1
|
Lampe NM, Rodill ZE, Nowakowski ACH. "My support groups… have saved my life.": facilitators of positive or satisfactory experiences in behavioral healthcare for transgender and gender nonconforming older adults. Aging Ment Health 2024:1-9. [PMID: 38982841 DOI: 10.1080/13607863.2024.2377261] [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: 05/04/2024] [Accepted: 07/01/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES Transgender and gender nonconforming (TGNC) older adults experience significant behavioral health and healthcare disparities. Facilitators that contribute to positive behavioral healthcare experiences among this population, however, remain uncertain. In this study, we investigate facilitators contributing to positive or satisfactory behavioral healthcare experiences among a sample of TGNC older adults in the United States (US). METHOD Between September 2021 and January 2022, the first author conducted 47 semi-structured, individual interviews with TGNC adults aged 65 years or over in the US. Using an inductive grounded theory approach, we examined respondents' positive or satisfactory experiences with accessing and utilizing behavioral health services, support, and resources. Analyses were conducted using NVivo (Release 1.6) software. RESULTS Findings underscore the importance of addressing the specific or unique needs of TGNC older patients to promote positive or satisfactory experiences in behavioral healthcare. Three themes emerged: (1) engaging with behavioral healthcare practitioners who offer compassionate, patient-centered care; (2) accessing and utilizing culturally tailored peer-support groups; and (3) receiving equitable access to gender-affirming care and social services. CONCLUSION These findings highlight opportunities for expanding and incorporating these identified facilitators into behavioral healthcare research and practice, especially when promoting gender affirmation in care for TGNC older patients.
Collapse
Affiliation(s)
- Nik M Lampe
- Department of Mental Health Law & Policy, University of South Florida, Tampa, FL, USA
| | - Zena E Rodill
- Department Mental Health Law & Policy, University of South Florida, Tampa, FL, USA
| | - Alexandra C H Nowakowski
- Department of Geriatrics/Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Orlando, FL, USA
| |
Collapse
|
2
|
Wright T, Solmi F, Ajnakina O, Ingram E, Kandola A, Lee S, Iob E, Steptoe A, Thomas B, Lewis G. The role of loneliness in the association between sexual orientation and depressive symptoms among older adults: A prospective cohort study. J Affect Disord 2024; 356:137-144. [PMID: 38593941 DOI: 10.1016/j.jad.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 03/13/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND This study aims to understand the mechanisms contributing to the elevated risk of depression among sexual minority older adults compared to heterosexuals. Specifically, the role of loneliness as a potential mediator is investigated to inform targeted interventions for preventing depression in sexual minority populations. METHODS Data from the English Longitudinal Study of Ageing, focusing on adults aged over 50, were analysed. Sexual orientation (sexual minority or heterosexual) and loneliness scores (UCLA scale) were assessed at wave six (2010-2011), while depressive symptoms (CESD) were assessed at wave seven (2013-14). Linear regression models and mediation analyses, using g-computation formula and adjusted for confounders, were conducted. RESULTS The sample included 6794 participants, with 478 (7.0 %) identifying as sexual minorities. After adjustments, sexual minorities scored higher on depressive symptoms at wave seven (mean difference): 0.23, 95 % CI 0.07 to 0.39) and loneliness at wave six (MD: 0.27, 95 % CI 0.08 to 0.46). Loneliness was positively associated with depressive symptoms (coefficient: 0.27, 95 % CI 0.26 to 0.29). In mediation analyses, loneliness explained 15 % of the association between sexual orientation and subsequent depressive symptoms. LIMITATIONS The dataset used sexual behaviour rather than desire and identity, potentially skewing representation of sexual minorities. Additionally, transgender older adults were not included due to limited gender diversity reported within the ELSA dataset. CONCLUSIONS Loneliness appears to be a significant modifiable mechanism contributing to the heightened risk of depressive symptoms in sexual minority older adults compared with their heterosexual counterparts.
Collapse
Affiliation(s)
- Talen Wright
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom.
| | - Francesca Solmi
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom
| | - Olesya Ajnakina
- Institute of Psychiatry, Psychology & Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
| | - Elizabeth Ingram
- Department of Applied Health Research, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom
| | - Aaron Kandola
- MRC Unit for Lifelong Health and Ageing, University College London, 1-19 Torrington Place, London, United Kingdom
| | - Stephen Lee
- Opening Doors, Unit 4.1b Resource for London, 356 Holloway Road, London N7 6PA, United Kingdom
| | - Eleonora Iob
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Ben Thomas
- Opening Doors, Unit 4.1b Resource for London, 356 Holloway Road, London N7 6PA, United Kingdom
| | - Gemma Lewis
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom
| |
Collapse
|
3
|
Chan ASW, Tam HL, Wong FKC, Wong G, Leung LM, Ho JMC, Tang PMK, Yan E. Investigating the Interrelationships Among Mental Health, Substance Use Disorders, and Suicidal Ideation Among Lesbian, Gay, and Bisexual Adults in the United States: Population-Based Statewide Survey Study. JMIR Public Health Surveill 2024; 10:e48776. [PMID: 38916938 PMCID: PMC11234069 DOI: 10.2196/48776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/14/2023] [Accepted: 12/18/2023] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Mental health disparities have been documented among lesbian, gay, and bisexual (LGB) adults in the United States. Substance use disorders and suicidal ideation have been identified as important health concerns for this population. However, the interrelationships among these factors are not well understood. OBJECTIVE This study aims to investigate the interrelationships among mental health, substance use disorders, and suicidal ideation among LGB adults in the United States using a population-based statewide survey. METHODS Our study was an observational cross-sectional analysis, and the data for this study were collected from a sample of LGB adults who participated in the statewide survey. The survey collected information on mental health, substance use disorders, and suicidal ideation using validated measures. Descriptive statistics and inferential data analysis were conducted to explore the interrelationships among these factors. RESULTS The results showed that LGB adults who reported higher levels of depression and drug abuse and dependence also reported higher levels of suicidal tendency and mental illness. Inferential data analysis using χ2 tests revealed significant differences in depression score (χ22=458.241; P<.001), drug abuse and dependence score (χ22=226.946; P<.001), suicidal tendency score (χ22=67.795; P<.001), and mental illness score (χ22=363.722; P<.001) among the 3 sexual identity groups. Inferential data analysis showed significant associations between sexual identity and mental health outcomes, with bisexual individuals reporting the highest levels of depression, drug abuse and dependence, suicidal tendency, and mental illness. CONCLUSIONS This study provides important insights into the interrelationships among mental health, substance use disorders, and suicidal ideation among LGB adults in the United States. The findings underscore the need for targeted interventions and research aimed at addressing the mental health needs of sexual minority populations. Future research should aim to better understand the underlying mechanisms driving these disparities and develop culturally sensitive and tailored interventions that meet the unique needs of LGB individuals. Reducing stigma and discrimination against sexual minority populations is also crucial to improving their mental health outcomes.
Collapse
Affiliation(s)
- Alex Siu Wing Chan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hon Lon Tam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Gordon Wong
- School of Clinical Medicine, Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Lok Man Leung
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jacqueline Mei Chi Ho
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Patrick Ming Kuen Tang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Elsie Yan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| |
Collapse
|
4
|
Camacho D, Pacheco K, Moxley J, Aranda MP, Reid C, Wethington E. Loneliness and global cognitive functioning in racially and ethnically diverse US midlife and older adults. Front Psychol 2024; 15:1344044. [PMID: 38962235 PMCID: PMC11221402 DOI: 10.3389/fpsyg.2024.1344044] [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: 01/22/2024] [Accepted: 04/15/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Few studies have examined the association of loneliness and cognitive functioning in the US. We used two common measures of loneliness and examined their association in a large sample of US Black, Latino, and White adults (ages ≥ 50). Methods We analyzed Wave 3 of the National Social Life, Health, and Aging Project (N = 2,757). We examined loneliness using one item from the CES-D and the Felt Loneliness Measure (NFLM); cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA) tool, where higher scores indicated better functioning. We used weighted ordinary least squares regressions to examine the effects of loneliness (CES-D loneliness and NFLM in separate models) on MoCA scores. In exploratory analyses, we examined if these relationships varied by race and ethnicity. We adjusted all models for sociodemographic and other salient factors (e.g., chronic disease, depressive symptoms, living alone). Results Mean age was 63.49 years, 52% were female, and 9% were Black and 6% Latino persons. Approximately 54% endorsed feeling lonely on at least one measure; 31% (CES-D) and 46% (NFLM). The relationship between loneliness measures was positive and significant, X 2 (1, N = 2,757) = 435.493 p < 0.001. However, only 40% of lonely individuals were identified as lonely on both assessments. CES-D loneliness was inversely (βˆ = -0.274, p = 0.032) associated with MoCA scores and this association did not vary by race and ethnicity. Greater NFLM loneliness was positively associated (βˆ = 0.445, p < 0.001) with higher MoCA scores for Latino participants only. Discussion Loneliness appears to be an important predictor of cognitive functioning. However, the association of loneliness and cognitive functioning varied when using the CES-D loneliness item or the NFLM. Future work is needed to understand how loneliness and its clinically relevant dimensions (social, emotional, existential, chronicity) relate to global and individual cognitive domains. Research is needed with racially and ethnically diverse midlife and older adults, particularly to understand our counterintuitive finding for Latino participants. Finally, findings also support the need for research on interventions to prevent cognitive decline targeting loneliness.
Collapse
Affiliation(s)
- David Camacho
- Department of Disability and Human Development, University of Illinois Chicago, Chicago, IL, United States
| | - Kelly Pacheco
- Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Jerad Moxley
- Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Maria P. Aranda
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, United States
| | - Cary Reid
- Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Elaine Wethington
- Weill Cornell Medicine, Cornell University, New York, NY, United States
| |
Collapse
|
5
|
Walsh CA, Grittner AL. Picturing the dance: intersections of gender, sexuality, and age in older women queer square dancers. J Women Aging 2024:1-16. [PMID: 38738807 DOI: 10.1080/08952841.2024.2347718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 04/21/2024] [Indexed: 05/14/2024]
Abstract
A dearth of research has focused on the diverse experiences of aging sexual minority populations and, in particular, older sexual minority women. Studies that have disaggregated the population of lesbian, gay, bisexual, transgender, questioning, queer, intersex and two-spirit (LGBTQIS+) older adults reveal that due to minority stress and a lifetime of disadvantage. Lesbians experience higher rates of chronic health conditions and mental health problems (including loneliness) than heterosexual women and greater financial inequalities compared to gay men or heterosexual women. Despite this, limited inquiry has explored the everyday lives of older queer women and fewer still draws upon women's commentary on their own lived experiences or centers older women as authoritative agents and experts on their own lives. In response to this knowledge deficit, this research traverses the aging experiences of female-identified members of a gay square dance (GSD) club in Toronto, Canada. We apply queer theory to explicate the unique ways in which a GSD club queers the aging process for 14 older women dancers. Findings of the inquiry highlight the ways in which these dancers confront and reject heteronormativity, while illuminating pathways to successful aging for older sexual diverse women. The older women dancers in this study perform gender in ways that challenged heteronormativity and gender binaries, enhanced belongingness and acceptance, embodied joy, and fostered wellness. These concepts have been identified as critical factors in successful aging and highlight what queering aging might look like for this resilient population who have overcome a lifetime of disadvantage.
Collapse
|
6
|
Danielewicz M. Medical Issues Affecting Older Gay and Bisexual Men. Clin Geriatr Med 2024; 40:239-250. [PMID: 38521595 DOI: 10.1016/j.cger.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Older gay and bisexual men constitute diverse, sizable, and potentially vulnerable populations. They have and continue to face discrimination and stigma in multiple settings, including health care. Older gay and bisexual men report worse health, higher rates of alcohol and tobacco use, and higher HIV rates compared with their heterosexual counterparts. They have unique needs and experiences in multiple realms of health care including mental health, sexual health, and cancer screenings. Geriatric medicine physicians and providers can educate themselves on these unique needs and risks and take steps to provide inclusive, affirming care.
Collapse
Affiliation(s)
- Michael Danielewicz
- Pride at the Jefferson Center for Healthy Aging, Division of Geriatric Medicine and Palliative Care, Department of Family and Community Medicine, Thomas Jefferson University, 1015 Walnut Street, Suite 401, Philadelphia, PA 19147, USA.
| |
Collapse
|
7
|
Cahill SR. Federal and State Policy Issues Affecting Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults. Clin Geriatr Med 2024; 40:357-366. [PMID: 38521605 DOI: 10.1016/j.cger.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Anti-lesbian, gay, bisexual, transgender, and queer (LGBTQ) + discrimination is widespread, harming the health of LGBTQ + people and constituting a barrier to care. This contributes to higher rates of poverty among LGBTQ + people, especially among people of color, and lower insurance coverage rates. The Affordable Care Act's expansion of insurance access has reduced uninsurance rates among LGBT people and people living with human immunodeficienc virus (HIV). Systemic improvements in culturally responsive health care have occurred over the past decade, including increased collection and use of sexual orientation and gender identity data to improve quality of care. As older LGBTQ + people enter elder service systems, reforms are needed to ensure equitable access.
Collapse
Affiliation(s)
- Sean R Cahill
- The Fenway Institute, 1340 Boylston Street, Boston, MA 02215, USA.
| |
Collapse
|
8
|
Kara Y. Brighten up the Rainbow: Ecology-Based Group Work for LGBTQ+ People. JOURNAL OF HOMOSEXUALITY 2024; 71:1356-1371. [PMID: 36689295 DOI: 10.1080/00918369.2023.2169852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This research was carried out as a pretest-posttest experimental study in order to evaluate the effect of ecology-based group work on 18 LGBTQ+ people living in different districts of Istanbul. The study group of the research carried out between July 2022 and August 2022 consists of 18 LGBTQ+ people, between the ages of 19-22. Study participants were randomly selected for each group and assigned to the experimental and control groups. In addition to the Personal Information Form, the Flourishing Scale, the Nature Relatedness Scale, and the Depression Stress and Anxiety Scale (DASS21) were applied to the study group as pretest-posttest. Socializing, hiking, gardening, and human-animal interaction activities were held in the group work sessions consisting of 6 sessions on Saturdays at 13.00. In addition to all these activities, some documentaries on ecology were also suggested for the participants to watch, to be discussed in different sessions. The collected data were analyzed in the SPSS 22.0 package program. At the end of the group work, it was observed that there was a significant difference in the total scores of the Flourishing Scale, the Nature Relatedness Scale, and Depression Stress and Anxiety Scale (DASS21) of LGBTQ+ people in the experimental group.
Collapse
Affiliation(s)
- Yunus Kara
- Faculty of Economics, Administrative and Social Sciences, Department of Social Work, Altınbaş University, Istanbul, Turkey
| |
Collapse
|
9
|
Gasteiger C, Collens P, du Preez E. Community-based support to improve mental health and wellbeing in older sexually and gender diverse people: a scoping review. Aging Ment Health 2024; 28:692-700. [PMID: 37855436 DOI: 10.1080/13607863.2023.2269097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/05/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES This scoping review seeks to identify what community-based support is used by older sexually and gender diverse (SGD) people, that aims to improve mental health/wellbeing. METHODS A scoping review was conducted using the Arksey and O'Malley framework. APA PsycInfo, Embase, MEDLINE, PubMed, and Scopus were searched. Key information was extracted and entered into a structured coding sheet before being summarized. RESULTS Seventeen studies were included (41% observational qualitative and 35% observational quantitative). The most commonly used community-based support was lesbian, gay, bisexual and transgender (LGBT) social groups. A range of practices were reported in five studies, including in SGD affirming religious congregations and mind-body practices. Two studies reported the use of formal programmes, with one based on a group initiative. Positive outcomes included feeling connected, improved social support and mental health, and coping with illness. Five studies reported null or negative findings, including a lack of acceptance. Most studies used categories for sex and gender inaccurately, and lacked detail when describing community-based support. CONCLUSION The use of community-based support by older SGD people is underexplored. More interventions designed for and by this community are needed, along with experimental research to draw conclusions on effectiveness to improve mental health or wellbeing.
Collapse
Affiliation(s)
- Chiara Gasteiger
- School of Clinical Sciences, AUT University, Auckland, New Zealand
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Paula Collens
- School of Clinical Sciences, AUT University, Auckland, New Zealand
| | | |
Collapse
|
10
|
Masa R, Inoue M, Prieto L, Baruah D, Nosrat S, Mehak S, Operario D. Mental Health of Older Adults by Sexual Minority Status: Evidence From the 2021 National Health Interview Survey. J Appl Gerontol 2024; 43:276-286. [PMID: 37801680 PMCID: PMC10809733 DOI: 10.1177/07334648231203838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 10/08/2023] Open
Abstract
This study explored differences among older adults in mental health by sexual minority status. Data came from the 2021 U.S. National Health Interview Survey. The study sample included older adults (or those aged ≥50 years, N = 15,559), and of those, two percent (n = 380) self-identified as lesbian, gay, or bisexual (LGB). Older LGB adults had significantly higher odds of reporting a diagnosis of depression and anxiety and experiencing serious psychological distress than older non-LGB adults. Additionally, older LGB adults reported higher odds of experiencing depression and anxiety more frequently than older non-LGB adults. Significant covariates included age, sex, housing, food security, and social support. Increased risk for mental illness may be long-term consequences of stigma and discrimination that this population has experienced over the life course. The combination of structural interventions and affirming mental healthcare that recognizes the cumulative negative experience among older LGB adults is necessary to achieve mental health equity.
Collapse
Affiliation(s)
- Rainier Masa
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Global Social Development Innovations, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Megumi Inoue
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Lucas Prieto
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Dicky Baruah
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah Nosrat
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Samreen Mehak
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Don Operario
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
11
|
Nguyen J, Anderson J, Pepping CA. A systematic review and research agenda of internalized sexual stigma in sexual minority individuals: Evidence from longitudinal and intervention studies. Clin Psychol Rev 2024; 108:102376. [PMID: 38218122 DOI: 10.1016/j.cpr.2023.102376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 10/07/2023] [Accepted: 12/21/2023] [Indexed: 01/15/2024]
Abstract
Internalized sexual stigma is a well-established risk factor for poor mental health among sexual minority individuals. However, there has been no synthesis of the literature pertaining to risk and protective factors that influence the development of internalized sexual stigma over time. This systematic review presents findings from 31 studies addressing this question (n = 9192); 23 studies examined psychosocial and sociodemographic predictors of internalized sexual stigma among sexual minority individuals, and eight studies tested the effects of psychological interventions on internalized sexual stigma. Longitudinal studies highlight the stability of internalized sexual stigma over time, and the role of stigma and discrimination, proximal minority stressors (e.g., outness, concealment), and psychological factors (e.g., depressive and anxious symptoms, coping styles, and demoralization) in predicting subsequent internalized sexual stigma. Demographic factors appear to play only a limited role in predicting subsequent internalized sexual stigma. Finally, most intervention studies found no significant effects in reducing internalized sexual stigma, with three exceptions finding significant intervention effects among young sexual minority individuals. We conclude by outlining a theory-driven model of internalized stigma and a research agenda to test more nuanced models of internalized stigma that include multifactorial risk indices.
Collapse
Affiliation(s)
- Josh Nguyen
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Joel Anderson
- Australian Research Centre in Sex, Health, and Society, La Trobe University, Melbourne, Australia; Institute for Positive Psychology and Education, Australian Catholic University, Melbourne, Australia
| | - Christopher A Pepping
- School of Applied Psychology, Griffith University, Brisbane, Australia; Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia.
| |
Collapse
|
12
|
Martinez ME, Felner JK, Shen J, McDaniels-Davidson C, Nodora JN, Lacey JV, Savage KE, Duffy CN, Spielfogel ES, Hong S. Mental health and social connection among older lesbian and bisexual women. Int Psychogeriatr 2024:1-10. [PMID: 38186234 PMCID: PMC11228127 DOI: 10.1017/s1041610223004453] [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] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To assess differences in psychosocial and mental health outcomes between older lesbian and bisexual women compared to heterosexual women. DESIGN Cross sectional study. SETTING The study was carried out in the California Teachers Study, a prospective cohort study. PARTICIPANTS Self-identified heterosexual (n = 35,846), lesbian (n = 710), and bisexual (n = 253) women 50 years of age and older were enrolled. MEASUREMENTS Validated questionnaires were used to measure social connection, overall happiness, and depression. Logistic regression modeling was used to estimate odds ratios (OR) and 95% confidence intervals (CI) comparing lesbian and bisexual women separately to heterosexual women in relation to psychosocial and mental health outcomes. RESULTS After controlling for age and marital status, older bisexual women were significantly more likely to report lack of companionship (OR = 2.00; 95% CI, 1.30-3.12) and feeling left out (OR = 2.33; 95% CI, 1.36-3.97) compared to older heterosexual women. The odds of reporting feeling isolated from others was significantly higher in lesbian (OR = 1.56; 95% CI, 1.06-2.30) and bisexual women (OR = 2.30; 95% CI, 1.37-3.87) than in heterosexual women. The OR (95% CI) for reporting not being very happy overall was 1.96 (CI, 1.09-3.52) in bisexual women and 1.40 (0.92-2.14) in lesbian women compared to heterosexual women. The likelihood of reporting diagnosed depression was significantly higher in lesbian women (OR = 1.65; 95% CI, 1.38-1.97) and bisexual women (OR = 2.21; 95% CI, 1.67-2.93) compared to heterosexual women. CONCLUSION Inclusion of lesbian and bisexual women in aging research is essential to understand their unique mental and other health needs, including those specific to bisexual women.
Collapse
Affiliation(s)
- Maria Elena Martinez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla CA 92093, USA
- Moores Cancer Center, University of California, San Diego, La Jolla CA 92037, USA
| | - Jennifer K. Felner
- School of Public Health, San Diego State University, San Diego CA 92182, USA
| | - Jian Shen
- Moores Cancer Center, University of California, San Diego, La Jolla CA 92037, USA
| | - Corinne McDaniels-Davidson
- Moores Cancer Center, University of California, San Diego, La Jolla CA 92037, USA
- School of Public Health, San Diego State University, San Diego CA 92182, USA
| | - Jesse N. Nodora
- Moores Cancer Center, University of California, San Diego, La Jolla CA 92037, USA
- Radiation Medicine and Applied Sciences, University of California, San Diego CA 92037, USA
| | - James V. Lacey
- Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope. 1500 E. Duarte Rd, Duarte, CA 91010, USA
| | - Kristen E. Savage
- Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope. 1500 E. Duarte Rd, Duarte, CA 91010, USA
| | - Christine N. Duffy
- School of Medicine, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94158, USA
| | - Emma S. Spielfogel
- Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope. 1500 E. Duarte Rd, Duarte, CA 91010, USA
| | - Suzi Hong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla CA 92093, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| |
Collapse
|
13
|
Chan ASW, Ku HB, Yan E. Exploring discrimination, social acceptance, and its impact on the psychological well-being of older men who have sex with men: A cross-sectional study. BMC Public Health 2024; 24:49. [PMID: 38166786 PMCID: PMC10763053 DOI: 10.1186/s12889-023-17574-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The exploration of discrimination, social acceptance, and their impact on the psychological well-being of older men who have sex with men (MSM) is a critical area of study within the broader field of LGBTQ+ research. This demographic, comprising individuals who identify as both male and homosexual and are aged in the older spectrum of the population, faces unique challenges that intersect age, sexual orientation, and societal attitudes. Objectives This study aimed to explore the relationship between social acceptance and isolation with discrimination and the impact on the psychological well-being of older MSM. METHODS A cross-sectional survey was administered among older MSM residing in three distinct regions: the People's Republic of China (PRC), Hong Kong, and Taiwan, with a total sample size of N = 453 participants, evenly distributed with N = 151 individuals from each region. The survey included the General Health Questionnaire-12 (GHQ-12), the Discrimination and Self-Stigma Evaluation Scale (DSSES), and the Perceived Acceptance Scale (PAS) which measures the perceived social acceptance from friends, mother, father, and family. The data were analyzed using descriptive statistics, ANOVA, and regression analysis. RESULTS The mean scores of the GHQ-12 indicated that the participants had a moderate level of psychological distress, with a mean score of 6.38 (SD = 2.55). The DSSES mean score was 27.78 (SD = 8.73), indicating that participants experienced discrimination in their everyday lives. The PAS mean score was 3.08 (SD = 0.48), indicating that participants had a moderate level of perceived social acceptance. These results suggest that discrimination and social acceptance differ among older MSM in different areas in PRC, Hong Kong, and Taiwan. CONCLUSIONS The study highlights the impact of discrimination and social acceptance on the psychological well-being of older MSM. The findings suggest that interventions aimed at reducing discrimination and promoting social acceptance may improve the psychological well-being of older MSM. These results have important implications for healthcare providers and policymakers in developing strategies to promote social acceptance and reduce discrimination towards older MSM.
Collapse
Affiliation(s)
- Alex Siu Wing Chan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
| | - Hok Bun Ku
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Elsie Yan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
| |
Collapse
|
14
|
Lampe NM, Barbee H, Tran NM, Bastow S, McKay T. Health Disparities Among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults: A Structural Competency Approach. Int J Aging Hum Dev 2024; 98:39-55. [PMID: 37122150 PMCID: PMC10598237 DOI: 10.1177/00914150231171838] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adults experience significant health disparities. Examining these disparities has become an international research priority, but gaps remain. In this review article, we summarize major contributions of and ongoing gaps in health disparities research among LGBTQ+ older adults, while focusing on four major content areas: (a) social determinants of health disparities, (b) mental, cognitive, and physical health disparities, (c) reproductive and sexual health disparities, and (d) seeking LGBTQ+-affirming and age-friendly care. Using a structural competency approach, we develop a four-part agenda for this research area that enhances our understanding of how macro-level systems, institutions, and structures drive health disparities among aging LGBTQ+ communities. We also outline future research on structural competency in LGBTQ+ older adult health, while providing recommendations for researchers and clinicians. These recommendations illuminate potential best practices for bettering the health and quality of life of LGBTQ+ older populations.
Collapse
Affiliation(s)
- Nik M. Lampe
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA
- Vanderbilt University LGBTQ+ Policy Lab, Vanderbilt University, Nashville, TN, USA
| | - Harry Barbee
- Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD, USA
| | - Nathaniel M. Tran
- Vanderbilt University LGBTQ+ Policy Lab, Vanderbilt University, Nashville, TN, USA
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Skyler Bastow
- Department of Sociology, Florida State University, Tallahassee, FL, USA
- Department of Geriatrics, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Tara McKay
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA
- Vanderbilt University LGBTQ+ Policy Lab, Vanderbilt University, Nashville, TN, USA
| |
Collapse
|
15
|
Leonard SI, Sharma Y, Hughes TL, Jackman KB, Bruzzese JM. Weight Stigma and Mental and Emotional Health Among Sexual and Gender Minority Individuals: A Scoping Review. LGBT Health 2023. [PMID: 37948558 DOI: 10.1089/lgbt.2023.0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Purpose: Weight stigma is associated with poor mental and emotional health and may be especially harmful to sexual and gender minority (SGM) individuals due to co-occurring minority stress. The literature on this topic has not been synthesized. We conducted a scoping review of the literature on weight stigma and mental and emotional health among SGM individuals to synthesize findings, highlight gaps, and identify clinical and research implications. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, we searched PubMed, CINAHL, PsycINFO, and Scopus in April 2022. Included studies examined the relationship between weight stigma and mental and emotional health among SGM people of any age. We did not restrict study design or publication date. Results: Of 513 records identified, 23 met inclusion criteria. Most focused on sexual minority individuals; one focused specifically on gender minority individuals. Weight stigma was associated with poorer mental and emotional health in nearly all studies. The most common outcomes examined were self-esteem, maladaptive eating, and depressive symptoms. Five studies, all using the same dataset, focused on adolescents; none focused on older adults. Conclusions: Weight stigma is associated with poorer mental and emotional health among SGM individuals and, through its intersections with minority stress, might impact SGM individuals differently than their cisgender and heterosexual counterparts. There are important gaps regarding weight stigma's effect on SGM adolescents and gender minority individuals and its relationship with a broader range of mental and emotional health outcomes.
Collapse
Affiliation(s)
- Sarah I Leonard
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
| | - Yashika Sharma
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
| | - Tonda L Hughes
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
| | - Kasey B Jackman
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
- NewYork-Presbyterian Hospital, New York, New York, USA
| | - Jean-Marie Bruzzese
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
| |
Collapse
|
16
|
Beringer R, de Vries B, Gill P, Gutman G. Beyond Mortality: The Social and Health Impacts of COVID-19 among Older (55+) BIPOC and LGBT Respondents in a Canada-Wide Survey. Healthcare (Basel) 2023; 11:2044. [PMID: 37510485 PMCID: PMC10379205 DOI: 10.3390/healthcare11142044] [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: 04/15/2023] [Revised: 06/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
This study focused on the effects of the COVID-19 pandemic on the marginalized populations-specifically Black and Indigenous people as well as People of Color (BIPOC) compared to White older adults and LGBT individuals compared to heterosexual older adults. Data were derived from our national online survey of Canadians aged 55+, conducted from 10 August to 10 October 2020. The survey explored the influence of COVID-19 on lifestyle changes, well-being, and planning for the future. Our sample comprised 4292 respondents. We compared sets of dichotomous variables with White vs. BIPOC, LGBT vs. heterosexual, and LGBT White vs. LGBT BIPOC respondents. Significantly more BIPOC than White individuals reported changes in accessing food (44.3% vs. 33.2%) and in family income (53.9% vs. 38.9%) and fewer reported feeling accepted and happy, and more felt isolated and judged. Significantly more LGBT than heterosexual respondents reported changes in routines and in accessing social support, medical and mental health care and more feeling depressed, lonely, anxious, and sad. More LGBT-BIPOC than LGBT-White respondents reported changes in access to food (66.7 vs. 30.6, p < 0.001); in family income (66.7 vs. 41.5, p < 0.005); and in access to mental health care (38.5 vs. 24.0, p < 0.05). The only difference in emotional response to COVID-19 was that more BIPOC-LGBT than White-LGBT respondents reported feeling judged (25.9 vs. 14.5, p < 0.05). These findings reflect a complex mix of the effects of marginalization upon BIPOC and LGBT older adults, revealing both hardship and hardiness and warranting further research.
Collapse
Affiliation(s)
- Robert Beringer
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8W 2Y2, Canada
| | - Brian de Vries
- Gerontology Program, San Francisco State University, San Francisco, CA 92262, USA
| | - Paneet Gill
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 2V8, Canada
| | - Gloria Gutman
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
| |
Collapse
|
17
|
Detwiler BP, Caskie GIL, Johnson NL. It's Complicated: Minority Stress, Social Support, In-Group Social Contact, and Sexual Minority Older Adults' Well-Being. THE GERONTOLOGIST 2023; 63:350-360. [PMID: 35767630 DOI: 10.1093/geront/gnac092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES We applied the Minority Stress Model to sexual minority older adults to examine how distal minority stressors of ageism and heterosexism related to psychological well-being (life satisfaction, quality of life, psychological distress, and loneliness). We investigated social support and in-group social contact as stress-ameliorating factors and tested for a potential intersection of stress due to minority identities. RESEARCH DESIGN AND METHODS A sample of 189 sexual minority older adults (50-86 years; M = 60.41) completed survey measures online. Hierarchical regression analyses with interaction terms were utilized to test study hypotheses. RESULTS Findings offered partial support for the Minority Stress Model. Large effect sizes were obtained, explaining 32%-56% of the variance in psychological well-being with models including ageism, heterosexism, stress-ameliorating factors, and demographics. Ageism and heterosexism related to greater psychological distress; however, heterosexism became nonsignificant after controlling for stress-ameliorating factors. Ageism and heterosexism's relations to loneliness and quality of life followed similar patterns. Social support was a strong predictor of better psychological well-being for all measures. In-group social contact buffered against distress resulting from ageism, but heightened distress resulting from heterosexism. The interaction of ageism and heterosexism was not significant. DISCUSSION AND IMPLICATIONS Ageism was a distinct source of distress for sexual minority older adults. Although social support emerged as crucial to well-being, the mixed findings related to in-group contact as a stress-ameliorating factor may indicate a need for tailored social engagement to optimize community connection as protective for sexual minority older adults.
Collapse
Affiliation(s)
- Bethany P Detwiler
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Grace I L Caskie
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Nicole L Johnson
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| |
Collapse
|
18
|
Spalding RL, Katz E, Byers ES, Edelstein B. Development and Initial Validation of the Attitudes Towards Older Adult Sexuality in Long-term Care Scale (AOASLC). JOURNAL OF SEX RESEARCH 2023; 60:137-145. [PMID: 34520304 DOI: 10.1080/00224499.2021.1975624] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In long-term care facilities where older adults may reside, negative attitudes about later life sexuality can result in restrictive facility policies and staff behaviors that suppress residents' rights to sexual expression. No assessment instrument specifically focuses on the sexual behaviors of long-term care residents and existing measures of attitudes toward older adult sexuality do not include sexual expression in long term care, nor do they assess a full range of sexual behaviors. We developed the Attitudes toward Older Adult Sexuality in Long-term Care Scale (AOASLC). A large, diverse sample of 295 community-dwelling adults in the United States completed an online survey through Amazon Mechanical Turk. The survey included the AOASLC and self-report measures of related constructs. Two-hundred-and-ninety-five participants completed the survey (Mage = 49.16, SD = 14.69, range = 18- 84 years). Of the sample, 50.2% identified as female, 49.5% identified as male, and one person identified as transgender male. An exploratory factor analysis indicated a two-factor structure. Factor 1 represented general attitudes toward sexual behaviors, and Factor 2 represented acceptability of various sexual behaviors. The instrument evidenced good reliability and validity. While further validation research is necessary, the AOASLC is a promising new measure.
Collapse
Affiliation(s)
| | - Emma Katz
- Department of Psychology, West Virginia University
| | | | | |
Collapse
|
19
|
Zullo L, Grzenda A, Vargas SM, Miranda J. Age-Associated Differences in Mental Distress Among Sexual and Gender Minority Adults. Psychiatr Serv 2022; 73:1352-1358. [PMID: 35734867 DOI: 10.1176/appi.ps.202100059] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to use a large population-based sample to investigate age-associated differences in mental distress among sexual and gender minority (SGM) adults compared with their heterosexual, cisgender counterparts. METHODS Data were pooled from five cycles (2014-2018) of the Behavioral Risk Factor Surveillance System (BRFSS) survey (N=762,541) and included states that administered the optional SGM module during that interval. Mean days of self-reported mental distress and the rate of frequent mental distress (≥14 days of mental distress per month) were calculated for each age and SGM identity stratum by using linear and logistic regression, respectively. Models controlled for socioeconomic factors and medical comorbid conditions. All analyses accounted for the complex survey design of the BRFSS. RESULTS Among those ages 18-24 years, mean days of mental distress and the rate of frequent mental distress were significantly higher for SGM subgroups compared with cisgender, heterosexual adults. Among those ages 45-54, 55-64, or ≥65, no differences were noted between SGM groups and their cisgender, heterosexual peers. CONCLUSIONS Younger SGM respondents reported the highest levels of mental distress. Differences in general mental distress were less detectable with increasing age. The findings suggest that SGM young adults have an increased need for mental health services.
Collapse
Affiliation(s)
- Lucas Zullo
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles (all authors); Olive View-UCLA Medical Center, Sylmar, California (Grzenda); Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles (Vargas)
| | - Adrienne Grzenda
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles (all authors); Olive View-UCLA Medical Center, Sylmar, California (Grzenda); Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles (Vargas)
| | - Sylvanna M Vargas
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles (all authors); Olive View-UCLA Medical Center, Sylmar, California (Grzenda); Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles (Vargas)
| | - Jeanne Miranda
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles (all authors); Olive View-UCLA Medical Center, Sylmar, California (Grzenda); Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles (Vargas)
| |
Collapse
|
20
|
Cannas Aghedu F, Blais M, Philibert M, Côté I, Samoilenko M, Chamberland L. Social resource patterns and health outcomes among Canadian LGBTQ2+ adults: A latent class analysis. Soc Sci Med 2022; 314:115476. [PMID: 36327629 DOI: 10.1016/j.socscimed.2022.115476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 08/18/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Decades of research have shown a strong association between wellbeing, health, and social resources. LGBTQ2+ communities are among those who historically have been excluded from accessing quality social resources. However, little is known about how access to different types of resources influences mental health and wellbeing. METHOD Data were drawn from an online sample of 3890 LGBTQ2+ people aged 18 years and older in Quebec, Canada. We identified key social resource patterns (from family of origin, friends, partner, neighbourhood, and LGBTQ2+ community) and investigated differences in socio-demographic and health outcomes across classes. RESULTS A five-class solution best fitted the data, highlighting distinctive patterns in access to five key social resources: moderate friend support access (42.14%), overall high support access (23.51%), high friend support access (18.06%), only close ties support access (10.90%) and overall low support access (5.39%). Marginalized groups (trans and non-binary people, racialized or disabled people, immigrants) were less likely to access diverse, high-quality social resources. Accessing diverse social resources, particularly close ties (e.g., family of origin), was associated with better health outcomes. In the absence of close ties, having at least one other social resource was associated with better health outcomes compared to having limited access to all resources. CONCLUSIONS We found a major imbalance in social resource access among LGBTQ2+ people. Creating safe spaces for LGBTQ2+ people and ensuring access to high-quality social resources is important in sustaining their health and wellbeing.
Collapse
Affiliation(s)
- Fabio Cannas Aghedu
- Chaire de Recherche sur La Diversité Sexuelle et La Pluralité des Genres, Université Du Québec à Montréal, Canada.
| | - Martin Blais
- Chaire de Recherche sur La Diversité Sexuelle et La Pluralité des Genres, Université Du Québec à Montréal, Canada; Département de Sexologie, Université Du Québec à Montréal, Canada
| | | | - Isabel Côté
- Département de Travail Social, Chaire de Recherche Du Canada sur La Procréation pour Autrui et Les Liens Familiaux, Université Du Québec en Outaouais, Québec, Canada
| | - Mariia Samoilenko
- Chaire de Recherche sur La Diversité Sexuelle et La Pluralité des Genres, Université Du Québec à Montréal, Canada
| | - Line Chamberland
- Chaire de Recherche sur La Diversité Sexuelle et La Pluralité des Genres, Université Du Québec à Montréal, Canada; Département de Sexologie, Université Du Québec à Montréal, Canada
| |
Collapse
|
21
|
Marshall A, Cahill S. Barriers and opportunities for the mental health of LGBT older adults and older people living with HIV: a systematic literature review. Aging Ment Health 2022; 26:1845-1854. [PMID: 34784488 DOI: 10.1080/13607863.2021.2003300] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE LGBT older adults and older people living with HIV (PLWH) experience a disproportionate burden of behavioral health conditions compared to their heterosexual, cisgender, and HIV-negative peers. This study intends to systematically review the literature regarding accessing mental health care among LGBT older adults and older PLWH. METHODS This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement framework. Three databases were searched using Boolean search strings, and inclusion/exclusion criteria were developed and applied to the search outcomes to appropriately narrow results. Article quality and evidence of bias were evaluated using the National Heart, Lung, and Blood Institute (NHLBI) quality-assessment tool, and the Critical Appraisal Skills Program (CASP) assessment tool, two instruments used to help reviewers in assessing for internal validity of studies. Two independent researchers coded the articles for themes, and consensus was reached on theme grouping through an iterative process. RESULTS Out of 2,031 articles initially screened, 28 met all inclusion criteria and advanced to final analysis. Several key themes emerged, including a lack of provider competency in caring for LGBT patients, lower rates of insurance coverage, greater mental health burden, social and structural determinants of health, policy solutions, and technology and health literacy. CONCLUSION There were several domains identified in the literature as barriers to accessing mental healthcare, as well as opportunities to better attend to the mental health needs of these populations. Provider training, implementing health technology solutions, and enacting public policy changes could improve mental health outcomes.
Collapse
Affiliation(s)
- Austin Marshall
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,University of California San Diego School of Medicine, San Diego, CA, USA
| | - Sean Cahill
- The Fenway Institute, Fenway Health, Boston, MA, USA.,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.,Bouve College of Health Sciences, Northeastern University, Boston, MA, USA
| |
Collapse
|
22
|
Minority stressors, protective factors and mental health outcomes in lesbian, gay and bisexual people in the UK. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03631-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
23
|
Cartujano-Barrera F, Hernández-Torres R, Orfin RH, Chávez-Iñiguez A, Alvarez Lopez O, Azogini C, Bermudez D, Arana-Chicas E, Cai X, McIntosh S, Ossip DJ, Cupertino AP. Proactive and Reactive Recruitment of Black and Latino Adolescents in a Vaping Prevention Randomized Controlled Trial. CHILDREN (BASEL, SWITZERLAND) 2022; 9:937. [PMID: 35883921 PMCID: PMC9321256 DOI: 10.3390/children9070937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to assesses the effectiveness of proactive and reactive methods in the recruitment of Black and Latino adolescents into a vaping-prevention randomized controlled trial (RCT). This study also assessed the characteristics of study participants by recruitment method. Proactive recruitment strategies included study presentations at community-based events (e.g., festivals, health fairs), school-based events (e.g., back-to-school events, after-school programs), and recreational centers (e.g., fitness centers, malls). Reactive recruitment strategies included study advertisements via social media (e.g., Facebook posts shared by local community-based organizations), word of mouth, and an academic-based research hub. Using proactive and reactive methods, in a 4-month period, 362 Black and Latino adolescents were successfully enrolled into the RCT. Compared to the proactive method, adolescents screened reactively were equally likely to be eligible but significantly more likely to enroll in the study. However, both proactive and reactive strategies made notable contributions to the overall recruitment effort. Moreover, proactive and reactive methods attracted adolescents with different characteristics (e.g., age, gender, sexual orientation, etc.). These findings suggest that both proactive and reactive recruitment strategies should be implemented for studies interested in recruiting a diverse sample of Black and Latino adolescents.
Collapse
Affiliation(s)
- Francisco Cartujano-Barrera
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Ruthmarie Hernández-Torres
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Rafael H. Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Arlette Chávez-Iñiguez
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Olga Alvarez Lopez
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Chiamaka Azogini
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Diana Bermudez
- Hackensack High School, Hackensack Public Schools, Hackensack, NJ 07601, USA;
| | - Evelyn Arana-Chicas
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Xueya Cai
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| |
Collapse
|
24
|
Silveri G, Schimmenti S, Prina E, Gios L, Mirandola M, Converti M, Fiorillo A, Pinna F, Ventriglio A, Galeazzi GM, Sherriff N, Zeeman L, Amaddeo F, Paribello P, Pinna F, Giallanella D, Gaggiano C, Ventriglio A, Converti M, Fiorillo A, Galeazzi GM, Marchi M, Arcolin E, Fiore G, Mirandola M, Schimmenti S, Silveri G, Prina E, Amaddeo F, Bragazzi NL. Barriers in care pathways and unmet mental health needs in LGBTIQ + communities. Int Rev Psychiatry 2022; 34:215-229. [PMID: 36151825 DOI: 10.1080/09540261.2022.2075256] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Lesbian, gay, bisexual, transgender, intersex, queer people and minority gender identities and sexualities (LGBTIQ+) are often stigmatized and experience discrimination in health care settings, leading to poorer mental health outcomes and unmet needs compared to heterosexual and cisgendered peers. It is thus imperative that mental health providers consider and address structural challenges in order to reduce mental health inequalities of this population. This narrative review assessed the barriers that may prevent access to care and the pathways for care in LGBTIQ + communities. PubMed, PsycInfo, Embase, and Scopus were searched for papers published between December 2021 and February 2022. A total of 107 papers were included with studies reflecting five themes: (1) Unmet mental health needs; (2) Young people; (3) Substance abuse and addiction; (4) Barriers and pathways to care; and (5) Interventions. Findings demonstrate that LGBTIQ + people experience stigmatization and higher rates of substance misuse and mental ill health, which may lead to barriers in accessing health care services, and fewer tailored interventions being provided. These findings have implications for policy, health care screening, and how specialist services are structured. Substantial gaps in the evidence-base exist, and future research should examine how mental health care providers can challenge social issues that maintain discriminatory and stigmatizing practices, and support LGBTIQ + individuals to sustain their resilience.
Collapse
Affiliation(s)
- Giada Silveri
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Simone Schimmenti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy.,School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of integrated activity of Mental Health and Pathological Dependencies, USL-IRCSS company of Reggio Emilia, Reggio Emilia, Italy
| | - Nigel Sherriff
- School of Sport and Health Sciences, University of Brighton, Brighton, UK.,Centre for Transforming Sexuality and Gender, University of Brighton, Brighton, UK
| | - Laetitia Zeeman
- School of Sport and Health Sciences, University of Brighton, Brighton, UK.,Centre for Transforming Sexuality and Gender, University of Brighton, Brighton, UK
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Pasquale Paribello
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniela Giallanella
- Department of Clinical and Experimental, University di Foggia, Foggia, Italy
| | - Costanza Gaggiano
- Department of Clinical and Experimental, University di Foggia, Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental, University di Foggia, Foggia, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisa Arcolin
- Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Gianluca Fiore
- Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Simone Schimmenti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giada Silveri
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | | |
Collapse
|
25
|
Fraser G, Brady A, Wilson MS. Mental health support experiences of rainbow rangatahi youth in Aotearoa New Zealand: results from a co-designed online survey. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2061019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Gloria Fraser
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Anita Brady
- School of English, Film, Theatre, Media Studies, and Art History, Victoria University of Wellington, Wellington, New Zealand
| | - Marc S. Wilson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| |
Collapse
|
26
|
Inventor BR, Paun O, McIntosh E. Mental Health of LGBTQ Older Adults. J Psychosoc Nurs Ment Health Serv 2022; 60:7-10. [PMID: 35353662 DOI: 10.3928/02793695-20220303-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
More than 54 million people in the United States are aged ≥65 years, including an estimated 2.4 million people who identify as lesbian, gay, bi-sexual, transgender, or queer (LGBTQ). As a group, LGBTQ older adults experienced criminalization, discrimination, and social stigma the majority of their lives, with rates of victimization and stigma increasing with age. LGBTQ older adults continue to experience social and health disparities compared to heterosexual individuals. To meet the needs of LGBTQ older adults, it is necessary to understand the impact of politics, culture, and social norms as they came of age. Unique mental health needs, such as social isolation, loneliness, disenfranchised grief, and long-term social support, are discussed through the lens of the minority stress model. Implications and recommendations for health care, research, and policy, such as creating a safe and welcoming environment and providing culturally competent care for LGBTQ older adults, are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 60(4), 7-10.].
Collapse
|
27
|
A Content Analysis of Osteopaths’ Attitudes for a More Inclusive Clinical Practice towards Transgender People. Healthcare (Basel) 2022; 10:healthcare10030562. [PMID: 35327040 PMCID: PMC8953530 DOI: 10.3390/healthcare10030562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/21/2022] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives. The aim of this qualitative study was to explore the attitudes, beliefs, and preferences of Italian osteopaths regarding the management of transgender patients through a content analysis of emergent data from semi-structured interviews. Methods. This study was a content analysis based on the Standards for Reporting Qualitative Research guidelines. Purposive sampling of 10 Italian osteopaths was applied. Data were collected through semi-structured interviews, from March to April 2021, and subsequently transcribed verbatim with the content analysis carried out as an iterative process. Results. One participant was excluded during the first interview due to them being unsuitable for this study. Data saturation was reached after two interviews with the remaining nine participants. Data analysis revealed four main themes: microaggressions, acceptance and non-judgement, person-centered treatment, and education implementation. Conclusions. This study presents cisgender Italian osteopaths’ attitudes in the care of transgender people, revealing the desire to embrace and apply osteopathic tenets regardless of the patient’s gender identity.
Collapse
|
28
|
Nobels A, Lemmens G, Thibau L, Beaulieu M, Vandeviver C, Keygnaert I. "Time Does Not Heal All Wounds": Sexual Victimisation Is Associated with Depression, Anxiety, and PTSD in Old Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052803. [PMID: 35270496 PMCID: PMC8910002 DOI: 10.3390/ijerph19052803] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 11/21/2022]
Abstract
Sexual violence (SV) has an important impact on mental health. Childhood sexual abuse is linked to internalising disorders in later life. In older adults, SV occurs more often than previously believed. Moreover, health care workers lack the skills to address SV in later life. Studies researching the mental health impact of lifetime SV, i.e., SV during childhood, adulthood, and old age, are lacking. Between July 2019 and March 2020, 513 older adults living in Belgium participated in structured face-to-face-interviews. Selection occurred via a cluster random probability sampling with a random walk finding approach. Depression, anxiety, and posttraumatic stress syndrome (PTSD) were measured using validated scales. Participants were asked about suicide attempts and self-harm during their lifetime and in the past 12 months. SV was measured using behaviourally specific questions based on a broad SV definition. We found rates for depression, anxiety, and PTSD of 27%, 26%, and 6% respectively, while 2% had attempted suicide, and 1% reported self-harm in the past 12 months. Over 44% experienced lifetime SV and 8% in the past 12 months. Lifetime SV was linked to depression (p = 0.001), anxiety (p = 0.001), and PTSD in participants with a chronic illness/disability (p = 0.002) or no/lower education (p < 0.001). We found no link between lifetime SV and suicide attempts or self-harm in the past 12 months. In conclusion, lifetime SV is linked to mental health problems in late life. Tailored mental health care for older SV victims is necessary. Therefore, capacity building of professionals and development of clinical guidelines and care procedures are important.
Collapse
Affiliation(s)
- Anne Nobels
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
- Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium;
- Correspondence: (A.N.); (I.K.)
| | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium;
- Department of Head and Skin–Psychiatry and Medical Psychology, Ghent University, 9000 Ghent, Belgium
| | - Lisa Thibau
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
| | - Marie Beaulieu
- School of Social Work, Research Chair on Mistreatment of Older Adults and Research Centre on Aging, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, 9000 Ghent, Belgium;
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
- Correspondence: (A.N.); (I.K.)
| |
Collapse
|
29
|
Alba B, Lyons A, Waling A, Minichiello V, Hughes M, Barrett C, Fredriksen-Goldsen K, Edmonds S, Savage T, Pepping CA, Blanchard M. Factors Associated with Self-Reported PTSD Diagnosis among Older Lesbian Women and Gay Men. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022; 65:129-142. [PMID: 34114944 DOI: 10.1080/01634372.2021.1939218] [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: 03/15/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
Lesbian women and gay men are at greater risk of post-traumatic stress disorder (PTSD) than heterosexual people, however few studies have examined PTSD in older lesbian women and gay men. This study examined predictors of having ever been diagnosed with PTSD, as well as relationships to current quality of life, among 756 lesbian women and gay men aged 60 years and older in Australia. Participants were surveyed on their sociodemographic characteristics, experiences of sexual orientation discrimination over their lifetime, whether they had ever been diagnosed with PTSD, whether they were currently receiving treatment for PTSD, and their current quality of life. After adjusting for sociodemographic variables, participants who reported having a PTSD diagnosis (11.2%) had significantly more frequent experiences of discrimination over their lifetime and were significantly less likely to currently be in a relationship. Older lesbian women were significantly more likely than older gay men to report ever having had a PTSD diagnosis. Additionally, having ever been diagnosed with PTSD significantly predicted current poorer quality of life. These findings suggest that a history of PTSD among older lesbian women and gay men is linked to experiences of discrimination and other factors, with associated links to current quality of life.
Collapse
Affiliation(s)
- Beatrice Alba
- School of Psychology, Deakin University, Melbourne Australia
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Andrea Waling
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Victor Minichiello
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- School of Justice, Faculty of Law, Queensland University of Technology, Brisbane, Australia
| | - Mark Hughes
- School of Arts and Social Sciences, Southern Cross University, Gold Coast, Australia
| | | | | | | | - Teresa Savage
- Silver Rainbow, LGBTIQ+ Health Australia, Sydney, Australia
| | | | - Michelle Blanchard
- SANE Australia, Melbourne, Australia
- Anne Deveson Research Centre, Melbourne, Australia
- Melbourne School of Psychological Sciences, the University of Melbourne, Melbourne, Australia
| |
Collapse
|
30
|
Building H.O.U.S.E (Healthy Outcomes Using a Supportive Environment): Exploring the Role of Affordable and Inclusive Housing for LGBTQIA+ Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031699. [PMID: 35162722 PMCID: PMC8834975 DOI: 10.3390/ijerph19031699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/08/2022] [Accepted: 01/28/2022] [Indexed: 11/21/2022]
Abstract
Little is known about how permanent, inclusive, affordable, and supportive long-term housing may affect the health of low-income lesbian, gay, bisexual, transgender, queer, intersex, asexual and/or another identity (LGBTQIA+) older adults. Focus group interviews were conducted with 21 older adults to explore the lived experiences and potential health benefits of living in a new LGBTQIA+-welcoming senior housing. Participants reported that moving into the housing was associated with benefits for health and well-being, especially for psychological health. Community, social support, and in-house services were particularly important. However, the combined nature of LGBTQIA+-welcoming and older adult only housing evoked mixed feelings. Appropriate and accessible housing solutions are essential for LGBTQIA+ older adults and may help address health disparities for these populations.
Collapse
|
31
|
Sexual minorities are at elevated risk of cardiovascular disease from a younger age than heterosexuals. J Behav Med 2022; 45:571-579. [PMID: 35034218 PMCID: PMC9287494 DOI: 10.1007/s10865-021-00269-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/29/2021] [Indexed: 12/22/2022]
Abstract
Cardiovascular disease is the leading cause of death worldwide. In this study, we assessed factors related to cardiovascular disease risk and outcomes among sexual minorities (SM). Data from multiple waves of the PATH study were used in this analysis. Multivariable regression models were used to assess the association between sexual identity and: tobacco or e-cigarette use, adverse cardiovascular events, and age at first diagnosis of adverse cardiovascular disease events. In our sample (N = 23,205), 1,660 (7.15%) participants identified as SM. SM men, relative to heterosexual men, are more likely to be diagnosed with high blood pressure (aRR = 1.27; 95% CI 1.10, 1.47), high cholesterol (aRR = 1.32; 95% CI: 1.12, 1.55), congestive heart failure (aRR = 2.29; 95% CI 1.13, 4.65), stroke (aRR = 2.39; 95% CI: 1.14, 5.04), heart attack (aRR = 2.40; 95% CI 1.42, 4.04), and other heart conditions (aRR = 1.52; 95% CI: 1.06, 2.18). Although no simple differences were observed among SM women compared to heterosexual women, SM women were more likely to be diagnosed at a younger age for high blood pressure (aRR = -0.69; 95% CI - 1.08, - 0.29), high cholesterol (aRR = -0.77; 95% CI - 1.15, - 0.38), stroke (aRR = - 1.04; 95% CI - 1.94, - 0.13), and heart attack (aRR = - 1.26; 95% CI - 2.42, - 0.10). SM men were only diagnosed at a younger age for stroke (aRR = - 1.18; 95% CI - 2.06, - 0.30). Compared to heterosexuals, sexual minorities are at higher risk for cardiovascular disease, more likely to develop cardiovascular disease at an earlier age, and more likely to use tobacco products. Future research should focus on decreasing cardiovascular risk among sexual minorities including reducing tobacco use and stress. Screening recommendations for sexual minority populations should also be reviewed in light of a growing body of literature suggesting elevated risk from a young age.
Collapse
|
32
|
Flatt JD, Cicero EC, Kittle KR, Brennan-Ing M. Recommendations for Advancing Research With Sexual and Gender Minority Older Adults. J Gerontol B Psychol Sci Soc Sci 2022; 77:1-9. [PMID: 34216459 DOI: 10.1093/geronb/gbab127] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Jason D Flatt
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Ethan C Cicero
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Krystal R Kittle
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, the City University of New York, New York City, New York, USA
| |
Collapse
|
33
|
Chen D, Watson RJ, Caputi TL, Shover CL. Proportion of U.S. Clinics Offering LGBT-Tailored Mental Health Services Decreased Over Time: A Panel Study of the National Mental Health Services Survey. ANNALS OF LGBTQ PUBLIC AND POPULATION HEALTH 2021; 2:174-184. [PMID: 34901933 DOI: 10.1891/lgbtq-2020-0071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Our objective was to characterize the proportion of U.S. mental health clinics that offered LGBT-tailored mental health services between 2014 and 2018. We used data from the National Mental Health Services Survey (NMHSS) to construct a mixed logistic model of availability of LGBT-tailored mental health services over time, by region (Northeast, South, Midwest and West), and by facility type (Veterans Administration, inpatient/residential, outpatient, community mental health centers and mixed). Our results show that the overall proportion of mental health clinics that offered LGBT-tailored services decreased from 2014 to 2018. Our results also indicate that Veteran Affairs clinics and facilities in the West and Northeast were most likely to offer LGBT-tailored mental health services. Given the temporal, regional, and facility gaps in LGBT-tailored mental health services availability, more effort should be dedicated to addressing this disparity.
Collapse
Affiliation(s)
- Derek Chen
- Stanford University School of Humanities and Sciences, Program in Feminist, Gender and Sexuality Studies, Stanford, CA
| | - Ryan J Watson
- University of Connecticut, Department of Human Development & Family Sciences, CT, USA
| | | | - Chelsea L Shover
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, CA, USA
| |
Collapse
|
34
|
Michalski T, Brosz M, Stepien J, Biernacka K, Blaszczyk M, Grabowski J. Perceived Stress Levels among Ukrainian Migrant and LGBT+ Minorities in Poland during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12838. [PMID: 34886564 PMCID: PMC8657859 DOI: 10.3390/ijerph182312838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/25/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic, immigrant status and being a member of the LGBT+ community are all independent factors associated with increased stress levels. Few studies provide more complex analysis on this issue, and there has been no research on the cumulative burden of perceived stress that people belonging to both minorities experience in the current epidemiological situation. The aim of this study was to assess the ability to deal with an external situation during the third wave of the COVID-19 pandemic in Poland in the following groups with different stress levels (total sample n = 370): Polish heterosexual men (n = 202), heterosexual men from Ukraine (n = 131) and homo- and bisexual men (men who have sex with men-MSM) from Ukraine (n = 37). A Perceived Stress Scale (PSS-10) was used. The analysis of the survey did not show statistically significant differences between the three study groups in the general level of perceived stress (24.71, 24.77 and 26.49 points, respectively, p = 0.551), but it revealed numerous differences in coping with various aspects of everyday functioning between these groups. Negative assessment of one's own health proved to be the main factor negatively affecting the level of perceived stress, however specific health risks, medical history or the participants' previous experience have not been taken into account in the study. Our research shows differences in the needs, resources and methods of coping with stress between men who are Polish citizens and migrants from Ukraine, both heterosexual and belonging to the MSM group. Proper identification and addressing of these needs, taking into account different availability of health services, could be the responsibility of NGOs or insurance providers. This should result in the reduction of mental health burdens and the risk of developing serious mental disorders, and consequently in better functioning of persons belonging to minorities and in a reduced burden on the health care system.
Collapse
Affiliation(s)
- Tomasz Michalski
- Department of Regional Development, Faculty of Social Science, University of Gdansk, 80-309 Gdansk, Poland;
| | - Maciej Brosz
- Institute of Sociology, Faculty of Social Sciences, University of Gdansk, 80-309 Gdansk, Poland;
| | - Joanna Stepien
- Department of Socio-Economic Geography, Faculty of Social Science, University of Gdansk, 80-309 Gdansk, Poland;
| | - Karolina Biernacka
- Adult Psychiatry Scientific Circle, Division of Developmental Psychiatry, Psychotic and Geriatric Disorders, Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland; (K.B.); (M.B.)
| | - Michal Blaszczyk
- Adult Psychiatry Scientific Circle, Division of Developmental Psychiatry, Psychotic and Geriatric Disorders, Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland; (K.B.); (M.B.)
| | - Jakub Grabowski
- Division of Developmental Psychiatry, Psychotic and Geriatric Disorders, Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland
| |
Collapse
|
35
|
Kuroki M. The rise in extreme mental distress among LGBT people during Trump's rise and presidency. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101034. [PMID: 34198029 DOI: 10.1016/j.ehb.2021.101034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
Lesbian, gay, bisexual, and transgender (LGBT) advocates argue that President Donald Trump's 2016 election victory and his administration's agenda raised concerns about changes to legal rights and discrimination based on sexual orientation and gender identity. Using data on more than one million randomly sampled people during 2014-2020, this study estimates event study and difference-in-differences models to examine whether the prevalence of extreme mental distress (the percentage who reported major mental and emotional problems in all 30 of the last 30 days) increased among LGBT people relative to non-LGBT people after Trump became the Republican presidential frontrunner in early 2016. The difference-in-differences estimate indicates that the extreme mental distress gap between LGBT people and non-LGBT people increased from 1.8 percentage points during 2014-2015 to 3.8 percentage points after Trump's presidency became a real possibility in early 2016.
Collapse
Affiliation(s)
- Masanori Kuroki
- Arkansas Technical University, Russellville, AR, United States.
| |
Collapse
|
36
|
Li H, Fernández-Guasti A, Xu Y, Swaab D. Retracted: Sexual orientation, neuropsychiatric disorders and the neurotransmitters involved. Neurosci Biobehav Rev 2021; 131:479-488. [PMID: 34597715 DOI: 10.1016/j.neubiorev.2021.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/17/2021] [Accepted: 09/26/2021] [Indexed: 11/26/2022]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor in Chief of Neuroscience and Biobehavioral Reviews after concerns were raised with respect to the phrasing of comparisons drawn between humans and animal models. These comparisons were deemed unsupportable, and thus in the best interests of publication standards the Editor has concluded it is necessary to retract the paper. The authors disagree with the reason for the retraction.
Collapse
Affiliation(s)
- Haimei Li
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, PR China; Department of Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, Amsterdam, 1105 BA, the Netherlands
| | | | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, PR China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, 310003, PR China; Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, 310003, PR China; Brain Research Institute of Zhejiang University, Hangzhou, 31003, PR China.
| | - Dick Swaab
- Department of Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, Amsterdam, 1105 BA, the Netherlands.
| |
Collapse
|
37
|
COVID-19, stress, and inequities in (neuro)science. Neuron 2021; 109:3358-3360. [PMID: 34559981 PMCID: PMC8596192 DOI: 10.1016/j.neuron.2021.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 12/05/2022]
Abstract
The COVID-19 pandemic has posed major challenges for diversity, equity, and inclusion (DEI) efforts in research and academia. As chairs of the ALBA Network, we reflect on how the pandemic has exacerbated, and also shone a spotlight on, inequalities in science and society.
Collapse
|
38
|
Javier NM. Palliative care needs, concerns, and affirmative strategies for the LGBTQ population. Palliat Care Soc Pract 2021; 15:26323524211039234. [PMID: 34527948 PMCID: PMC8436312 DOI: 10.1177/26323524211039234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022] Open
Abstract
The Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning population, also known as sexual and gender minorities, are an incredibly marginalized and vulnerable population that have been disproportionately affected by the provision, delivery, and optimal access to high-quality medical care including palliative, hospice, and end-of-life care. The long-standing and unique experiences shaped by positive and negative historical events have led to a better understanding of significant barriers and gaps in equitable healthcare for this population. The intersection of both internal and external stressors as well as minority identities in the context of discriminatory political and societal infrastructures have resulted in variable health outcomes that continues to be plagued by economic barriers, oppressive legislative policies, and undesirable societal practices. It could not be more urgent and timely to call upon the government and healthcare systems at large to execute reforms in policies and regulations, engage in cultural competency training, and promote cultural shifts in beliefs, attitudes, and practices that will ultimately recognize, prioritize, and address the needs of this population. After all, health care access is a universal right regardless of personal, social, political, and economic determinants of comprehensive medical care.
Collapse
Affiliation(s)
- Noelle Marie Javier
- Icahn School of Medicine at Mount Sinai, One Levy Place, 1070, New York, NY 10029, USA
| |
Collapse
|
39
|
Anderson A, Dierkhising J, Rush G, Carleton M, Rosendale N, Bove R. Experiences of sexual and gender minority people living with multiple sclerosis in Northern California: An exploratory study. Mult Scler Relat Disord 2021; 55:103214. [PMID: 34428637 DOI: 10.1016/j.msard.2021.103214] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/20/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Sexual and gender minority (SGM) individuals may face unique challenges in accessing quality medical care due to structural disparities, social discrimination, and lack of culturally competent healthcare. Multiple sclerosis (MS) requires complex care. Little research has been carried out at the intersection between SGM identity and MS care. OBJECTIVE To identify unmet clinical and social needs in our clinical population of SGM patients with MS. METHODS Patients with MS who self-identified as SGM were recruited through the UCSF MS Center and a National MS Society web post to complete a 45-minute web-based (Qualtrics) survey. The mixed qualitative and quantitative survey covered experiences with different domains of MS care, drug/alcohol use, relationship status, social support, and participation in MS and SGM communities. RESULTS Among the 26 survey respondents, mean age was 50.2 (SD 10.6) years; gender identity was women (46%) men (38%) and genderqueer, transgender, or other (15%); sexual orientation was gay/lesbian/bisexual (35%), pansexual/queer (27%), questioning (23%), or other identity (15%). Over two thirds (69%) of respondents were partnered. Overall satisfaction with MS care was high: 79.2% participants scored ≥4/5 (somewhat or extremely satisfied); participants dissatisfied with their care cited feeling dismissed. While 87.5% felt that their SGM identities did not affect their MS care, still 30% did report feeling uncomfortable discussing their SGM identities with their clinician. Participants rated low impact of having MS on participation in SGM communities (mean 2.4/5 on Likert scale); those participants reporting higher impact cited fatigue, immobility and stigmatization of disease as primary factors. Similarly, SGM status had low effect on participation in the MS community (mean 1.4/5); higher impact was related to apprehension around identity disclosure to new groups. Identified resources that might improve MS care included more representation, inclusivity and openness from clinicians, and SGM-focused MS support groups. DISCUSSION In this exploratory survey of the needs of SGM people living with MS in Northern California, most participants reported that they were unlikely to participate in activities in the SGM community due to MS status or symptoms, however most felt that their SGM status did not affect their MS care. Given the center's location in a hub for SGM community and activism, surveying individuals in other settings would provide greater insights into the role of community, clinical support and the experience of SGM people living with MS.
Collapse
Affiliation(s)
- Annika Anderson
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA.
| | - Jason Dierkhising
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Gillian Rush
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Mia Carleton
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Nicole Rosendale
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA.
| | - Riley Bove
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA.
| |
Collapse
|
40
|
Meanley SP, Plankey MW, Matthews DD, Hawk ME, Egan JE, Teplin LA, Shoptaw SJ, Surkan PJ, Stall RD. Lifetime Prevalence and Sociodemographic Correlates of Multifactorial Discrimination Among Middle-Aged and Older Adult Men Who Have Sex with Men. JOURNAL OF HOMOSEXUALITY 2021; 68:1591-1608. [PMID: 31860386 PMCID: PMC7305044 DOI: 10.1080/00918369.2019.1702353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study describes multifactorial discrimination (discrimination attributed to multiple social identities) among middle-aged and older adult MSM. MSM aged 40+ years (N = 1,193) enrolled in the Multicenter AIDS Cohort Study completed behavioral surveys ascertaining experiences of discrimination and their social identity attributions. Non-proportional odds regressions assessed multifactorial discrimination by age, race/ethnicity, HIV status, and covariates. Twenty-seven percent of participants reported multifactorial discrimination. Adjusted models indicated that middle-aged men were more likely to report multifactorial discrimination compared to older adult men. Racial/ethnic minorities were more likely to report multifactorial discrimination compared to non-Hispanic white participants. These same patterns emerged among the sub-sample of participants living with HIV. To our knowledge, this is the first assessment of multifactorial discrimination in middle-aged and older MSM. Our findings support the deleterious association between multiple-marginalization and multifactorial discrimination. Multilevel interventions targeting interconnected experiences of stigma may improve the health of MSM in transition to older age.
Collapse
Affiliation(s)
- Steven P. Meanley
- University of Pennsylvania School of Nursing, Department of Family and Community Health, Philadelphia, PA
| | - Michael W. Plankey
- Georgetown University Department of Medicine, Division of Infectious Diseases, Washington, DC
| | - Derrick D. Matthews
- University of Pittsburgh Graduate School of Public Health, Department of Infectious Diseases and Microbiology, Pittsburgh, PA
| | - Mary E. Hawk
- University of Pittsburgh Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, PA
| | - James E. Egan
- University of Pittsburgh Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, PA
| | - Linda A. Teplin
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL
| | - Steven J. Shoptaw
- University of California – Los Angeles, Department of Family Medicine and Psychiatry and Biobehavioral Sciences, Los Angeles, CA
| | - Pamela J. Surkan
- Johns Hopkins University Bloomberg School of Public Health, Department of International Health, Baltimore, MD
| | - Ron D. Stall
- University of Pittsburgh Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, PA
| |
Collapse
|
41
|
Flatt JD, Cicero EC, Lambrou NH, Wharton W, Anderson JG, Bouldin ED, McGuire LC, Taylor CA. Subjective cognitive decline higher among sexual and gender minorities in the United States, 2015-2018. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12197. [PMID: 34337136 PMCID: PMC8319657 DOI: 10.1002/trc2.12197] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/25/2021] [Accepted: 06/20/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Subjective cognitive decline (SCD) represents self-reported problems with memory, a possible early sign of dementia. Little is known about SCD among sexual and gender minority (SGM) adults who identify as lesbian, gay, bisexual, and/or transgender or gender non-binary. METHODS Data were weighted to represent population estimates from 25 states' 2015-2018 Behavioral Risk Factor Surveillance System to describe SCD in adults ≥45 years by SGM status. Logistic regression tested associations between demographic and health conditions. RESULTS SCD prevalence was higher in SGM (15.7%; 95% confidence interval [CI]:13.1-18.2) than in non-SGM adults (10.5%; 95% CI:10.1-10.9; P < .0001). SGM adults with SCD were also more likely to report functional limitations due to SCD than non-SGM adults with SCD, 60.8% versus 47.8%, P = .0048. Differences in SCD by SGM status were attenuated after accounting for depression. DISCUSSION Higher prevalence of SCD in SGM adults highlights the importance of ensuring inclusive screenings, interventions, care services, and resources for SGM adults.
Collapse
Affiliation(s)
- Jason D. Flatt
- School of Public HealthUniversity of Nevada Las VegasLas VegasNevadaUSA
| | - Ethan C. Cicero
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgiaUSA
| | - Nickolas H. Lambrou
- Department of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Whitney Wharton
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgiaUSA
| | | | - Erin D. Bouldin
- Division of Population HealthNational Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
- Department of Health and Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Lisa C. McGuire
- Division of Population HealthNational Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Christopher A. Taylor
- Division of Population HealthNational Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| |
Collapse
|
42
|
Bertoncelli Tanaka M, Sahota K, Burn J, Falconer A, Winkler M, Ahmed HU, Rashid TG. Prostate cancer in transgender women: what does a urologist need to know? BJU Int 2021; 129:113-122. [PMID: 34157213 DOI: 10.1111/bju.15521] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/29/2021] [Accepted: 06/18/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review of the existing literature, current guidelines and standard of practice related to prostate cancer in transgender women, as the transgender population share many of the same healthcare needs as their cisgender counterparts, but may have additional specialist needs. MATERIALS AND METHODS We performed a non-systematic review of the literature, current guidelines and standard of practice related to prostate cancer in transgender women. RESULTS Our search revealed 10 case reports of prostate cancer in transgender women, four specialist opinion papers, six cohort studies, and four systematic reviews. The information in these publications were assimilated to produce a review of prostate cancer in transgender women. CONCLUSION The risk of prostate cancer in transgender women who are not on gender-affirming hormone therapy (GAHT) or who have not had gender-affirming surgery (GAS) and gender non-conforming individuals (who may never commence GAHT or have GAS) is the same as that in the cis male population. In these patients, healthcare professionals need to be able to discuss screening, diagnostic and treatment options considering future wishes for gender-affirming treatment. Prostate cancer incidence in transgender women on GAHT or following GAS is lower than age-matched cis-male counterparts, but diagnosis and treatment is more nuanced. The present review discusses the existing literature about development and incidence of prostate cancer in this population, and makes recommendations about screening, the usefulness of diagnostic tools e.g. prostate-specific antigen and magnetic resonance imaging, and considerations when formulating treatment. Potential directions for future research are discussed, which will hopefully lead to development of robust evidence-based guidelines for the diagnosis and management of prostate cancer in transgender women.
Collapse
Affiliation(s)
- Mariana Bertoncelli Tanaka
- Imperial Urology, Division of Surgery, Cancer and Cardiovascular Medicine, Imperial College Healthcare NHS Trust, London, UK.,Imperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | | | - James Burn
- Imperial Urology, Division of Surgery, Cancer and Cardiovascular Medicine, Imperial College Healthcare NHS Trust, London, UK.,Radiology Department, Imperial College Healthcare NHS Trust, London, UK
| | - Alison Falconer
- Imperial Urology, Division of Surgery, Cancer and Cardiovascular Medicine, Imperial College Healthcare NHS Trust, London, UK.,Radiotherapy Department, Imperial College Healthcare NHS Trust, London, UK
| | - Mathias Winkler
- Imperial Urology, Division of Surgery, Cancer and Cardiovascular Medicine, Imperial College Healthcare NHS Trust, London, UK.,Imperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Hashim U Ahmed
- Imperial Urology, Division of Surgery, Cancer and Cardiovascular Medicine, Imperial College Healthcare NHS Trust, London, UK.,Imperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Tina G Rashid
- Imperial Urology, Division of Surgery, Cancer and Cardiovascular Medicine, Imperial College Healthcare NHS Trust, London, UK
| | | |
Collapse
|
43
|
Hobaica S, Szkody E, Owens SA, Boland JK, Washburn JJ, Bell DJ. Mental health concerns and barriers to care among future clinical psychologists. J Clin Psychol 2021; 77:2473-2490. [PMID: 34125968 DOI: 10.1002/jclp.23198] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/20/2021] [Accepted: 05/30/2021] [Indexed: 11/06/2022]
Abstract
Few studies have examined the mental health of clinical psychology doctoral students, a unique group given their education and training in psychopathology, assessment, and intervention. Students (N = 912) completed an online survey assessing demographics, mental health, mental healthcare utilization, and barriers to care during graduate school. Nearly 25% of participants reported moderate to severe symptoms of anxiety, 20% reported moderate to severe symptoms of depression or suicidal intent (SI), and more than 10% reported a high risk of alcohol abuse or moderate to severe drug use during graduate school. In comparison to peers, ethnic minority and lesbian, gay, bisexual, transgender, and queer (LGBTQ+) participants reported more symptoms of depression and SI. LGBTQ+ participants reported more nonsuicidal self-injury and drug use. Participants also experienced significant barriers to receiving mental healthcare (e.g., financial difficulties, limited availability, insufficient time). Leadership is encouraged to prioritize the mental health of clinical psychology doctoral students, which may have implications on their service provision.
Collapse
Affiliation(s)
- Steven Hobaica
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Erica Szkody
- Department of Psychology, Mississippi State University, Starkville, Mississippi, USA
| | - Sarah A Owens
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer K Boland
- Department of Psychology and Philosophy, Sam Houston State University, Huntsville, Texas, USA
| | - Jason J Washburn
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Debora J Bell
- Department of Psychology, University of Missouri, Columbia, Missouri, USA
| |
Collapse
|
44
|
Expanding sexual and gender minority research in movement disorders: More than awareness and acceptance. Parkinsonism Relat Disord 2021; 87:162-165. [PMID: 34088617 DOI: 10.1016/j.parkreldis.2021.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/10/2021] [Accepted: 05/21/2021] [Indexed: 11/23/2022]
Abstract
Culturally competent and inclusive care is slowly becoming the standard throughout healthcare institutions. Awareness, acceptance, and inclusion of the sexual and gender minority (SGM) groups in medicine and neurology are progressing. Research in SGM health, although increasing, remains remarkably scant in parkinsonism and other movement disorders, a community whose patient population is on the rise. Most SGM health research in movement disorders only focuses on the symptoms associated with infection by the human immunodeficiency virus and the acquired immunodeficiency syndrome. Multiple clinical and epidemiological research questions remain unaddressed when considering the intersection of movement disorders and SGM health. In this article, we highlight gaps in the care of SGM individuals with movement disorders. First, the prevalence and phenomenology of movement disorders could be different, considering the different rates of risk factors and the use of gender-affirming hormones. Also, the effect of creating a safe environment in healthcare institutions to disclose sexual orientation and gender identity on seeking care, access to resources, and quality of services remains unknown. Moreover, many individuals with movement disorders would require services from multidisciplinary teams or long-term care facilities, which might not consider the needs of SGM patients in their models of care. Last, the effect of social isolation and self-perception (or misperceptions) in the SGM populations on the non-motor and motor symptoms of movement disorders and the treatment plans is not understood.
Collapse
|
45
|
Vale MT, Bisconti TL. Age Differences in Sexual Minority Stress and the Importance of Friendship in Later Life. Clin Gerontol 2021; 44:235-248. [PMID: 33143546 DOI: 10.1080/07317115.2020.1836107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study examined whether younger and middle-aged and older sexual minorities (YSM, MAOSM) experience minority stress differently in relation to social support and depressive symptomatology. METHODS Cross-sectional data from 238 sexual minorities (18-80; M = 40.93) comprised the sample, who were strategically separated into cohorts. Group difference and regression methods were used to examine differences in minority stress between groups and the relationships between minority stress-social support-depressive symptomatology within groups. RESULTS MAOSM had greater outness and lower IH. Additionally, outness and IH were the best predictors for the MAOSM and YSM group, respectively. MAOSM indicated better adaption to minority stresses, highlighting the importance of friend support as a protective mechanism. CONCLUSIONS The minority stress-depressive symptomatology is mitigated by friend support in MAOSM. CLINICAL IMPLICATIONS OSM and YSM demonstrate different susceptibility of minority stress on depressive symptomatology, with outness being a stronger indicator in MAOSM and IH being a stronger predictor in YSM. Social support does not work uniformly in different cohorts; however, multiple sources (i.e., family, friends) should be discussed with clients. Clinicians should treat cohort as one of the defining features of a sexual minority's lifelong experience with minority stress.
Collapse
Affiliation(s)
- Michael T Vale
- Department of Psychology, University of Akron, Akron, Ohio, USA
| | - Toni L Bisconti
- Department of Psychology, University of Akron, Akron, Ohio, USA
| |
Collapse
|
46
|
Vale MT, Bisconti TL. Minority Stress and Relationship Well-Being in Sexual Minorities: The Varying Role of Outness on Relationship and Sexual Satisfaction. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 33:297-311. [PMID: 38595746 PMCID: PMC10903706 DOI: 10.1080/19317611.2021.1909684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/13/2021] [Accepted: 03/23/2021] [Indexed: 04/11/2024]
Abstract
Objectives: Empirical inquiry has targeted how same-sex couples grapple with unique stressors in their romantic relationships. Meta-analyses demonstrate that the adverse link between minority stress and sexual and relationship well-being is contingent on the type of stressor and relationship component. Methods: We conducted a cross sectional study examining a sample of 238 individuals currently in same-sex relationships. Results: Outness predicted relationship satisfaction, sexual satisfaction, and sexual dissatisfaction relative to other stressors, and depressive symptomatology mediated the minority stressors and relationship well-being associations. Conclusions: The current findings offer practical applications for practitioners working with sexual minority clients and researchers who continue to reveal the boundaries in the minority stress process.
Collapse
Affiliation(s)
- Michael T. Vale
- Department of Psychology, University of Akron, Akron, OH, USA
| | | |
Collapse
|
47
|
Meanley S, Haberlen SA, Okafor CN, Brown A, Brennan-Ing M, Ware D, Egan JE, Teplin LA, Bolan RK, Friedman MR, Plankey MW. Lifetime Exposure to Conversion Therapy and Psychosocial Health Among Midlife and Older Adult Men Who Have Sex With Men. THE GERONTOLOGIST 2021; 60:1291-1302. [PMID: 32556123 DOI: 10.1093/geront/gnaa069] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Conversion therapies to minimize same-sex attractions are classified as a dangerous practice by numerous scientific institutions in the United States. These practices may contribute to poor long-term psychosocial health, thereby interrupting processes of healthy aging. Few studies have examined psychosocial differences between persons with and without prior experiences of conversion therapy. We assessed associations between prior conversion therapy experiences and psychosocial health among midlife and older men who have sex with men (MSM; age 40+ years). RESEARCH DESIGN AND METHODS Participants included a multicity sample of MSM (N = 1,156) enrolled in the Multicenter AIDS Cohort Study who completed health surveys (2016-2019) as part of their biannual study visits. Using multivariable regressions, we investigated the associations of prior conversion therapy with current depressive symptoms, internalized homophobia, post-traumatic stress, and cumulative psychosocial conditions. Using a trait-level measure (e.g., life purpose and perseverance), we tested whether resilience moderated these associations. RESULTS The full sample was predominantly non-Hispanic white with a mean age of 62.6 years. Fifteen percent of men (n = 171/1,156) reported prior conversion therapy. In multivariable models, men exposed to conversion therapy were more likely to have depressive symptoms and above-average internalized homophobia. Men exposed to conversion therapy had 2-2.5 times the odds of reporting 1 and ≥2 psychosocial conditions, respectively, compared with those who reported 0 conditions. Resilience did not moderate these associations. DISCUSSION AND IMPLICATIONS Conversion therapies are nonaffirming social stressors for MSM and may compromise critical psychosocial aspects of healthy aging among MSM.
Collapse
Affiliation(s)
- Steven Meanley
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia.,Research Education Institute for Diverse Scholars, Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut
| | - Sabina A Haberlen
- Department of Epidemiology, John Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Chukwuemeka N Okafor
- Department of Public Health, Baylor University Robbins College of Health and Human Services, Waco, Texas
| | - Andre Brown
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, New York City, New York
| | - Deanna Ware
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia
| | - James E Egan
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Linda A Teplin
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Mackey R Friedman
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Michael W Plankey
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia
| |
Collapse
|
48
|
Gutman SA, Precin P, LaForest ML, Chu A, Diaz M, Engel R, Epino K, Gotlieb R, Hart L, Plaus N, Xing S, Zimmer A. The Association between LGBTQIA+ Self-Identification and Factors Facilitating Homelessness: A Scoping Review of the Occupational Therapy Peer-Reviewed Literature. Occup Ther Health Care 2021; 35:138-181. [PMID: 33761821 DOI: 10.1080/07380577.2021.1901171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The purpose of this paper was to perform a scoping review examining the occupational therapy peer-reviewed literature regarding the LGBTQIA+ community to (a) determine what types of scholarship have been generated and (b) whether the association between LGBTQIA+ self-identification and homelessness has been identified and addressed in occupational therapy practice. A database search of seven peer-reviewed, health care publication indexes, with 19 key search terms was performed. The database search targeted articles published prior to January 2020. Fifty-three articles were identified within the occupational therapy literature and addressing the LGBTQIA+ community. The majority of this literature (n = 40) was exploratory studies through which researchers sought to better understand the unique needs of subgroups within the LGBTQIA+ community. Only three articles addressed the link between LGBTQIA+ self-identification and homelessness with no articles that addressed evaluation and intervention of the factors predisposing this population to homelessness. As occupational therapists have a unique skill set that could be used to help LGBTQIA+ community members transition from and remain free from homelessness, occupational therapy researchers must develop and assess interventions that target these factors. Occupational therapy educators should develop and assess curricular programming to heighten student comfort and preparedness in service delivery to this community.
Collapse
Affiliation(s)
- Sharon A Gutman
- Occupational Therapy Doctorate Program, Department of Rehabilitation and Movement Science, Rutgers University, Newark, New Jersey
| | - Pat Precin
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | | | - Alison Chu
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Maria Diaz
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Rena Engel
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Katarina Epino
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Rachel Gotlieb
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Lara Hart
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Nicole Plaus
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Susan Xing
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Alana Zimmer
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| |
Collapse
|
49
|
Wang YC, Chang SR, Miao NF. Health Status and Quality of Life of Middle-Aged and Older Taiwanese Sexual and Gender Minorities. J Nurs Scholarsh 2021; 53:369-377. [PMID: 33675160 DOI: 10.1111/jnu.12640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine the health status and quality of life of middle-aged and older sexual and gender minority adults in Taiwan. RESEARCH DESIGN AND METHODS A cross-sectional online survey was conducted between May and December 2019. A total of 535 self-identified lesbian, gay, bisexual, and transgender (LGBT) men and women ≥40 years of age were included in the final sample. An online questionnaire, which included the following three sections, was used to collect data in this study: (a) demographics, (b) the World Health Organization Quality of Life-Brief Taiwan version, and (c) physical and psychological health status. RESULTS Middle-aged and older Taiwanese LGBT adults who were single, were unemployed, and earned monthly incomes of <20,000 New Taiwan Dollars reported poorer quality of life. Participants with one or more physical or psychological health problems also reported poorer quality of life than those who had no health problems. In addition, singlehood, unemployment, and poor quality of life and health were positively associated with mental health issues. CONCLUSIONS It is important to attenuate health disparities and mitigate discrimination within Taiwanese society to enhance the quality of life and mental health of middle-aged and older Taiwanese LGBT adults. CLINICAL RELEVANCE Healthcare providers should be attuned to and knowledgeable about the health issues and specific healthcare needs of middle-aged and older LGBT adults, and they should also provide culturally competent care to reduce health disparities of the LGBT adults.
Collapse
Affiliation(s)
- Ya-Ching Wang
- Assistant Professor, School of Nursing, College of Medicine, National Taiwan University, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Shiow-Ru Chang
- Professor, School of Nursing, College of Medicine, National Taiwan University, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Nae-Fang Miao
- Associate Professor, Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
50
|
Lunn MR, Lubensky M, Hunt C, Flentje A, Capriotti MR, Sooksaman C, Harnett T, Currie D, Neal C, Obedin-Maliver J. A digital health research platform for community engagement, recruitment, and retention of sexual and gender minority adults in a national longitudinal cohort study--The PRIDE Study. J Am Med Inform Assoc 2021; 26:737-748. [PMID: 31162545 DOI: 10.1093/jamia/ocz082] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/02/2019] [Accepted: 05/10/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Sexual and gender minority (SGM) people are underrepresented in research. We sought to create a digital research platform to engage, recruit, and retain SGM people in a national, longitudinal, dynamic, cohort study (The PRIDE Study) of SGM health. MATERIALS AND METHODS We partnered with design and development firms and engaged SGM community members to build a secure, cloud-based, containerized, microservices-based, feature-rich, research platform. We created PRIDEnet, a national network of individuals and organizations that actively engaged SGM communities in all stages of health research. The PRIDE Study participants were recruited via in-person outreach, communications to PRIDEnet constituents, social media advertising, and word-of-mouth. Participants completed surveys to report demographic as well as physical, mental, and social health data. RESULTS We built a secure digital research platform with engaging functionality that engaged SGM people and recruited and retained 13 731 diverse individuals in 2 years. A sizeable sample of 3813 gender minority people (32.8% of cohort) were recruited despite representing only approximately 0.6% of the population. Participants engaged with the platform and completed comprehensive annual surveys- including questions about sensitive and stigmatizing topics- to create a data resource and join a cohort for ongoing SGM health research. DISCUSSION With an appealing digital platform, recruitment and engagement in online-only longitudinal cohort studies are possible. Participant engagement with meaningful, bidirectional relationships creates stakeholders and enables study cocreation. Research about effective tactics to engage, recruit, and maintain active participation from all communities is needed. CONCLUSION This digital research platform successfully recruited and engaged diverse SGM participants in The PRIDE Study. A similar approach may be successful in partnership with other underrepresented and vulnerable populations.
Collapse
Affiliation(s)
- Mitchell R Lunn
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.,The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, California, USA
| | - Micah Lubensky
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, California, USA.,Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Carolyn Hunt
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, California, USA.,Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Annesa Flentje
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, California, USA.,Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Matthew R Capriotti
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, California, USA.,Department of Psychology, San Jose State University, San Jose, California, USA
| | | | | | | | | | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, California, USA.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|