Population-Specific Eating Disorder Risk Factors in Sexual Minority Women

项目总结

PROJECT SUMMARY Eating disorders have the highest mortality rate of all psychiatric illnesses and profound health consequences for those affected. Relative to their heterosexual peers, sexual minority women are at heightened risk of developing an eating disorder, yet little is known about the risk factors contributing to this disparity. The overarching goal of this Pathway to Independence Award is to gain advanced training and mentorship required to launch Dr. Simone's career as an independent investigator who rigorously investigates the mechanisms contributing to disparities in sexual minority populations. To achieve this goal, a multifaceted training plan including coursework, training, mentorship, and research is proposed in: (1) community-based and community- engaged research, (2) mixed-methods design and analysis, and (3) sexual minority health equity research. The knowledge derived from this training plan will prepare Dr. Simone to execute the proposed research, including three research aims and two data collection efforts. During the K99 phase, a mixed-methods case-control study will gain a broad scope of population-specific eating disorder risk factors in sexual minority women (Aim 1) through rich quantitative assessments about eating disorder symptoms, sociocultural pressures and minority stress, and video diaries that capture the response to discrimination, social pressure, and eating disorder episodes in real time. The results from Aim 1 and the community stakeholder advisory board (n=6) will inform the scope of the subsequent research. A well-known limitation of health disparity research is a lack of validated measures for use with minority samples. In line with NIH priorities, during the R00 phase, a population-specific measure of eating disorder risk factors will be developed (Aim 2) with guidance from the community advisory board and pertinent themes from Aim 1. Cognitive interviews with 30 sexual minority women will elucidate the content validity of each item. The psychometric properties of the scale will be derived from the Aim 3 sample. Finally, the temporality of associations between population-specific risk factors and eating disorder behaviors and the extent to which such relations differ by sexual identity (e.g., queer, lesbian), race, and ethnicity (Aim 3) by employing a daily process ecological momentary assessment in a case-control study. The proposed novel mixed-methods research will elucidate population-specific eating disorder risk factors in an understudied population, sexual minority women. Identification of population-specific risk factors and their associations with eating disorder symptoms in racially and ethnically diverse sexual minority women will produce guidelines for community programs and intervention efforts to rectify disparities, and the proposed measure will enhance surveillance of population-specific eating disorder risk and advance future research of such mechanisms. This award will launch the PI's independence by laying a foundation for a career in innovative multi-method research that may be applied to additional mental health outcomes wherein disparities are present and with other diverse sexual and gender minority populations.