Geographically-Explicit Ecological Momentary Assessment Protocol to Assess the Linkages Between Intersectional Discrimination and CVD Risk Among Sexual and Gender Minorities

NIH RePORTER · NIH · R01 · $636,567 · view on reporter.nih.gov ↗

Abstract

PROJECT SUMMARY Sexual and gender minorities are at an increased risk of cardiovascular disease (CVD) at an earlier age than heterosexuals. One of the reasons is that emerging adult (18-29) young sexual and gender minorities (YSGM) have higher rates of harmful cardiometabolic health behaviors (CHB; e.g., physical inactivity, dysregulated sleep, smoking, and alcohol use) than cisgender heterosexuals. One key factor that leads to increased rates of harmful CHB within YSGM is exposure to intersectional discrimination (i.e., the experiences of discrimination occurring amid multiple identities and/or positions [e.g., race/ethnicity, gender identity, sexual orientation]). Although there is currently research demonstrating links between intersectional discrimination and cardiometabolic health behaviors among SGM, much of this research cannot characterize the experiences and effects of intersectional discrimination on CHB in ways that reflect the lived experience of race, place, and identity among YSGM. Thus, to better understand the contextual features that influence intersectional discrimination on CHB, we will employ a geographically explicit ecological momentary assessment (GEMA) and a qualitative mapping approach. This approach will help to reveal the rich, context specific, experiences of intersectional discrimination, protective social and interpersonal factors, and CHB across and within different racial groups of YSGM. The qualitative mapping method involves making maps of participant activities based on their geolocation and EMA data (gathered via GEMA) and then conducting an in-depth qualitative interview to explore participants’ thoughts, feelings, and experiences while in the mapped locations. This approach is critically important as YSGM experience unique exposures to intersectional discrimination based on the geographical locations in which they travel, while also having differing appraisals of discrimination experiences based on the features of these spaces (e.g., time spent in them, purpose [school, home, work], safety). Our overarching approach is to utilize GEMA and qualitative mapping to understand the complex relationships between environmental and interpersonal experiences of intersectional discrimination and related CHB behaviors for YSGM. Specifically, this study aims to; 1) examine how daily experiences of intersectional discrimination and CHB differ by level of structural inequality, measured by the combination of individual GPS and census data among YSGM; 2) examine how social protections (e.g., community relationships, social cohesion) buffer the negative effects of intersectional discrimination on CHB among YSGM; and 3) explore context-specific risks/protective factors associated with CHB across different racial/ethnic groups of YSGM using GEMA methodology. In all, our innovative approach allows reporting of experiences of intersectional discrimination in real time while also considering the situational factors that are associ...

Key facts

NIH application ID
10879368
Project number
1R01HL169503-01A1
Recipient
NEW YORK UNIVERSITY
Principal Investigator
Stephanie Hazel Cook
Activity code
R01
Funding institute
NIH
Fiscal year
2024
Award amount
$636,567
Award type
1
Project period
2024-04-01 → 2028-03-31