Modeling Resilience as a Multidimensional Protective Factor for Transgender Health Disparities: Measure Development and Longitudinal Evaluation of Resilience

摘要 这项拟议的研究将侧重于了解心理弹性在解决心理健康问题中的作用 变性人和性别多元化(TGD)个人的差异。对TGD的临床和科学认识 健康主要是通过少数群体压力模型来概念化的(Brooks，1981；Meyer，1995； 2003年；Testa等人，2015年)，不成比例地侧重于赤字和风险。相比之下，韧性会随着 超越风险识别，并有可能为制定干预措施提供信息，以帮助保护TGD 来自少数族裔压力源的人会从由此造成的伤害中恢复过来(Meyer，2015)。松野与以色列(2018) 最近提出了变性人复原力干预模型(TRIM)作为 少数群体压力模型(Meyer，2003；Testa等人，2015)。TRIM提出了一个很有前途的理论框架， 了解复原力在缓解少数族裔压力对心理健康的影响方面的作用 TGD个体。然而，目前的措施没有提供一种全面的方法来评估TGD的复原力 如饰边所示。我们的初步工作极大地拓宽了韧性的概念和 为我们建议的多维TGD提供了一个重要的起点来开发项目- 弹性量表。我们将我们综述(Puckett等人，2022年)的发现与最近的研究和 来自每个MPI的初步数据，以便映射到NIMHD的健康差距研究框架。 我们将使用此框架作为概念图，为我们的多维TGD开发初始项目- 韧性量表，反映个人、人际、社区和社会层面的影响。为了 扩大我们措施的效用为满足TGD POC的独特需求，我们建议 与跨部门弹性相关的影响。在这个为期4年的MPI项目中，Puckett、Matsuno和Galupo博士将 与专家和社区小组成员一起开发和评估我们的多维度的初始量表项目 TGD-Resilience Scale(Aim 1)，心理测量学研究我们的新测量(Aim 2)，并调查 采用纵向设计(目标3)，研究复原力对TGD健康差距的保护作用。这 该项目旨在扩大我们对TGD复原力的概念化和测量实践，重新构建 TGD健康的整体方法，纳入基于优势的重点，并为发展提供信息 有针对性的心理健康干预，以增强复原力。此应用程序是对PAR-22-072的响应 呼吁研究促进少数群体健康和健康差距研究的措施和方法-- 相关构造。影响TGD健康差距的因素还没有得到充分的研究 反映复原力的多维表现或复原力的独特特征的衡量标准 为TGD人准备的。我们对保护因素的关注直接与NIMHD的感兴趣领域和我们的 社区参与的方法为未来的研究提供了一条途径，以更好地反映TGD人的生活。

ABSTRACT The proposed research will focus on understanding the role of resilience in addressing mental health disparities for transgender and gender diverse (TGD) individuals. Clinical and scientific understandings of TGD health have been conceptualized primarily through the minority stress model (Brooks, 1981; Meyer, 1995; 2003; Testa et al., 2015) which disproportionately focuses on deficit and risk. In contrast, resilience moves beyond risk identification and has the potential to inform the development of interventions to help protect TGD people from minority stressors and heal from the consequent harm (Meyer, 2015). Matsuno & Israel (2018) recently proposed the Transgender Resilience Intervention Model (TRIM) as an expanded version of the minority stress model (Meyer, 2003; Testa et al., 2015). TRIM presents a promising theoretical framework from which to understand the role of resilience in mitigating the impact of minority stressors on mental health for TGD individuals. However, current measures do not provide a comprehensive way to assess TGD resilience as outlined in the TRIM. Our preliminary work significantly broadens the conceptualization of resilience and provides an important starting point from which to develop items for our proposed Multidimensional TGD- Resilience Scale. We incorporate findings from our review (Puckett et al., 2022) with recent research and preliminary data from each of the MPIs in order to map onto NIMHD’s health disparities research framework. We will use this framework as a conceptual map for developing initial items for our Multidimensional TGD- Resilience Scale that reflect individual, interpersonal, community, and societal levels of influence. In order to broaden the utility of our measure to address the unique needs of TGD POC, we propose a fifth level of influence related to intersectional resilience. In this 4-year MPI project, Drs. Puckett, Matsuno, and Galupo will work with expert and community panelists to develop and evaluate initial scale items for our Multidimensional TGD-Resilience Scale (Aim 1), psychometrically investigate our novel measure (Aim 2), and investigate the protective function of resilience in relation to TGD health disparities using a longitudinal design (Aim 3). This project is poised to broaden our conceptualization and measurement practices for TGD Resilience, reframe the overall approach to TGD health to incorporate a strengths-based focus, and inform the development of targeted mental health interventions to bolster resilience. This application is in response to PAR-22-072, which calls for research on measures and methods to advance research on minority health and health disparities- related constructs. The factors influencing TGD health disparities are under-researched and there are no measures that reflect multidimensional manifestations of resilience or the unique characteristics of resilience for TGD people. Our focus on protective factors directly aligns with NIMHD’s areas of interest and our community-participatory approach provides an avenue for future research to better reflect TGD people’s lives.