Cardiovascular Health of Sexual and Gender Minorities in the Hispanic Community Health Study/Study of Latinos (SGM HCHS/SOL)

项目概要/摘要 西班牙裔/拉丁裔性和性别少数群体（SGM）是美国SGM中增长最快的种族群体。 心血管疾病（CVD）是西班牙裔/拉丁美洲人发病率和死亡率的主要原因。SGM 心血管疾病（CVD）风险的不公平性早在成年早期就已确定;少数 压力被认为是一种潜在的调节剂。然而，少数少数族裔参与SGM 研究排除了对性取向、性别认同和种族交叉点的研究。 我们提出了一个具有成本效益的辅助研究，将利用现有的数据，从父母西班牙裔 社区健康研究/拉丁美洲人研究（HCHS/SOL），同时收集有关性取向、性别 身份，耻辱，歧视，压力，应对，社会支持和心血管疾病风险。拟议的研究是及时的 因为HCHS/SOL参与者将于11月开始进行第三次面对面访问（V3） 2019.在本研究中，我们将（1）检查性取向和性别认同对CVD风险的影响 在V3的所有HCHS/SOL参与者中（~9300）;（2）性取向和性别的模型路径 在1：2匹配的SGM子队列中，通过羞辱、歧视和压力对CVD风险的认同， V3时的非SGM参与者（~1680）;（3）检查污名/歧视对性行为的影响 V3时子队列参与者之间的定向和心血管疾病风险关系。数据分析将遵循 概念模型源自LGBT少数群体压力模型，其中过度的耻辱歧视 SGM导致少数民族压力，增加CVD风险。在这个模型中，应对和社会支持作为 缓解少数民族压力对CVD风险影响的弹性因素。横断面和纵向 回归模型和结构方程模型将用于测试这些关系。理解 在西班牙裔/拉丁裔SGM中，污名诱导的压力对CVD风险的影响具有重要意义， 制定针对特定文化的CVD风险降低策略。研究结果将用于建立在 确定了西班牙裔/拉丁裔的文化优势，为家庭和社区的适应和测试提供信息 接受干预。 .

Project Summary/Abstract Hispanic/Latino sexual and gender minorities (SGM) are the fastest growing ethnic group of SGM in the U.S. Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among Hispanic/Latinos. SGM inequities in cardiovascular disease (CVD) risk have been identified as early as young adulthood; and minority stress has been identified as a potential moderator. Yet, small numbers of ethnic minority participants in SGM studies have precluded examination of the intersections of sexual orientation, gender identity, and ethnicity. We propose a cost-effective ancillary study that will leverage existing data from the parent Hispanic Community Health Study/Study of Latinos (HCHS/SOL) while collecting new data on sexual orientation, gender identity, stigma, discrimination, stress, coping, social support, and CVD risk. The proposed study is timely because HCHS/SOL participants will be scheduled for their third in-person visits (V3) starting in November 2019. In this study, we will (1) examine the influence of sexual orientation and gender identity on CVD risk among all HCHS/SOL participants at V3 (~9300); (2) model pathways from sexual orientation and gender identity to CVD risk through stigma, discrimination, and stress among a 1:2 matched sub-cohort of SGM and non-SGM participants at V3 (~1680); and (3) examine the influence of stigma/discrimination on sexual orientation and CVD risk relationships among sub-cohort participants at V3. Data analysis will follow a conceptual model derived from the LGBT Minority Stress Model in which excess stigma discrimination against SGM leads to minority stress that increases CVD risk. In this model, coping and social support serve as resilience factors that mitigate the impact of minority stress on CVD risk. Cross-sectional and longitudinal regression models as well as structural equation models will be used to test these relationships. Understanding the influence of stigma-induced stress on CVD risk among Hispanic/Latino SGM has significant implications for the development of culturally-specific CVD risk reduction strategies. Study findings will be used to build on identified Hispanic/Latino cultural strengths to inform adaptation and testing of family and community acceptance interventions. .