保了这个项目的成功和高影响力。首先，拟议的项目利用创新 方法来自一个当前资助的项目(R01 DA036606；Drabble&Trocki，多PI)，该项目使用受访者驱动 基于全国酒精调查(NAS)基于人群的“种子”的抽样(RDS)以收集全国范围内的数据 来自大约1000名SMW的庞大和多样化的人口。其次，通过制定措施描述婚姻是如何 认知可能会影响健康，我们的研究有助于对以下人群的弹性进行稀少但迫切需要的研究 SMW。第三，这项研究有助于加深对婚姻认可对健康结果的影响的理解， 特别关注按种族/族裔划分的风险差异，以及如何通过其他风险/保护性措施来降低这些风险 个人、人际、社区和社会政治层面的因素。最后，这项研究利用了最近的 国家法律的历史性变化，现在承认所有州的同性婚姻，提供了一个及时的机会 开发和测试新的量表，旨在调查婚姻认可如何影响不同种族人群的健康结果 和种族多元化的SMW。为此，我们将测试以下目标：1)开发新的措施来评估以下因素 通过对大约32个不同的人进行深入的定性访谈，揭示了婚姻认可的影响 SMW。2)在大约500-600名SMW中评估新测量的心理测量特性，使用条目 分析和验证性因素分析。3)检查这些针对SMW的新措施的预测价值 危险饮酒、抑郁和自我报告的健康，特别关注种族/民族差异。我们会 将新数据与以前收集的数据合并，其中包括来自同一数据库的丰富的人口统计、风险和恢复能力数据 参与者。研究结果将用于未来的人口和志愿者样本研究，为预防和预防提供信息。 旨在提高妇女和妇女的复原力和缩小其健康差距的干预战略。