Sexual minority women (i.e., women who identify as lesbian, bisexual, or other non-heterosexual orientations) report more hazardous drinking compared to heterosexual women. Sexual minority stress (SMS), or experiences related to sexual orientation-based discrimination and marginalization, have been implicated as contributing to these disparities. The association between sexual minority stress and alcohol use has been supported in cross-sectional, and to a limited extent, longitudinal studies. Few studies, however, have examined associations between SMS and alcohol use in sexual minority women's daily lives. Young sexual minority women (age 18-35; N = 321) were recruited to participate in a 14-day daily diary study in which they reported each morning on their SMS and alcohol use (drinking or not; drinking quantity; alcohol consequences) from the previous day. SMS was operationalized in four ways (global negative SMS experiences, specific SMS events, concealment of identity, discrimination). Results from concurrent multilevel models revealed that on days when sexual minority women experienced more global negative SMS, any specific SMS event, or discrimination, they were more likely to drink. Further, prospective models indicated that participants drank more and were more likely to report binge drinking on the day after they experienced at least one SMS event. These findings extend prior research by demonstrating that the association between SMS and alcohol use extends to the daily level of analysis among sexual minority women. Understanding the connection between SMS and alcohol use among sexual minority women is imperative to developing culturally tailored interventions to improve the health and well-being of this at-risk group.
Background
Previous research has identified health disparities between sexual minority and heterosexual women, including increased rates of obesity and binge eating in sexual minority women. Established predictors of binge eating behavior include negative emotions and sociocultural processes; however, these studies are generally conducted in samples of young women where sexual identity is not known or reported. There is a dearth of research evaluating how sexual minority–specific factors (eg, minority stress and connectedness to the lesbian, gay, bisexual, transgender, and queer community) may affect binge eating in sexual minority women. In addition, no studies have examined these processes in racially diverse samples or considered how intersecting minority identities (eg, Black and sexual minority) may affect eating behaviors.
Objective
The Health and Experiences in Real Life (HER Life) Project aims to clarify real-world predictors of binge eating in young heterosexual and sexual minority women using ecological momentary assessment. The role of affective, social, and health behavior factors in binge eating will be examined for all women (aim 1), and sexual minority–specific predictors will also be considered for sexual minority women participants (aim 2). Person-level moderators of race, body- and eating-related factors, and sexual minority–specific factors will also be examined to better understand how real-world binge eating predictors may differ for various demographic groups (aim 3).
Methods
Researchers aim to recruit 150 sexual minority and 150 heterosexual women from across the United States, including at least 50 Black women for each group, using web-based recruitment methods. The eligibility criteria include identifying as a woman, being aged between 18 and 30 years, and having had at least two binge eating episodes in the last 2 weeks. Participants must endorse being only or mostly attracted to men (considered heterosexual) or only or mostly attracted to women or having a current or most recent female partner (considered sexual minority). Eligible participants complete an initial web-based baseline survey and then 14 days of ecological momentary assessment involving the completion of a morning and before-bed survey and 5 prompted surveys per day as well as a user-initiated survey after binge eating episodes. The data will be analyzed using a series of multilevel models.
Results
Data collection started in February 2021. We have currently enrolled 129 sexual minority women and 146 heterosexual women. Data collection is expected to conclude in fall 2022.
Conclusions
The Health and Experiences in Real Life Project aims to elucidate potential differences between sexual minority and heterosexual women in within-person factors predicting binge eating and inform eating disorder interventions for sexual minority women. The challenges in recruiting sexual minority women, including the determination of eligibility criteria and considerations for remote data collection, are discussed.
International Registered Report Identifier (IRRID)
DERR1-10.2196/41199
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