Stigma, Romantic Relationships, and Alcohol Use Among Transgender and Nonbinary Young Adults

跨性别和非二元性别年轻人的耻辱、浪漫关系和饮酒

基本信息

批准号：
10571064
负责人：
Gabriel R Murchison
金额：
$ 13.05万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-02-25 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10571064
关键词：
Accidents Address Adult Advocacy Affect Alcohol consumption Alcohol dependence Alcohols Anxiety Attenuated Buffers Cardiovascular Diseases Clinical Communities Complement Data Data Collection Data Set Development Discrimination Educational workshop Epidemiologist Epidemiology Evaluation Factor Analysis Feasibility Studies Feedback Future Gender Goals Guidelines Health Intervention Interview Link Measurement Measures Mediating Mental Depression Mental Health Mentors Mentorship Methods Modeling Outcome Performance Persons Phase Population Process Property Psychometrics Qualitative Methods Qualitative Research Reporting Research Risk Factors Role Scientist Series Sexual and Gender Minorities Shapes Social Identification Structure Surveys Technology Testing Training Violence Work alcohol intervention anxiety symptoms arm career community engagement design diaries drinking efficacy trial experience improved intimate partner violence motivational enhancement therapy nonbinary online intervention prospective prototype reduced alcohol use satisfaction social stigma sound technology validation therapy development transgender usability violence victimization young adult young adult alcohol use

项目摘要

PROJECT SUMMARY/ABSTRACT For transgender and nonbinary (TNB) people, anti-TNB stigma is a risk factor for adverse alcohol outcomes, often co-occurring with depression and anxiety. Stigma’s impact on alcohol use and mental health is of particular concern in TNB young adults (YA; 21-30 years old), who report more adverse alcohol and mental health outcomes than older TNB adults. For these YA, favorable romantic relationship experiences may attenuate the mental health impact of anti-TNB stigma, yet stigma may contribute to adverse relationship experiences (e.g., intimate partner violence; IPV) linked to adverse alcohol and mental health outcomes. Accordingly, relationship-focused interventions have the potential to improve alcohol and mental health outcomes in TNB YA. However, targets for such interventions remain unclear—first, because the mechanisms by which stigma affects relationship experiences have not been identified, and second, because it is not clear what kinds of general or TNB-specific relationship experiences should be addressed. This project responds to these gaps, culminating in development of a relationship-focused intervention for alcohol use and co-occurring depression/anxiety in TNB YA. In Aim 1, I will collect survey data from 200 TNB YA in romantic relationships to revise and validate a new measure of TNB-specific relationship experiences. In Aim 2, I will use the new measure in a 2-month weekly diary study of stigma, relationship experiences, alcohol use, and depression/anxiety (n=250 TNB YA in romantic relationships). I will use these data to (1) assess weekly associations of stigma and relationship experiences with alcohol use and depression/anxiety, and (2) identify mechanisms by which stigma may affect relationship experiences. In Aim 3, I will adapt an existing type of online alcohol intervention—technology-adapted motivational interviewing with personalized feedback—by tailoring content for TNB YA and (if supported by Aim 2 findings) adding components to address relationship experiences in the context of anti-TNB stigma. The intervention, Whole Selves, will be developed through a multi-phase co-design process with 8 TNB YA, followed by evaluation of acceptability, usability, and engagement in user-testing interviews (n=5 TNB YA in romantic relationships) and a single-arm feasibility study (n=107 TNB YA in romantic relationships). In the K99 phase, this work will be coordinated with training in psychometrics/scale development, diary methods, and community-engaged intervention development, with mentorship from senior scholars known for applying these methods to research on stigma, alcohol use, mental health, and romantic relationships. This training and mentorship will prepare me to develop and evaluate Whole Selves in the R00 phase, producing preliminary data for an R01 efficacy trial proposal. Thus, the project and associated training will allow me to launch an independent research career with the goals of (1) identifying the mechanisms by which stigma affects young people’s alcohol use and mental health, and (2) partnering with affected communities to mitigate these effects through scalable interventions.

项目概要/摘要对于跨性别者和非二元性别 (TNB) 人士来说，抗 TNB 耻辱是不良酒精的危险因素耻辱感对饮酒和心理健康的影响通常与抑郁和焦虑同时发生。 TNB 年轻人（YA；21-30 岁）尤其值得关注，他们报告更多不良酒精和精神问题对于这些青少年来说，他们的健康状况可能比年长的 TNB 成年人更有利。减轻抗 TNB 耻辱对心理健康的影响，但耻辱可能会导致不良关系与不良酒精和心理健康结果相关的经历（例如亲密伴侣暴力；IPV）。因此，以关系为中心的干预措施有可能改善酒精和心理健康然而，此类干预措施的目标仍不清楚——首先是因为其机制。耻辱对人际关系经历的影响尚未确定，第二，因为尚不清楚该项目应解决哪些一般或 TNB 特定的关系经历。这些差距，最终导致针对酒精使用和同时发生的以关系为中心的干预措施的发展 TNB YA 中的抑郁/焦虑在目标 1 中，我将从 200 名 TNB YA 的恋爱关系中收集调查数据，以修改并验证 TNB 特定关系体验的新衡量标准在目标 2 中，我将使用新的衡量标准。通过为期 2 个月的每周日记研究来衡量耻辱感、人际关系经历、饮酒情况和抑郁/焦虑（恋爱关系中 n=250 TNB YA）我将使用这些数据来 (1) 每周进行评估。耻辱和关系经历与饮酒和抑郁/焦虑的关联，以及（2）确定在目标 3 中，我将采用现有的耻辱类型。在线干预酒精——技术适应的动机访谈和个性化反馈——通过为 TNB YA 定制内容并（如果目标 2 结果支持）添加组件以解决关系干预措施“整体自我”将通过一个项目来发展。与 8 个 TNB YA 进行多阶段协同设计流程，然后评估可接受性、可用性和参与用户测试访谈（恋爱关系中 n=5 TNB YA）和单臂可行性研究（n=107 名TNB YA 恋爱关系）在K99 阶段，这项工作将与培训相协调。心理测量/量表开发、日记方法和社区参与干预开发，来自资深学者的指导，这些学者因应用这些方法来研究耻辱、酗酒、心理问题而闻名。这种培训和指导将使我做好发展和评估的准备。整个自我处于 R00 阶段，为 R01 功效试验提案提供初步数据。和相关的培训将使我能够开展独立的研究生涯，其目标是（1）确定耻辱影响年轻人饮酒和心理健康的机制，以及 (2) 与受影响社区通过可扩展的干预措施减轻这些影响。