Sexual Fluidity and Longitudinal Changes in Alcohol Misuse and Associated Health Consequences

性流动性和酒精滥用的纵向变化及相关健康后果

• 批准号: 10698153
• 负责人: Rebecca J. Evans-Polce
• 金额: $ 28.03万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-10 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10698153
• 关键词: Address; Adolescent; Adult; Age; Alcohols; Behavior; COVID-19; Cannabis; Complement; Criminal Justice; Data; Dimensions; Discrimination; Distal; Engineering; Gender Identity; Goals; Health; Healthcare; Heterogeneity; Heterosexuals; Individual; Intervention; Laws; Lesbian Gay Bisexual; Liquid substance; Longitudinal Studies; Measures; Medicine; Modeling; Movement; Outcome; Patient Self-Report; Pharmaceutical Preparations; Policies; Population Assessment of Tobacco and Health; Population Study; Prevention; Productivity; Public Policy; Reporting; Research; Research Design; Risk; Risk Factors; Sampling; Severities; Sex Orientation; Sexual Health; Sexual and Gender Minorities; Shapes; Social Concepts; Social Interaction; Subgroup; Substance Use Disorder; Symptoms; Time; Tobacco; United States National Academy of Sciences; Variant; Work; Youth; alcohol measurement; alcohol misuse; alcohol related consequences; alcohol risk; alcohol use disorder; cost; ethnic identity; fluidity; gender minority group; gender minority health disparity; health data; improved; interest; longitudinal design; modifiable risk; neglect; physical conditioning; polysubstance use; population based; protective factors; public policy on alcohol; racial identity; response; screening; secondary analysis; sex; sexual identity; sexual minority; sexual minority women; social; stressor

PROJECT SUMMARY/ABSTRACT In response to the Notices of Special Interest on Research on the Health of Sexual and Gender Minority Populations (NOT-MD-19-001) and Public Policy Effects on Alcohol-, Cannabis-, Tobacco-, and Other Drug- Related Behaviors and Outcomes (NOT-AA-21-028), this project will identify trajectories of alcohol misuse by sexual orientation and their associated health consequences. We will also examine risk and protective factors across individual, social, and policy domains. Sexual minorities are at heightened risk of alcohol misuse; however, existing research is often based on a static and unidimensional construct of sexual orientation rather than a fluid and multidimensional construct of sexual orientation, despite evidence indicating sexual orientation fluidity is common, especially among sexual minorities. Prior work has shown alcohol misuse and alcohol use disorder (AUD) symptoms are more prevalent and more severe among sexual minorities than heterosexuals. There is a lack of population-based longitudinal studies of alcohol misuse trajectories and related negative health consequences based on a fluid and multidimensional construct of sexual orientation. Additionally, studies examining risk and protective factors for alcohol misuse among sexual minorities have largely focused on individual-level factors and neglected factors at the social and policy level. There is a need to expand this research and draw on concepts from the Social Ecological Model to include upstream risk and protective factors, such as those at the social and policy level. To address these gaps, this project will use longitudinal data from a sample of U.S. adolescents and adults based on six waves of the Population Assessment of Tobacco and Health study (n=45,971; 2013-2021). This study design will allow us to explore changes in alcohol misuse based on sexual orientation before and after COVID-19 onset. Our study aims to: (1) Identify alcohol misuse trajectories over an 8-year period and determine if these associations differ by sexual orientation (a) concordance vs. discordance, and (b) stability vs. fluidity. We will also examine potential heterogeneity in risk by age, sex, race, ethnicity, and gender identity and compare changes in alcohol misuse before and after COVID-19 onset by sexual orientation. (2) Examine (a) how variation in alcohol misuse trajectories shape negative health-related consequences (e.g., AUD symptoms, other substance use disorder symptoms, polysubstance use, and negative physical health consequences) and (b) whether this differs across sexual orientation subgroups, by sexual orientation discordance vs. concordance, and sexual identity fluidity vs. stability. (3) Examine longitudinal relationships of individual- (e.g., internalizing symptoms), social- (e.g., degree of social interaction), and policy-level (e.g., antidiscrimination laws) protective/risk factors with trajectories of alcohol misuse and negative alcohol-related health consequences and determine if associations differ by sexual orientation concordance vs. discordance and sexual identity fluidity vs. stability.

项目概要/摘要 响应《性与性别少数群体健康研究特别关注通知》 人口 (NOT-MD-19-001) 和公共政策对酒精、大麻、烟草和其他药物的影响 相关行为和结果（NOT-AA-21-028），该项目将通过以下方式确定酒精滥用的轨迹： 性取向及其相关的健康后果。我们还将检查风险和保护因素 跨越个人、社会和政策领域。性少数群体滥用酒精的风险更高； 然而，现有的研究通常基于静态和单维的性取向结构，而不是基于性取向的结构。 尽管有证据表明性取向，但性取向的流动性和多维结构并非如此 流动性很常见，尤其是在性少数群体中。先前的研究表明酒精滥用和饮酒 与异性恋者相比，性少数群体中的性障碍（AUD）症状更普遍、更严重。 缺乏对酒精滥用轨迹和相关负面影响的基于人群的纵向研究 基于流动性和多维性取向结构的健康后果。此外， 研究性少数群体滥用酒精的风险和保护因素的研究主要集中在 个人层面的因素以及社会和政策层面被忽视的因素。这个有必要扩展一下 研究并借鉴社会生态模型的概念，包括上游风险和保护 因素，例如社会和政策层面的因素。为了解决这些差距，该项目将使用纵向 基于六波人口评估的美国青少年和成年人样本数据 烟草与健康研究（n=45,971；2013-2021）。这项研究设计将使我们能够探索以下方面的变化： COVID-19 发病前后基于性取向的酒精滥用。我们的研究目的是：（1）确定 8 年期间的酒精滥用轨迹，并确定这些关联是否因性别而异 方向（a）一致性与不一致，以及（b）稳定性与流动性。我们还将考察潜力 按年龄、性别、种族、民族和性别认同划分的风险异质性，并比较酒精滥用的变化 根据性取向，在 COVID-19 发病之前和之后。 (2) 检查 (a) 酒精滥用的变化情况 轨迹塑造了与健康相关的负面后果（例如，AUD 症状、其他物质使用障碍） 症状、多物质使用和负面身体健康后果）以及 (b) 这是否因人而异 性取向亚组，按性取向不一致与一致性以及性身份流动性分类 与稳定性。 (3) 检查个体（例如，内化症状）、社会（例如， 社会互动程度）和政策层面（例如反歧视法）保护/风险因素 酒精滥用的轨迹和与酒精相关的健康不良后果，并确定是否存在关联 差异在于性取向一致性与不一致以及性身份流动性与稳定性。