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Gillani B, Prince DM, Ray-Novak M, Feerasta G, Jones D, Mintz LJ, Moore SE. Mapping the Dynamic Complexity of Sexual and Gender Minority Healthcare Disparities: A Systems Thinking Approach. Healthcare (Basel) 2024; 12:424. [PMID: 38391800 PMCID: PMC10888405 DOI: 10.3390/healthcare12040424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/10/2023] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Sexual and gender minority (SGM) populations experience extensive health disparities compared to their straight and cisgender counterparts. The importance of addressing these disparities is paramount, as SGM groups often encounter significant barriers to accessing comprehensive healthcare, including societal stigma, provider bias, and financial constraints. This study utilizes a community-based system dynamics approach to understand and visualize the barriers to and facilitators of healthcare engagement for SGM groups across their life course. It aims to identify core constructs, relationships, and dynamic feedback mechanisms related to the experiences of connection/disconnection with physical, mental, and dental healthcare of SGM individuals. Barriers to access, such as discriminatory practices and the limited availability of SGM-informed healthcare professionals, exacerbate these disparities, underscoring the urgency of developing targeted interventions. System dynamics, a complex systems science (CSS) methodology, was used for this research. Group model building sessions were conducted with diverse SGM groups, including youth, older adults, and trans and gender-expansive community members. Causal loop diagrams were developed according to an iterative process, and a meta-model of their collective experiences was created. The study revealed extensive, dynamic, and shifting structural barriers for SGM community members accessing healthcare. Societal and structural stigma, provider bias, and pathologization were identified as significant barriers throughout their life course. Community-led interventions and SGM-focused holistic healthcare were identified as critical facilitators of SGM healthcare connection. The findings highlight the need for SGM-affirming and culturally responsive healthcare settings. This paper calls for a concerted effort from SGM health researchers to use CSS in developing interventions to reduce SGM health disparities.
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Affiliation(s)
- Braveheart Gillani
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA; (B.G.); (M.R.-N.)
| | - Dana M. Prince
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA; (B.G.); (M.R.-N.)
| | - Meagan Ray-Novak
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA; (B.G.); (M.R.-N.)
| | - Gulnar Feerasta
- LGBT Center of Greater Cleveland, Cleveland, OH 44102, USA; (G.F.); (D.J.)
| | - Devinity Jones
- LGBT Center of Greater Cleveland, Cleveland, OH 44102, USA; (G.F.); (D.J.)
| | - Laura J. Mintz
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Scott Emory Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA;
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Keum BT, Maurin-Waters E, Chong ESK. The Mental Health Costs of Online Heterosexism Among LGBTQ+ Individuals: Development and Initial Validation of the Perceived Online Heterosexism Scale. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:525-541. [PMID: 37943472 DOI: 10.1007/s10508-023-02733-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023]
Abstract
Experiences of heterosexism are rampant online, where bias and harassment against LGBTQ+ individuals spread conveniently and widely. Yet, research has been limited in understanding the exposure to online heterosexism among LGBTQ+ individuals partly due to the lack of a quantitative measure to advance this research. Thus, the current study developed and examined the psychometric properties of the Perceived Online Heterosexism Scale (POHS). Items were developed via a literature review, a survey of social media platforms, and an expert review. Exploratory (N = 288) and confirmatory (N = 653) factor analyses yielded a 4-factor structure and produced a 20-item scale with the following subscales: (1) Heterosexist Cyberaggression (4 items), (2) Online Heterosexist Stereotyping (4 items), (3) Online Exposure to Systemic Heterosexism (8 items), and (4) Heterosexist Online Media (four items). Internal consistency estimates ranged from .91 to .96, and the POHS accounted for 65.9% of the variance. Examination of a second-order model suggested that a total scale score can also be used. Initial construct validity was evidenced as POHS scores were associated with an existing heterosexism measure, anxiety and depressive symptoms, internalized heterosexism, and LGBTQ+ community connectedness in line with theory and empirical evidence. Implications for research practice are discussed.
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Affiliation(s)
- Brian TaeHyuk Keum
- Department of Counseling, Developmental & Educational Psychology, Lynch School of Education and Human Development, Boston College, 140 Commonwealth Ave., Chestnut Hill, MA, 02467, USA.
| | - Emily Maurin-Waters
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
| | - Eddie S K Chong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Williams AJ, Cleare S, Borschmann R, Tench CR, Gross J, Hollis C, Chapman-Nisar A, Naeche N, Townsend E, Slovak P. Enhancing emotion regulation with an in situ socially assistive robot among LGBTQ+ youth with self-harm ideation: protocol for a randomised controlled trial. BMJ Open 2024; 14:e079801. [PMID: 38195171 PMCID: PMC10806609 DOI: 10.1136/bmjopen-2023-079801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/08/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION Purrble, a socially assistive robot, was codesigned with children to support in situ emotion regulation. Preliminary evidence has found that LGBTQ+ youth are receptive to Purrble and find it to be an acceptable intervention to assist with emotion dysregulation and their experiences of self-harm. The present study is designed to evaluate the impact of access to Purrble among LGBTQ+ youth who have self-harmful thoughts, when compared with waitlist controls. METHODS AND ANALYSIS The study is a single-blind, randomised control trial comparing access to the Purrble robot with waitlist control. A total of 168 LGBTQ+ youth aged 16-25 years with current self-harmful ideation will be recruited, all based within the UK. The primary outcome is emotion dysregulation (Difficulties with Emotion Regulation Scale-8) measured weekly across a 13-week period, including three pre-deployment timepoints. Secondary outcomes include self-harm (Self-Harm Questionnaire), anxiety (Generalised Anxiety Disorder-7) and depression (Patient Health Questionnaire-9). We will conduct analyses using linear mixed models to assess primary and secondary hypotheses. Intervention participants will have unlimited access to Purrble over the deployment period, which can be used as much or as little as they like. After all assessments, control participants will receive their Purrble, with all participants keeping the robot after the end of the study. After the study has ended, a subset of participants will be invited to participate in semistructured interviews to explore engagement and appropriation of Purrble, considering the young people's own views of Purrble as an intervention device. ETHICS AND DISSEMINATION Ethical approval was received from King's College London (RESCM-22/23-34570). Findings will be disseminated in peer review open access journals and at academic conferences. TRIAL REGISTRATION NUMBER NCT06025942.
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Affiliation(s)
- A Jess Williams
- Department of Informatics, King's College London, London, UK
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Seonaid Cleare
- Department of Informatics, King's College London, London, UK
- University of Glasgow, Glasgow, UK
| | - Rohan Borschmann
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- University of Oxford, Oxford, UK
| | | | - James Gross
- Stanford University, Stanford, California, USA
| | - Chris Hollis
- Division of Psychiatry, University of Nottingham, Nottingham, UK
| | | | | | - Ellen Townsend
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Petr Slovak
- Department of Informatics, King's College London, London, UK
- University of Oxford, Oxford, UK
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Escobar-Viera CG, Porta G, Coulter RW, Martina J, Goldbach J, Rollman BL. A chatbot-delivered intervention for optimizing social media use and reducing perceived isolation among rural-living LGBTQ+ youth: Development, acceptability, usability, satisfaction, and utility. Internet Interv 2023; 34:100668. [PMID: 37746640 PMCID: PMC10511780 DOI: 10.1016/j.invent.2023.100668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/21/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023] Open
Abstract
Background Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) youth are at higher risk of isolation and depression than their heterosexual peers. Having access to tailored mental health resources is a documented concern for rural living LGBTQ+ youth. Social media provides access to connections to a broader and like-minded community of peers, but it also is a vehicle for negative interactions. We developed REALbot, an automated, social media-based educational intervention to improve social media efficacy, reduce perceived isolation, and bolster connections for rural living LGBTQ+ youth. This report presents data on the acceptability, feasibility, and utility of REALbot among its target audience of rural living LGBTQ+ youth. Methods We conducted a week-long exploratory study with a single non-comparison group of 20 rural-living LGBTQ+ youth aged 14-19 recruited from social media to test our Facebook- and Instagram-delivered chatbot. We assessed pre- and post-test scores of social media self-efficacy, social isolation (4-item Patient-Reported Outcomes Measurement System - PROMIS), and depressive symptoms (Patient Health Questionnaire, Adolescent Version - PHQ-A). At post-test, we assessed acceptability (User Experience Questionnaire - UEQ-S), usability (Chatbot Usability Questionnaire -CUQ and Post-Study Satisfaction and Usability Questionnaire -PSSUQ), and satisfaction with the chatbot (Client Satisfaction Questionnaire - CSQ), along with two open-ended questions on 'likes' and 'dislikes' about the intervention. We compared pre- and post-test scores with standard univariate statistics. Means and standard deviations were calculated for usability, acceptability, and satisfaction. To analyze the responses to post-test open-end questions, we used a content analysis approach. Results Acceptability of REALbot was high with UEQ-S 5.3 out of 7 (SD = 1.1) and received high usability scores with CUQ and PSSUQ (mean score (M) = 78.0, SD = 14.5 and M = 86.9, SD = 25.2, respectively), as well as high user satisfaction with CSQ (M = 24.9, SD = 5.4). Themes related to user 'likes' and 'dislikes' were organized in two main categories: usability and content provided. Participants were engaged with the chatbot, sending an average of 49.3 messages (SD = 43.6, median = 30). Pre-/post- changes in scores of perceived isolation, depressive symptoms and social media self-efficacy were not significant (p's > 0.08). Conclusion REALbot deployment was found to be feasible and acceptable, with good usability and user satisfaction scores. Participants reported changes from pre- to post-test in most outcomes of interest and effect sizes were small to medium. Additional development and a formal evaluation of feasibility and engagement with behavioral targets is warranted.
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Affiliation(s)
- César G. Escobar-Viera
- Department of Psychiatry, School of Medicine, University of Pittsburgh, United States
- The Enhancing Triage and Utilization for Depression and Emergent Suicidality (ETUDES) Center, School of Medicine, University of Pittsburgh, United States
- Center for Behavioral Health, Media, and Technology, School of Medicine, University of Pittsburgh, United States
| | - Giovanna Porta
- The Enhancing Triage and Utilization for Depression and Emergent Suicidality (ETUDES) Center, School of Medicine, University of Pittsburgh, United States
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, United States
| | - Robert W.S. Coulter
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, United States
| | - Jamie Martina
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, United States
| | - Jeremy Goldbach
- Brown School of Social Work, Washington University in St. Louis, United States
| | - Bruce L. Rollman
- The Enhancing Triage and Utilization for Depression and Emergent Suicidality (ETUDES) Center, School of Medicine, University of Pittsburgh, United States
- Center for Behavioral Health, Media, and Technology, School of Medicine, University of Pittsburgh, United States
- Division of General Internal Medicine, School of Medicine, University of Pittsburgh, United States
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Biernesser C, Win E, Escobar-Viera C, Farzan R, Rose M, Goldstein T. Development and codesign of flourish: A digital suicide prevention intervention for LGBTQ+ youth who have experienced online victimization. Internet Interv 2023; 34:100663. [PMID: 37693013 PMCID: PMC10491770 DOI: 10.1016/j.invent.2023.100663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023] Open
Abstract
Background LGBTQ+ youth experience disproportionately high rates of online victimization (OV), referring to harmful remarks, images, or behaviors in online settings, which is associated with suicidal risk. Current services have gaps in supporting LGBTQ+ youth facing OV events. To address these gaps, this study aims to develop Flourish, a digital suicide prevention intervention for LGBTQ+ youth who have experienced OV. Methods Qualitative interviews were conducted with 20 LGBTQ+ youth with past-year history of OV and lifetime history of suicidality, 11 of their parents, and 10 LGBTQ+-serving professionals. Subsequently, an iterative codesign process was conducted with 22 youth through individual and group design sessions, followed by usability testing. Data were recorded and transcribed. Qualitative interviews were analyzed using a qualitative description approach, and data from design sessions and usability testing were analyzed using rapid qualitative techniques. Results Interviews with youth, parents, and professionals suggested preferences for Flourish to be a partially automated, text message intervention leveraging web-based content that is a safe space for LGBTQ+ youth to seek support for OV through education, coping skills, and help-seeking resources. School and mental health services professionals considered the potential for implementing Flourish within youth services settings. Usability testing, assessed through the System Usability Scale, yielded an average rating of 91, indicating excellent perceived usability. Conclusions Flourish has potential to be an acceptable intervention to support LGBTQ+ youth following OV. Future steps will include testing the feasibility and efficacy of Flourish and further examining Flourish's potential for implementation within services for LGBTQ+ youth.
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Affiliation(s)
- Candice Biernesser
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
| | - Emma Win
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
- University of Pittsburgh School of Social Work, United States of America
| | - César Escobar-Viera
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
| | - Rosta Farzan
- University of Pittsburgh, School of Computing and Information, United States of America
| | - Morgan Rose
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
- University of Pittsburgh Dietrich School of Arts and Science, Department of Psychology, United States of America
| | - Tina Goldstein
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
- University of Pittsburgh Dietrich School of Arts and Science, Department of Psychology, United States of America
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Fowler JA, Buckley L, Muir M, Viskovich S, Paradisis C, Zanganeh P, Dean JA. Digital mental health interventions: A narrative review of what is important from the perspective of LGBTQIA+ people. J Clin Psychol 2023; 79:2685-2713. [PMID: 37528773 DOI: 10.1002/jclp.23571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/19/2023] [Accepted: 07/15/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES Digital mental health interventions are a promising therapeutic modality to provide psychological support to LGBTQIA+ (lesbian, gay, bisexual, trans, Queer, intersex, asexual, plus other gender, sexual, and romantic minority identities) people. The aim of this narrative review is to explore how the LGBTQIA+ community has been engaged in the design of digital mental health interventions, how content has been tailored to the LGBTQIA+ community, and features identified as important by LGBTQIA+ participants. METHODS A total of 33 studies were included in this review from a larger yield of 1933 identified from systematic searches of five databases (PsycINFO, PubMed, Scopus, CINAHAL, and Medline). Data were analyzed narratively and using content analysis. RESULTS Only half of the studies reported engaging the LGBTQIA+ community in intervention designs. Interventions have been tailored in a variety of ways to support LGBTQIA+ individuals-such as through affirming imagery, recruitment through LGBTQIA+ networks, and designing content to focus specifically on LGBTQIA+ issues. A range of features were identified as important for participants, namely how content was tailored to LGBTQIA+ experiences, providing connection to community, and links to other relevant LGBTQIA+ resources. While not a primary aim, results also showed that a wide range of digital modalities can significantly improve a range of mental health problems. CONCLUSION Digital interventions are an acceptable and effective form of therapeutic intervention, but future research needs to focus on meaningful engagement of community members to inform design and implementation.
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Affiliation(s)
- James A Fowler
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Buckley
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Miranda Muir
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Shelley Viskovich
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Chris Paradisis
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Parnian Zanganeh
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
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Liu Y, Wu YC, Fu H, Guo WY, Wang X. Digital intervention in improving the outcomes of mental health among LGBTQ+ youth: a systematic review. Front Psychol 2023; 14:1242928. [PMID: 37809309 PMCID: PMC10556462 DOI: 10.3389/fpsyg.2023.1242928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
LGBTQ+ youth experience mental health disparities and higher rates of mental disorders due to barriers to accessing care, including insufficient services and the anticipated stigma of revealing their identities. This systematic review incorporated 15 empirical studies on digital interventions' impact on LGBTQ+ youth mental health, examining their potential to address these inequities. This study innovatively categorized existing digital interventions into four streams: Structured Formal (telehealth, online programs), Structured Informal (serious games), Unstructured Formal (mobile applications), and Unstructured Informal (social media). We found that S&F and U&F effectively reduced symptoms. U&F showed potential but required enhancement, while U&I fostered resilience but posed risks. Further integration of emerging technologies like virtual reality may strengthen these interventions. This review identifies the characteristics of effective digital health interventions and evaluates the overall potential of digital technologies in improving LGBTQ+ youth mental health, uniquely contributing insights on digital solutions advancing LGBTQ+ youth mental healthcare.
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Affiliation(s)
- Yanni Liu
- McCormick School of Engineering, Northwestern University, Evanston, IL, United States
| | - Ying Cheng Wu
- Tandon School of Engineering, New York University, New York, NY, United States
| | - Hongpeng Fu
- School of Law, University of Washington, Seattle, WA, United States
| | - Wu Yuan Guo
- Department of Curriculum and Instruction, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Martin P, Alberti C, Gottot S, Bourmaud A, de La Rochebrochard E. Young people's proposals for a web-based intervention for sexual health promotion: a French qualitative study. BMC Public Health 2023; 23:1389. [PMID: 37468863 DOI: 10.1186/s12889-023-16257-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 07/06/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Promoting sexual health is key to improving the supportive behaviors and well-being of young people. With the advent of the Internet, web-based features for sexual health promotion may be attractive to a diverse range of young people. This study aims to assess young people's proposals regarding a web-based intervention for sexual health promotion. METHODS Nineteen French young people aged 15-24 years participated to the study. In a semi-structured interview, they presented their views on a web-based intervention for sexual promotion. Data were coded with N'Vivo and subjected to qualitative thematic analysis to explore their proposals. RESULTS The majority of participants (n = 18) thought that a web-based intervention for sexual health promotion would be attractive. Young people interviewed made 31 concrete proposals for sexual health promotion on the Internet. Participatory and interactive dimensions on the internet appeared essential, with the need for stimulating activities and interaction with peers, but also with competent professionals and moderation. Face to the risks of the internet, they expressed the need of a secure and confidential space, to generate trust and participation in intervention. For participants, sexual health should be addressed in all its dimensions, taking into account the relational, sexual, and gender dimensions, and by incrementing on the internet valid, credible and personalized content. CONCLUSIONS In sexual health promotion, young people are indispensable stakeholders who can make concrete proposals and can also participate in content creation and research. More broadly, in health promotion, involving target audiences in decisions represents a promising perspective.
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Affiliation(s)
- Philippe Martin
- Université Paris Cité, ECEVE, Inserm U1123 UFR de Médecine, 10 Avenue de Verdun, 75010, Paris, France.
- AP-HP, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, 1426, Inserm, CIC, France.
- GDID Santé, Paris, France.
- Institut National d'Etudes Démographiques (INED), UR14 - Sexual and Reproductive Health and Rights, Aubervilliers, F-93322, France.
| | - Corinne Alberti
- Université Paris Cité, ECEVE, Inserm U1123 UFR de Médecine, 10 Avenue de Verdun, 75010, Paris, France
- AP-HP, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, 1426, Inserm, CIC, France
| | | | - Aurélie Bourmaud
- Université Paris Cité, ECEVE, Inserm U1123 UFR de Médecine, 10 Avenue de Verdun, 75010, Paris, France
- AP-HP, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, 1426, Inserm, CIC, France
| | - Elise de La Rochebrochard
- Institut National d'Etudes Démographiques (INED), UR14 - Sexual and Reproductive Health and Rights, Aubervilliers, F-93322, France
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, F-94800, France
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Blackburn AM, Todd NR. Pride in our community: Reflecting on LGBTQ publications in the American Journal of Community Psychology. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 71:158-165. [PMID: 35901504 DOI: 10.1002/ajcp.12618] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/24/2022] [Indexed: 05/07/2023]
Abstract
In this Virtual Special Issue (VSI), we curate and discuss a set of 28 articles previously published in the American Journal of Community Psychology (AJCP) focused on lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. The purpose of this VSI is to bring visibility to this body of scholarship in AJCP and to reflect on how the strengths of our field have been used throughout this work in pursuit of supporting LGBTQ wellbeing. In this VSI, we first discuss articles that help to set the historical background for publications in AJCP. We then discuss papers under the broad themes of HIV/AIDS, identities within ecological context, and social activism among LGBTQ communities. We then reflect on opportunities for our field to further leverage our strengths in contributing to LGBTQ scholarship. Overall, this VSI celebrates the contributions to LGBTQ research already present in AJCP, and we hope inspires future contributions to the pages of AJCP and beyond.
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Affiliation(s)
| | - Nathan R Todd
- University of Illinois at Urbana-Champaign, Champaign, Illinois, 61820, USA
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10
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Sun S, Guy AA, Zelaya DG, Operario D. Mindfulness for Reducing Minority Stress and Promoting Health Among Sexual Minority Men: Uncovering Intervention Principles and Techniques. Mindfulness (N Y) 2022; 13:2473-2487. [PMID: 36097523 PMCID: PMC9452865 DOI: 10.1007/s12671-022-01973-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 02/04/2023]
Abstract
Objectives Tailored, evidence-based interventions are in high need for sexual minority men (gay, bisexual, and queer men who have sex with men) to address prevalent mental health issues and HIV/STI risk. This study describes the formative research that informed the development of Mindfulness-Based Queer Resilience (MBQR): a mindfulness-based intervention for health promotion among sexual minority men. Methods Guided by the ADAPT-ITT model, we conducted a series of interviews with community stakeholders, including sexual minority men with anxiety and depressive symptoms (n = 15) and mindfulness service providers with experience working with sexual minority men (n = 11). Thematic analysis was used for data analysis. Results Six intervention principles and seven key techniques/delivery considerations emerged relevant to intervention development. Principles included (a) reducing minority stress as a key theoretical guide, (b) affirming LGBTQ + identity and facilitating healthy identity development, (c) attending to intersectionality, (d) facilitating resilience and self-empowerment, (e) trauma sensitivity, and (f) promoting healthy relationships and a healthy community. Key techniques represent the pathways through which MBQR may address the adverse impacts of minority stress, including through attention control practice to facilitate agency and self-awareness, enhancing emotion regulation, reducing reactivity to minority stress-informed thoughts, self-compassion to increase self-acceptance, and reducing behavioral avoidance. Delivery considerations also included careful navigation regarding mindfulness and religion, as well as using modern technology to increase reach, access, and engagement. Conclusions If proven to be feasible and efficacious, MBQR may offer the potential to alleviate adverse impacts of minority stress and improve mental and sexual health of sexual minority men.
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Affiliation(s)
- Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02906 USA
- Mindfulness Center, Brown University School of Public Health, 121 South Main St, Providence, RI 02906 USA
| | - Arryn A. Guy
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02906 USA
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI USA
| | - David G. Zelaya
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02906 USA
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI USA
| | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02906 USA
- Mindfulness Center, Brown University School of Public Health, 121 South Main St, Providence, RI 02906 USA
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Whaibeh E, Vogt EL, Mahmoud H. Addressing the Behavioral Health Needs of Sexual and Gender Minorities During the COVID-19 Pandemic: a Review of the Expanding Role of Digital Health Technologies. Curr Psychiatry Rep 2022; 24:387-397. [PMID: 35841471 DOI: 10.1007/s11920-022-01352-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW To review the role of digital health technologies in behavioral health treatment and promotion for sexual and gender minorities (SGM). RECENT FINDINGS Digital technologies have advantages and limitations at multiple levels in addressing SGM's behavioral health needs. For patients, digital technologies improve convenience and may reduce stigma; however, privacy concerns in the home may limit their utilization. Providers also benefit from the convenience of these technologies; however, not all providers are comfortable delivering virtual care to SGM. For society, digital technologies reduce transportation-related costs and increase access to healthcare in an increasingly hostile political climate for SGM; however, these advantages are limited by technological access and anti-SGM policies. Digital technologies can improve the behavioral health of SGM at the patient, provider, and systemic levels. Further efforts are necessary to standardize provider training, improve SUD-specific care delivery, and increase quality and accessibility of these technologies.
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Affiliation(s)
- Emile Whaibeh
- Department of Public Health, University of Balamand, Beirut, Lebanon.,École Doctorale Sciences Et Santé, Saint Joseph University, Beirut, Lebanon
| | - Emily L Vogt
- University of Michigan Medical School, Ann Arbor, MI, USA.
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Coping Strategies to Enhance the Mental Wellbeing of Sexual and Gender Minority Youths: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148738. [PMID: 35886595 PMCID: PMC9319075 DOI: 10.3390/ijerph19148738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
Robust population-based research has established that sexual and gender minority youths (SGMYs) are at an increased risk of mental ill-health, but there is a dearth of literature that seeks to explore how to best support SGMY mental wellbeing. This scoping review aims to identify findings related to coping strategies and/or interventions for building resilience and/or enhancing the mental wellbeing of SGMYs. PRISMA extension for scoping review (PRISMA-ScR) guidelines was utilized for this review. Studies were included if they were peer-reviewed papers containing primary data; reported psycho-social coping strategies for SGMY; were conducted with SGMYs in the adolescent age range; and were published in English. MEDLINE, Embase, and PsycINFO databases were searched. Of the 3692 papers initially identified, 68 papers were included with 24 intervention-focused studies of 17 unique interventions found. The most commonly cited therapeutic modality was cognitive behavioral therapy (CBT) (n = 11 studies). Despite the need to support the mental wellbeing of SGMYs, few interventions focused on this area and unique populations have been reported upon in the peer-reviewed literature. As a result, there is considerable potential to develop supports for SGMYs.
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