Rationale and Design of an Ecological Momentary Assessment Study Examining Predictors of Binge Eating Among Sexual Minority and Heterosexual Young Women: Protocol for the Health and Experiences in Real Life (HER Life) Study

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): DERR1-10.2196/4119

Similarities and Differences in Female Same-Sex Couples’ Drinking and Eating Behaviors

Prior research has supported co-occurring hazardous alcohol use and disordered eating within individuals and concordance in couples’ drinking habits, with couples displaying similar hazardous drinking behavior. Less is known about concordance in couples’ eating behaviors, particularly in female same-sex couples. This study examined eating and alcohol use patterns in female same-sex couples where at least one couple member engaged in risky drinking. This study examined if couples had similar or differing drinking and disordered eating behaviors. An online survey with alcohol use and disordered eating measures was administered separately to both partners in 163 young female same-sex couples. Using intraclass correlation coefficients (ICCs), we measured the proportion of variance in drinking and disordered eating variables attributable to the couple level of analysis. Results showed partners were moderately similar in their hazardous drinking, with 29.2% of the binge drinking frequency variable, 35.5% of the average drinks/binge drinking day variable, and 28.3% of the problematic alcohol use variable explained at the couple-level. Conversely, of the disordered eating variables, 14% of eating cognitive restraint, 0.3% of body dissatisfaction, 2.8% of binge eating, 9.2% of dietary restriction, and 7.7% purging, were explained by the couple-level ICCs, indicating far lower within-couple similarities in disordered eating. Couple-level associations explained more variability in problematic alcohol use than disordered eating, suggesting partners were more similar in their drinking than disordered eating. Future research should explore why couples are less similar in their disordered eating than hazardous drinking and if this pattern is unique to female same-sex couples

Effects of Cultural Stress on Identity Development and Depression among Hispanic College Students

Hispanic emerging adults are routinely faced with a variety of cultural stressors that adversely impact mental health and compromise identity development. Given that identity emerges through day-to-day interactions, there is a need to explore the impact of cultural stress on identity development and depressive symptoms at the micro-level (across days). To address these gaps, the current study utilized a 12-day diary study conducted among 792 Hispanic college students (75.9% female, M age  = 20.14 years, SD = 1.85, Range = 18-24 years) to determine the impact of cultural stress on daily identity coherence, identity confusion, depressive symptoms, and the association between identity coherence and confusion and depressive symptoms in this population. Results indicated that Day 1 cultural stress positively predicted average daily depressive symptoms and identity confusion and negatively predicted identity coherence. Finally, cultural stress predicted a stronger daily association between identity confusion and depressive symptoms. As a whole, our findings emphasize the detrimental impact that cultural stressors have on both identity development and depressive symptoms at the daily level. These results are discussed in relation to the specific types of cultural stressors that Hispanic emerging adults face, and the need for appropriate intervention and prevention efforts for this population is emphasized