A Behavioral Intervention to Reduce Psychological Distress Symptoms among Black Gender Minority Women Experiencing Chronic Stigma

A Behavioral Intervention to Reduce Psychological Distress Symptoms among Black Gender Minority Women Experiencing Chronic Stigma PROJECT SUMMARY: Black gender minority (GM) women in the United States face a nearly universal experience of chronic stigma (i.e., enacted, anticipated, and structural stigma), associated with a

disproportionate prevalence of psychological distress symptoms compared to cisgender peers. Psychological distress symptoms, specifically post-traumatic stress (PTS) and depressive symptoms, can be highly debilitating and traditional pathways to care are impeded by widespread barriers to healthcare access and engagement for

Black GM women. Such barriers include underprepared healthcare providers, lack of health insurance, medical mistrust, and high rates of discrimination and victimization within healthcare settings, which have been associated with increased PTS and depressive symptom severity among Black GM women. Conversely, coping

and GM community connection have been shown to decrease psychological distress symptom severity among Black GM women. Thus, culturally informed community-based interventions are needed to offset the high burden of barriers to healthcare and address psychological distress symptoms among this population. The research

objectives of this application are to first, develop a culturally informed community-based intervention with guidance from community members (via focus groups and theater testing; N=20) to reduce the effect of chronic stigma exposure on psychological distress symptoms (PTS and depressive symptoms) among Black GM

women. Second, we will conduct a proof-of-concept trial (N=40) to determine the feasibility and preliminary efficacy of the resulting intervention. Findings will inform intervention optimization to improve symptom management for this group. The proposed study plays an essential role in developing and evaluating evidence-

based interventions to improve psychological distress symptom management among Black GM women. To accomplish the proposed research, I propose a research and training program facilitating my transition to an independent, patient-oriented research career, specializing in symptom science and culturally appropriate

interventions for symptom management that are easily implemented in real-world settings. Research and training aims will be accomplished through close interdisciplinary mentorship and carefully selected didactic activities, conference attendance, applied research experiences, and manuscript and grant proposal preparation (i.e., R-

series). Additionally, I will achieve these goals by obtaining clinical and research training in intervention design, implementation, and evaluation; psychological distress treatment among GM people; and research ethics and management specific to engaging vulnerable populations. The training plan leverages the well-supported

infrastructure at Emory University, as well as national and institutional opportunities to ensure didactic, experiential, and specialized individual instruction. 1