Links between social safety and health among sexual and gender minorities

项目摘要/摘要(30行) SGMS个体(LGBTQ+)面临着显著的心理和身体健康差距，但生物行为 这些差异背后的机制还没有完全被理解。这项拟议的研究测试了一种新的理论 模型(Diamond&Alley，2022)认为，社会保障不足会助长慢性疾病，从而恶化SGM的健康 威胁-警觉。社会安全感是指对他人的归属感、包容性和保护感， 这是人类在人生各个阶段的核心需求。公共场所的社会安全提示(如看到“欢迎” 迹象或类似人的存在)帮助我们在日常生活中移动，而不是持续的威胁--警惕， 通过提醒我们，我们属于一个更大的保护性社会结构。然而，这种保护性的社会结构往往 一旦被污名化的人的身份被知道，他们就会退出，导致他们感到不够安全， 受保护，并包括在公共环境中。安全不足的日常经验滋生了长期的威胁-警觉， 这增加了SGM睡眠障碍、药物使用、抑郁、焦虑、自杀念头/行为的风险， 和全身炎症。这项拟议的研究测试了这一突破性的SGM健康新方法 一项创新的研究设计：我们将使用定制设计的智能手机应用程序来收集“众包” 关于社会安全信号(如看到像你一样的人或进行友好互动)的报告 与陌生人)在15个预先选择的校园环境中。参与者为300名本科生(50%SGM和 少数民族占30%)。使用这4500份报告，我们将计算(1)每个设置的感知安全 白人中小企业，(2)少数民族中小企业，(3)非白人中小企业，(4)少数民族中小企业。30个SGM的子集 参与者(30%为少数民族)将在佩戴移动无线生物传感器的同时完成这些报告 连续5天(120小时)的设备，以捕获威胁生理指标的实时变化- 警觉(皮肤电活动增加和心率变异性降低)与占领安全相关 与不安全设置的对比。我们预测，在120小时评估中花费更多时间的参与者 在更安全的环境中，那些降低了并发威胁警戒水平的人，将有更好的睡眠质量， 更少的抑郁和焦虑，更少的药物使用，更少的自我伤害/自杀想法，以及更低的全身性 炎症(一种与慢性社会威胁直接相关的免疫风险因素)。我们的研究测试了一种创新的 SGM健康的理论模型，使用了创新的方法(通过定制开发的众包 智能手机应用程序)，并采用创新技术(我们的无线“智能”是目前最小的 用于非卧式皮肤电刺激评估的设备)。通过测试社会安全之间的预期关联， 白人和少数民族SGM的威胁警觉和健康结果，这项研究将开辟新的天地 在我们的理解中，社会安全是边缘人群健康的关键社会决定因素之一。

Project Summary/Abstract (30 lines) SGMs individuals (LGBTQ+) face significant mental and physical health disparities, but the biobehavioral mechanisms underlying these disparities are not fully understood. The proposed study tests a new theoretical model (Diamond & Alley, 2022) positing that insufficient social safety worsens SGM health by fostering chronic threat-vigilance. Social safety refers to perceptions of belongingness, inclusion, and protection by other people, which are core human needs at all stages of life. Cues of social safety in public spaces (such as seeing “welcome” signs or the presence of similar people) help us to move through our daily lives without constant threat-vigilance, by reminding us that we belong to a larger protective social fabric. Yet this protective social fabric is often withdrawn from stigmatized individuals once their identities are known, leading them to feel insufficiently safe, protected, and included in public settings. Daily experiences of insufficient safety foster chronic threat-vigilance, which increases SGM’s risks for sleep disruption, substance use, depression, anxiety, suicidal ideation/behavior, and systemic inflammation. The proposed research tests this groundbreaking new approach to SGM health with an innovative research design: We will use a custom-designed smartphone application to collect “crowdsourced” reports on the presence of social safety signals (such as seeing people like yourself or having friendly interactions with strangers) across 15 pre-selected campus settings. Participants will be 300 undergraduates (50% SGM and 30% ethnic-minority). Using these 4500 reports, we will calculate the perceived safety of each setting for (1) white SGMs, (2) ethnic-minority SGMs, (3) white non-SGMs, and (4) ethnic-minority SGMs. A subset of 30 SGM participants (30% ethnic-minority) will complete these reports while also wearing ambulatory wireless biosensing devices for 5 consecutive days (120 hours), to capture real-time changes in physiological indices of threat- vigilance (increased electrodermal activity and reduced heart-rate variability) associated with occupying safe versus unsafe settings. We predict that participants who spend a greater proportion of the 120-hour assessment period in safer settings, and who have reduced levels of concurrent threat-vigilance, will have better sleep quality, less depression and anxiety, less substance use, less self-harm/suicidal ideation, and lower systemic inflammation (an immunological risk factor directly related to chronic social threat). Our study tests an innovative theoretical model of SGM health, uses an innovative methodology (crowdsourcing with a custom-developed smartphone application), and employs innovative technology (our wireless “smartring” is the smallest available device for ambulatory electrodermal assessment). By testing prospective associations among social safety, threat-vigilance, and health outcomes in both white and ethnic-minority SGMs, this study will break new ground in our understanding of social safety as one of the key social determinants of health for marginalized populations.