Adverse childhood experiences among black sexually minoritized men and Black transgender women in Chicago
Abstract Background Adverse childhood experiences (ACE) are important predictors of mental health outcomes in adulthood. However, commonly used ACE measures such as the Behavioural Risk Factor Surveillance System (BRFSS) have not been validated among Black sexually minoritized men (SMM) nor transgen...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-04-01
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| Series: | International Journal for Equity in Health |
| Online Access: | https://doi.org/10.1186/s12939-024-02168-6 |
| _version_ | 1827277323914706944 |
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| author | Christoffer Dharma Katherine M. Keyes Kara E. Rudolph Cho-Hee Shrader Yen-Tyng Chen John Schneider Dustin T. Duncan |
| author_facet | Christoffer Dharma Katherine M. Keyes Kara E. Rudolph Cho-Hee Shrader Yen-Tyng Chen John Schneider Dustin T. Duncan |
| author_sort | Christoffer Dharma |
| collection | DOAJ |
| description | Abstract Background Adverse childhood experiences (ACE) are important predictors of mental health outcomes in adulthood. However, commonly used ACE measures such as the Behavioural Risk Factor Surveillance System (BRFSS) have not been validated among Black sexually minoritized men (SMM) nor transgender women (TW), whom are known to have higher rates of ACE and poorer mental health outcomes. Assessing the psychometric properties of the measure is important for health equity research, as measurements that are not valid for some populations will render uninterpretable results. Methods Data are drawn from the Neighborhoods and Networks (N2) study, a longitudinal cohort of Black SMM and TW living in Southern Chicago. We conducted confirmatory factor analysis, correlation analysis and a two-parameter Item Response Theory (IRT) on the BRFSS ACE measure, an 11-item measure with 8 domains of ACE. Results One hundred forty seven participants (85% cisgender male) completed the BRFSS ACE measurement in the N2 study with age ranges from 16–34. The cohort were from a low socioeconomic background: about 40% of the cohort were housing insecure and made than $10,000 or less annually. They also have a high number of ACEs; 34% had endorsed 4 or more ACE domains. The three-factor structure fit the BRFSS ACE measure best; the measurement consisted of three subscales: of “Household Dysfunction”, “Emotional / Physical”, and “Sexual Abuse” (CFI = 0.975, TLI = 0.967, and RMSEA = 0.051). When the 8 domains of ACE were summed to one score, the total score was is correlated with depressive symptoms and anxiety scores, establishing concurrent validity. Item Response Theory model indicated that the “parental separation” domain had a low discrimination (slope) parameter, suggesting that this domain does not distinguish well between those with and without high ACE. Conclusions The BRFFS ACE measure had adequate reliability, a well-replicated structure and some moderate evidence of concurrent validity among Black SMM and TW. The parental separation domain does not discriminate between those with high and low ACE experiences in this population. With changing population demographics and trends in marriage, further examination of this item beyond the current study is warranted to improve health equity research for all. |
| first_indexed | 2024-04-24T07:17:57Z |
| format | Article |
| id | doaj.art-e89ec6a2d6d54c4caea3195ac9dc2620 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-04-24T07:17:57Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-e89ec6a2d6d54c4caea3195ac9dc26202024-04-21T11:12:25ZengBMCInternational Journal for Equity in Health1475-92762024-04-0123111310.1186/s12939-024-02168-6Adverse childhood experiences among black sexually minoritized men and Black transgender women in ChicagoChristoffer Dharma0Katherine M. Keyes1Kara E. Rudolph2Cho-Hee Shrader3Yen-Tyng Chen4John Schneider5Dustin T. Duncan6Department of Epidemiology, Mailman School of Public Health, Columbia UniversityDepartment of Epidemiology, Mailman School of Public Health, Columbia UniversityDepartment of Epidemiology, Mailman School of Public Health, Columbia UniversityDepartment of Epidemiology, Mailman School of Public Health, Columbia UniversityDepartment of Public Health, William Paterson University of New JerseyDepartment of Medicine, University of Chicago School of MedicineDepartment of Epidemiology, Mailman School of Public Health, Columbia UniversityAbstract Background Adverse childhood experiences (ACE) are important predictors of mental health outcomes in adulthood. However, commonly used ACE measures such as the Behavioural Risk Factor Surveillance System (BRFSS) have not been validated among Black sexually minoritized men (SMM) nor transgender women (TW), whom are known to have higher rates of ACE and poorer mental health outcomes. Assessing the psychometric properties of the measure is important for health equity research, as measurements that are not valid for some populations will render uninterpretable results. Methods Data are drawn from the Neighborhoods and Networks (N2) study, a longitudinal cohort of Black SMM and TW living in Southern Chicago. We conducted confirmatory factor analysis, correlation analysis and a two-parameter Item Response Theory (IRT) on the BRFSS ACE measure, an 11-item measure with 8 domains of ACE. Results One hundred forty seven participants (85% cisgender male) completed the BRFSS ACE measurement in the N2 study with age ranges from 16–34. The cohort were from a low socioeconomic background: about 40% of the cohort were housing insecure and made than $10,000 or less annually. They also have a high number of ACEs; 34% had endorsed 4 or more ACE domains. The three-factor structure fit the BRFSS ACE measure best; the measurement consisted of three subscales: of “Household Dysfunction”, “Emotional / Physical”, and “Sexual Abuse” (CFI = 0.975, TLI = 0.967, and RMSEA = 0.051). When the 8 domains of ACE were summed to one score, the total score was is correlated with depressive symptoms and anxiety scores, establishing concurrent validity. Item Response Theory model indicated that the “parental separation” domain had a low discrimination (slope) parameter, suggesting that this domain does not distinguish well between those with and without high ACE. Conclusions The BRFFS ACE measure had adequate reliability, a well-replicated structure and some moderate evidence of concurrent validity among Black SMM and TW. The parental separation domain does not discriminate between those with high and low ACE experiences in this population. With changing population demographics and trends in marriage, further examination of this item beyond the current study is warranted to improve health equity research for all.https://doi.org/10.1186/s12939-024-02168-6 |
| spellingShingle | Christoffer Dharma Katherine M. Keyes Kara E. Rudolph Cho-Hee Shrader Yen-Tyng Chen John Schneider Dustin T. Duncan Adverse childhood experiences among black sexually minoritized men and Black transgender women in Chicago International Journal for Equity in Health |
| title | Adverse childhood experiences among black sexually minoritized men and Black transgender women in Chicago |
| title_full | Adverse childhood experiences among black sexually minoritized men and Black transgender women in Chicago |
| title_fullStr | Adverse childhood experiences among black sexually minoritized men and Black transgender women in Chicago |
| title_full_unstemmed | Adverse childhood experiences among black sexually minoritized men and Black transgender women in Chicago |
| title_short | Adverse childhood experiences among black sexually minoritized men and Black transgender women in Chicago |
| title_sort | adverse childhood experiences among black sexually minoritized men and black transgender women in chicago |
| url | https://doi.org/10.1186/s12939-024-02168-6 |
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