Sexual Orientation Differences: Prevalence & Correlates of Substance Use & Abuse

描述（由申请人提供）：先前的研究表明，与异性恋人群相比，性少数群体的酒精消费、有害饮酒、烟草和非法药物使用率更高，而性少数群体妇女（SMW）在有害饮酒方面的差异尤为明显。与此同时，对风险调节因子的研究一直受到依赖于SMW的抽样策略的阻碍，这些策略在推广方面受到限制（例如，主要是志愿者样本，没有异性恋比较）或更复杂的建模能力（基于人群的样本，具有较小的SMW数量）。拟议的研究回应了PA-12-111 （LGBTI人群健康研究），并解决了医学研究所（IOM）最近两份与性少数群体健康相关的报告中发现的差距。我们的具体目标包括：目标1：测试扩大稀有种群样本的创新方法和技术。1.1利用NAS概率样本中的种子，采用受访者驱动抽样（RDS）对性少数女性进行抽样（n ~1000）。1.2对样本特征和主要NAS进行方法学比较。目的2：与异性恋人群相比，检查并比较性少数人群中物质使用的中介和调节者。2.1使用来自SMW的样本数据、来自SMW的补充调查数据和来自全国酒精调查的匹配异性恋女性的数据来测试更复杂的模型，以了解少数群体性取向和物质使用之间关系的中介（例如，心理困扰）和调节因子（例如，社会支持，精神）。2.2通过对地理编码NAS和SMW样本的分析，调查社区层面因素在性少数群体健康和福祉中的作用，包括地方态度和信仰（如宗教信仰和会众分布）和法律模式（如支持或禁止同性婚姻的政策）与SMW中物质使用结果之间的可能关系。目的3：方法学研究比较基于人群的SMW和志愿者样本。使用来自样本（在目标1中收集）和NAS（国家概率样本）和CHLEW（地理上受限制的非概率样本）的定量数据来检查和比较SMW中物质使用（有害饮酒、烟草使用和非法药物使用）的估计和相关因素。

DESCRIPTION (provided by applicant): Previous studies indicate that rates of alcohol consumption, hazardous drinking, and use of tobacco and illicit drugs are higher among sexual minorities compared to heterosexual populations, and that differences in hazardous drinking are particularly pronounced among sexual minority women (SMW). At the same time, research to on moderators of risk have been hampered by reliance on sampling strategies for SMW that are limited in generalizability (e.g., predominantly volunteer samples without heterosexual comparisons) or power for more complex modeling (population-based samples with small SMW numbers). The proposed study responds to PA-12-111 (Research on the Health of LGBTI Populations) and addresses gaps identified in two recent Institute of Medicine (IOM) reports related to sexual minority health. Our specific aims include: Aim 1: Test innovative methods and techniques for expanding samples of rare populations. 1.1 Collect an oversample of sexual minority women (n ~1000), using respondent-driven sampling (RDS) with seeds from the NAS probability sample. 1.2 Conduct methodological comparisons between characteristics of the oversample and the primary NAS. Aim 2: Examine and compare mediators and moderators of substance use in sexual minority compared to heterosexual populations. 2.1 Use data from an oversample of SMW, supplemental survey data from SMW and matched heterosexual women from the National Alcohol Surveys to test more complex models to understand mediators (e.g., psychological distress) and moderators (e.g., social support, spirituality) of the relationship between minority sexual orientation and substance use. 2.2 Investigate the role of community level factors in the health and well-being of sexual minorities through analyses of geo- coded NAS and the oversample of SMW, including possible relationships between local attitudes and beliefs (e.g., religiosity and congregational distribution) and legal patterns (e.g., policies supporting or prohibiting same-sex marriage) and substance use outcomes among SMW. Aim 3: Methodological study comparing population-based to volunteer samples of SMW. Use quantitative data from the oversample (collected in Aim 1) and NAS (a national probability sample) and the CHLEW (a geographically restricted non-probability sample) to examine and compare estimates and correlates of substance use (hazardous drinking, tobacco use and illicit drug use) among SMW.