PROJECT SUMMARY
Sexual and gender minorities are at an increased risk of cardiovascular disease (CVD) at an earlier age than
heterosexuals. One of the reasons is that emerging adult (18-29) young sexual and gender minorities (YSGM)
have higher rates of harmful cardiometabolic health behaviors (CHB; e.g., physical inactivity, dysregulated
sleep, smoking, and alcohol use) than cisgender heterosexuals. One key factor that leads to increased rates of
harmful CHB within YSGM is exposure to intersectional discrimination (i.e., the experiences of discrimination
occurring amid multiple identities and/or positions [e.g., race/ethnicity, gender identity, sexual orientation]).
Although there is currently research demonstrating links between intersectional discrimination and
cardiometabolic health behaviors among SGM, much of this research cannot characterize the experiences and
effects of intersectional discrimination on CHB in ways that reflect the lived experience of race, place, and
identity among YSGM. Thus, to better understand the contextual features that influence intersectional
discrimination on CHB, we will employ a geographically explicit ecological momentary assessment (GEMA)
and a qualitative mapping approach. This approach will help to reveal the rich, context specific, experiences of
intersectional discrimination, protective social and interpersonal factors, and CHB across and within different
racial groups of YSGM. The qualitative mapping method involves making maps of participant activities based
on their geolocation and EMA data (gathered via GEMA) and then conducting an in-depth qualitative interview
to explore participants’ thoughts, feelings, and experiences while in the mapped locations. This approach is
critically important as YSGM experience unique exposures to intersectional discrimination based on the
geographical locations in which they travel, while also having differing appraisals of discrimination experiences
based on the features of these spaces (e.g., time spent in them, purpose [school, home, work], safety). Our
overarching approach is to utilize GEMA and qualitative mapping to understand the complex relationships
between environmental and interpersonal experiences of intersectional discrimination and related CHB
behaviors for YSGM. Specifically, this study aims to; 1) examine how daily experiences of intersectional
discrimination and CHB differ by level of structural inequality, measured by the combination of individual GPS
and census data among YSGM; 2) examine how social protections (e.g., community relationships, social
cohesion) buffer the negative effects of intersectional discrimination on CHB among YSGM; and 3) explore
context-specific risks/protective factors associated with CHB across different racial/ethnic groups of YSGM
using GEMA methodology. In all, our innovative approach allows reporting of experiences of intersectional
discrimination in real time while also considering the situational factors that are associated with these
experiences to improve external validity. This study is significant because it will inform tailored harmful CHB
prevention interventions for diverse groups of YSGM, including future Just in Time interventions.
