A Mixed Methods Study to Enhance Alcohol Treatment Help-seeking and Engagement Among Gender Diverse Adults - 7. Project Summary Abstract Transgender and gender diverse (TGD) individuals have elevated rates of risky alcohol use and alcohol use disorders compared to their cisgender peers. Despite these disparities, the literature on alcohol use and interventions in these populations remains limited. Recent research indicates that TGD people encounter general and transphobia-related barriers to accessing care and systems and providers ill-equipped to help them. However, little is known about alcohol intervention efficacy and engagement in TGD communities as few studies have evaluated or adapted evidence-based interventions with these populations, or examined factors that might influence help-seeking. Research is needed to explore potential adaptations and strategies to increase the appeal and efficacy of interventions and promote help-seeking among TGD populations. The proposed project aims to 1) explore factors that may increase intervention appeal and participation among TGD adults reporting risky alcohol use, as defined by NIAAA thresholds, 2) elicit specific suggestions about potentially meaningful areas of intervention adaptation (e.g., location, format, length, content, provider) and intervention promotion strategies, and 3) explore the acceptability and feasibility of proposed adaptations. The applicant proposes to address these aims via a mixed methods study with a sequential explanatory design. The first phase of the study will be a quantitative survey (N = 200) of TGD adults reporting current or lifetime risky alcohol use to elicit preferences around intervention adaptation and intervention promotion strategies. The next phase will entail four focus groups of various stakeholders including TGD individuals, community leaders, and service providers to review, discuss, and refine the preferences and suggestions elicited in phase one with a focus on maximizing acceptability and feasibility. During the funding period, the applicant will receive advanced training in mixed methods research methodologies, conducting trauma-informed and intersectional alcohol research with TGD populations, evidence-based alcohol interventions, and culturally sensitive intervention adaptation research. The applicant will leverage the skills and expertise gained through this fellowship to address important gaps in the literature and further NIAAA’s goals to 1) address health disparities, 2) enhance diversity and inclusion in the alcohol research enterprise, and 3) improve AUD intervention uptake and efficacy in order to reduce the enormous health and social consequences of alcohol misuse in the U.S. The proposed project will solicit the perspectives, preferences, and expertise of stakeholders (e.g., TGD people with risky alcohol use, LGBTQ+ organization leaders, alcohol intervention and TGD healthcare providers) to gather data about meaningful areas of adaptation for alcohol interventions and intervention promotion strategies as well as the acceptability and feasibility of potential adaptations. The knowledge gained from the proposed study will help direct future research to sensitively adapt and evaluate specific evidence-based alcohol interventions for TGD populations.
