Intersectionality of Sexual Orientation, Gender Expression, and Weight Status on Risk of Disordered Eating Behaviors

性取向、性别表达和体重状况对饮食行为失调风险的交叉影响

• 批准号: 10272420
• 负责人: Ariel L Beccia
• 金额: $ 2.57万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-28 至 2022-05-13
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10272420
• 关键词: Academy; Address; Adopted; Appearance; Behavior; Binge Eating; Caloric Restriction; Complex; Dangerousness; Data; Depression and Suicide; Development; Diet; Dimensions; Disadvantaged; Discrimination; Eating; Eating Behavior; Eating Disorders; Epidemiology; Fasting; Fellowship; Future; Glare; Goals; Health; Health behavior; Heterosexuals; Individual; Individual National Research Service Award; Institutes; Intervention; Knowledge; Lesbian Gay Bisexual; Link; Longitudinal cohort study; Mediating; Medicine; Mentorship; Metabolic; Metabolic Diseases; Methods; Minority; Minority Groups; Modification; Obesity; Outcome; Outcomes Research; Overweight; Participant; Pathology; Pattern; Policies; Population; Prevalence; Reporting; Reproductive Health; Research; Research Personnel; Risk; Risk Factors; Role; Sex Orientation; Sexual Health; Sexual and Gender Minorities; Social Conditions; Social Environment; Social Identification; Statistical Methods; Statistical Models; Stress; Structure; Subgroup; Training; Victimization; Vomiting; Weight; aged; base; bullying; career; disorder risk; experience; gender difference; gender expression; gender nonconforming; health disparity; health equity; health equity promotion; high risk; innovation; insight; interest; intersectionality; laxative; lens; minority health; multilevel analysis; non-heterosexual; novel; peer; pill; pre-doctoral; purge; sexual minority; skills; social determinants; social disadvantage; social exclusion; social stigma; social stressor; stressor; substance use; young adult

PA-19-195 Ruth L. Kirschstein National Research Service Award Individual Predoctoral Fellowship, NOT-MD- 19-001, Notice of Special Interest in Research on the Health of Sexual and Gender Minority Populations: A glaring sexual orientation-related disparity is in the prevalence of disordered eating behaviors (DEBs), including severe calorie restriction, self-induced vomiting, laxative and diet pill use, and binge-eating. One in three sexual minority young people (lesbian, gay, bisexual, and other non-heterosexual individuals) engage in DEBs, a seven-fold higher odds than their heterosexual peers. There are considerable health consequences associated with these behaviors, such as metabolic and reproductive health issues, substance use, depression, and suicidality. However, research on DEBs lags behind that on other sexual orientation-related health disparities, with critical gaps including failing to consider both within-group diversity in risk and the upstream social determinants of the observed disparities. Importantly, experiencing multiple forms of social disadvantage has been shown to increase risk of eating-related pathologies, including DEBs. Gender nonconforming and higher-weight (i.e., overweight/obese) statuses are especially relevant dimensions of disadvantage to consider, as these groups experience high levels of appearance-based discrimination and may use DEBs as dangerous body-modification practices to cope. Sexual minorities who experience further marginalization through membership in these groups may encounter unique and/or compounding social stressors that exacerbate risk. Examining the intersectionality of sexual orientation, gender expression, and weight status is thus critical to addressing these research gaps. Using the Growing Up Today Study (GUTS), a national longitudinal cohort study of over 27,000 participants (~20% of whom are sexual minorities), the aims of this proposal are to: 1) Quantify the intersectional effects of sexual orientation, gender expression, and weight status on risk of DEBs among young adults; 2) Quantify the effects of interpersonal-level determinants (bullying victimization, weight-based harassment) on risk of DEBs by sexual orientation, and evaluate differences by gender expression and/or weight-status; and 3) Quantify the effects of structural-level determinants (discriminatory social conditions, state policies) on risk of DEBs by sexual orientation, and evaluate differences by gender expression and/or weight-status. The National Academy of Medicine’s 2011 landmark report on sexual minority health stressed the importance of adopting an intersectional framework for disparities research to inform the development of inclusive health equity efforts. Applying this lens through leveraging novel statistical methods will further understanding of a critically understudied sexual minority health issue and help identify high-risk subgroups and modifiable contextual risk factors. A tailored training plan accompanies this proposal and outlines the steps required to advance the Applicant’s career as an independent researcher focused on intersectional health disparities research.

PA-19-195 Ruth L.基尔施斯坦国家研究服务奖个人博士前奖学金，非MD- 19-001，关于性和性别少数群体健康研究的特别关注通知：A 与性取向有关的明显差异是饮食失调行为（DEB）的流行， 包括严格的热量限制、自我诱发的呕吐、泻药和减肥药的使用以及暴饮暴食。分之一 三个性少数年轻人（女同性恋，男同性恋，双性恋和其他非异性恋个体）参与 DEB，比异性恋同龄人高出七倍。会对健康造成严重影响 与这些行为相关的，如代谢和生殖健康问题，物质使用， 抑郁和自杀倾向然而，对DEB的研究落后于其他与性取向相关的研究 健康差距，关键差距包括未能考虑群体内风险的多样性和 上游社会决定因素所观察到的差距。重要的是，体验多种形式的社会 已经证明，不利因素会增加进食相关疾病的风险，包括DEB。性别 更大和更高重量（即，超重/肥胖）状态是 这是一个需要考虑的不利因素，因为这些群体经历了严重的基于外表的歧视， 可能会使用DEB作为危险的身体改造实践来科普。性少数群体经历更多 由于属于这些群体而被边缘化，可能会遇到独特和/或复杂的社会问题， 加剧风险的压力源。研究性取向、性别表达和性别平等的交叉性， 因此，体重状况对于解决这些研究差距至关重要。《今日成长研究》（Growing Up Today Study，GUTS） 超过27，000名参与者（其中约20%是性少数群体）的国家纵向队列研究， 这项建议是：1）量化性取向，性别表达和体重的交叉影响 青少年DEB风险状况; 2）量化人际层面决定因素（欺凌）的影响 受害、基于体重的骚扰）对性取向的DEB风险的影响，并通过以下方式评估差异 性别表达和/或体重状况; 3）量化结构层面决定因素的影响 （歧视性的社会条件，国家政策）的风险DEBs的性取向，并评估差异 性别表达和/或体重状况。美国国家医学院2011年里程碑式的报告， 性少数群体健康强调了采用跨部门框架进行差异研究的重要性 为包容性卫生公平工作的发展提供信息。通过利用新颖的技术应用该透镜， 统计方法将进一步了解一个严重不足的性少数群体的健康问题， 确定高风险亚组和可改变的背景风险因素。定制的培训计划伴随着这一点 建议，并概述了所需的步骤，以推进申请人的职业生涯作为一个独立的研究人员 专注于跨部门健康差异研究。