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

项目概要/摘要 酒精和其他物质（AOD）的使用和滥用的差异是有据可查的性之间 少数民族青少年（SMA）及其异性恋同龄人。彩色SMA也有较高的AOD使用率， 与同种族/民族的异性恋同龄人以及在某种程度上与他们的白色SMA同龄人相比，每日 与其边缘化身份有关的具体压力因素（即，少数民族压力源， 基于种族主义的压力源）导致有色人种SMA之间的健康差异。这些压力源发生在 人际层面（例如，歧视）并在结构层面得到加强（例如，反同性恋法律，或者种族歧视 体制政策）。少数民族的压力在一个单一的轴的身份是直接相关的AOD使用和滥用 在性别和种族/少数民族人口中。同样，结构性压迫（即，结构 异性恋或种族主义）对健康有长期的影响，包括使用和滥用AOD。 然而，这项工作很少采取交叉透镜，既考虑性取向和种族/民族。 虽然越来越多的横截面和最近但有限的纵向证据暗示少数民族的压力， 在AOD使用和滥用的差异，这些前瞻性的，日常的和长期的影响， 在青少年时期，SMA对有色人种AOD使用和误用的压力源在很大程度上是未知的。也缺乏 研究的结构压迫的影响SMA的颜色的AOD使用，它如何可能发挥关键作用 在加速青少年时期AOD使用和误用进展中的病因学作用，以及它如何可能 影响交叉少数民族压力与AOD使用和滥用之间的长期和日常联系， 色彩的日常生活。此外，少数民族应激与AOD之间的保护性因素尚不清楚 使用和滥用情况，这是为预防和治疗干预措施提供信息所必需的。依靠我们 研究人员的团队的方法，理论，分析和临床专业知识和试点工作，我们提出了一个 严谨和创新的研究交叉压力和结构性压迫，以及它们如何与AOD 彩色SMA之间的使用和误用。使用测量-爆破设计，纵向和 日常日记的方法，我们的目的是：1）测试交叉压力和 结构压迫和AOD使用和误用在超过2.5年的SMA有色人种的国家样本中 （N=950）6个月的时间点; 2）测试的人内波动之间的日常关联， 交叉压力和AOD渴望，使用，误用和问题之间的样本超过10天，在每6- 3）测试减弱或加剧之间的关联的保护性和风险因素 跨2.5年的青少年时期和日常生活中的交叉压力和AOD使用和误用。的 结果将允许更准确地了解少数民族的压力，结构性压迫，和AOD的使用， 在这一人群中的滥用，并告知临床评估和文化敏感的发展 干预SMA的颜色。

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.