SUBSTANCE USE AND DISORDERED WEIGHT BEHAVIORS IN SEXUAL MINORITY YOUTH CONTEXTS

描述（由申请人提供）：性少数青年（SMY;即，男/女同性恋者、双性恋者或质疑者）更有可能使用物质（例如，烟草、酒精、大麻）和从事体重紊乱行为（例如，净化）比他们的异性恋同龄人。这些健康差异出现在青春期早期，并使SMY患癌症、心血管疾病、物质相关损伤和疾病、饮食失调和肥胖的风险不成比例。SMY可能参与物质使用和紊乱的体重行为，以减轻压力。也有可能，这些行为被采用和维持，因为它们有助于建立与SMY同龄人的联系，通过遵守感知的性少数物质使用和身体形象规范。这些压力和社会化途径的运作可能取决于SMY穿越的不同社会环境以及环境提供安全、连通性、结构和有益健康的健康行为规范的能力。然而，缺乏实证研究的特点和活动的设置，促进SMY的健康。虽然有限的研究表明，正式组织的支持环境的存在可能会保护免受负面影响和社会性，但缺乏对这种支持环境如何以及为什么具有保护作用的理解，或者这些保护作用是否也会扩展到物质使用和紊乱的体重行为。在计划的K 01研究中，我将使用前瞻性纵向调查数据和生态瞬时评估（EMA）技术来调查SMY中缓解少数民族压力和防止物质使用和体重紊乱行为的特征和活动。数据将来自（1）“今日成长研究”--一项由16,000多名青少年和年轻人组成的全国性队列研究--以评估背景特征、压力、物质使用和体重紊乱行为之间的总体关联;以及（2）从SMY服务机构招募的60名SMY队列，并通过受访者-在波士顿地区的驱动抽样技术，以检查设置SMY遍历的动态和他们的时间连接到少数民族的压力，物质使用，和无序的体重行为。为了促进这种研究，我必须获得基于社区的参与性研究（CBPR）和预防科学，EMA研究设计和分析以及各种纵向统计方法（例如，具有密集纵向数据的有限混合建模），用于分析上下文交互与健康行为之间的联系。CBPR与SMY可以促进可持续的积极变化，通过生成有关导致健康差异的背景因素的详细信息，通过建立SMY的领导技能和自我效能感，以及通过加强SMY服务组织内的社会支持基础设施。拟议的研究将确定可修改的背景水平的杠杆点，为预防干预和定位我的职业生涯作为一个预防科学家。

DESCRIPTION (provided by applicant): Sexual minority youth (SMY; i.e., gay/lesbian, bisexual, or questioning) are more likely to use substances (e.g., tobacco, alcohol, marijuana) and engage in disordered weight behaviors (e.g., purging) than their heterosexual peers. These health disparities emerge in early adolescence and place SMY at disproportionate risk for developing cancer, cardiovascular disease, substance-related injuries and disorders, eating disorders, and obesity. SMY may engage in substance use and disordered weight behaviors to mitigate stress. It is also possible that these behaviors are adopted and maintained because they help to build connections with SMY peers though conformity to perceived sexual minority substance use and body image norms. The operation of these stress and socialization pathways is likely contingent on the diverse social settings SMY traverse and the capacity of settings to provide safety, connectedness, structure, and salubrious health behavior norms. However, there is a dearth of empirical research examining characteristics and activities of settings that promote health in SMY. Although limited research suggests that the presence of formally organized support settings may protect against negative affect and sociality, there is a lack of understanding of how and why such support settings have a protective effect or whether these protective effects will also extend to substance use and disordered weight behaviors. In the planned K01 research I will use prospective longitudinal survey data and ecological momentary assessment (EMA) techniques to investigate characteristics and activities in settings that mitigate minority stress and protect against substance use and disordered weight behaviors among SMY. Data will come from (1) the Growing Up Today Study -- a national cohort of over 16,000 adolescents and young adults -- to assess overall associations between contextual characteristics, stress, and substance use and disordered weight behaviors; and (2) a cohort of 60 SMY recruited from SMY-serving organizations and via respondent-driven sampling techniques in the Boston area to examine the dynamics of the settings SMY traverse and their temporal connections to minority stress, substance use, and disordered weight behaviors. To facilitate such research, I must gain training in community-based participatory research (CBPR) and prevention science, EMA study design and analysis, and diverse longitudinal statistical methods (e.g., finite mixture modeling with intensive longitudinal data) for analyzing the connections between contextual interactions and health behaviors. CBPR with SMY can promote sustainable positive change by generating detailed information about the contextual factors contributing to health disparities, by building the leadership skills and feelings of self-efficacy in SMY, and by bolstering social support infrastructure within SMY-serving organizations. The proposed research will identify modifiable contextual-level leverage points for preventive interventions and position me for a career as a prevention scientist.