Multilevel Protective Factors For LGB Youth In North America

描述：越来越多的文献表明，女同性恋者、男同性恋者和双性恋者(LGB)和异性恋青年之间在健康方面存在巨大差异，包括问题药物使用、艾滋病毒危险行为和自杀。2011年，医学研究所呼吁对这一人群进行更多研究，优先考虑健康差异研究，认为这是在LGB Heath中建立坚实证据基础的关键。国际移民组织的报告强调了多层次社会影响对路易斯安那人生活的重要性，明确指出家庭、学校、工作场所、宗教机构和社区组织等社会结构作为关键研究主题的作用，以扩大我们对这一人群健康决定因素的理解。拟议的R01由一名新的调查员领导，以回应PA-12-111，直接满足这一需求。这项研究的目的是扩大和加深我们对家庭、同龄人、学校和社区环境的理解，这些环境可以保护LGB年轻人免受高风险健康行为的影响，包括药物使用、艾滋病毒危险行为和自杀行为。这项研究的目的是1)在深入了解LGB青少年的社区和学校环境的基础上，制定一种理论上有基础的方法来促进他们的健康；2)将使用清单收集的环境数据与现有的基于人群的学生数据联系起来，以确定在个人、家庭、同伴、学校和社区层面上保护LGB青少年免受健康危险行为影响的因素。对不同地点的72名青年进行的“继续”访谈将被用来获得有关LGB青少年对其学校和社区中支持因素的看法的深入信息；这些信息将与出版的文献、专家评论和心理测试一起用于创建LGB环境清单，以表征这些环境中存在的对LGB青年的政策、方案、资源和其他支持。然后，该清单将用于衡量明尼苏达州、不列颠哥伦比亚省和马萨诸塞州120个社区的支助指标，使用可公开获得的材料(如网站)和与主要信息提供人的简短接触(目标1)。然后，这些社区一级的数据将与这些社区中约3,600名LGB青少年的现有学生调查数据联系起来，其中将包括关于家庭、同伴和个人支助的信息，以及健康行为和人口信息(目标2)。将检验以下假设：a)社区和学校的LGB环境得分较高将保护LGB青少年免受健康危险行为的影响；b)更大的家庭联系和支持以及更具支持性的同伴环境将保护LGB青少年免受健康危险行为的影响；c)家庭、同伴和个人层面的因素将调节LGB环境(社区和学校)与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.