Developing a Peer Advocate Intervention for Rural LGBT Populations

为农村 LGBT 人群制定同伴倡导干预措施

• 批准号: 8501687
• 负责人: Cathleen E. Willging
• 金额: $ 19.91万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-20 至 2015-03-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8501687
• 关键词: Acute; Address; Advocacy; Advocate; Affect; Alcohol dependence; Alcohol or Other Drugs use; Anxiety; Area; Behavior; Bisexual; Case Manager; Clinical; Commit; Communities; Community Health; Data; Disadvantaged; Discrimination; Disease; Educational Curriculum; Environment; Exercise; Face; Feeling; Future; Gays; Gender; Health; Heterosexuals; High Prevalence; Individual; Institute of Medicine (U.S.); Institution; Intervention; Intervention Studies; Knowledge; Lesbian; Life; Manuals; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Minority; Modeling; National Institute of Mental Health; New Mexico; Persons; Population; Population Heterogeneity; Prejudice; Procedures; Professional counselor; Protocols documentation; Provider; Psyche structure; Psychiatrist; Psychologist; Recruitment Activity; Research; Research Design; Resources; Rural; Rural Community; Rural Population; Science; Services; Social Alienation; Social Network; Social Workers; Social support; Specific qualifier value; Staging; Strategic Planning; Stress; Structure; Substance Use Disorder; Suicide; Support System; Testing; Training; United States National Institutes of Health; Violence; Work; base; contextual factors; design; effectiveness trial; empowered; empowerment; experience; health disparity; improved; interest; member; novel; outreach; peer; response; rural area; service utilization; skills; social; social stigma; stressor; theories; transgender

DESCRIPTION (provided by applicant): A decade of studies confirm that lesbian, gay, bisexual, and transgender (LGBT) people suffer disproportionately from mental health and substance use problems in comparison to their heterosexual counterparts. The higher prevalence of disorders within this population is most reasonably explained by minority stress, referring here to stigma, prejudice, discrimination, and violence toward socially disadvantaged groups. Our previous formative research in the rural and multi-ethnic state of New Mexico suggests that professional providers frequently fail to recognize how the experience of minority stress affects rural LGBT people and are often ill-prepared to provide quality services to this population. Rural LGBT people, particularly those who are isolated from supportive social networks, have few LGBT-specific resources to draw from when in need of assistance for mental health and substance use problems. We propose the use of well-trained peer advocates as a creative response to this situation. The advocates will perform several vital functions in rural areas: reduction of social contextual factors associated with minority stress that can adversely affect wellbeing and service utilization among LGBT people; outreach to professional providers and others; and cultivation of LGBT social support. The day-to-day work of the advocates will be informed by an empowerment protocol that specifies the general range of community-based activities they will engage in to provide assistance to rural LGBT help seekers. To obtain the knowledge and skills needed to effectively implement this protocol, peer advocates will take part in didactic and interactive training exercises that are to be evaluated and refined in the course of this research. This study has three aims: (1) Develop the empowerment protocol, coaching manual, and peer advocate support system; (2) Design and implement a training curriculum to prepare individuals to serve as peer advocates; (3) Conduct a pilot test of the empowerment protocol that will yield preliminary qualitative and quantitative data on feasibility, acceptability, and impacts on treatment access and utilization and social support for LGBT help seekers. In pursuit of all three aims, we will evaluate procedures to recruit and retain peer advocates and LGBT help seekers both members of a widely dispersed, rural population in intervention research. Data generated from this multi-method study will also be used to improve utility of the protocol and refine the training curriculum. Most importantly, these essential data will comprise the groundwork for a broader scale effectiveness trial of a promising intervention for an underserved and understudied population. To our knowledge, there are no similar interventions tailored for rural sexual and gender minorities, even though such individuals face significant mental health disparities.

描述（由申请人提供）：十年的研究证实，与异性恋者相比，女同性恋、男同性恋、双性恋和跨性别者 (LGBT) 遭受心理健康和药物滥用问题的比例更高。该人群中疾病患病率较高的最合理原因是少数群体压力，这里指的是针对社会弱势群体的耻辱、偏见、歧视和暴力。我们之前在新墨西哥州农村和多民族州进行的形成性研究表明，专业提供者经常无法认识到少数群体压力的经历如何影响农村 LGBT 人群，并且往往没有准备好为这一人群提供优质服务。农村 LGBT 人群，尤其是那些与支持性社交网络隔离的人群，在因心理健康和药物滥用问题需要援助时几乎没有专门针对 LGBT 的资源可供利用。我们建议使用训练有素的同行倡导者作为对这种情况的创造性回应。倡导者将在农村地区履行几项重要职能：减少与少数群体压力相关的社会背景因素，这些因素可能对 LGBT 人群的福祉和服务利用产生不利影响；联系专业提供者和其他人；以及培养 LGBT 社会支持。倡导者的日常工作将以赋权协议为基础，该协议详细说明了他们将参与的社区活动的一般范围，以便为农村 LGBT 求助者提供帮助。为了获得有效实施该协议所需的知识和技能，同行倡导者将参加教学和互动培训练习，这些练习将在本研究过程中进行评估和完善。 本研究有三个目标：（1）制定授权协议、辅导手册和同伴倡导支持系统； (2) 设计并实施培训课程，帮助个人做好成为同伴倡导者的准备； (3) 对赋权协议进行试点测试，将产生关于可行性、可接受性以及对 LGBT 求助者的治疗获取和利用以及社会支持的影响的初步定性和定量数据。为了实现这三个目标，我们将评估招募和留住同伴倡导者和 LGBT 帮助寻求者的程序，他们都是广泛分散的农村人口中的干预研究成员。这项多方法研究生成的数据也将用于提高协议的实用性并完善培训课程。最重要的是，这些基本数据将为针对服务不足和研究不足的人群进行有希望的干预措施进行更广泛的规模有效性试验奠定基础。据我们所知，目前还没有针对农村性少数群体的类似干预措施，尽管这些人面临着巨大的心理健康差异。

项目成果

A Mixed-Method Assessment of a Pilot Peer Advocate Intervention for Rural Gender and Sexual Minorities.

对农村性别和性少数群体试点同伴倡导干预的混合方法评估。

• 发表时间: 2018-05
• 影响因子: 2.7
• 作者: Willging, Cathleen E;Harkness, Audrey;Israel, Tania;Ley, David;Hokanson, Patricia S;DeMaria, Catherine;Joplin, Aaron;Smiley, Verida
• 通讯作者: Smiley, Verida

Coaching mental health peer advocates for rural LGBTQ people.

为农村 LGBTQ 人群提供心理健康同伴倡导者辅导。

• 发表时间: 2016
• 作者: Willging, Cathleen E;Israel, Tania;Ley, David;Trott, Elise M;DeMaria, Catherine;Joplin, Aaron;Smiley, Verida
• 通讯作者: Smiley, Verida

Development and Evaluation of Training for Rural LGBTQ Mental Health Peer Advocates.

农村 LGBTQ 心理健康同伴倡导者培训的制定和评估。

• 发表时间: 2016-01
• 作者: Israel T;Willging C;Ley D
• 通讯作者: Ley D