SGM Youth Substance Use: Subgroup Differences, Risk, and Protective Factors

项目摘要/摘要 尽管对性少数群体和性别少数群体(即女同性恋、男同性恋、双性恋、变性人和 同性恋/提问)美国青少年(SGMY)，物质使用方面的性取向和性别认同差异 是令人震惊的，而且随着时间的推移而扩大。这表明迫切需要了解SGMY中的谁 是风险最大的，以及导致SGMY物质使用的可修改因素。受到数据排斥的阻碍， 测量的局限性和小的样本量，研究人员还没有探索至关重要的 加剧或降低SGMY药物使用风险的社会人口学和人际因素。作为一名 结果：以SGMY为重点的药物使用预防和干预策略缺乏经验依据， 尤其是对年轻人来说。目前的大多数国家研究都不包括从理论上捕捉 支持SGMY健康差距的驱动因素，如耻辱和歧视。然而，针对少数族裔的 物质使用机制可能是制定有重点和有效的预防战略的关键 减少SGMY物质的使用。如果不加以探索，利益相关者无法确定最佳途径 支持SGMY种族多元化的年轻人中最脆弱的群体。这项提案解决了以下问题 通过对新收集的国家样本进行严格和系统的二级数据分析来限制 年龄13-17岁(N=9,299)的不同SGMY；该研究项目明确旨在捕获更多 民族、地理和社会经济多样性，以及与以下方面有关的少数民族特有经验 健康。提出了三个具体目标：(1)评估酒精、烟草、大麻和多种物质的比率 在由多种与健康相关的人口统计特征(即，性别， 性取向、性别认同和民族认同)，(2)严格测试 近端(即内在化的同性恋恐惧症、排斥预期)和远端(即SGMY特有的歧视 和受害)少数民族应激源和SGMY物质使用，以及(3)检查家庭和 教师SGMY特有的支持缓和了少数民族压力与物质使用之间的联系 以及这些影响是否因性别、性取向、性别认同和民族认同而不同。我们 在通径分析中提出Logistic回归模型、中介和多组分析的组合 按性别、性取向、性别对单物质和多物质使用的框架和潜在分类分析 身份认同和民族身份认同。对风险因素和保护因素的检查将突出关键点 关于消除性取向和性别认同的政策以及个人一级的预防战略-- 在物质使用方面的相关差异，并促进SGMY的积极发展。我们希望我们的发现能有所帮助。 对SGMY物质使用及其可修正因素的了解取得进展。

PROJECT SUMMARY/ABSTRACT Despite improved attitudes towards sexual and gender minority (i.e., lesbian, gay, bisexual, transgender, and queer/questioning) youth (SGMY) in the US, sexual orientation and gender identity disparities in substance use are staggering and widening over time. This demonstrates an urgent need to understand who among SGMY are most at risk and the amendable factors that contribute to SGMY substance use. Stymied by data exclusion, measurement limitations, and small sample sizes, researchers have yet to explore critically important sociodemographic and interpersonal factors that exacerbate or attenuate risk for SGMY substance use. As a result, there is little empirical basis for SGMY-focused substance use prevention and intervention strategies, particularly for youth. Most current national studies do not include measures that capture theoretically supported drivers of SGMY health disparities such as stigma and discrimination. Yet, minority-specific mechanisms of substance use could hold the key to developing focused and effective prevention strategies to curtail SGMY substance use. Left unexplored, stakeholders are unable to determine the best avenues to support the most vulnerable among SGMY ethnoracially-diverse young people. This proposal addresses these limitations through a rigorous and systematic secondary data analysis of a newly collected national sample of diverse SGMY ages 13-17 (N = 9,299); the research project was explicitly designed to capture greater ethnoracial, geographic, and socioeconomic diversity, as well as minority-specific experiences in relation to health. Three specific aims are proposed: (1) assess rates of alcohol, tobacco, marijuana, and polysubstance use among SGMY across groups defined by multiple health-relevant demographic characteristics (i.e., sex, sexual orientation, gender identity, and ethnoracial identity), (2) rigorously test the relationships between proximal (i.e., internalized homophobia, expectations of rejection) and distal (i.e., SGMY-specific discrimination and victimization) minority stressors and SGMY substance use, and (3) examine the extent to which family and teacher SGMY-specific support moderate the association between minority stress and substance use for SGMY and whether these effects vary by sex, sexual orientation, gender identity, and ethnoracial identity. We propose a combination of logistic regression models, mediation and multiple-group analyses in a path analysis framework, and latent class analysis to mono- and polysubstance use by sex, sexual orientation, gender identity, and ethnoracial identity. The examination of both risk and protective factors will highlight critical points for policy as well as individual-level prevention strategies to eliminate sexual orientation and gender identity- related disparities in substance use and foster positive development for SGMY. We expect our findings to help progress understanding of SGMY substance use and the amendable factors that contribute to them.