Sexual Fluidity and Longitudinal Changes in Alcohol Misuse and Associated Health Consequences

性流动性和酒精滥用的纵向变化及相关健康后果

• 批准号: 10698153
• 负责人: Rebecca J. Evans-Polce
• 金额: $ 28.03万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-10 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10698153
• 关键词: Address; Adolescent; Adult; Age; Alcohols; Behavior; COVID-19; Cannabis; Complement; Criminal Justice; Data; Dimensions; Discrimination; Distal; Engineering; Gender Identity; Goals; Health; Healthcare; Heterogeneity; Heterosexuals; Individual; Intervention; Laws; Lesbian Gay Bisexual; Liquid substance; Longitudinal Studies; Measures; Medicine; Modeling; Movement; Outcome; Patient Self-Report; Pharmaceutical Preparations; Policies; Population Assessment of Tobacco and Health; Population Study; Prevention; Productivity; Public Policy; Reporting; Research; Research Design; Risk; Risk Factors; Sampling; Severities; Sex Orientation; Sexual Health; Sexual and Gender Minorities; Shapes; Social Concepts; Social Interaction; Subgroup; Substance Use Disorder; Symptoms; Time; Tobacco; United States National Academy of Sciences; Variant; Work; Youth; alcohol measurement; alcohol misuse; alcohol related consequences; alcohol risk; alcohol use disorder; cost; ethnic identity; fluidity; gender minority group; gender minority health disparity; health data; improved; interest; longitudinal design; modifiable risk; neglect; physical conditioning; polysubstance use; population based; protective factors; public policy on alcohol; racial identity; response; screening; secondary analysis; sex; sexual identity; sexual minority; sexual minority women; social; stressor

PROJECT SUMMARY/ABSTRACT In response to the Notices of Special Interest on Research on the Health of Sexual and Gender Minority Populations (NOT-MD-19-001) and Public Policy Effects on Alcohol-, Cannabis-, Tobacco-, and Other Drug- Related Behaviors and Outcomes (NOT-AA-21-028), this project will identify trajectories of alcohol misuse by sexual orientation and their associated health consequences. We will also examine risk and protective factors across individual, social, and policy domains. Sexual minorities are at heightened risk of alcohol misuse; however, existing research is often based on a static and unidimensional construct of sexual orientation rather than a fluid and multidimensional construct of sexual orientation, despite evidence indicating sexual orientation fluidity is common, especially among sexual minorities. Prior work has shown alcohol misuse and alcohol use disorder (AUD) symptoms are more prevalent and more severe among sexual minorities than heterosexuals. There is a lack of population-based longitudinal studies of alcohol misuse trajectories and related negative health consequences based on a fluid and multidimensional construct of sexual orientation. Additionally, studies examining risk and protective factors for alcohol misuse among sexual minorities have largely focused on individual-level factors and neglected factors at the social and policy level. There is a need to expand this research and draw on concepts from the Social Ecological Model to include upstream risk and protective factors, such as those at the social and policy level. To address these gaps, this project will use longitudinal data from a sample of U.S. adolescents and adults based on six waves of the Population Assessment of Tobacco and Health study (n=45,971; 2013-2021). This study design will allow us to explore changes in alcohol misuse based on sexual orientation before and after COVID-19 onset. Our study aims to: (1) Identify alcohol misuse trajectories over an 8-year period and determine if these associations differ by sexual orientation (a) concordance vs. discordance, and (b) stability vs. fluidity. We will also examine potential heterogeneity in risk by age, sex, race, ethnicity, and gender identity and compare changes in alcohol misuse before and after COVID-19 onset by sexual orientation. (2) Examine (a) how variation in alcohol misuse trajectories shape negative health-related consequences (e.g., AUD symptoms, other substance use disorder symptoms, polysubstance use, and negative physical health consequences) and (b) whether this differs across sexual orientation subgroups, by sexual orientation discordance vs. concordance, and sexual identity fluidity vs. stability. (3) Examine longitudinal relationships of individual- (e.g., internalizing symptoms), social- (e.g., degree of social interaction), and policy-level (e.g., antidiscrimination laws) protective/risk factors with trajectories of alcohol misuse and negative alcohol-related health consequences and determine if associations differ by sexual orientation concordance vs. discordance and sexual identity fluidity vs. stability.

项目摘要/摘要 回应有关性和性别少数族裔健康研究的特别感兴趣的通知 人口（非MD-19-001）和公共政策对酒精，大麻，烟草和其他药物的影响 相关的行为和结果（非AA-21-028），该项目将确定滥用酒精的轨迹 性取向及其相关的健康后果。我们还将检查风险和保护因素 跨个体，社会和政策领域。性少数群体受到滥用酒精的风险； 但是，现有的研究通常基于性取向的静态和一维结构 尽管有证据表明性取向 流动性很普遍，尤其是在性少数群体中。先前的工作显示滥用酒精和酒精 在性少数群体中，疾病（AUD）症状比异性恋者更普遍，更严重。 缺乏基于人群的纵向研究滥用酒精的轨迹和相关的负面研究 基于性取向的液体和多维结构的健康后果。此外， 研究少数群体中滥用酒精滥用的风险和保护因素的研究主要集中 在社会和政策层面上的个人级别因素和被忽视的因素。有必要扩展这一点 研究并利用社会生态模型的概念，包括上游风险和保护性 因素，例如社会和政策层面的因素。为了解决这些差距，该项目将使用纵向 基于六波人口评估的六波浪潮，来自美国青少年和成人样本的数据 烟草和健康研究（n = 45,971; 2013-2021）。这项研究设计将使我们能够探索变化 基于Covid-19发作之前和之后的性取向滥用酒精。我们的研究旨在：（1）确定 在8年内滥用酒精滥用轨迹，并确定这些关联是否因性别而不同 方向（a）一致性与不一致，以及（b）稳定性与流动性。我们还将检查潜力 划分年龄，性别，种族，种族和性别认同的风险异质性，并比较滥用酒精的变化 Covid-19-19通过性取向发作之前和之后。 （2）检查（a）滥用酒精的变化 轨迹塑造了与健康相关的负面后果（例如AUD症状，其他药物使用障碍 症状，多物结构使用和负面的身体健康后果）和（b） 性取向亚组，通过性取向不一致与一致性以及性认同的流动性 与稳定性。 （3）检查个体（例如内部化症状），社会 - （例如， 社会互动程度）和政策级别（例如反歧视法）保护/风险因素 酒精滥用和与酒精相关的负面健康后果的轨迹，并确定是否关联 通过性取向的一致性与不一致和性认同流动性与稳定性的不同之处。