Multilevel Protective Factors For LGB Youth In North America

摘要 越来越多的文献表明，女同性恋者、男同性恋者和男同性恋者之间的健康差异很大 双性恋(LGB)和异性恋青年，包括问题药物使用、艾滋病毒危险行为和自杀。 2011年，医学研究所呼吁对这一人群进行更多研究，将健康放在首位 在LGB Heath中，差异研究是“建立坚实的证据基础所必需的”。国际移民组织的报告强调了 多层次社会影响对LGB人生活的重要性，具体说明社会结构的作用 如家庭、学校、工作场所、宗教机构和社区组织等 研究以扩大我们对这一人群健康决定因素的理解。 拟议的R01由一名新的调查员领导，以回应PA-12-111，直接满足这一需求。 这项研究的目的是扩大和加深我们对家庭、同伴、学校和 保护LGB年轻人不参与高风险健康行为的社区环境， 包括药物使用、艾滋病毒危险行为和自杀行为。这项研究的目的是1)开发一种 在LGB青少年中促进健康的理论基础的方法，基于对 他们的社区和学校环境，以及2)将使用清单收集的环境数据与 现有的基于人口的学生数据，以确定个人、家庭、同伴、学校和社区的因素 保护LGB青少年不参与健康危险行为的水平。《继续前进》采访72名青年 在不同的地点将被用来获得关于LGB青少年对支持的看法的深入信息 学校和社区的要素；这一信息与出版的文献相结合，专家 审查和心理测试将用于创建LGB环境清单，以确定 存在于这些环境中的针对LGB青年的政策、方案、资源和其他支持。库存 然后将被用来衡量明尼苏达州、不列颠哥伦比亚省和 马萨诸塞州，使用可公开获得的材料(如网站)和与关键线人的简短联系 (目标1)。然后，这些社区级数据将与现有的学生调查数据相关联 这些社区中约有3600名LGB青少年，其中将包括以下信息 家庭、同伴和个人支持，以及健康行为和人口统计信息(目标2)。这个 将检验以下假设：a)社区和学校的LGB环境分数将更高 防止男女同性恋青年的健康危险行为；b)加强家庭联系和支持，以及 一个更具支持性的同伴环境将防止LGB青少年的健康危险行为，以及 C)家庭、同龄人和个人因素将缓和LGB环境之间的联系 (社区和学校)和感兴趣的健康危险行为。

Abstract A growing body of literature demonstrates dramatic disparities in health between lesbian, gay and bisexual (LGB) and heterosexual youth, including problem substance use, HIV risk behaviors and suicide. In 2011 the Institute of Medicine called for additional research with this population, prioritizing health disparities research as "essential for building a solid evidence base" in LGB heath. The IOM report highlights the importance of multilevel social influences on the lives of LGB people, specifying the role of social structures such as families, schools, workplaces, religious institutions and community organizations as critical subjects of study to expand our understanding of the determinants of health in this population. The proposed R01 led by a new investigator in response to PA-12-111, directly addresses this need. The goal of this study is to broaden and deepen our understanding of the family, peer, school and community environments that protect young LGB people from involvement in high risk health behaviors, including substance use, HIV risk behaviors and suicide behaviors. This research aims to 1) develop a theoretically grounded approach to promoting health among LGB adolescents based on in-depth knowledge of their community and school environments, and 2) link environmental data, collected using the Inventory, with existing population-based student data to identify factors at the individual, family, peer, school and community levels that protect LGB youth from involvement in health risk behaviors. "Go-along" interviews with 72 youth in diverse locations will be used to elicit in-depth information on LGB adolescents' perceptions of supportive elements in their schools and communities; this information, in conjunction with published literature, expert review, and psychometric testing, will be used to create an LGB Environment Inventory to characterize policies, programs, resources and other supports for LGB youth that exist in these settings. The Inventory will then be used to measure indicators of support in 120 communities in Minnesota, British Columbia and Massachusetts, using publicly available materials (e.g. websites) and brief contacts with key informants (Aim 1). These community-level data will then be linked with existing student survey data from approximately 3,600 LGB adolescents in these same communities, which will include information about family, peer and individual supports, as well as health behaviors and demographic information (Aim 2). The following hypotheses will be tested: a) higher LGB environment scores for the community and school will be protective against health risk behaviors among LGB youth; b) greater family connectedness and support and a more supportive peer environment will be protective against health risk behaviors among LGB youth, and c) family, peer and individual-level factors will moderate the associations between the LGB environment (community and school) and the health risk behaviors of interest.