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

项目摘要。年轻成年性少数女性 (SMW)，包括女同性恋者和双性恋者，处于 风险特别高，吸烟的几率是异性恋女性的 4.8 倍；最多 660,000 年轻成年人吸烟，患与吸烟相关的癌症和心肺疾病的风险增加 疾病。接触烟草业营销、少数族裔压力源、酗酒和吸毒以及社交 决定因素是与该人群吸烟行为增加相关的关键因素。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），以提高 LGBT 受众抵御烟草营销影响的能力。然而， 尚未研究针对年轻成年 SMW 的文化定制接种方法的效果。我们的 长期目标是消除 LGBT 人群中与吸烟相关的健康差异。的目标 这项研究的目的是确定使用适合文化的接种方法来提高复原力的效果 了解烟草营销对年轻成年 SMW 的影响，并获取利益相关者的关键投入以支持 后采纳并实施。我们的中心假设是，根据文化定制的接种信息 与非量身定制的信息相比，解决年轻成年法定最低工资的独特观点将更有效 提高烟草营销的弹性。科学前提得到 1) 宣传活动的支持 LGBT 受众对烟草公司和吸烟的抵抗力，2) 我们的试点研究显示年轻人 成年 SMW 对 LGBT 图像有更高的相关性、良好的态度和积极的情绪 与控制意象相比，3）基于传播科学的综合概念框架， 少数民族压力框架，以及SMW中复原力因素的社会生态模型。我们的具体 目标是： 1) 与主要利益相关者合作，优化信息构建并收集试点数据以提供信息 未来的干预设计，2）评估文化定制的反吸烟信息对年轻人的影响 SMW 的吸烟和戒烟意愿，以及 3) 评估接种信息类型、剂量和 年轻成年法定最低工资者对烟草营销、吸烟和戒烟意图的适应力的潜伏期。我们会 每年举行两次会议、快速循环反馈以及与专家顾问进行关键知情人访谈 委员会由 LGBT 组织领导人、性少数群体健康调查员、 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；和随机调查实验。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 年轻成年中小型妇女对烟草营销的适应能力，并满足未来采用者和 实施者。研究方法和结果将进一步为反营销干预研究提供信息 减少所有性少数群体中与吸烟有关的健康差异。

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.