PROJECT SUMMARY/ABSTRACT
Cigarette smoking is a leading cause of morbidity and mortality in the U.S. Marginalized communities, such as
Black/African Americans (B/AA) and sexual and gender minorities (SGM), experience increased risk for
smoking-related cancers and unique social and contextual stressors that may hinder successful quitting. For
example, B/AA and SGM experience pervasive minority stressors (e.g., stigmatization and discrimination)
known to negatively impact mental health, health behaviors, and physical health outcomes. Although extensive
research has linked perceived discrimination with current smoking behavior among B/AA and SGM, no studies
have examined how discrimination impacts smoking cessation within these groups. Mobile health (mHealth)
technologies such as ecological momentary assessment (EMA) and AutoSense – a suite of wearable
physiological sensors – can provide real-time, real-world assessments of lived experiences during a quit
attempt to predict smoking behavior and inform the development of adaptive interventions. The objective of
the proposed research is to use mHealth approaches to advance current knowledge of the mechanisms by
which minority stressors such as discrimination contribute to inequities in cancer risk among B/AA and SGM.
Aim 1 will utilize data from a recently completed study to analyze pathways linking real-time, real-world
experiences of discrimination and smoking lapse during a quit attempt among B/AA (N = 300). Aim 2 will utilize
data from an ongoing study to elucidate pathways linking real-time, real-world experiences of discrimination
and smoking lapse during a quit attempt among SGM, and further compare experiences of discrimination,
associated intrapersonal experiences (e.g., stress, affect), and smoking lapse between SGM and non-SGM
during a quit attempt (N = 375 [300 non-SGM + 75 SGM]). Key mechanisms hypothesized to mediate the
temporal association between discrimination and smoking lapse are stress, negative affect, urge, and self-
efficacy. This research will be conducted at Huntsman Cancer Institute, an NCI-Designated Cancer Center that
offers an exceptionally supportive and collaborative training environment. The applicant’s comprehensive
training plan, developed in conjunction with an expert mentoring team, will directly support the completion of
the proposed research and complement the applicant’s prior training in cancer inequities research. Fellowship
training goals focus on: 1) advanced statistical methods for analyzing intensive longitudinal data; 2) mHealth
assessment and intervention approaches; 3) primary cancer prevention and smoking cessation; 4) health
inequities and the social determinants of health; and 5) professional development, including grant writing,
research dissemination, research ethics, and mentoring. The proposed research and training activities will
provide the applicant with the necessary knowledge and skills needed to establish an independent and
productive research program dedicated to eliminating cancer inequities across the cancer control continuum.