Multilevel Protective Factors For LGB Youth In North America

产品说明：越来越多的文献表明，女同性恋、男同性恋和双性恋青年与异性恋青年在健康方面存在巨大差异，包括问题药物使用、艾滋病毒风险行为和自杀。2011年，医学研究所呼吁对这一人群进行更多的研究，将健康差异研究列为LGB健康“建立坚实证据基础所必需的”优先事项。国际移民组织的报告强调了多层面社会影响对男女同性恋、双性恋和变性者生活的重要性，并具体说明了家庭、学校、工作场所、宗教机构和社区组织等社会结构的作用，认为这些都是重要的研究课题，有助于扩大我们对这一人群健康决定因素的了解。 根据PA-12-111，由一名新研究者领导的拟定R 01直接解决了这一需求。本研究的目的是扩大和加深我们对家庭，同伴，学校和社区环境的理解，这些环境保护年轻的LGB人不参与高风险的健康行为，包括药物使用，艾滋病毒风险行为和自杀行为。本研究的目的是：1）在深入了解LGB青少年的社区和学校环境的基础上，开发一种有理论基础的方法来促进LGB青少年的健康; 2）将使用清单收集的环境数据与现有的基于人口的学生数据联系起来，以确定个人，家庭，同伴，学校和社区层面上保护LGB青少年参与健康风险行为的因素。将对不同地点的72名青年进行“随叫随到”访谈，以深入了解男女同性恋、双性恋和变性者青少年对学校和社区支助因素的看法;这些信息，结合已发表的文献、专家评论和心理测量测试，将被用来创建一个LGB环境清单，以描述政策、方案，为这些环境中的男女同性恋、双性恋和变性青年提供资源和其他支持。然后，将利用公开资料（如网站）和与关键信息提供者的简短接触，利用清单衡量明尼苏达州、不列颠哥伦比亚省和马萨诸塞州120个社区的支助指标（目标1）。然后，这些社区一级的数据将与来自这些社区约3 600名男女同性恋、双性恋和变性者青少年的现有学生调查数据相联系，这些数据将包括有关家庭、同伴和个人支持的信息，以及健康行为和人口统计信息（目标2）。本研究将检验以下假设：（1）社区和学校较高的LGB环境得分将保护LGB青少年免受健康风险行为的影响; B）更大的家庭联系和支持以及更支持的同伴环境将保护LGB青年免受健康风险行为的影响，以及c）家庭，同伴和个人水平的因素将调节LGB环境（社区和学校）和感兴趣的健康风险行为之间的关联。

DESCRIPTION: A growing body of literature demonstrates dramatic disparities in health between lesbian, gay and bisexual (LGB) and heterosexual youth, including problem substance use, HIV risk behaviors and suicide. In 2011 the Institute of Medicine called for additional research with this population, prioritizing health disparities research as "essential for building solid evidence base" in LGB heath. The IOM report highlights the importance of multilevel social influences on the lives of LGB people, specifying the role of social structures such as families, schools, workplaces, religious institutions and community organizations as critical subjects of study to expand our understanding of the determinants of health in this population. The proposed R01 led by a new investigator in response to PA-12-111, directly addresses this need. The goal of this study is to broaden and deepen our understanding of the family, peer, school and community environments that protect young LGB people from involvement in high risk health behaviors, including substance use, HIV risk behaviors and suicide behaviors. This research aims to 1) develop a theoretically grounded approach to promoting health among LGB adolescents based on in-depth knowledge of their community and school environments, and 2) link environmental data, collected using the Inventory, with existing population-based student data to identify factors at the individual, family, peer, school and community levels that protect LGB youth from involvement in health risk behaviors. "Go-along" interviews with 72 youth in diverse locations will be used to elicit in-depth information on LGB adolescents' perceptions of supportive elements in their schools and communities; this information, in conjunction with published literature, expert review, and psychometric testing, will be used to create an LGB Environment Inventory to characterize policies, programs, resources and other supports for LGB youth that exist in these settings. The Inventory will then be used to measure indicators of support in 120 communities in Minnesota, British Columbia and Massachusetts, using publicly available materials (e.g. websites) and brief contacts with key informants (Aim 1). These community-level data will then be linked with existing student survey data from approximately 3,600 LGB adolescents in these same communities, which will include information about family, peer and individual supports, as well as health behaviors and demographic information (Aim 2). The following hypotheses will be tested: a) higher LGB environment scores for the community and school will be protective against health risk behaviors among LGB youth; b) greater family connectedness and support and a more supportive peer environment will be protective against health risk behaviors among LGB youth, and c) family, peer and individual-level factors will moderate the associations between the LGB environment (community and school) and the health risk behaviors of interest.