Prospective Cohort of Rural US LGBTQ Persons to Definitively Characterize Depression and Suicidal Ideation Burdens, Determinants, and Preferred Intervention Approaches

美国农村 LGBTQ 群体的未来群体，明确描述抑郁症和自杀意念负担、决定因素和首选干预方法

• 批准号: 10600039
• 负责人: Sarah Sutherlin-McIvor Murray
• 金额: $ 79.04万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10600039
• 关键词: Address; Adolescent; Adult; Affect; Age; Area; Baseline Surveys; Cities; Collaborations; Communication; Consultations; Country; Data; Development; Discrimination; Disparity; Distal; Enrollment; Ethnic Origin; Feeling suicidal; Female; Funding; Gays; General Population; Geography; Goals; Health; Heterogeneity; Heterosexuals; Institute of Medicine (U.S.); Intervention; Intervention Studies; Investigation; Lesbian Gay Bisexual Transgender Queer; Life Cycle Stages; Literature; Measures; Mediating; Mediator; Mental Depression; Mental Health; Mental disorders; Mental health promotion; Methods; Minority Health Research; Modeling; Outcome; Participant; Pathway interactions; Persons; Population; Population Programs; Procedures; Prospective cohort; Psychiatric epidemiology; Public Health Schools; Questionnaires; Race; Recommendation; Reporting; Research; Research Personnel; Risk Factors; Rural; Sample Size; Sampling; Services; Sexual Health; Sexual and Gender Minorities; Strategic Planning; Subgroup; Suicide; Suicide attempt; Suicide prevention; Surveys; Technology; Time; Trauma; United States; United States National Institutes of Health; Universities; cis-female; cis-male; cisgender; cognitive interview; cohort; depression prevention; epidemiology study; ethnic identity; evidence based guidelines; experience; experimental study; follow-up; gender minority community; gender minority group; gender minority health disparity; health disparity; high risk; improved; innovation; interest; marginalization; men who have sex with men; metropolitan; minority stress; minority stressor; peer; preference; programs; prospective; protective factors; psychologic; rural area; rural counties; sexual minority female; sexual minority health; sexual minority male; social stigma; suicidal risk; therapy development; transfeminine; transmasculine; young adult

Mental health disparities affecting sexual and gender minority (SGM) persons are well documented and indicate a substantially greater burden of mental disorders and suicide among SGM as compared to their heterosexual, cisgender peers across the life course. The Institutes of Medicine (IOM) identified substantial gaps in research on these health disparities among SGM persons, particularly in the context of sustained stigma. Additionally, as highlighted in NIH’s 2021-2025 SGM Research Office Strategic Plan, limited data exists on SGM persons residing in rural contexts; though where data are available, they suggest higher rates of mental disorders for SGM outside of, as opposed to residing within, urban centers. Technology-delivered interventions addressing depression are being increasingly explored among the general population and hold promise for use among rural SGM communities, but they must take into account both the substantial heterogeneity of rural SGM persons and pervasive experiences of SGM-related stigma, discrimination, and trauma to be effective. This research team from the Department of Mental Health and Key Populations Program at Johns Hopkins University and the Programs, Research, & Innovation in Sexual Minority Health at Emory University will use online approaches to enroll 2000 SGM (500 each cisgender female and male sexual minorities, and 500 each transfeminine and transmasculine persons) from rural counties and small cities across the US to follow for 12 months with repeated questionnaires to: 1) determine whether classes of stigma, discrimination, and traumatic experiences vary across rural SGM subgroups and whether these exposure classes are associated with increased prevalent depression and suicide ideation or attempt; 2) determine whether these exposure classes are associated with incident depression or suicidal ideation or attempt across rural SGM groups; and, 3) compare the relative acceptability of various technology-delivered interventions for depression and suicide prevention tailored to address rural SGM persons’ experiences of stigma, discrimination, and trauma. This study will produce the first comprehensive investigation of rural SGM adults’ experiences of distal minority stressors and their relationship to prevalent mental health outcomes, as well as by what pathways they may predict incident depression, suicidal ideation and attempts. The study will also provide substantive evidence-based recommendations for the development or adaptation of technology- delivered interventions to address mental health among heterogenous rural SGM communities, and in so doing is responsive to NIH’s Notice of Special Interest on the Health of SGM Populations (NOT-MD-19-001).

影响性少数和性别少数 (SGM) 人群的心理健康差异已有充分记录，并且 表明 SGM 的精神障碍和自杀负担比普通人要大得多 医学研究所（IOM）在整个生命过程中发现了大量的异性恋、顺性别同龄人。 对 SGM 人员之间这些健康差异的研究存在差距，特别是在持续存在的背景下 此外，正如 NIH 2021-2025 年 SGM 研究办公室战略计划中所强调的，数据有限。 居住在农村地区的 SGM 人员中存在这种情况；尽管有数据表明，他们的比率更高； SGM 在城市中心之外而不是居住在技术提供的城市中心内的精神障碍。 普通民众正在越来越多地探索针对抑郁症的干预措施，并坚持 承诺在农村 SGM 社区中使用，但他们必须考虑到实质性问题 农村 SGM 人员的异质性以及与 SGM 相关的耻辱、歧视和普遍经历 该研究小组来自心理健康和重点人群。 约翰·霍普金斯大学的项目以及性少数健康项目、研究和创新 埃默里大学将采用在线方式报名 2000 名 SGM（顺性别女性和男性各 500 名） 少数民族、跨性别女性和跨性别男性各 500 名）来自农村县和小城市 在美国各地进行为期 12 个月的重复问卷调查，以：1) 确定是否存在以下类别： 不同农村 SGM 亚群体的耻辱、歧视和创伤经历各不相同，这些是否 暴露类别与抑郁症和自杀意念或企图增加有关 2) 确定这些暴露类别是否与抑郁症或自杀意念有关，或者 农村 SGM 群体的尝试；3) 比较各种技术交付的相对可接受性 针对农村 SGM 人员的抑郁和自杀预防干预措施 这项研究将对农村 SGM 进行首次全面调查。 成年人对远端少数压力源的经历及其与普遍心理健康结果的关系，如 以及他们可以通过什么途径预测抑郁症、自杀意念和企图。 还为技术的开发或适应提供实质性的基于证据的建议 为解决异质农村 SGM 社区的心理健康问题而采取的干预措施，并因此 所做的事情是对 NIH 关于 SGM 人群健康特别关注的通知 (NOT-MD-19-001) 的回应。