Long-term and Daily Associations among Intersectional Minority Stress, Structural Oppression, and Alcohol Use and Misuse among Sexual Minority Adolescents of Color

项目摘要/摘要 酒精和其他物质(AOD)的使用和滥用方面的差异在性别之间有很好的记录 少数民族青少年(SMA)及其异性恋同龄人。颜色的SMA也有更高的AOD使用率和 滥用行为比同种族/民族的异性恋同龄人更多，在某种程度上也比他们的白人SMA同龄人更严重。每天 特定于其边缘化身份的耻辱和歧视相关压力源(即，少数族裔压力源， 基于种族主义的压力源)导致了肤色SMA之间的健康差异。这些应激源发生在 人际层面(例如，歧视)，并在结构层面(例如，反同性恋法律或种族主义)得到加强 体制政策)。单一同一性轴上的少数应激与AOD的使用和误用直接相关 在性和种族/少数民族人口中。同样，结构性压迫(即结构性压迫 在青春期)对健康有长期影响，包括使用AOD和误用AOD。 然而，这项工作很少采用同时考虑性取向和种族/民族的交叉视角。 尽管越来越多的横截面和最近但有限的纵向证据表明，少数人的应力是一种 造成AOD使用和误用差异的主要因素，以及这些影响的预期、日常和长期影响 在整个青春期，颜色的AOD使用和滥用对SMA的压力在很大程度上是未知的。此外，还缺乏一个 这项研究考察了结构性压迫对色彩AOD使用的SMA的影响，以及它可能如何发挥关键作用 在青春期加速AOD使用和误用进展的病因作用，以及它如何可能 影响交叉少数民族应激与AOD使用和误用之间的长期和日常联系 色彩的日常生活的SMA。此外，少数人应激与AOD之间的保护因素知之甚少。 使用和误用，这是为预防和治疗干预提供信息所必需的。依靠我们的 研究人员团队的方法学、理论、分析和临床专业知识以及试点工作，我们建议 对横截面应力和构造压迫及其与AOD的关系的严谨和创新研究 颜色在SMA中的使用和误用。使用测量突发设计，纵向和纵向组合 日常日记的方法，我们的目的是：1)测试交叉应激和未来的联系 2.5年全国有色SMA样本中结构性压抑和AOD的使用与误用 (n=950)具有6个月的时间点；2)测试人内波动之间的每日关联性 样本中的交叉压力和AOD的渴求、使用、误用和问题每6天- 月份时间点；3)测试保护性因素和风险因素，以减弱或加剧 青春期2.5年和日常生活中的交叉应激与AOD的使用和误用。这个 结果将允许更准确地理解少数民族压力、结构性压迫和AOD的使用以及 在这一人群中滥用药物，并为临床评估和文化敏感性的发展提供信息 对有色SMA的干预。

PROJECT SUMMARY/ABSTRACT Disparities in alcohol and other substance (AOD) use and misuse are well documented between sexual minority adolescents (SMA) and their heterosexual peers. SMA of color also have higher rates of AOD use and misuse than heterosexual peers of the same race/ethnicity and to some extent their White SMA peers. Daily stigma and discrimination-related stressors specific to their marginalized identities (i.e., minority stressors, racism-based stressors) contribute to health disparities among SMA of color. These stressors occur at the interpersonal level (e.g., discrimination) and are reinforced at the structural level (e.g., anti-gay laws, or racist institutional policies). Minority stress at a single axis of identity is directly correlated with AOD use and misuse among sexual and racial/ethnic minority populations. Similarly, structural oppression (i.e., structural heterosexism or racism) during adolescence has long-lasting health effects, including AOD use and misuse. However, this work rarely takes an intersectional lens that considers both sexual orientation and race/ethnicity. Although mounting cross-sectional and recent but limited longitudinal evidence implicates minority stress as a key contributor to disparities in AOD use and misuse, the prospective, daily, and chronic impact of these stressors on SMA of color's AOD use and misuse across adolescence is largely unknown. There is also a lack of research examining the impact of structural oppression on SMA of color's AOD use, how it may play a key etiological role in accelerating the progression of AOD use and misuse over adolescence, and how it may impact the long-term and daily associations between intersectional minority stress and AOD use and misuse in SMA of color's daily lives. In addition, little is known about protective factors between minority stress and AOD use and misuse, which is needed to inform prevention and treatment interventions. Relying on our investigator's team methodological, theoretical, analytic, and clinical expertise and pilot work, we propose a rigorous and innovative study of intersectional stress and structural oppression and how they relate to AOD use and misuse among SMA of color. Using a measurement-burst design, a combination of longitudinal and daily diary methods, our aims are to: 1) test the prospective associations between intersectional stress and structural oppression and AOD use and misuse among a national sample of SMA of color over 2.5 years (N=950) with 6-month time-points; 2) test the daily associations between within-person fluctuations of intersectional stress and AOD craving, use, misuse, and problems among the sample over 10-days at each 6- month time point; 3) test protective and risk factors that attenuate or exacerbate the associations between intersectional stress and AOD use and misuse over adolescence across the 2.5 years and in daily life. The results will allow for more precise understanding of minority stress, structural oppression, and AOD use and misuse in this population and inform clinical assessment and the development of culturally sensitive interventions for SMA of color.