Reducing Black Men's Drug Use and Co-Occurring Negative Mental and Physical Health Outcomes: Intersectionality,Social-Structural Stressors, and Protective Factors

项目摘要/摘要 混合方法解释-顺序(Quant→Quant)父母研究将测试一个概念模型 社会结构性应激源、保护性因素以及药物使用和同时出现的负面心理和生理因素 处于性别认同和社会经济地位(SEP)交叉点的黑人男性的健康结果。 在交叉性理论框架的指导下，父母研究的初步设计提供了三个 性认同类别(即，同性恋、双性恋和异性恋)和两个SEP位置(即，较低、较高)和 1,440人的样本量(即，6个抽样帧中的每一个有240名参与者：低SEP、低SEP、低SEP 双性恋、SEP较低的异性恋者、SEP较高的同性恋、SEP较高的双性恋者、SEP较高的异性恋者)。这个 招募双性恋男性并在两个不同的SEP类别这样做所涉及的相当大的挑战是 考虑到这项研究的5年时间框架和有限的资源，方法上是不可行的。因此，单一的性行为 由男同性恋者、双性恋者和其他与男性发生性关系的男性组成的少数民族(SM)类别是为了 产生一个只按两种性别认同立场(即SM和异性恋)分层的抽样框。一个 已确定，就征聘而言，这一抽样框架在方法上更可行。 因为它提供了960个样本大小(即，低SEP SM、低SEP SM、低SEP 异性恋，SEP较高的SM，SEP较高的异性恋者)。要解决布莱克存在的关键差距 双性恋男性健康，拟议的行政补充的目标是增加黑人的数量 双性恋男性参与者，并将双性恋男性确立为所有父母研究的独特的SM职位 分析。为了实现这一目标，将与美国比奈大学建立学术和社区合作伙伴关系 美国最古老的全国性双性恋组织。拟议的附录增加了新的主要推论和 专门针对双性恋男性的探索性分析(目标1，父母研究)。它还增加了一种收敛的混合方法 第一阶段的设计部分，其中将在第一阶段进行深入的定性访谈 对30名有目的地抽样的I期量化双性恋参与者进行了定量分析。采访 将促进对黑人双性恋男性经历的丰富、文化和背景基础的理解 与父母研究的重点相关，以及他们特定于交叉性的经验(例如，双负性)。 对于母研究的目标3，第二阶段(重点小组解释第一阶段的量化结果)和第三阶段 (混合方法综合和有效性评估)保持不变。双性恋参与者将是 有目的地为第二阶段重点小组抽样。第三阶段定量和定性综合分析 将评估双性恋参与者的结果的趋同和分歧。这种对双性恋的特别关注 参与者代表了性少数群体研究的典范转变。建议的重要意义 研究在于未来发展减少药物使用的多层次干预措施的预期结果 并促进黑人双性恋男性的心理和身体健康。

PROJECT SUMMARY/ABSTRACT The mixed methods explanatory-sequential (QUANT→quant) parent study will test a conceptual model of social-structural stressors, protective factors, and drug use and co-occurring negative mental and physical health outcomes among Black men at the intersection of sexual identity and socioeconomic position (SEP). Informed by the intersectionality theoretical framework, the initial design for the parent study provided for three sexual identity categories (i.e., gay, bisexual, and heterosexual) and two SEP positions (i.e., lower, higher) and a sample size of 1,440 (i.e., 240 participants for each of the 6 sampling frames: lower- SEP gay, lower-SEP bisexual, lower-SEP heterosexual, higher-SEP gay, higher-SEP bisexual, higher-SEP heterosexual). The considerable challenges involved in recruiting bisexual men and doing so at two different SEP-categories, was methodologically infeasible given the study's 5-year timeframe and limited resources. Thus a single sexual minority (SM) category composed of gay, bisexual, and other men who have sex with men was created to produce a sampling frame stratified by just two sexual identity positions (i.e., SM and heterosexual). A determination was made that this sampling frame was more methodologically feasible in terms of recruitment because it provided for a sample size of 960 (i.e., 240 participants each of lower-SEP SM, lower-SEP heterosexual, higher-SEP SM, higher-SEP heterosexual). To address the critical gaps that exist about Black bisexual men's health, the goal of the proposed administrative supplement is to increase the number of Black bisexual men participants and establish bisexual men as a distinct SM position for all of the parent study's analyses. To accomplish this goal, an academic-community partnership will be established with BiNet USA, the oldest national bisexual organization in the U.S. The proposed supplement adds new primary inferential and exploratory analyses specific to bisexual men (Aim 1, parent study). It also adds a convergent mixed methods design component in Phase I in which in-depth qualitative interviews will be conducted during the Phase I quantitative analyses with 30 purposively sampled Phase I quantitative bisexual participants. The interviews will facilitate a rich, culturally and contextually-grounded understanding of Black bisexual men's experiences relevant to the parent study's focus, as well as their intersectionality-specific experiences (e.g., binegativity). For Aim 3 of the parent study, Phases II (Focus Groups to Explain the Phase I Quantitative Results) and III (Mixed Methods Syntheses and Assessment of Validity) are unchanged. Bisexual participants will be purposively sampled for the Phase II focus groups. Phase III quantitative and qualitative synthesis analyses will assess the convergence and divergence of results for bisexual participants. This specific focus on bisexual participants represents a paradigmatic shift in sexual minority research. The significance of the proposed research lies in the expected outcome of the future development of multilevel interventions to reduce drug use and promote mental and physical health for Black bisexual men.