A Behavioral Intervention to Reduce Psychological Distress Symptoms among Black Gender Minority Women Experiencing Chronic Stigma

减少遭受慢性耻辱的黑人少数族裔女性心理困扰症状的行为干预

• 批准号: 10548854
• 负责人: Athena D. F. Sherman
• 金额: $ 16.23万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-10 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10548854
• 关键词: Address; Adherence; Applications Grants; Applied Research; Behavior Therapy; Behavioral; Black race; Cardiovascular Diseases; Caring; Chronic; Collaborations; Communities; Complex; Coping Skills; Discrimination; Education; Emotional; Ensure; Evaluation; Evidence based intervention; Face; Feedback; Feeling; Feminine; Focus Groups; Fright; Gender; General Population; Goals; HIV; Health; Health Insurance; Health Personnel; Healthcare; Individual; Inflammation; Infrastructure; Institution; Institutional Racism; Instruction; Intervention; Interview; Investigation; Major Depressive Disorder; Manuscripts; Medical; Mental Health; Mentorship; Metabolic Diseases; Methods; Modeling; Murder; Participant; Pathway interactions; Personal Satisfaction; Persons; Phase; Physiological; Play; Policies; Population; Post-Traumatic Stress Disorders; Preparation; Prevalence; Public Health; Publishing; Quality of life; Race; Reporting; Research; Research Ethics; Research Training; Risk Factors; Role; Safety; Self Determination; Series; Severities; Sexual and Gender Minorities; Social Functioning; Strategic Planning; Surveys; Symptoms; Testing; Therapeutic; Training; Training Programs; Trauma; Treatment Efficacy; United States; United States National Institutes of Health; Universities; Victimization; Vulnerable Populations; adaptive intervention; barrier to care; career; career development; cisgender; clinical training; community engaged research; community-level factor; coping; depressive symptoms; disenfranchised population; experience; future implementation; gender behavior; gender minority; gender minority community; gender minority group; gender minority women; health care availability; health care settings; improved; informant; innovation; intervention refinement; iterative design; male; member; minority stressor; novel; patient oriented research; peer; persistent symptom; poor health outcome; post-traumatic symptoms; prevent; psychological distress; psychological symptom; psychosocial; racism; recruit; reduce symptoms; resilience; resilience factor; response; retention rate; satisfaction; sex assigned at birth; social stigma; symposium; symptom management; symptom science; symptomatic improvement; therapy design; therapy development; transgender; uptake; virtual delivery; vulnerable community

A Behavioral Intervention to Reduce Psychological Distress Symptoms among Black Gender Minority Women Experiencing Chronic Stigma PROJECT SUMMARY: Black gender minority (GM) women in the United States face a nearly universal experience of chronic stigma (i.e., enacted, anticipated, and structural stigma), associated with a disproportionate prevalence of psychological distress symptoms compared to cisgender peers. Psychological distress symptoms, specifically post-traumatic stress (PTS) and depressive symptoms, can be highly debilitating and traditional pathways to care are impeded by widespread barriers to healthcare access and engagement for Black GM women. Such barriers include underprepared healthcare providers, lack of health insurance, medical mistrust, and high rates of discrimination and victimization within healthcare settings, which have been associated with increased PTS and depressive symptom severity among Black GM women. Conversely, coping and GM community connection have been shown to decrease psychological distress symptom severity among Black GM women. Thus, culturally informed community-based interventions are needed to offset the high burden of barriers to healthcare and address psychological distress symptoms among this population. The research objectives of this application are to first, develop a culturally informed community-based intervention with guidance from community members (via focus groups and theater testing; N=20) to reduce the effect of chronic stigma exposure on psychological distress symptoms (PTS and depressive symptoms) among Black GM women. Second, we will conduct a proof-of-concept trial (N=40) to determine the feasibility and preliminary efficacy of the resulting intervention. Findings will inform intervention optimization to improve symptom management for this group. The proposed study plays an essential role in developing and evaluating evidence- based interventions to improve psychological distress symptom management among Black GM women. To accomplish the proposed research, I propose a research and training program facilitating my transition to an independent, patient-oriented research career, specializing in symptom science and culturally appropriate interventions for symptom management that are easily implemented in real-world settings. Research and training aims will be accomplished through close interdisciplinary mentorship and carefully selected didactic activities, conference attendance, applied research experiences, and manuscript and grant proposal preparation (i.e., R- series). Additionally, I will achieve these goals by obtaining clinical and research training in intervention design, implementation, and evaluation; psychological distress treatment among GM people; and research ethics and management specific to engaging vulnerable populations. The training plan leverages the well-supported infrastructure at Emory University, as well as national and institutional opportunities to ensure didactic, experiential, and specialized individual instruction. 1

减少黑人性别少数群体心理困扰症状的行为干预 经历长期耻辱的女性 项目摘要：美国黑人性别少数 (GM) 女性几乎普遍面临着 慢性耻辱的经历（即，制定的、预期的和结构性的耻辱），与 与顺性别同龄人相比，心理困扰症状的患病率不成比例。心理 痛苦症状，特别是创伤后应激障碍 (PTS) 和抑郁症状，可能会导致高度衰弱 传统的护理途径受到医疗保健获取和参与方面普遍存在的障碍的阻碍 黑人通用汽车女性。这些障碍包括医疗保健提供者准备不足、缺乏健康保险、医疗 医疗机构内的不信任、歧视和受害率很高，这些问题 与黑人 GM 女性的 PTS 增加和抑郁症状严重程度相关。反之，应对 和 GM 社区联系已被证明可以降低心理困扰症状的严重程度 黑人通用汽车女性。因此，需要基于文化的社区干预措施来抵消沉重的负担 消除医疗保健障碍并解决该人群的心理困扰症状。研究 该应用程序的目标是首先开发一种基于文化的社区干预措施 社区成员的指导（通过焦点小组和剧院测试；N=20）以减少慢性病的影响 黑人 GM 中心理困扰症状（PTS 和抑郁症状）的耻辱暴露 女性。其次，我们将进行概念验证试验（N=40）以确定可行性和初步结果 由此产生的干预效果。研究结果将为优化干预措施以改善症状提供信息 对这个群体的管理。拟议的研究在开发和评估证据方面发挥着至关重要的作用 基于干预措施来改善黑人转基因女性的心理困扰症状管理。到 完成拟议的研究后，我提出了一项研究和培训计划，以促进我向 独立、以患者为中心的研究生涯，专注于症状科学和文化适宜性 易于在现实环境中实施的症状管理干预措施。研究与培训 目标将通过密切的跨学科指导和精心挑选的教学活动来实现， 会议出席情况、应用研究经验以及手稿和赠款提案的准备（即，R- 系列）。此外，我将通过获得干预设计方面的临床和研究培训来实现这些目标， 实施和评估；转基因人群的心理困扰治疗；和研究伦理以及 针对弱势群体的具体管理。该培训计划充分利用了得到良好支持的 埃默里大学的基础设施，以及国家和机构的机会，以确保教学， 体验式、专业化的个人指导。 1