A Strengths-Based, Intersectional Approach to Suicide Prevention Among Black Sexual and Gender Minority Youth

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PROJECT SUMMARY Black sexual and gender minority (SGM) youth demonstrate higher rates of suicidal ideation and behavior than White SGM youth and Black cisgender heterosexual youth. However, limited research has examined racial, sexual, and gender identities as they co-occur and intersect to result in experiences producing suicide risk and protection among Black SGM youth. Further, suicide research often lacks intercategorical comparisons needed to understand suicide risk and protection across subgroups of Black SGM youth, limited research has examined Black SGM-specific protective factors as moderators of suicide risk, and most research has relied on single method inquiries that limit understanding of the constellation of factors associated with suicide risk among Black SGM youth over time and across a week. We propose to conduct a multi-level, multi-component mixed-methods, longitudinal study to examine how intersectional minority stress and Black SGM-specific protective factors affect active suicide ideation over time, day-to-day, and within specific contexts within and between populations of Black SGM youth. We will pursue the following specific aims: (1) To examine the moderating effects of intersectional Black SGM-specific individual and community protective factors on theoretical pathways of risk, including intersectional minority stress, over time; (2) To identify and describe proximal correlates of suicide risk, including protective factors, among Black SGM youth; and (3) To explore in- depth the effects of contextual factors on suicide risk among Black SGM youth. We will recruit 625 Black SGM youth aged 13 to 26 in the U.S. via social media marketing and impose sampling quotas based on SGM identity (lesbian, gay, bisexual women, bisexual men, transgender/nonbinary) and age (13-17yrs, 18-21yrs, 22- 26yrs). All participants will complete an online survey every 3 months over 18-months. For Aim 1, we will perform stratified latent trajectory moderated mediation analyses for SGM groups separately to examine associations between intersectional discrimination across time as a predictor of change in entrapment and psychopathology, which in turn predicts changes in the trajectory of active suicide ideation across time. We hypothesize that individual protective factors will moderate the trajectory of discrimination across time, while community protective factors will moderate trajectories of psychological vulnerabilities. We also will examine moderating effects of structural factors. For Aim 2, a subsample of 450 participants will complete 1 of 3 daily diary surveys over the study period to examine cross-level interactions between person-level protective factors and day-level risk factors predicting suicide ideation across SGM groups at the daily level. Aim 3 involves conducting individual interviews with a subset of 180 participants across SGM identities and age groups to glean insights into contextual factors associated with increasing/decreasing suicide risk. This research will help address social injustices that characterize mental health disparities among Black SGM youth by identifying modifiable Black SGM-specific protective factors that will inform future tailored strengths-based interventions.