Using EMA to Examine Minority Stress Mechanisms Underlying Cannabis Use among Sexual Minorities - PROJECT SUMMARY/ABSTRACT Despite often being used legally, cannabis use is associated with several harmful outcomes (e.g., mental health problems). Moreover, cannabis use is disproportionately higher among sexual minorities (SM) relative to their heterosexual counterparts. SM who use cannabis are also more likely to develop cannabis use disorder (CUD) compared to heterosexuals. Our understanding of mechanisms that explain disparities in SM cannabis use outcomes is nascent. In line with NIDA’s funding priorities to identify mechanisms underlying differences in SM drug use outcomes, this K99/R00 application aims to evaluate mediators of associations between minority stressors, cannabis use, and use-related negative outcomes among young adult SM. The minority stress psychological mediation framework posits that minority stressors result in substance use outcomes through impaired coping, interpersonal, and cognitive processes. This model has support for SM alcohol use; however, only eight studies have tested putative mechanisms explaining how minority stressors relate to cannabis use. Among these studies, many are cross-sectional and most solely test coping motives mediation. Longitudinal research examining how minority stressors and these mechanisms relate to use and negative outcomes (e.g., CUD) is necessary to address these research gaps and advance understanding of SM health. Moreover, identifying how daily experiences relate to use will provide targets for prevention and intervention development, particularly when certain experiences (e.g., stigma) may be unavoidable. This K99/R00 study leverages ecological momentary assessment (EMA) to capture real-time measures in daily life of stressors, cannabis use, and related outcomes. Foundational work during the K99 phase will collect data to inform EMA item development (Aim 1), then conduct an EMA feasibility and acceptability study (Aim 2). Dr. Parnes’ training goals include (1) refine skills to independently design, develop, execute, and analyze EMA research, (2) build expertise in conducting substance use research with SM populations, (3) continue training in advanced statistical modeling of EMA data, and (4) promote a successful transition from postdoctoral fellow to independent faculty researcher. Dr. Parnes’ mentorship team, Drs. Miranda, Mereish, and Treloar Padovano, are experts in EMA, sexual minority research, and advanced statistical analysis. These training goals build on Dr. Parnes’ F32 (DA054718), which provided foundational training in identifying mechanisms of behavior change in adolescent cannabis treatment. Using the protocol finalized through the K00, the R00 study will conduct a 30-day EMA study among SM who use cannabis to test putative mechanisms relating daily minority stressors to use-related negative outcomes (Aim 3). Findings from the proposed study will inform whether and how SM minority stressors relate to harmful use-related outcomes. Evaluating mechanisms can also be used to identify intervention targets to complement or replace cannabis use, thus reducing liability for CUD or other negative outcomes, and reducing known health disparities in this population.
