Testing a multistage model of risk factors for cannabis use utilizing a measurement burst design among sexual minority women, sexual minority gender diverse individuals, and heterosexual women

利用突发测量设计在性少数女性、性少数性别多样化个体和异性恋女性中测试大麻使用风险因素的多阶段模型

• 批准号: 10711584
• 负责人: CHRISTINA DYAR
• 金额: $ 71.52万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10711584
• 关键词: Address; Affect; Age; Bisexual; Data; Development; Disparity; Ecological momentary assessment; Education; Emotions; Event; Growth; Heterosexuals; Individual; Intervention; Lesbian; Measurement; Modeling; National Institute of Drug Abuse; Negative Reinforcements; Perception; Population; Positive Reinforcements; Process; Research; Risk; Risk Factors; Sampling; Severities; Sexual and Gender Minorities; Stress; Surveys; Symptoms; Testing; Theoretical model; Time; Woman; assigned female at birth; coping; design; disorder risk; experience; gender diversity; high risk; marijuana use; marijuana use disorder; minority stress; negative affect; nonbinary; positive emotional state; queer; recruit; response; risk sharing; sexual minority; sexual minority women; social; social stigma; substance use; theories; young adult

PROJECT SUMMARY/ABSTRACT Sexual minority women (e.g., lesbian, bisexual, queer women) and gender diverse (e.g., non-binary) sexual minorities assigned female at birth are at elevated risk for cannabis use disorder (CUD) compared to heterosexual women. Alarmingly, rates of CUD are increasing for sexual minority women and gender diverse individuals (SMWGD) as well as heterosexual women, with more rapid increases among SMWGD leading to growing disparities in CUD. This highlights the urgent need for CUD research in both populations. Examining event-level risk processes clarifies the temporal order of risk factors and CU in near-real time. However, ecological momentary assessment (EMA) studies, including our own, provide mixed evidence for two sets of risk factors for CU: risk factors related to increasing positive affect (positive reinforcement; e.g., enhancement motives, social use) and decreasing negative affect (negative reinforcement; e.g., coping motives, solitary use). SMWGD also experience unique positive and negative reinforcement risk factors (e.g., CU with SMWGD; minority stress). Providing a potential explanation for mixed evidence, our preliminary results and the multistage model of substance use suggest these two sets of risk factors may be relevant at different stages of CUD, with positive reinforcement most relevant when CUD symptoms are absent to mild and negative reinforcement becoming dominant when CUD symptoms become more severe. We propose to empirically test a theoretical model that incorporates the multistage model and unique risk factors for SMWGD. We will use a measurement burst design, with 5 semi-annual bursts of 14-days of EMA (2 surveys per day), allowing us to examine changes in event-level effects of risk factors on CU as a function of longer-term (i.e., semi-annual) changes in CUD symptoms. We will include SMWGD and heterosexual women, allowing us to identify similarities and differences in effects of shared risk factors on CU for these two groups, determine if differences in CU trajectories contribute to CUD disparities, and identify unique risk factors for SMWGD. The purpose of this R01 is to advance our understanding of CUD among SMWGD and heterosexual women, with a focus on how event-level associations between risk factors and CU change as CUD develops. We will use a measurement burst design, with 400 SMWGD and 200 heterosexual women (age 18-25) who use cannabis at least weekly. The proposed study will accomplish three specific aims: 1) identify changes in the effects of event-level risk factors on CU as CUD develops, 2) test for differences in effects of shared event- level risk factors on CU for SMWGD and heterosexual women, and 3) determine if differences in CU trajectories for SMWGD and heterosexual women contribute to disparities in the development of CUD. The proposed study will inform efforts to increase efficacy of existing CUD interventions for heterosexual women and determine which risk factors should be targeted in interventions for SMWGD. The proposed study is in response to NOT-MD-19-001 and NIDA priorities to understand substance use disparities affecting SMWGD.

项目概要/摘要 性少数女性（例如女同性恋、双性恋、酷儿女性）和性别多样化（例如非二元性别） 与出生时被指定为女性的性少数群体相比，其患大麻使用障碍 (CUD) 的风险更高 异性恋女性。令人担忧的是，性少数女性和性别多元化女性的 CUD 发生率正在上升 个人（SMWGD）以及异性恋女性，其中 SMWGD 增长更快，导致 CUD 的差距日益扩大。这凸显了在这两个人群中进行 CUD 研究的迫切需要。 检查事件级风险流程可以近乎实时地阐明风险因素和 CU 的时间顺序。 然而，生态瞬时评估（EMA）研究，包括我们自己的研究，为两种观点提供了混合证据： CU 的风险因素集：与增加积极情感相关的风险因素（积极强化；例如， 增强动机、社会使用）和减少负面影响（负面强化；例如，应对 动机，单独使用）。 SMWGD 还经历独特的正强化和负强化风险因素（例如， CU 与 SMWGD；少数民族压力）。我们的初步研究为混合证据提供了可能的解释 结果和物质使用的多阶段模型表明，这两组风险因素可能在以下方面相关： CUD 的不同阶段，当 CUD 症状不存在或轻微时，积极强化最为相关 当 CUD 症状变得更加严重时，负强化变得占主导地位。我们建议 实证检验了一个理论模型，该模型结合了 SMWGD 的多阶段模型和独特的风险因素。 我们将使用突发测量设计，每半年突发 5 次 14 天的 EMA（每天 2 次调查）， 使我们能够检查风险因素对 CU 的事件水平影响的变化作为长期函数（即 每半年）CUD 症状的变化。我们将包括 SMWGD 和异性恋女性，使我们能够 确定这两组的共同风险因素对 CU 影响的相似性和差异，确定是否 CU 轨迹的差异导致 CUD 差异，并确定 SMWGD 的独特风险因素。 本 R01 的目的是增进我们对 SMWGD 和异性恋者 CUD 的理解 女性，重点关注风险因素与 CU 之间的事件级关联如何随着 CUD 的发展而变化。 我们将采用突发测量设计，让 400 名 SMWGD 和 200 名异性恋女性（18-25 岁）参与其中 至少每周使用大麻。拟议的研究将实现三个具体目标：1）确定 随着 CUD 的发展，事件级风险因素对 CU 的影响，2) 测试共同事件影响的差异 SMWGD 和异性恋女性的 CU 风险因素水平，以及 3) 确定 CU 是否存在差异 SMWGD 和异性恋女性的发展轨迹导致了 CUD 发展的差异。这 拟议的研究将为提高现有 CUD 干预措施对异性恋女性的功效提供信息 并确定 SMWGD 干预措施应针对哪些风险因素。拟议的研究是在 响应 NOT-MD-19-001 和 NIDA 优先事项，以了解影响 SMWGD 的物质使用差异。