Advancing help-seeking and recovery measures for sexual and gender minority survivors of gender-based violence

Project Summary Research has documented that gender-based violence (GBV; e.g. intimate partner violence, sexual assault, child abuse, hate-motivated violence) disproportionately impacts sexual and gender minority (SGM) populations, with unaddressed

victimization experiences representing a key driver of SGM health disparities (e.g., suicidality, substance use, depression, HIV transmission, morbidity, mortality). To advance from identifying these disparities to intervening, research that

evaluates SGM barriers to seeking help and GBV recovery needs, as well as the social, cultural, and structural influences

of these processes at multiple levels is required. There is a scarcity of tools to measure GBV-specific concepts validated in SGM populations, with no current instruments to measure the help-seeking barriers SGM survivors face and their recovery progress. Thus, there is a critical need to develop these instruments to inform acceptable and effective

interventions to increase the access, engagement, care linkages, and effectiveness of survivor support infrastructure for SGM populations. Through an exploratory sequential mixed-methods approach, we aim to: 1) develop an SGM Barriers to Help-seeking and an SGM GBV Healing Scale and 2) psychometrically evaluate these instruments. Study aims will

draw on four sequentially collected sources of data: a) an existing dataset of SGM ethnographic narrative interviews (N=40, n=20 gender minority survivors), b) data gathered from our community advisory board (N=10), c) cognitive interviews with SGM survivors (N=35), and d) a national online survey (N=1000), with quota sampling to ensure

adequate representation of cisgender, sexual minority men, cisgender, sexual minority women, and transgender/ otherwise gender expansive people, purposively sampled to achieve maximum diversity in race and ethnicity. A community advisory board with SGM GBV survivors, clinicians, scientific experts, and community stakeholders will be engaged

throughout the research process ensuring potential impact and sustainability. This study is innovative because it uses rich community-engaged approaches to articulate help-seeking and recovery experiences at multiple levels, incorporating SGM survivors at all stages of the process, with an emphasis on recovery rather than deficit. In turn, the instruments

created are expected to open new horizons in SGM survivorship research and practice, specifically the ability to illuminate SGM recovery needs and prioritize interventions to mitigate drivers of SGM health disparities at multiple

levels of influence. Successful completion of this project is expected to have a positive impact by enhancing our ability to:

1) evaluate future help-seeking and recovery intervention effectiveness, 2) enhance help-seeking and recovery exploration in SGM populations, and 3) determine how changes in policy influence help-seeking and recovery for SGM populations. The study's key deliverables will include two instruments measuring help-seeking barriers and GBV recovery needs,

validated in SGM populations, using rigorous community-engaged qualitative, quantitative, and mixed methods approaches. These expected outcomes will support NIH priorities for Health Disparities Science by strengthening measurement of help-seeking barriers and recovery in SGM survivors, thereby improving understanding on multi-level

areas for additional exploration to improve health disparities in these populations.