Stigma, Romantic Relationships, and Alcohol Use Among Transgender and Nonbinary Young Adults

跨性别和非二元性别年轻人的耻辱、浪漫关系和饮酒

• 批准号: 10571064
• 负责人: Gabriel R Murchison
• 金额: $ 13.05万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-25 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10571064
• 关键词: Accidents; Address; Adult; Advocacy; Affect; Alcohol consumption; Alcohol dependence; Alcohols; Anxiety; Attenuated; Buffers; Cardiovascular Diseases; Clinical; Communities; Complement; Data; Data Collection; Data Set; Development; Discrimination; Educational workshop; Epidemiologist; Epidemiology; Evaluation; Factor Analysis; Feasibility Studies; Feedback; Future; Gender; Goals; Guidelines; Health; Intervention; Interview; Link; Measurement; Measures; Mediating; Mental Depression; Mental Health; Mentors; Mentorship; Methods; Modeling; Outcome; Performance; Persons; Phase; Population; Process; Property; Psychometrics; Qualitative Methods; Qualitative Research; Reporting; Research; Risk Factors; Role; Scientist; Series; Sexual and Gender Minorities; Shapes; Social Identification; Structure; Surveys; Technology; Testing; Training; Violence; Work; alcohol intervention; anxiety symptoms; arm; career; community engagement; design; diaries; drinking; efficacy trial; experience; improved; intimate partner violence; motivational enhancement therapy; nonbinary; online intervention; prospective; prototype; reduced alcohol use; satisfaction; social stigma; sound; technology validation; therapy development; transgender; usability; violence victimization; young adult; young adult alcohol use

PROJECT SUMMARY/ABSTRACT For transgender and nonbinary (TNB) people, anti-TNB stigma is a risk factor for adverse alcohol outcomes, often co-occurring with depression and anxiety. Stigma’s impact on alcohol use and mental health is of particular concern in TNB young adults (YA; 21-30 years old), who report more adverse alcohol and mental health outcomes than older TNB adults. For these YA, favorable romantic relationship experiences may attenuate the mental health impact of anti-TNB stigma, yet stigma may contribute to adverse relationship experiences (e.g., intimate partner violence; IPV) linked to adverse alcohol and mental health outcomes. Accordingly, relationship-focused interventions have the potential to improve alcohol and mental health outcomes in TNB YA. However, targets for such interventions remain unclear—first, because the mechanisms by which stigma affects relationship experiences have not been identified, and second, because it is not clear what kinds of general or TNB-specific relationship experiences should be addressed. This project responds to these gaps, culminating in development of a relationship-focused intervention for alcohol use and co-occurring depression/anxiety in TNB YA. In Aim 1, I will collect survey data from 200 TNB YA in romantic relationships to revise and validate a new measure of TNB-specific relationship experiences. In Aim 2, I will use the new measure in a 2-month weekly diary study of stigma, relationship experiences, alcohol use, and depression/anxiety (n=250 TNB YA in romantic relationships). I will use these data to (1) assess weekly associations of stigma and relationship experiences with alcohol use and depression/anxiety, and (2) identify mechanisms by which stigma may affect relationship experiences. In Aim 3, I will adapt an existing type of online alcohol intervention—technology-adapted motivational interviewing with personalized feedback—by tailoring content for TNB YA and (if supported by Aim 2 findings) adding components to address relationship experiences in the context of anti-TNB stigma. The intervention, Whole Selves, will be developed through a multi-phase co-design process with 8 TNB YA, followed by evaluation of acceptability, usability, and engagement in user-testing interviews (n=5 TNB YA in romantic relationships) and a single-arm feasibility study (n=107 TNB YA in romantic relationships). In the K99 phase, this work will be coordinated with training in psychometrics/scale development, diary methods, and community-engaged intervention development, with mentorship from senior scholars known for applying these methods to research on stigma, alcohol use, mental health, and romantic relationships. This training and mentorship will prepare me to develop and evaluate Whole Selves in the R00 phase, producing preliminary data for an R01 efficacy trial proposal. Thus, the project and associated training will allow me to launch an independent research career with the goals of (1) identifying the mechanisms by which stigma affects young people’s alcohol use and mental health, and (2) partnering with affected communities to mitigate these effects through scalable interventions.

项目摘要/摘要 对于跨性别和非二进制（TNB）人，抗TNB污名是广告酒精的危险因素 结果，通常与抑郁和焦虑共同出现。污名对酒精使用和心理健康的影响是 在TNB年轻人（YA； 21-30岁）中特别关注的是，他们报告了更多不良酒精和精神 与年龄较大的TNB成年人相比，健康结果。对于这些，有利的浪漫关系经历可能 减轻抗TNB污名的心理健康影响，但污名可能会导致广告关系 经验（例如亲密伴侣暴力； IPV）与不良酒精和心理健康成果有关。 彼此之间，以关系为中心的干预措施有可能改善酒精和心理健康 TNB YA的结果。但是，此类干预措施的目标尚不清楚 - 首先，因为机制 尚未确定污名会影响关系经历，其次，因为还不清楚 应该解决哪些类型的一般或TNB特定的关系经验。这个项目回应 这些差距，最终是针对与饮酒和共同发生的以关系为中心的干预的开发 TNB YA的抑郁/焦虑。在AIM 1中，我将从200 TNB YA中收集浪漫关系中的调查数据 修改并验证TNB特定关系经验的新量度。在AIM 2中，我将使用新的 在每周2个月的污名，关系经验，饮酒和 抑郁/焦虑（n = 250 tnb ya在浪漫关系中）。我将使用这些数据来（1）评估每周 污名和与酒精使用和抑郁/焦虑的关系经历的关联，（2）确定 污名可能会影响关系经历的机制。在AIM 3中，我将适应现有类型的 在线酒精干预 - 技术适应性的动机访谈，并通过个性化反馈 - 定制TNB YA的内容，并（如果得到AIM 2的支持），则添加组件以解决关系 在抗TNB污名的背景下的经历。整个自我的干预将通过 具有8 TNB YA的多阶段共同设计过程，然后评估可接受性，可用性和 参与用户测试的访谈（n = 5 tnb ya在浪漫关系中）和单臂可行性 研究（n = 107 tnb ya在浪漫关系中）。在K99阶段，这项工作将通过培训进行协调 心理计量学/规模的开发，日记方法和社区参与干预开发，以及 高级学者以应用这些方法来研究污名，酒精使用，精神 健康和浪漫关系。这种培训和精神训练将使我为发展和评估做好准备 在R00阶段的整个自我，为R01有效试验提案产生初步数据。那，项目 相关的培训将使我能够以（1）确定的目标启动独立的研究职业 污名会影响年轻人的酒精使用和心理健康的机制，以及（2）与 影响社区通过可扩展的干预措施来减轻这些影响。