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Project Summary
Health disparities among sexual and gender minority (SGM) young adults are well-documented, including elevated risk of substance use and mental health disorders. Cannabis is one of the more widely used substances among young adults and has been linked to mental health concerns. A key conceptual framework for understanding substance use and mental health disparities among SGMs is the Minority Stress Theory (MST). MST posits that SGMs face excess stressors that are specific to marginalized individuals. This chronic stress is thought to contribute to negative health outcomes. Cannabis use among SGMs might reflect an attempt to cope with minority-related stress and resultant mental health problems.
Access to providers who offer mental health and substance use treatment tailored for SGMs is limited, particularly in rural areas. Thus, SGMs have reported greater unmet mental healthcare needs. Although some sexual minority groups are more likely to seek out treatment, there is lessened satisfaction with care received. Digital health interventions (DHIs) offer one possible avenue to improve access to care and treatment satisfaction among SGM young adults, while also enhancing the potential for tailored components sensitive to both sexual and gender identities that may further enhance outcomes. Tailored interventions which target underlying mechanisms for co-occurring substance use and mental health problems offer promise, but no such interventions for cannabis use have been developed.
This proposed project will initiate a program of research to develop a tailored DHI, grounded in MST, for SGM young adults with problematic cannabis use and co-occurring internalizing symptoms. In the first step of this project, we will recruit a large sample of young adults with diverse SGM identities to complete an online survey that will allow for examination of relationships between cannabis use, depression, anxiety, and dimensions of minority stressors. From the sample who complete this survey, a subset of participants with cannabis and mental health problems will be recruited to aide in developing content for a tailored intervention for a later-stage DHI prototype. This project will characterize a unique and vulnerable sample of SGM. The resultant product will be a completed intervention manual for a tailored DHI that targets theoretically relevant and empirically supported processes with relevance to substance use and co-occurring mental health problems. Accomplishment of these aims will provide data necessary for development of an extramural grant application to develop a cost-effective DHI prototype that can be delivered via multiple platforms (e.g., desktop, smartphones, tablets), and to conduct initial feasibility and effectiveness of this innovative product.