Interpersonal Protective Factors and Mental Health Symptom Self-Management Among Black Transgender Women: A Mixed-Methods Study

提案摘要 整个生命过程中的保护因素可以对个人健康产生深远的影响。已经充分 儿童时期的不良经历和一生中遭受歧视和受害的机会， 对身心健康造成负面影响。对于黑人和变性妇女来说，逆境可能是 种族主义和基于性别的歧视的交叉影响加剧了这一问题。的星座 整个生命周期的人际保护因素，包括积极的童年经历，家庭 接受和社会支持，可能有助于改善个人的心理健康结果，因为他们 在整个生命历程中经历逆境。此外，心理健康症状自我管理可能 调节黑人跨性别妇女的经历与保护因素和当前 心理困扰症状自我管理，定义为利用自己的能力， 健康或管理疾病，可能有助于改善心理健康结果，并可能对此至关重要 由于医疗保健参与的重大已知障碍，然而，对以下方面的探索有限： 保护性因素和自我管理对黑人跨性别妇女心理健康结果的影响。到 为了解决这一差距，提出了一项融合的混合方法研究，以增加我们对保护性 因素与黑人跨性别者的心理健康自我管理和心理困扰有关 妇女这项培训补助金，嵌套在一个更大的家长研究，采取了基于优势的方法来检查 感兴趣的变量之间的复杂关系。具体目标是：目标1。确定关联 在人际保护因素中（即，积极的童年经历，感知的家庭接受，以及 目前的社会支持）和黑人跨性别妇女（N=150）的心理困扰的当前症状。 目标2.确定心理健康自我管理在调节 人际保护因素、抑郁症状和创伤后应激障碍症状。目标3.使用主题内容 对目标1中的30名黑人变性妇女进行深入访谈，分析人际关系如何 保护性因素影响黑人跨性别女性自我管理心理困扰的能力 症状调查结果将为未来的干预措施提供信息，以减少有害的 逆境和歧视对不同种族的跨性别青年和成年人的影响。

Proposal Summary Protective factors across the life course can have profound effects on individual health. It has been well established that adverse childhood experiences and lifetime exposure to discrimination and victimization have negative mental and physical health effects. For women who are Black and transgender, adversity can be compounded by the intersectional impact of racism and gender-based discrimination. A constellation of interpersonal protective factors throughout the lifespan, including positive childhood experiences, family acceptance, and social support, may help to improve mental health outcomes among individuals as they experience adversity throughout the life course. Additionally, mental health symptom self-management may moderate the relationship between Black transgender women's experiences with protective factors and current psychological distress symptoms. Self-management, defined as drawing upon one's own ability to promote health or manage disease, may be instrumental in improving mental health outcomes and could be vital for this population due to significant known barriers to healthcare engagement. However, there is limited exploration of protective factors and self-management on mental health outcomes among Black transgender women. To address this gap, a convergent mixed-methods study is proposed to increase our understanding of how protective factors are associated with mental health self-management and psychological distress among Black transgender women. This training grant, nested within a larger parent study, takes a strengths-based approach to examine complex relationships between the variables of interest. The specific aims are: Aim 1. Determine the associations among interpersonal protective factors (i.e., positive childhood experiences, perceived family acceptance, and current social support) and current symptoms of psychological distress for Black transgender women (N=150). Aim 2. Determine the role of mental health self-management in moderating the associations between interpersonal protective factors, symptoms of depression, and symptoms of PTSD. Aim 3. Use thematic content analysis of in-depth interviews with 30 Black transgender women from Aim 1 to analyze how interpersonal protective factors influenced Black transgender women's abilities to self-manage psychological distress symptoms. Findings will inform future recommendations for interventions aimed at decreasing the harmful effects of adversity and discrimination for racially diverse transgender youth and adults.