Reducing Black Men's Drug Use and Co-Occurring Negative Mental and Physical Health Outcomes: Intersectionality,Social-Structural Stressors, and Protective Factors

减少黑人吸毒和同时发生的负面身心健康结果：交叉性、社会结构压力源和保护因素

• 批准号: 10093425
• 负责人: Ingrid Alisa Bowleg
• 金额: $ 9.99万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10093425
• 关键词: AIDS/HIV problem; Accidental Injury; Address; Administrative Supplement; Adult; Affect; Age; Alcohol consumption; Alcohols; Area; Award; Biological Markers; Bisexual; Blood Pressure; Blood specimen; Cardiovascular Diseases; Categories; Cause of Death; Cholesterol; Collection; Data; Dependence; Development; Discrimination; Drug usage; Economic Factors; Environmental Risk Factor; Epidemiology; Focus Groups; Future; Gays; Goals; Health; Heart Diseases; Heterosexuals; Homicide; Imprisonment; Individual; Inequality; Intervention; Interview; Knowledge; Malignant Neoplasms; Marijuana; Mental Health; Methodology; Methods; Mission; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Nicotine; Outcome; Parents; Participant; Pathway interactions; Patient Self-Report; Pattern; Pharmaceutical Preparations; Phase; Police; Political Factor; Positioning Attribute; Process; Psyche structure; Public Health; Race; Reporting; Research; Research Design; Research Support; Resources; Risk; Sample Size; Sampling; Sexual and Gender Minorities; Social status; Socioeconomic Status; Stress; Suicide; Testing; Time; Toxicology; United States National Institutes of Health; Urine; Washington; base; community partnership; design; epidemiology study; experience; health data; health disparity; health goals; illicit drug use; intersectionality; low socioeconomic status; male health; men; men who have sex with men; mortality; multidisciplinary; physical conditioning; protective factors; psychological distress; recruit; resilience; sexual identity; sexual minority; social factors; social structure; stressor; therapy design; virtual

PROJECT SUMMARY/ABSTRACT The mixed methods explanatory-sequential (QUANT→quant) parent study will test a conceptual model of social-structural stressors, protective factors, and drug use and co-occurring negative mental and physical health outcomes among Black men at the intersection of sexual identity and socioeconomic position (SEP). Informed by the intersectionality theoretical framework, the initial design for the parent study provided for three sexual identity categories (i.e., gay, bisexual, and heterosexual) and two SEP positions (i.e., lower, higher) and a sample size of 1,440 (i.e., 240 participants for each of the 6 sampling frames: lower- SEP gay, lower-SEP bisexual, lower-SEP heterosexual, higher-SEP gay, higher-SEP bisexual, higher-SEP heterosexual). The considerable challenges involved in recruiting bisexual men and doing so at two different SEP-categories, was methodologically infeasible given the study's 5-year timeframe and limited resources. Thus a single sexual minority (SM) category composed of gay, bisexual, and other men who have sex with men was created to produce a sampling frame stratified by just two sexual identity positions (i.e., SM and heterosexual). A determination was made that this sampling frame was more methodologically feasible in terms of recruitment because it provided for a sample size of 960 (i.e., 240 participants each of lower-SEP SM, lower-SEP heterosexual, higher-SEP SM, higher-SEP heterosexual). To address the critical gaps that exist about Black bisexual men's health, the goal of the proposed administrative supplement is to increase the number of Black bisexual men participants and establish bisexual men as a distinct SM position for all of the parent study's analyses. To accomplish this goal, an academic-community partnership will be established with BiNet USA, the oldest national bisexual organization in the U.S. The proposed supplement adds new primary inferential and exploratory analyses specific to bisexual men (Aim 1, parent study). It also adds a convergent mixed methods design component in Phase I in which in-depth qualitative interviews will be conducted during the Phase I quantitative analyses with 30 purposively sampled Phase I quantitative bisexual participants. The interviews will facilitate a rich, culturally and contextually-grounded understanding of Black bisexual men's experiences relevant to the parent study's focus, as well as their intersectionality-specific experiences (e.g., binegativity). For Aim 3 of the parent study, Phases II (Focus Groups to Explain the Phase I Quantitative Results) and III (Mixed Methods Syntheses and Assessment of Validity) are unchanged. Bisexual participants will be purposively sampled for the Phase II focus groups. Phase III quantitative and qualitative synthesis analyses will assess the convergence and divergence of results for bisexual participants. This specific focus on bisexual participants represents a paradigmatic shift in sexual minority research. The significance of the proposed research lies in the expected outcome of the future development of multilevel interventions to reduce drug use and promote mental and physical health for Black bisexual men.

项目总结/摘要 混合方法验证-序贯（QUANT→quant）母研究将测试以下概念模型： 社会结构性压力源、保护因素、吸毒以及同时发生的负面精神和身体影响 在性身份和社会经济地位（SEP）的交叉点黑人男性的健康结果。 在交叉性理论框架的指导下，母研究的初步设计提供了三个 性身份类别（即，同性恋、双性恋和异性恋）和两个SEP位置（即，更低，更高）和 样本量为1，440（即，240名参与者参与6个采样框架：低SEP同性恋，低SEP 双性恋、低SEP异性恋、高SEP同性恋、高SEP双性恋、高SEP异性恋）。的 在招募双性恋男子和在两个不同的SEP类别这样做时， 鉴于研究的5年时间和有限的资源，在方法上不可行。因此，一个单一的性 少数民族（SM）类别由同性恋，双性恋和其他与男性发生性关系的男性组成， 产生仅由两个性别身份位置分层的采样帧（即，SM和异性恋）。一 经确定，这一抽样框架在征聘方面更具方法可行性 因为它提供了960的样本大小（即，240名受试者分别接受低SEP SM、低SEP 高SEP SM，高SEP异性）。为了解决黑人存在的关键差距， 双性恋男性的健康，建议的目标是增加行政补充黑人的数量 双性恋男性参与者，并建立双性恋男性作为一个独特的SM位置，为所有的母研究的 分析。为了实现这一目标，将与BiNet USA建立学术-社区伙伴关系， 美国最古老的全国性双性恋组织。拟议的补充增加了新的主要推论和 针对双性恋男性的探索性分析（目标1，母研究）。它还增加了一个收敛的混合方法 第一阶段的设计部分，在第一阶段将进行深入的定性访谈 对30名有目的地抽样的I期定量双性恋参与者进行定量分析。访谈 将促进对黑人双性恋男性经历的丰富，文化和背景基础的理解 与母公司研究的重点相关，以及其跨学科的具体经验（例如，双负性）。 对于母研究的目标3，第II阶段（焦点小组解释第I阶段定量结果）和第III阶段 （混合方法合成和有效性评估）保持不变。双性恋参与者将 第二阶段焦点小组的有目的抽样。第三阶段定量和定性综合分析 将评估双性恋参与者结果的趋同和分歧。这种对双性恋的特别关注 参与者代表了性少数群体研究的范式转变。建议的意义 研究取决于未来制定减少吸毒的多层次干预措施的预期结果 促进黑人双性恋男性的身心健康