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Detecting, explaining, and reducing substance use,mental health, and violence inequities for sexual and gender minority youth and emerging adults

Coulter, Robert (2017) Detecting, explaining, and reducing substance use,mental health, and violence inequities for sexual and gender minority youth and emerging adults. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

This dissertation extended the existing scientific literature concerning the detection, explanation, and reduction of substance use, mental health, and violence victimization inequities for sexual and gender minority (SGM) youth and emerging adults (people aged less than 18 years and 18-25 years, respectively). This dissertation aimed to: (1) estimate sexual-orientation differences in longitudinal alcohol use trajectories (AUTs) and alcohol use disorders (AUDs) during emerging adulthood, and test whether AUTs mediated sexual-orientation differences in AUDs; (2) investigate sexual-orientation differences in typologies of familial and non-familial warmth during childhood and adolescence, and test whether these differences mediated sexual-orientation differences in AUTs and AUDs during emerging adulthood; and (3) systematically review the peer-reviewed scientific literature on interventions and their efficacy in preventing or reducing substance use, mental health problems, and violence victimization among SGM youth. In Aim 1, this dissertation found that several sexual-minority subgroups had higher odds of belonging to heavier AUTs than completely heterosexuals. These differences partially explained the higher risk of AUDs among sexual-minority women but not among sexual-minority men. In Aim 2, sexual-minority women were less likely to report having familial and non-familial warmth during childhood and adolescence, which partially explained why they have greater risk of AUDs. However, there were fewer sexual-orientation differences in warmth for men, and these did not explain the sexual-orientation differences in AUTs and AUDs for men. In Aim 3, this dissertation found that 6 interventions were evaluated among SGM youth for reducing mental health problems, 1 for substance use, and 0 for violence victimization in the extant scientific literature. In conclusion, this dissertation used the life-course perspective to advance research concerning the detection and explanation of sexual-orientation inequities in AUTs and AUDs during emerging adulthood. This dissertation also found significant gaps in intervention research for SGM youth. Without more evidence-based interventions, SGM youth and emerging adults will likely continue to experience health inequities in substance use, mental health, and violence victimization across the life course. Despite the major advances in public health research on SGM populations, intervention research is sorely lacking—but essential—for SGM youth and emerging adults to achieve health equity.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Coulter, Robertrobert.ws.coulter@pitt.edurwc190000-0001-8350-0075
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairStall, Ronrstall@pitt.edurstall
Committee MemberMarkovic, Ninaninam@pitt.eduninam
Committee MemberMair, Christinacmair@pitt.educmair
Committee MemberSilvestre, Anthonytonys@pitt.edutonys
Committee MemberFriedman, Mackeymrf9@pitt.edumrf9
Date: 29 June 2017
Date Type: Publication
Defense Date: 3 April 2017
Approval Date: 29 June 2017
Submission Date: 29 March 2017
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 126
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Behavioral and Community Health Sciences
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: sexual minority populations; gender minority populations; youth; emerging adults; epidemiology; interventions
Date Deposited: 29 Jun 2017 23:40
Last Modified: 29 Jun 2017 23:40
URI: http://d-scholarship.pitt.edu/id/eprint/31075

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