Pilot proof of concept exploring longitudinal links between minority stress, stress physiology dysregulation, and drug use in sexual minority adults

概念试点验证探索少数群体压力、压力生理失调和性少数成年人吸毒之间的纵向联系

• 批准号: 10800410
• 负责人: Ezemenari M Obasi
• 金额: $ 7.75万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-08 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10800410
• 关键词: Address; Adult; Affect; Alcohol consumption; Anxiety; Applications Grants; Behavioral; Biological; Biological Markers; Blood; Body mass index; Chronic; Chronic stress; Data; Development; Disclosure; Discrimination; Disparity; Drug Addiction; Drug usage; Economics; Environmental Risk Factor; General Population; Health; Heterosexuals; Hydrocortisone; Individual; Intervention; Lead; Lesbian Gay Bisexual; Link; Literature; Longitudinal Studies; Measures; Mediating; Mental Depression; Mentors; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Neurobiology; Outcome; Participant; Patient Self-Report; Pattern; Pharmaceutical Preparations; Physiological; Physiology; Pilot Projects; Play; Population; Population Heterogeneity; Populations at Risk; Prevention; Procedures; Process; Public Health; Race; Research; Research Personnel; Research Support; Risk; Risk Factors; Role; Sample Size; Sampling; Sex Orientation; Societies; Stress; Structure; Substance Use Disorder; Testing; Time; United States National Institutes of Health; Universities; addiction; allostasis; allostatic load; burden of illness; cancer prevention; career; cost; cytokine; drug use vulnerability; eligible participant; ethnic diversity; expectation; experience; feasibility testing; health disparity; health outcome disparity; high risk; homonegativity; hypothalamic-pituitary-adrenal axis; innovation; insight; interest; longitudinal design; minority stress; mortality; non-heterosexual; perceived discrimination; prevent; prospective; psychosocial stressors; recruit; resilience; resilience factor; sexual minority; sexual minority group; sexual minority health; sexual minority stress; social; social factors; stress reactivity; stressor

PROJECT SUMMARY/ABSTRACT Sexual minority (SM) adults are disproportionately affected by drug use and are at greater risk for substance use disorders than their heterosexual counterparts. One explanation for the high rates of drug use and substance use disorders among sexual minorities is that increased stress related to being a SM puts SM individuals at risk for drug use. Research demonstrates that chronic stress and subsequent activation of the hypothalamic-pituitary-adrenal axis lead to allostasis, or a state of sustained stability outside of normal functioning that is necessary to meet the demands of the chronic stressor(s). Overtime, allostasis leads to allostatic load, or the cumulative “wear and tear” on the body as a result of chronic stress. Moreover, allostatic load has been linked to both the initiation and trajectories of drug use. However, no research has examined allostatic load in the context of drug use outcomes among SMs. The purpose of the proposed research is to conduct a feasibility and proof-of-concept study to examine the relationships between SM stress (e.g., discrimination experiences, internalized homonegativity), allostatic load, and drug use. The specific aims are to (1) assess the feasibility of following a sample of 40 racially/ethnically-diverse SM adults over the course of 1 year to explore the links between minority stress, allostatic load, and drug use, (2) obtain estimates of effect size that will allow the investigators to determine the required sample size for a subsequent, fully-powered study, (3) begin to explore the temporal links between minority stress, allostatic load, and drug use, and (4) provide targeted mentoring of a new investigator by an established investigator. To meet these aims, we will recruit a racially/ethnically-diverse sample of SM adults in Houston, TX. Eligible participants will complete self-report measures, including minority stress and drug use, among others, in addition to biological measures collected via blood and anthropometrics (e.g., cytokines, BMI). This innovative study will be the first to explore the links between allostatic load and drug use in this population, which has demonstrated drug-use health disparities. Moreover, it will be the first study to comprehensively test the impact of minority stress on allostatic load among SM adults. Study results will be used to develop a subsequent NIH grant application to conduct a fully-powered, 2-year longitudinal study. In addition, results will help to inform the development of individually-tailored interventions to detect, prevent, and treat addiction in this at-risk population, which will help to lessen the disease burden of drug use and addiction. The proposed research addresses the Notice of Special Interest (NOT-MD-23-001) by leveraging the University of Houston’s HEALTH Center for Addictions Research and Cancer Prevention to conduct this innovative pilot study examining how biological, behavioral, and social/environmental factors contribute to SM health outcomes and health disparities, specifically drug use and addiction.

项目概要/摘要 性少数 (SM) 成年人受吸毒影响尤为严重，并且面临更大的风险 药物滥用率高于异性性行为的一种解释。 性少数群体中的使用和物质使用障碍是与成为 SM 相关的压力增加 研究表明，慢性压力和随后的压力使 SM 个体面临吸毒的风险。 下丘脑-垂体-肾上腺轴的激活导致动态平衡，或持续稳定的状态 满足慢性压力源的需求所必需的正常功能之外， 失衡会导致失衡负荷，或由于慢性运动而对身体造成的累积“磨损” 此外，稳态负荷与药物使用的开始和轨迹有关。 然而，尚无研究在 SM 中药物使用结果的背景下检验非稳态负荷。 拟议研究的目的是进行可行性和概念验证研究，以检验 SM 压力（例如，歧视经历、内在同负性）、变稳态之间的关系 具体目标是 (1) 评估跟踪 40 个样本的可行性。 在一年的时间里，对不同种族/族裔的 SM 成年人进行调查，探索少数族裔压力、 (2) 获得效应大小的估计值，以便研究人员能够确定 后续全面研究所需的样本量，(3) 开始探索时间联系 少数群体压力、稳态负荷和药物使用之间的关系，以及 (4) 为新的群体提供有针对性的指导 为了实现这些目标，我们将招募一名种族/民族多元化的调查员。 德克萨斯州休斯顿的 SM 成年人样本将完成自我报告措施，包括 除了通过血液和药物收集的生物测量值外，少数群体的压力和药物使用等也包括在内。 这项创新研究将首次探讨人体测量学（例如细胞因子、BMI）之间的联系。 该人群的稳态负荷和药物使用，这表明药物使用健康差异。 此外，这将是第一个全面测试少数应力对非稳态载荷影响的研究 SM 成年人中的研究结果将用于制定后续的 NIH 拨款申请以开展一项研究。 此外，研究结果将有助于为该领域的发展提供信息。 针对这一高危人群采取量身定制的干预措施来检测、预防和治疗成瘾，这将 拟议的研究旨在帮助减轻吸毒和成瘾带来的疾病负担。 通过利用休斯顿大学健康中心进行特别关注（NOT-MD-23-001） 成瘾研究和癌症预防开展这项创新试点研究，探讨如何 生物、行为和社会/环境因素有助于 SM 健康结果和健康 差异，特别是吸毒和成瘾。