Developing prevention strategies for stigmatized women

Thesis Abstract

Description This Mentored Research Scientist Development Award (K01) will provide the education and skills that I need to make an important and significant transition in my career. Through the training and research experiences under this award, I will transition from conducting descriptive survey research on risk factors for health problems to developing and testing interventions to address these problems. Sexual minority women (SMW; lesbians, bisexual women, and other women who partner with women) are an understudied and underserved group, at risk for multiple health and mental health problems compared to their heterosexual peers. Research suggests that these women face unique minority stressors (e.g., discrimination, victimization, rejection) that are associated with negative health outcomes (mental health disorders, alcohol and drug abuse, smoking, and obesity-related behaviors). However, virtually no research exists on strategies to reduce the impact of minority stressors and thereby prevent mental health disorders and health risk behaviors among SMW. In order to do so, it is necessary to identify mediators and moderators in the relationship between minority stressors and health outcomes. These intermediate variables may be the target of prevention efforts. Furthermore, while the majority of studies on SMW focus on white samples, there is evidence that ethnic minority SMW face additional stressors and health risks that might benefit from targeted intervention. My long-term career goal is to develop and test the efficacy of community-based interventions to prevent health problems in ethnically diverse sexual minority adults. This will require additional education, training and mentorship in several areas (1) intervention development and evaluation, (2) public health and community-based interventions, (3) cultural competence in research with ethnic minority populations (4) comorbidity of mental health disorders and health risk behaviors. In addition to the training plan, this application also outlines a research plan that will further support my transition into an independent, NIH-funded investigator. This research will comprise 3 phases (1) conducting a survey to test the relationships between risk and protective factors and health outcomes among ethnically diverse SMW; (2) using survey data and existing literature to develop a preventive intervention for SMW and obtaining feedback on the proposed intervention from providers and community members; and (3) conducting a community-based randomized controlled trial of the intervention. Data gathered in each of these phases will directly support a subsequent RO1 application in which I aim to test the efficacy of an intervention designed to prevent mental disorders and health risk behaviors in SMW.