Understanding Disparities in Obesity and Weight Behaviors by Sexual Identity

描述（由申请人提供）：先前的研究表明，女同性恋，男同性恋，双性恋和变性人（LGBT）成年人比同龄人经历更多的不良健康结果。少数几项研究调查了成年人之间的体重差异，结果表明，女同性恋者与异性恋者相比更容易超重或肥胖，尽管对男同性恋者和双性恋者的了解较少。鉴于迄今为止在这一领域的研究很少，医学研究所（IOM）最近呼吁对LGBT健康进行更多的研究。 此外，国际移民组织强调，在审查按性别特征划分的健康差距时，需要利用生命过程框架，承认不同生命阶段对健康的独特影响。成年期（即，18-25岁）是出现健康差异的一个重要年龄，其特点是体重、饮食质量和体育活动发生不利变化。新兴的成年人在向成年过渡的过程中，在寻找独立和谈判新的责任、生活技能和身份时，会经历脆弱性。为 LGBT青年，这些过渡可能会有许多额外的复杂性。由于美国24岁以下的高中毕业生中有一半接受了中学后教育，中学后教育机构可能是检查和解决新出现的成人健康差异的重要场所，包括LGBT群体之间的差异。 我们在这里有独特的机会来分析2007-2011年近30，000名中学后学生的国家监测数据，其中包括近2，000名女同性恋，男同性恋，双性恋和质疑（LGB）年轻人的大型子样本，参加了一系列2年和4年制学院和大学。我们的目标是：（1）量化LGB和异性恋学生在肥胖、饮食摄入、体育活动、不健康的体重控制行为、身体满意度和其他与体重相关的健康结果方面的差异;（2）确定主要的与体重相关的健康行为模式或特征，以及这些行为特征在性别认同和性别方面的差异程度;以及（3）通过人口统计学因素和健康结果（例如，年龄、社会经济地位、医疗保健覆盖率、肥胖和健康状况）。我们假设，LGB学生从事更多的不良行为比他们的异性恋同龄人，并表现出不同的行为模式。例如，根据以前的研究，我们假设男同性恋者更有可能表现出不健康的体重控制和身体不满的模式，而女同性恋者更有可能参与高体力活动，加上更高的酒精和烟草使用和其他不良行为。鉴于对LGB体重相关健康的了解有限，特别是新兴的成年人，这项研究将填补IOM和其他人确定的文献中的重要空白。此外，R21的研究结果将作为关键的形成性研究，为R 01提供信息，以定制和测试LGBT特定的肥胖干预措施。

DESCRIPTION (provided by applicant): Previous research indicates that lesbian, gay, bisexual and transgender (LGBT) adults experience more adverse health outcomes than their peers. Findings from the few studies examining weight disparities among adults suggest that lesbian women are more likely to be overweight or obese compared to their heterosexual peers, though less is known about gay men and bisexuals. Given the scant research to date in this area, the Institute of Medicine (IOM) recently issued a call for additional research on LGBT health. Furthermore, IOM highlighted the need to utilize a life-course framework when examining health disparities by sexual identity, acknowledging the unique influence of various life stages on health. Emerging adulthood (i.e., ages 18-25) is an important age at which health disparities emerge, and an age characterized by adverse changes in weight, dietary quality, and physical activity. Emerging adults experience vulnerabilities as they find independence and negotiate new responsibilities, life skills, and identities during the transition to adulthood. For LGBT youth, these transitions may be layered with many additional complexities. In that half of US high school graduates up to age 24 are enrolled in post-secondary education, post-secondary institutions may be important arenas for examining and addressing emerging adult health disparities, including those among LGBT groups. We have the unique opportunity here to analyze 2007-2011 state surveillance data of nearly 30,000 post-secondary students, including a large sub-sample of nearly 2,000 lesbian, gay, bisexual and questioning (LGB) young people, attending an array of 2- and 4-year colleges and universities. Our aims are to: (1) Quantify disparities in obesity, dietary intake, physical activity, unhealthy weight control behavior, body satisfaction and other weight-related health outcomes among LGB and heterosexual students; (2) Identify major weight-related health behavioral patterns, or profiles, and the extent to which these behavioral profiles differ by sexual identity and gender; and (3) Characterize these behavioral profiles by demographic factors and health outcomes (e.g., age, socioeconomic status, health care coverage, obesity, and health status). We hypothesize that LGB students engage in more adverse behaviors than their heterosexual peers and exhibit differential behavioral patterning. For example, based on previous research, we hypothesize that gay men are more likely to exhibit a pattern of unhealthy weight control and body dissatisfaction, whereas lesbians are more likely to engage in a pattern characterized by high physical activity coupled with higher alcohol and tobacco use and other adverse behaviors. Given the limited understanding of LGB weight-related health, particularly emerging adults, this study will fill important gaps in the literature identified by IOM and others. Furthermore, the findings from this R21 will serve as critical formative research needed to inform an R01 that will tailor and test an LGB-specific obesity intervention.