Project RESIST: Increasing Resistance to Tobacco Marketing Among Young Adult Sexual Minority Women Using Inoculation Message Approaches

项目总结。年轻的成年性少数民族妇女(SMW)，包括女同性恋者和双性恋者，在 风险特别高，吸烟的几率比异性恋女性高4.8倍； 66万青年SMW吸烟，患与吸烟相关的癌症和心肺疾病的风险增加 疾病。接触烟草行业营销、少数群体压力、酗酒和吸毒以及社交 决定因素是导致这一人群吸烟行为增加的关键因素。反吸烟运动 利用接种信息(类似于疫苗)和文化定制(即，LGBT图像，符号， 和语言)，以促进在LGBT受众中抵御烟草营销影响的韧性。然而， 针对文化定制的接种方法对青年SMW的影响尚未得到检验。我们的 长期目标是消除LGBT人群中与吸烟有关的健康差距。的目标 这项研究旨在确定使用文化定制的接种方法来提高复原力的效果 对青年SMW的烟草营销影响，并获得利益相关者的关键投入，以支持 以后采用和实施。我们的中心假设是文化上量身定做的接种信息 与非量身定制的信息相比，解决年轻人SMW的独特视角将更有效地实现 提高对烟草营销的适应能力。科学前提得到了1)宣传活动的支持 在LGBT人群中对烟草公司和吸烟的韧性，2)我们的初步研究显示 成人SMW对LGBT意象有较高的相关性、良好的态度和积极的情绪 与控制图像相比，以及3)传播学提供的综合概念框架， 少数群体压力框架，以及SMW中复原力因素的社会生态学模型。我们的特定 目标是：1)与关键利益攸关方接触，以优化消息结构并收集试点数据以提供信息 未来干预设计，2)评估针对文化定制的禁烟信息对年轻人的影响 SMW的吸烟和戒烟意图，以及3)评估接种信息类型、剂量和 青少年SMW对烟草营销、吸烟和戒烟意图的适应能力的潜伏期。我们会 举行一年两次的会议、快速周期反馈和与专家顾问的关键线人面谈 由LGBT组织领导人、性和性别少数群体健康调查人员组成的委员会， 社区成员和国家机构(NCI、CDC和FDA)；消息开发和测试使用 定性研究方法；随机调查实验。影响：这项研究的结果将 为开发基于证据和文化定制的接种方法提供基础，以增加 青年SMW对烟草营销的适应能力，并满足未来采用者和 实施者。研究方法和发现将进一步为反营销干预研究提供参考。 减少所有性少数群体和性别少数群体中与吸烟有关的健康差距。

PROJECT SUMMARY. Young adult sexual minority women (SMW), including lesbians and bisexuals, are at particularly high risk, with up to 4.8 times increased odds of cigarette smoking than heterosexual women; up to 660,000 young adult SMW smoke and are at increased risks of smoking-related cancers and cardiopulmonary illnesses. Exposure to tobacco industry marketing, minority stressors, alcohol and drug use and social determinants are key factors linked to increased smoking behavior in this population. Anti-smoking campaigns utilized inoculation messages (analogous to vaccines) and culturally-tailoring (i.e., LGBT imagery, symbols, and language) to promote resilience against tobacco marketing influences among LGBT audiences. However, the effects of culturally tailored inoculation approaches in young adult SMW have not yet been examined. Our long-term goal is to eliminate smoking-related health disparities among LGBT populations. The objectives of this study are to determine the effects of using a culturally-tailored inoculation approach to increase resilience to tobacco marketing influences among young adult SMW and obtain stakeholders' critical inputs that support later adoption and implementation. Our central hypothesis is that culturally tailored inoculation messages addressing unique perspectives of young adult SMW will be more effective versus non-tailored messages to increase resilience to tobacco marketing. The scientific premise is supported by 1) campaigns promoting resilience against tobacco companies and smoking among LGBT audiences, 2) our pilot study showing young adult SMW perceive higher relevance, favorable attitudes, and positive emotions toward LGBT imagery compared to control imagery, and 3) an integrative conceptual framework informed by communication science, the minority stress framework, and the socioecological model of resilience factors among SMW. Our specific aims are: 1) Engage with key stakeholders to optimize message construction and collect pilot data to inform future intervention design, 2) Evaluate the effects of culturally tailored anti-smoking messages on young adult SMW's smoking and quitting intentions, and 3) Evaluate the effects of inoculation message type, dose, and latency on young adult SMW's resilience to tobacco marketing, smoking and quitting intentions. We will conduct twice-yearly meetings, rapid cycle feedback, and key informant interviews with an Expert Advisory Committee comprising LGBT organization leaders, investigators in sexual and gender minority health, community members, and national agencies (NCI, CDC, and FDA); message development and testing using qualitative research methods; and randomized survey experiments. Impact: Findings from this study will provide the foundation to develop an evidence-based and culturally tailored inoculation approach to increase resilience to tobacco marketing among young adult SMW and that addresses the needs of future adopters and implementers. The study methods and findings will further inform research on counter-marketing interventions to reduce smoking-related health disparities among all sexual and gender minority populations.