Exploring health equity for Asian American, Native Hawaiian, and Pacific Islander Adolescents in a large epidemiologic study: Intersections of ethnicity, sexual orientation, and gender identity

在大型流行病学研究中探索亚裔美国人、夏威夷原住民和太平洋岛民青少年的健康公平性：种族、性取向和性别认同的交叉点

• 批准号: 10645666
• 负责人: G. Nic Rider
• 金额: $ 22.88万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10645666
• 关键词: 19 year old; Address; Adolescent; Affect; Age; Ancillary Study; Area; Asian Americans; California; Caring; Cause of Death; Characteristics; Child; Communities; Complex; Data; Data Set; Development; Disadvantaged; Disparity; Ethnic Origin; Ethnic Population; Exposure to; Face; Family; Feeling; Funding; Future; Gender; Gender Identity; Health; Health Professional; Health Services; Homophobia; Immigrant; Individual; Inequality; Intervention; Interview; Language; Lesbian; Lesbian Gay Bisexual Transgender Queer; Link; Measures; Mediating; Mental Health; Mentorship; Methods; Minnesota; Minority; Modeling; Native Hawaiian or Other Pacific Islander; Neighborhood Health Center; Personal Satisfaction; Persons; Population; Process; Production; Protocols documentation; Public Health; Race; Recommendation; Religion; Reporting; Research; Resources; Risk; Risk Behaviors; Risk Factors; Safety; Sample Size; Sampling; Schools; Services; Sex Orientation; Sexual and Gender Minorities; Sexual and Gender Minority Youth; Social status; Source; Spirituality; Stereotyping; Structure; Students; Subgroup; Suicide; Suicide attempt; Surveys; System; Teenagers; Testing; Training; Training Programs; Variant; Victimization; Work; Youth; adolescent health; bullying; cisgender; design; emotional distress; epidemiology study; experience; gender minority group; gender minority youth; girls; health disparity; health equity; high risk; high risk sexual behavior; improved; innovation; insight; intersectionality; lens; marginalization; minority children; nonbinary; peer; protective factors; public health intervention; queer; racism; resilience; service providers; sexual minority; social; social factors; stressor; structural determinants; substance use

PROJECT ABSTRACT/SUMMARY Asian American, Native Hawaiian, and Pacific Islander (AANHPI) sexual and gender minority (SGM) youth face substantial health disparities compared to their cisgender and straight peers. They must also contend with stereotypes, such as the model minority myth, contributing to misconceptions and inaccurate/insufficient information to guide intervention strategies. AANHPI youth are not a monolith; yet, they are often aggregated in studies, masking important health disparities across AANHPI subpopulations. Intersectionality is a critical analysis framework describing complex ways that power and privilege are structured based on mutually constitutive social positions and how processes that confer privilege and disadvantage impact people’s lives. Exposure to overlapping concurrent forms of social oppression (e.g., homophobia and racism simultaneously) may differentially affect treatment of AANHPI youth subgroups, yielding longer-term health concerns. AANHPI youth facing multiple marginalization may experience challenges that affect healthy development, but also unique strengths. AANHPI youth are a fast-growing, poorly understood population, especially AANHPI SGM youth, and their risks and support needs are critical public health issues. This proposed developmental study responds to NOT-HL-23-001 and is an ancillary study to a funded R01 (MD015722). We will use an intersectional lens and a sequential explanatory design to answer questions specific to AANHPI SGM youth (13-19 years old), which are beyond the scope of our existing study: 1) What are differences in bullying, risk behaviors, mental health, and protective factors among AANHPI youth with different social positions (e.g. AANHPI sexual and/or gender minority youth, various ethnic groups)? 2) How do differences in protective factors and other characteristics explain variations in bullying, risk behaviors, and mental health among AANHPI youth (and ethnic groups) with different social positions? and 3) What positive and negative experiences are relevant to the overlapping, simultaneous production of inequalities by AANHPI ethnicity and SGM identity? We will explore these new areas using two study aims: first, conduct intersectionality-informed, harmonized and parallel quantitative analyses of three adolescent datasets to examine risk and protective factors for AANHPI youth at intersecting social positions. We will use the California Healthy Kids Survey (N~1,042,000), Minnesota Student Survey (N~122,000), and LGBTQ National Teen Survey (N~17,000). Second, we will conduct interviews with 15 AANHPI SGM youth to gain rich insight into Aim 1 findings and 15 professionals who work with AANHPI SGM youth to understand training/resource needs and interpersonal and community-specific assets. Findings will generate concrete recommendations to bolster care and service systems for AANHPI SGM youth. This study, capitalizing on existing protocols, resources and mentorship of our funded R01, is expected to provide preliminary data to develop and test training programs for educators, health professionals and service providers in various settings to improve the wellbeing of AANHPI youth.

项目摘要/总结 亚裔美国人、夏威夷原住民和太平洋岛民 (AANHPI) 性少数群体 (SGM) 青少年 与同性别者和异性恋同龄人相比，他们还必须应对巨大的健康差异。 刻板印象，例如模范少数族裔神话，导致误解和不准确/不充分 指导干预策略的信息。 研究表明，掩盖 AANHPI 亚人群之间的重要健康差异是一个关键。 描述权力和特权相互构建的复杂方式的分析框架 构成性社会地位以及赋予特权和劣势的过程如何影响人们的生活。 暴露于重叠的并发形式的社会压迫（例如同时恐惧同性恋和种族主义） 可能会对 AANHPI 青年亚组的治疗产生不同的影响，从而产生长期的健康问题。 面临多重边缘化的青少年可能会遇到影响健康发展的挑战，但也 AANHPI 青年人是一个快速增长但鲜为人知的群体，尤其是 AANHPI SGM。 青年及其风险和支持需求是关键的公共卫生问题。 响应 NOT-HL-23-001，是资助的 R01 (MD015722) 的辅助研究。 交叉镜头和顺序解释设计来回答 AANHPI SGM 青少年的具体问题 （13-19岁），这超出了我们现有研究的范围：1）欺凌、风险有什么区别 不同社会地位的 AANHPI 青少年的行为、心理健康和保护因素（例如 AANHPI 性和/或性别少数青年、不同种族群体） 2) 保护方面有何差异？ 因素和其他特征解释了欺凌、危险行为和心理健康的差异 具有不同社会地位的 AANHPI 青年（和族裔群体）以及 3) 有哪些积极和消极因素？ 经验与 AANHPI 种族重叠、同时产生的不平等有关 SGM 身份？我们将通过两个研究目标来探索这些新领域：第一，进行交叉性知情， 对三个青少年数据集进行协调和并行定量分析，以检查风险和保护 AANHPI 青少年处于交叉社会地位的因素 我们将使用加州健康儿童调查。 (N~1,042,000)、明尼苏达州学生调查 (N~122,000) 和 LGBTQ 全国青少年调查 (N~17,000)。 其次，我们将采访15位AANHPI SGM青年，以深入了解目标1的发现和15 与 AANHPI SGM 青少年合作以了解培训/资源需求和人际关系的专业人士 调查结果将产生具体建议，以加强护理和服务。 这项研究利用了现有的协议、资源和指导。 我们资助的 R01 预计将为教育工作者开发和测试培训计划提供初步数据， 各种环境下的卫生专业人员和服务提供者，以改善 AANHPI 青少年的福祉。