Project Recognize: Improving Measurement of Alcohol Use and Other Disparities by Sex, Sexual Orientation, and Gender Identity through Community Engagement

项目认可：通过社区参与改善对酒精使用和其他性别、性取向和性别认同差异的衡量

• 批准号: 10700962
• 负责人: Lauren Brittany Beach
• 金额: $ 63.14万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-21 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10700962
• 关键词: Address; Adolescent; Adult; Advocacy; Affect; Age; Alcohol consumption; Alcohols; Anxiety; Behavior; Bisexual; Categories; Characteristics; Classification; Clinical; Cognitive; Communities; Complex; Data; Development; Dimensions; Discrimination; Disparity; Dissemination and Implementation; Drug usage; Effectiveness; Electronic Health Record; Ensure; Ethnic Origin; Evaluation; Exclusion; Feeling suicidal; Female; Focus Groups; Funding; Future; Gays; Gender Identity; Grant; Health; Health Care Research; Health Surveys; Healthcare; Heterosexuals; Individual; Intersex; Intervention; Interview; Label; Lesbian Gay Bisexual Transgender; Literature; Live Birth; Location; Measurement; Measures; Mental Depression; Mental Health; Mental disorders; Methodology; Methods; Minority; Monitor; Nature; Outcome; Pathway interactions; Patient Care; Performance; Personal Satisfaction; Persons; Pilot Projects; Policies; Population; Population Heterogeneity; Prevalence; Process; Provider; Psychometrics; Public Health; Qualitative Methods; Race; Recommendation; Reporting; Research; Research Personnel; Sampling; Sex Orientation; Sexual Health; Sexual and Gender Minorities; Special Population; Standardization; Stigmatization; Surveys; System; Techniques; Testing; Time; Underrepresented Populations; United States National Institutes of Health; Victimization; Voice; Work; academic review; alcohol measurement; asexual; cisgender; community engaged research; community engagement; demographics; drug of abuse; effectiveness evaluation; experience; flexibility; gender minority community; gender minority group; gender minority health; gender minority health disparity; gender nonconforming; health disparity; health disparity populations; health equity; implementation context; improved; informant; interest; male; marginalization; marginalized population; minority disparity; minority stress; national surveillance; nonbinary; novel; pansexual; patient engagement; population health; practice setting; queer; research study; same-sex partnership; sex; sex assigned at birth; sex disparity; sexual minority; social; social stigma; stressor; substance use; therapy development; transgender; usability

PROJECT SUMMARY Researchers and health practitioners use data from federal health surveys, electronic health records (EHRs), and research studies to monitor the health of sexual and gender minority (SGM) populations. Compared to non-SGM populations, SGM populations are disproportionately affected by poor health, including disparities in alcohol use, substance use, and mental illness. Substantial prior work has supported the minority stress framework to contextualize SGM health disparities; stressors related to discrimination and victimization tied to SGM status are strongly associated with disparities. The ability to accurately identify such disparities and potential causal pathways is vital to ensure that public health and health care research, policy, and practice are appropriately equipped to address the health needs of marginalized populations such as SGM individuals. This is particularly true in the case of alcohol, which remains one of the most commonly used and abused drugs nationwide, particularly among both adolescent and adult SGM. However, measurement of demographic characteristics associated with SGM identity and stigmatization – e.g., sex, sexual orientation, and gender identity (SSOGI) – remains poorly defined and inconsistently used across health research and practice settings. For example, despite evident limitations, most studies, providers, and national surveys continue to use a binary framework (male vs. female) to assess sex assigned at birth. This approach fails to capture a substantial population of intersex individuals (estimated prevalence of 1-2 per 1,000 live births). Further, most surveys continue to use the non-recommended practice of conflating sex and gender identity by asking about only one of these constructs, thereby failing to appropriately identify or characterize transgender, non-binary, and gender nonconforming individuals. While a growing number of surveys ask about sexual orientation, they frequently do not account for its multidimensional nature: many items conflate identity (e.g., gay, bisexual), with behavior (e.g., sex with only same-sex partners) and attraction (e.g., only attracted to male-presenting individuals). This is especially concerning as research has shown that a substantial number of individuals would only be classified as a sexual minority based on one category, but not another (e.g., a person who identifies as heterosexual but has sex with same-sex partners). Furthermore, current measures often are not comprehensive, exclude understudied or emerging orientations (e.g., asexual, pansexual, queer), lack the ability to select multiple options, and fail to account for changes in identity over time. Without comprehensive, validated measures to assess SSOGI, the ability to understand the magnitude of SGM disparities or how best to intervene to promote SGM health equity is limited. Therefore, it is vital to develop standardized, flexible measures for use across diverse demographics and regions. This project will address these gaps through iterative, community-engaged development of new SSOGI measures, and will assess the effectiveness of new vs. prior measures to characterize disparities in alcohol use, substance use, and mental health among SGM.

项目摘要 研究人员和卫生从业人员使用联邦健康调查，电子健康记录（EHRS）的数据， 以及监测性别和性别少数群体（SGM）人群健康的研究。相比 非SGM人群，SGM人群受到健康状况不佳的影响，包括 饮酒，吸毒和精神疾病。大量的先前工作支持了少数派压力 将SGM健康分布的框架化；与歧视和欺诈有关的压力源 SGM状态与分布密切相关。准确识别此类分布的能力和 潜在的因果途径对于确保公共卫生和保健研究，政策和实践是至关重要的 适当地等同于解决边缘化人群（例如SGM个人）的健康需求。这 对于酒精而言，尤其如此，它仍然是最常用和滥用的药物之一 全国，特别是在青少年和成人SGM中。但是，人群的测量 与SGM身份和污名化相关的特征 - 例如性，性取向和性别 身份（SSOGI） - 在健康研究和实践中的定义较差且不一致地使用 设置。例如，目的地证据限制，大多数研究，提供者和国家调查继续 使用二元框架（男性与女性）评估出生时分配的性别。这种方法无法捕获 大量的双性恋个体（估计每1000名活产1-2的患病率）。此外，最多 调查继续使用询问性别和性别认同的非审查习惯 这些结构中只有一个，因此未能适当地识别或表征跨性别，非二进制 和性别不合格的个人。虽然越来越多的调查询问性取向，但他们 经常不考虑其多维性质：许多项目将身份（例如，同性恋，双性恋）与 行为（例如，仅与同性伴侣发生性关系）和吸引力（例如，仅吸引男性出现 个人）。这尤其关注研究表明，大量个人 只会根据一个类别将其归类为性少数群体，而不是另一个类别（例如，一个人 识别为异性恋，但与同性伴侣发生性关系）。此外，当前的措施通常不是 全面，排除理解或新兴方向（例如，无性，同性恋，酷儿），缺乏 能够选择多个选项的能力，并且无法说明身份随时间的变化。没有全面的 经过验证的评估SSOGI的措施，了解SGM分布的大小或如何最好的措施 干预以促进SGM健康公平是有限的。因此，发展标准化，灵活至关重要 潜水员人口统计和地区使用的措施。该项目将通过 迭代，社区参与新的SSOGI测量结果的开发，并将评估新的效果 与先前的措施，以表征SGM中酒精使用，药物使用和心理健康的分布。