Reducing Black Men's Drug Use and Co-Occurring Negative Mental and Physical Health Outcomes: Intersectionality,Social-Structural Stressors, and Protective Factors

减少黑人吸毒和同时发生的负面身心健康结果：交叉性、社会结构压力源和保护因素

• 批准号: 10093425
• 负责人: Ingrid Alisa Bowleg
• 金额: $ 9.99万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10093425
• 关键词: AIDS/HIV problem; Accidental Injury; Address; Administrative Supplement; Adult; Affect; Age; Alcohol consumption; Alcohols; Area; Award; Biological Markers; Bisexual; Blood Pressure; Blood specimen; Cardiovascular Diseases; Categories; Cause of Death; Cholesterol; Collection; Data; Dependence; Development; Discrimination; Drug usage; Economic Factors; Environmental Risk Factor; Epidemiology; Focus Groups; Future; Gays; Goals; Health; Heart Diseases; Heterosexuals; Homicide; Imprisonment; Individual; Inequality; Intervention; Interview; Knowledge; Malignant Neoplasms; Marijuana; Mental Health; Methodology; Methods; Mission; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Nicotine; Outcome; Parents; Participant; Pathway interactions; Patient Self-Report; Pattern; Pharmaceutical Preparations; Phase; Police; Political Factor; Positioning Attribute; Process; Psyche structure; Public Health; Race; Reporting; Research; Research Design; Research Support; Resources; Risk; Sample Size; Sampling; Sexual and Gender Minorities; Social status; Socioeconomic Status; Stress; Suicide; Testing; Time; Toxicology; United States National Institutes of Health; Urine; Washington; base; community partnership; design; epidemiology study; experience; health data; health disparity; health goals; illicit drug use; intersectionality; low socioeconomic status; male health; men; men who have sex with men; mortality; multidisciplinary; physical conditioning; protective factors; psychological distress; recruit; resilience; sexual identity; sexual minority; social factors; social structure; stressor; therapy design; virtual

PROJECT SUMMARY/ABSTRACT The mixed methods explanatory-sequential (QUANT→quant) parent study will test a conceptual model of social-structural stressors, protective factors, and drug use and co-occurring negative mental and physical health outcomes among Black men at the intersection of sexual identity and socioeconomic position (SEP). Informed by the intersectionality theoretical framework, the initial design for the parent study provided for three sexual identity categories (i.e., gay, bisexual, and heterosexual) and two SEP positions (i.e., lower, higher) and a sample size of 1,440 (i.e., 240 participants for each of the 6 sampling frames: lower- SEP gay, lower-SEP bisexual, lower-SEP heterosexual, higher-SEP gay, higher-SEP bisexual, higher-SEP heterosexual). The considerable challenges involved in recruiting bisexual men and doing so at two different SEP-categories, was methodologically infeasible given the study's 5-year timeframe and limited resources. Thus a single sexual minority (SM) category composed of gay, bisexual, and other men who have sex with men was created to produce a sampling frame stratified by just two sexual identity positions (i.e., SM and heterosexual). A determination was made that this sampling frame was more methodologically feasible in terms of recruitment because it provided for a sample size of 960 (i.e., 240 participants each of lower-SEP SM, lower-SEP heterosexual, higher-SEP SM, higher-SEP heterosexual). To address the critical gaps that exist about Black bisexual men's health, the goal of the proposed administrative supplement is to increase the number of Black bisexual men participants and establish bisexual men as a distinct SM position for all of the parent study's analyses. To accomplish this goal, an academic-community partnership will be established with BiNet USA, the oldest national bisexual organization in the U.S. The proposed supplement adds new primary inferential and exploratory analyses specific to bisexual men (Aim 1, parent study). It also adds a convergent mixed methods design component in Phase I in which in-depth qualitative interviews will be conducted during the Phase I quantitative analyses with 30 purposively sampled Phase I quantitative bisexual participants. The interviews will facilitate a rich, culturally and contextually-grounded understanding of Black bisexual men's experiences relevant to the parent study's focus, as well as their intersectionality-specific experiences (e.g., binegativity). For Aim 3 of the parent study, Phases II (Focus Groups to Explain the Phase I Quantitative Results) and III (Mixed Methods Syntheses and Assessment of Validity) are unchanged. Bisexual participants will be purposively sampled for the Phase II focus groups. Phase III quantitative and qualitative synthesis analyses will assess the convergence and divergence of results for bisexual participants. This specific focus on bisexual participants represents a paradigmatic shift in sexual minority research. The significance of the proposed research lies in the expected outcome of the future development of multilevel interventions to reduce drug use and promote mental and physical health for Black bisexual men.

项目摘要/摘要 混合方法挖掘 - 续顺序（Quant→Quant）父母研究将测试一个概念模型 社会结构压力源，保护因素以及药物使用以及同时发生的负面精神和身体 在性认同与社会经济地位（SEP）的交汇处，黑人的健康成果。 由交叉性理论框架得知，父母研究的初始设计为三个 性认同类别（即同性恋，双性恋和异性恋）和两个SEP位置（即，较低，更高）和 样本量为1,440（即6个采样框架中的每个参与者：下sep sep，下sep较低的参与者 双性恋，下层异性恋，高层同性恋，高层双性恋，高级异性恋）。 在招募双性恋男人并在两个不同的SEP类别中涉及的挑战是 鉴于该研究的5年时间表和有限的资源，方法论上是不可行的。那个性 由同性恋，双性恋和其他与男人发生性关系的男人组成的少数族裔（SM）类别被创造为 产生仅通过两个性认同位置（即SM和异性恋）分层的采样框架。一个 确定该采样框架在招聘方面更可行 因为它规定了960个样本量（即240个参与者，每个参与者均为下sm，下sep较低sm 异性恋，更高的SM，更高的异性恋）。解决有关黑色存在的关键差距 双性恋男子的健康，拟议的行政补充的目标是增加黑色的数量 双性恋男性参与者并建立双性恋男性作为所有父母研究的独特SM位置 分析。为了实现这一目标，将与Binet USA建立学术社区合作伙伴关系， 美国最古老的国家双性恋组织拟议的补充剂增加了新的原始推论和 探索性分析是针对双性恋男性的（AIM 1，父母研究）。它还添加了收敛的混合方法 第一阶段的设计组成部分，其中将在第一阶段进行深入的定性访谈 与30个基本上取样的I期定量双性恋参与者进行定量分析。采访 将促进对黑人双性恋男人经历的丰富，文化和上下文的理解 与父母研究的重点以及其特定于交叉性的经验有关（例如，BineGativity）。 对于父母研究的目标3，阶段II（解释I期定量结果的焦点组）和III （混合方法合成和有效性评估）没有变化。双性恋参与者将 大部分为II期焦点小组采样。第三阶段定量和定性合成分析 将评估双性恋参与者结果的收敛性和分歧。对双性恋的具体关注 参与者代表了性少数群体研究的范式转变。提议的意义 研究在于多层次干预措施的未来发展的预期结果，以减少药物使用 并促进黑人双性恋男人的心理和身体健康。