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Multilevel Intersectional Stigma & Empowerment: Decreasing Tobacco Use among Black & Latine Adult Sexual and Gender Minorities

Award Number: DP1DA061347
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/15/2024
PERIOD OF PERFORMANCE END DATE: 10/10/2024

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Multilevel Intersectional Stigma & Empowerment: Decreasing Tobacco Use among Black & Latine Adult Sexual and Gender Minorities - Abstract/Project Summary The Intersectional Substance Use & Lived Analysis (ISLA) lab, is dedicated to developing a novel framework for community-directed research approaches that seeks to reduce intersectional (race/ethnicity + sexual orientation) and intergenerational inequities in (commercial) tobacco use (TU) among Black & Latine young adult sexual and gender minorities (SGMs). SGM adults experience heightened TU, with racial/ethnic SGMs exhibiting elevated TU compared to their racial/ethnic heterosexual peers. Efforts to redress intersectional stigma is currently constrained in two significant ways: 1) overwhelming foci on individual-level measurement without identification of useful empowering strategies that mitigate individual-level stressors/harms and 2) lacking evidence illuminating how intersectional stigma constrains organizational capacity of community-based organizations (CBOs) historically serving those experiencing harmful TU. CBOs serving racial/ethnic SGM adults with heightened TU behaviors, and whose leadership historically has been led by racial minorities (e.g., HIV/AIDS service organizations), have not experienced enhanced R&D growth capacity on par with CBOs serving similar populations but with non-racially minoritized leadership. Such client-service provider racial disconcordance (R/D) has been linked to elevated mistrust, although such evidence within harm-reduction settings warrants greater clarity. We hypothesize that multilevel empowerment strategies (individual+organizational) is positively associated with decreases in TU/motivations among Black & Latine adult SGM Philadelphians. The current project combines inventive community-directed design and measurement strategies to investigate multilevel influences of empowerment in mitigating the harms of TU among racial/ethnic SGM adults. Guided by a 13-member Community Advisory Council, we will use a community-driven systems dynamic modeling process to identify significant multilevel intersectional drivers shaping TU/motivations among clients served by a BIPOC queer/trans urban CBO (n=30). Second, we evaluate how empowerment, resulting from direct policy engagement, can disrupt TU/motivations among clients with smoking histories, using expanded notions of intergenerational familial composition germane collected via surveys. Third, we will develop/assess the psychometric properties of a new organizational-level metric of intersectional stigma (n=488). Fourth, we will identify unique drivers of organizational empowerment, augmenting the R&D environment, to uncover new strategies for combating racial/ethnic inequities in TU. Lastly, we collect longitudinal (t=4, 3-month intervals: 24 clients/16 providers) qualitative multilevel data to better understand racialized dimensions of medical mistrust within harm-reduction settings, uncovering strategies to improve challenges arising from client-provider R/D in harm-reduction settings. These five components synergistically contribute to the development of the first empirically measureable framework of successful community-directed tobacco harm reduction (THR) research; a framework needed to achieve multiple crosscutting issues outlined within NIDA's Racial Equity Action Plan.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$957,600 )
2025	2024	DREXEL UNIVERSITY	3141 CHESTNUT ST	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Drug Use and Addiction Research Programs	000	1	10/21/2024	NEW	-$957,600
														Subtotal = -$957,600

Issue Date FY: 2024 ( Subtotal = $957,600 )
2024	2024	DREXEL UNIVERSITY	3141 CHESTNUT ST	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Drug Use and Addiction Research Programs	001	1	8/30/2024	NEW	$35,595
2024	2024	DREXEL UNIVERSITY	3141 CHESTNUT ST	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Drug Use and Addiction Research Programs	000	1	8/7/2024	NEW	$922,005
														Subtotal = $957,600

Grand Total All Awards = $0

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Multilevel Intersectional Stigma & Empowerment: Decreasing Tobacco Use among Black & Latine Adult Sexual and Gender Minorities

Award Number: DP1DA061347

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/15/2024

PERIOD OF PERFORMANCE END DATE: 10/10/2024

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