Massachusetts General Hospital/Harvard Medical School, Boston, USA.
Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, Suite 701, Boston, MA, 02114, USA.
J Behav Med. 2022 Jun;45(3):461-471. doi: 10.1007/s10865-022-00320-7. Epub 2022 May 3.
Resilience, or the process of adapting to adversity, may protect against the harmful effects of minority-related stressors on the cardiovascular health of sexual minority women (SMW). An online survey was conducted in a sample of cisgender, non-heterosexual women to evaluate resilience as a moderator of the association between discrimination experiences and key cardiovascular disease (CVD) risk factors: stress, tobacco-smoking, hazardous alcohol consumption, poor diet quality, physical inactivity, and sedentary behaviors. Overall, 191 women (mean age = 29.34, SD = 6.92; 84.5% White) completed the survey and met eligibility to be included in the data analysis. White race (b = - 6.71, SE = 2.49) and education (b = - 3.36, SE = 0.56) were each independently associated with fewer discrimination experiences. Latinx ethnicity was associated with more discrimination experiences (b = 9.34, SE = 2.61). Education was associated with greater resilience (b = 4.57, SE = 0.83). Multivariable regression models were adjusted for race, ethnicity, and education. Discrimination was associated with a higher likelihood of smoking in the past month (b = 0.04, SE = 0.02) and drinking at hazardous levels (b = 0.09, SE = 0.02). Resilience was associated with less stress (b = - 0.15, SE = 0.02), a lower likelihood of hazardous alcohol consumption (b = - 0.02, SE = 0.01) and less time spent engaging in sedentary behaviors (b = - 0.02, SE = 0.01). One moderation emerged, such that discrimination was negatively associated with stress for those low in resilience (b = - 1.75, SE = 0.58), and not associated with stress for those high in resilience. These findings may inform the development of CVD-risk reduction interventions for SMW, which could include both strategies to mitigate the effects of discrimination on substance use and coping skills to promote resilience.
韧性，或适应逆境的过程，可能有助于保护少数族裔相关压力源对性少数女性（SMW）心血管健康的有害影响。本研究在线调查了一组跨性别、非异性恋女性，以评估韧性作为歧视经历与关键心血管疾病（CVD）风险因素之间关联的调节因素：压力、吸烟、危险饮酒、不良饮食质量、身体活动不足和久坐行为。总体而言，191 名女性（平均年龄=29.34，SD=6.92；84.5%为白人）完成了调查，并符合数据分析的纳入标准。种族（b=-6.71，SE=2.49）和教育（b=-3.36，SE=0.56）独立与较少的歧视经历有关。拉丁裔与更多的歧视经历有关（b=9.34，SE=2.61）。教育与更高的韧性有关（b=4.57，SE=0.83）。多元回归模型调整了种族、族裔和教育。歧视与过去一个月吸烟的可能性增加（b=0.04，SE=0.02）和饮酒量达到危险水平的可能性增加（b=0.09，SE=0.02）有关。韧性与压力降低有关（b=-0.15，SE=0.02）、危险饮酒可能性降低（b=-0.02，SE=0.01）和久坐行为时间减少（b=-0.02，SE=0.01）有关。有一个调节因素出现，即对于韧性低的人，歧视与压力呈负相关（b=-1.75，SE=0.58），而对于韧性高的人，歧视与压力无关。这些发现可能为 SMW 的 CVD 风险降低干预措施提供信息，这些干预措施可以包括减轻歧视对物质使用影响的策略和促进韧性的应对技能。
