Current Trends in the study of Gender Norms and Health Behaviors

Associations of role, area deprivation index, and race with health behaviors and body mass index among localized prostate cancer patients and their partners

PURPOSE

To examine the associations of role (localized prostate cancer (PCa) patient vs. their intimate partner), area deprivation index (ADI-higher scores indicating higher neighborhood deprivation levels), and race (Black/African American (AA) vs. White) with health behaviors and body mass index (BMI) among PCa patients and partners. The behaviors include smoking, alcohol consumption, diet quality, sedentary behaviors, and physical activity (PA).

METHODS

This study used the baseline data collected in a clinical trial. Given the nested structure of the dyadic data, multi-level models were used.

RESULTS

Significant role-race interaction effects on smoking, ADI-race effects on alcohol consumption, and role-ADI effects on BMI were found. Meanwhile, patients smoked more cigarettes, decreased alcohol consumption, had less healthful diets, spent longer time watching TV, did fewer sedentary hobbies, had more confidence in PA, and had higher BMIs than their partners. High ADI was independently associated with lower odds of drinking alcohol, using computer/Internet, and doing non-walking PA, and higher BMI compared to low ADI controlling for role and race. Black/AA dyads had less smoking amount and alcohol consumption and higher sedentary time and BMI than White dyads when adjusted for role and ADI.

CONCLUSIONS

This study identified significant interaction and main effects of role, ADI, or race on health behaviors and BMI.

IMPLICATIONS FOR CANCER SURVIVORS

Future behavioral interventions should address divergent individual needs between patients and partners, social and neighborhood barriers, and cultural indicators of racial groups to promote healthful behaviors and improve the quality of survivorship for PCa patients and partners.

Family Factors and Gender Norms as Protective Factors Against Sexual Risk-Taking Behaviors Among Adolescent Girls in Southern Uganda

Adolescent girls and young women are at a higher risk for HIV infection stemming from barriers to accessing comprehensive sexual health education, unequal cultural, social, and economic statuses, limited access to education and health care services, and gender-based violence. This makes adolescent girls susceptible to high-risk sexual behaviors. This study examines the protective role of family, social support factors and gender norms against sexual risk-taking behaviors among secondary school adolescent girls in Uganda. Baseline data from the National Institute of Mental Health-funded Suubi4Her study were analyzed. A total of 1260 girls aged 14-17 years and enrolled in the first or second year of secondary school were recruited across 47 secondary schools. Hierarchical linear regression models were conducted to determine the role of family, social support factors and gender norms on sexual risk-taking behaviors. Results indicate that traditional gender norms, family care and relationships, and social support were all associated with lower levels of sexual risk-taking intentions-a proxy for engaging in sexual risk behaviors. Findings point to the need to develop family level support interventions to equip adolescent girls with adequate sexual health-related knowledge and skills to facilitate safer sexual practices and reduce high-risk sexual-taking behaviors, as they develop and transition into young adulthood.

Health consequences of structural sexism: Conceptual foundations, empirical evidence and priorities for future research

A nascent body of work has begun exploring the health consequences of structural sexism. This article provides an overview of the concept of structural sexism and an elaboration of the potential pathways connecting it to health. Next, it reviews existing measurement approaches and the current state of empirical evidence on the relationship between structural sexism and health in the United States. Finally, it highlights key priorities for future research, which include: expanding and refining measures, increasing public data availability, broadening the scope of inquiry to include a wider range of outcomes, exploring mechanisms, incorporating intersectionality, and applying a life course lens.

Emotional experiences and gender roles of men with fibromyalgia syndrome: a cross-cultural qualitative study

Introduction

Gender roles may impact men with fibromyalgia, causing a high number of negative emotional states and affective disorders. There are few studies that detect men's high emotional suffering. This study examined the emotional experience of men with fibromyalgia.

Methods

A qualitative cross-cultural study utilized inductive thematic analysis was performed at the Fibromyalgia and Chronic Fatigue Unit Santa Maria University Hospital in Spain, the Fibromyalgia and Chronic Fatigue Clinic at Mayo Clinic in the US, and volunteers from the Winneshiek County in the US A total of 17 participants, 10 men from Spain and 7 men from the US were included.

Results

Three themes related to feelings/emotions emerged: (1) psychological level; (2) social level; and (3) physical level. Men with fibromyalgia from Spain and the US experienced many negative emotions. Men often experience negative emotions that are worsened by common misunderstandings and social biases/stigma about their condition.

Conclusion/implications

A proper assessment of emotions when evaluating the global health of men with fibromyalgia as well as the provision of emotional support would improve their mental health and therefore their overall physical health. Emotional management should be incorporated into all treatment protocols for fibromyalgia, especially for men given the gender stigma. Health policies designed by legislators, policymakers, and support agencies must be accompanied by education in gender role concepts to improve the emotions of men with FMS. The mass media will be essential for the disclosure of the emotional suffering of male patients so that society might better understand them.

Community gender norms, mental health, and suicide ideation and attempts among older Japanese adults: a cross-sectional study

OBJECTIVES

Gender norms embedded in communities may restrict opportunities and harm the mental health of older adults, yet this phenomenon has received little attention. This study investigates the connection between older adults' perceptions of community gender norms and mental health and suicide-related outcomes.

DESIGN

Cross-sectional.

SETTING

This study analyzed data from the 2019 wave of the Japan Gerontological Evaluation Study.

PARTICIPANTS

In total, 25,937 participants aged 65 years or older in 61 municipalities.

MEASUREMENTS

Perceptions of community gender norms were assessed by the respondents' perceptions of the gender-differentiating language used by those around them such as "You should/should not do XXX, because you are a man/woman."

RESULTS

The prevalence of all mental health outcomes was higher among both men and women who perceived community gender norms as restrictive. These associations remained in fully adjusted multivariable analyses. Prevalence ratios for men were 1.36 [95% confidence interval: 1.13, 1.65] for psychological resistance to obtaining help, 1.85 [1.54, 2.23] for depressive symptoms, 1.99 [1.34, 2.96] for suicidal ideation, and 2.15 [1.21, 3.80] for suicide attempts. The corresponding figures for women were 1.39 [1.17, 1.65], 1.80 [1.55, 2.10], 2.13 [1.65, 2.74], 2.62 [1.78, 3.87]. There was a more pronounced association between perceiving community gender norms as restrictive and depressive symptoms and suicidal behaviors among those with nonconventional gender role attitudes compared to those with conventional attitudes.

CONCLUSIONS

Considering the effects of community gender norms, in addition to individual gender role attitudes, may be critical in designing effective public health interventions for improving mental health.

Beyond femininity or masculinity: gender typologies and healthy eating in early adulthood

PURPOSE

In the field of health sciences gender is often confused with biological sex (male/female) or reduced to a dichotomous classification (masculinity/femininity). The concepts of sex and gender interact with each other, but they are not equivalent. According to Sandra Bem four gender typologies can be established (androgynous, masculine, feminine and undifferentiated). A relationship has been shown to exist between gender and health. Yet, there is little evidence as to the relationship between gender typologies and adherence to the Mediterranean diet. The aim of this research is to evaluate the association between Bem's gender typologies and adherence to the Mediterranean diet.

METHODS

Mediterranean Diet Adherence Screener (MEDAS) and Bem's gender typologies were the main variables. Sex, age, socioeconomic status (SES), body mass index (BMI) and obesity were analyzed as covariates.

RESULTS

Multilevel multivariate analysis showed that androgynous typology was associated with increased adherence to Mediterranean diet (β = 0.46 (SE 0.21), p = 0.033), adjusting by covariates, in a university population in Spain. Moreover, this was not the case with masculinity or femininity typologies.

CONCLUSION

Thus, the results of this study suggest (1) that androgynous typology is not only associated with better mental health but also with healthy/healthier lifestyles, and (2) the complexity of the relationship between sex-gender and health would advise researchers avoid dichotomies such as male/female or masculinity/femininity.

Structural Sexism and Preventive Health Care Use in the United States

Preventive health care use can reduce the risk of disease, disability, and death. Thus, it is critical to understand factors that shape preventive care use. A growing body of research identifies structural sexism as a driver of population health, but it remains unknown if structural sexism is linked to preventive care use and, if so, whether the relationship differs for women and men. Gender performance and gendered power and resource allocation perspectives lead to competing hypotheses regarding these questions. This study explores the relationship between structural sexism and preventive care in gender-stratified, multilevel models that combine data from the Behavioral Risk Factor Surveillance System with state-level data (N = 425,454). We find that in states with more structural sexism, both men and women were less likely to seek preventive care. These findings support the gender performance hypothesis for men and the gendered power and resource allocation hypothesis for men and women.

Transforming masculine norms to improve men's contraceptive acceptance: results from a pilot intervention with men in western Kenya

Men's adherence to constraining male gender norms can lead them to resist contraceptive use. Very few interventions have attempted to transform masculine norms to encourage greater contraceptive acceptance and gender equality. We designed and evaluated a small-scale community-based intervention targeting the masculine norms tied to contraceptive resistance among partnered men (N = 150) in two western Kenya communities (intervention vs. control). Pre-post survey data fit to linear and logistic regression models evaluated differences in post-intervention outcomes, accounting for pre-intervention differences. Intervention participation was associated with increases in contraceptive acceptance scores (adjusted coefficient (aβ) 1.04; 95% confidence interval (CI) 0.16, 1.91; p = 0.02) and contraceptive knowledge scores (aβ 0.22; 95% CI 0.13, 0.31; p < 0.001) and with contraceptive discussions with one's partner (adjusted Odds Ratio (aOR) 3.96; 95% CI 1.21, 12.94; p = 0.02) and with others (aOR 6.13; 95% CI 2.39, 15.73; p < 0.001). The intervention was not associated with contraceptive behavioural intention or use. Our findings demonstrate the promise of a masculinity-driven intervention on increasing men's contraceptive acceptance and positive contraceptive involvement. A larger randomised trial is needed to test the effectiveness of the intervention among men as well as among couples.

Men's Health as a Telehealth Strategy

Although telehealth seems to be an emerging technological marvel, it has been used in some way for many years now. Moreover, although the coronavirus disease 2019 pandemic wreaked horrific and tragic havoc around the world, it brought with it a new era of patient-centered care that forced many reluctant providers to adopt its use. With newer technologies at our fingertips and on the horizon and an increased number of qualified men's health specialists coming to the fore, men's telehealth will increasingly continue to provide a viable option for men seeking care and treatment.

Gender inequities in women's access to maternal health care utilisation in Zambia: a qualitative analysis

BACKGROUND

The role of gender inequities in women's ability to access maternal health care has mainly been analysed from either women's or men's perspective only. In this article, we explore the role of gender inequities in maternal health care utilisation from both men's and women's perspectives.

METHODS

Thirty-six interviews were conducted with reproductive age women (n = 24), and men whose wives/partners gave birth within the last three years prior to our study in Zambia (n = 12). Our study sought to improve understanding of the normative environment in which women and men make decisions on maternal health care utilisation in Zambia.

RESULTS

We found that men and women had different expectations regarding their gender roles in maternal health care utilisation, which created inequities reinforced by societal norms and traditions. Men make most household decisions including those related to reproductive health and they often have the major say in access to maternal health services despite not having holistic maternal health information which creates challenges in maternal health care utilisation.

CONCLUSION

The study highlights the need for maternal health care utilisation decisions to be made by both men and women and that men should be fully involved in maternal health care from pregnancy until after child birth. Further, there is urgent need for concerted and sustained efforts to change traditional norms that reinforce these inequities and affect maternal health care utilisation if Zambia is to meet Sustainable Development Goal-3.1.

[A gendered perspective of information behaviors, its drivers, and barriers : Results of an online survey of a sample stratified for the German population]

BACKGROUND

The gender perspective is an essential level of effective health communication approaches. Against the background of the gender perspective as an essential level of effective health communication approaches, we focus on health-related information behaviors. Complementary to information seeking, information avoidance is included. Both forms of information behavior are described in gender-specific ways, and their predictors are identified using a resource-centered approach covering the individual's health, empowerment, involvement, and social support.

METHOD

An online survey of a sample stratified for the German population (N = 3000) was conducted. The two modes of information behavior as well as their theoretically derived predictors were assessed. In addition to descriptive analyses, blockwise regression analyses were used to identify gender-specific predictors of information seeking and avoidance.

RESULTS

Information seeking occurs more frequently than information avoidance. Both differ only slightly between men and women and showed the strongest correlations with the respondents' involvement. For information seeking, coping resources are also a significant predictor, while information avoidance is associated with psychological well-being and social support. Similar patterns of association emerge across genders.

CONCLUSION

Across genders, it is evident that health communication measures should strengthen the involvement of the population and their coping resources to promote information seeking and counteract information avoidance. Additionally, the findings revealed that avoiders should be more focused as one of the main target groups of health communication.

Conformity to Masculinity Norms and Mental Health Outcomes Among Gay, Bisexual, Trans, Two-Spirit, and Queer Men and Non-Binary Individuals

Homophobia and biphobia negatively impact the mental health of gay, bisexual, trans, Two-Spirit, and queer men and non-binary individuals (GBT2Q) and sexual and gender minority men, but little is known about the impact of gender-related oppression. The current study examines the impact of pressure to conform to masculine norms in Canada-based GBT2Q individuals. Specifically, the associations between (a) gender expression and pressure to be masculine and (b) pressure to be masculine and depression, anxiety, and self-rated mental health were investigated. Drawing from an online national cross-sectional survey of 8,977 GBT2Q individuals and sexual and gender minority men living in Canada aged 15 years or older, 56.4% (n = 5,067) of respondents reported experiencing pressure to conform to masculine norms. Respondents were more likely to report masculine pressure if they were younger than 30 years, described their gender expression as fluid, identified their sexuality as queer, were an ethnoracial minority, and were trans. Pressure to be masculine was associated with increased odds of depression, anxiety, and reporting poor or fair mental health. The current study provides evidence of the detrimental impact of pressure to conform to masculine norms on the mental health of gay, bisexual, trans, Two-Spirit, and queer men and non-binary peoples.

Longitudinal and bidirectional associations between posttraumatic stress disorder and emotional support among disaster-affected men and women

Research has demonstrated a negative association between social support and symptoms of posttraumatic stress disorder (PTSD). This has been interpreted as a protective influence of social support against the development of posttraumatic stress symptoms (PTSS). Research on the opposite association is more limited, but findings suggest that PTSS have a negative impact on social support. There is conflicting evidence that these effects are moderated by gender. Few studies have assessed both associations and gender moderation in a postdisaster context. We examined the longitudinal and bidirectional effects of emotional support and PTSS and whether gender moderates these effects among U.S. survivors of the 2017-2018 season. Participants (N = 1,347) were assessed at four time points over 1 year. Bidirectional effects were assessed using cross-lagged, autoregressive analyses with the combined sample (Model 1) and grouped by gender (Model 2) to assess gender moderation. The results supported small bidirectional negative effects of social support and PTSS on one another from one assessment point (e.g. Wave 1) to the subsequent point (e.g., Wave 2) for all waves, βs = -.07-.15, p < .001-p = .040. Multigroup analyses suggested the effects were not significantly different by gender. Overall, the results suggest that social support and PTSS may mutually diminish one another. Such effects may result in a positive or negative cascade wherein high PTSS may lead to lower social support and, therefore, even higher PTSS and vice versa. These findings support the importance of including social support in interventions to promote PTSS prevention and recovery.

Public conformism with health regulation is crumbling as COVID-19 becomes a chronic threat: Repeated Cross-sectional Studies

BACKGROUND

The purpose of this study is to analyze the long terms trends in public attitudes toward the COVID-19 pandemic and compliance with self-quarantine regulations.

METHODS

Repeated cross-sectional studies looking into data collected from nationally representative samples (N = 2568) of the adult population in Israel at five points in time representing the five morbidity waves of the COVID-19 pandemic. This study examined public trust in Israeli health regulations, levels of public panic, feelings of personal worry, and compliance with health regulations, specifically self-quarantine.

RESULTS

Public trust in health regulations in January 2022 is at an all-time low (25%) compared to the maximum value of nearly 75% measured in March 2020. While reported worry is steadily reducing, the perception of public panic is increasing. In earlier rounds, public compliance with self-quarantine was reported close to 100%; however, it has dropped to 38% by January 2022 when compensation is not assumed. Regression analysis suggests that trust is a major predictor of compliance with health regulations.

CONCLUSIONS

The "fifth wave" of the COVID-19 pandemic brought about an all-time low in public trust in health regulations. The Israeli public, normally a highly compliant one, is showing signs of crumbling conformity.

Muscle-Building Exercise and Weapon Carrying and Physical Fighting Among U.S. Adolescent Boys

This study aimed to determine the association between engagement in muscle-building exercise and weapon carrying and physical fighting among adolescent boys. Cross-sectional data from the 2019 Youth Risk Behavior Survey (U.S.) were analyzed (N = 4120). Muscle-building exercise was assessed based on the number of days reported in the past 7 days, recategorized into four levels of engagement (no engagement [0 days], low engagement [1-2 days], moderate engagement [3-5 days], and high engagement [6-7 days]). Three forms of weapon carrying (general, on school grounds, gun carrying) and two forms of physical fighting (general, on school grounds) were assessed. Five logistic regression analyses with adjusted odds ratios (AOR) and 95% confidence intervals (CI) were used to determine the association between engagement in muscle-building exercise and weapon carrying and physical fighting, while adjusting for relevant demographic and control variables. Over 75% of participants reported engaging in muscle-building exercise. One in five (19.8%) participants reported any general weapon carrying in the past 30 days, 3.3% reported any weapon carrying at school in the past 30 days, 6.5% reported any gun carrying in the past 12 months, 28.0% reported any general physical fighting in the past 12 months, and 10.7% reported any physical fighting at school in the past 12 months. Logistic regressions showed that, compared to no engagement, participants who reported high engagement of muscle-building exercise had higher odds of general weapon carrying (AOR 2.18, 95% CI 1.54-3.07), gun carrying (AOR 2.12, 95% CI 1.23-3.64), and general physical fighting (AOR 2.07, 95% CI 1.53-2.79). These are novel findings that add to a growing literature related to engagement in muscularity-oriented behaviors among males. Prevention and intervention efforts are needed to ensure that adolescent boys engage in muscle-building exercise in ways that are not harmful and to reduce weapon carrying and physical fighting.

Sex-Specific Neurocognitive Impairment

This article explores sex-specific neurocognitive impairment. It first defines relevant terms such as gender and sex. Next, it describes the nature of the problem including under-representation of women and other gender and sexual minorities in neuroscience research, including cognitive studies. A biopsychosocial framework is employed to account for structural and social determinants of health in sex/gender-specific neurocognitive impairment. Issues in assessment including the use of gender/sex-specific normative data are also discussed. Lastly, the article covers the current state of research as it relates to sex/gender-specific neurocognitive impairment across a range of medical conditions including neurodegenerative diseases and coronavirus disease-2019.

Sex-Linked Biology and Gender-Related Research Is Essential to Advancing Hearing Health

There is robust evidence that sex (biological) and gender (behavioral/social) differences influence hearing loss risk and outcomes. These differences are noted for animals and humans-in the occurrence of hearing loss, hearing loss progression, and response to interventions. Nevertheless, many studies have not reported or disaggregated data by sex or gender. This article describes the influence of sex-linked biology (specifically sex-linked hormones) and gender on hearing and hearing interventions, including the role of sex-linked biology and gender in modifying the association between risk factors and hearing loss, and the effects of hearing loss on quality of life and functioning. Most prevalence studies indicate that hearing loss begins earlier and is more common and severe among men than women. Intrinsic sex-linked biological differences in the auditory system may account, in part, for the predominance of hearing loss in males. Sex- and gender-related differences in the effects of noise exposure or cardiovascular disease on the auditory system may help explain some of these differences in the prevalence of hearing loss. Further still, differences in hearing aid use and uptake, and the effects of hearing loss on health may also vary by sex and gender. Recognizing that sex-linked biology and gender are key determinants of hearing health, the present review concludes by emphasizing the importance of a well-developed research platform that proactively measures and assesses sex- and gender-related differences in hearing, including in understudied populations. Such research focus is necessary to advance the field of hearing science and benefit all members of society.

Developmental Trajectories of Self-, Other-, and Dual-Harm across Adolescence: The Role of Relationships with Peers and Teachers

INTRODUCTION

We investigated the longitudinal course of self-, other-, and dual-harm in adolescents, focusing on the infliction of physical injury on oneself, another person, or both parties, respectively. We examined the within-person transitions between these types of harm and whether relationships with peers and teachers predict individual harm trajectories.

METHODS

We used community-representative longitudinal data (N = 1,482; 52% male; 50% both parents born abroad). The participants self-reported self- and other-harm at 13, 15, 17, and 20 years. We assigned them to groups with self-, other-, dual- or no harm at specific assessments. Bullying victimization and relationship quality with classmates and teachers were assessed at 13 and 17. We estimated transition probabilities between the harm groups using latent Markov chain models.

RESULTS

At age 13, 3% of the sample engaged in dual-harm, 10% in self-harm only, and 7% in other-harm only. These percentages decreased in late adolescence. Initial dual-harm was often followed by sex-specific single-harm: most of the female participants transitioned to self-harm, and male participants to other-harm. Those in the initial dual-harm group were less likely to stop harming than those in the initial single-harm groups (p < 0.05). Adverse relationship experiences generally predicted harm. A positive teacher-student bond was associated with the cessation of single-harm.

CONCLUSION

Single- and dual-harm in the form of physical injury typically emerge by mid-adolescence. After this point, adolescents commonly maintain harm, especially those who have presented with dual-harm. Helping adolescents cope with adverse relationship experiences and creating opportunities for positive relationship experiences could address these harmful behaviors.

Sex and Gender and Allostatic Mechanisms of Cardiovascular Risk and Disease

Cardiovascular diseases are leading causes of mortality and morbidity in adults worldwide. Multiple studies suggest that there are clinically relevant sex differences in cardiovascular disease. Women and men differ substantially in terms of prevalence, presentation, management, and outcomes of cardiovascular disease. To date, however, little is known about why cardiovascular disease affects women and men differently. Because many studies do not differentiate the concept of sex and gender, it is sometimes difficult to discriminate sociocultural vs biological contributors that drive observed clinical differences. Female sex has some biological advantages in relation to cardiovascular disease, but many of these advantages seem to disappear as soon as women develop cardiovascular risk factors (eg, type 2 diabetes, hypertension, dyslipidemia). Furthermore, stress and allostatic load could play an important role in the relationship between sex/gender and cardiovascular diseases. In this narrative review, we argue that chronic stress and psychosocial factors might better encompass the patterns of allostatic load increases seen in women, while biological risk factors and unhealthy behaviours might be more important mechanisms that drive increased allostatic load in men. Indeed, men show allostatic load patterns that are more associated with impaired anthropometric, metabolic, and cardiovascular functioning and women have greater dysregulation in neuroendocrine and immune functioning. Thus gender-related factors might contribute to the pathogenesis of cardiovascular disease especially through stress mechanisms. It is important to continue to study the mechanisms by which gender influences chronic stress, because chronic stress could influence modifiable gendered factors to promote cardiovascular disease prevention.

Scarier than the flu shot? : The social determinants of shingles and influenza vaccinations among U.S. older adults

BACKGROUND

Although more than half of older adults receive the annual influenza vaccine (flu shot), only about one-third have ever been vaccinated for shingles. With this in mind, our study examines how the associations between sociodemographic characteristics, health behaviors, and vaccine uptake differ between these two viruses. In doing so, it also investigates whether the social predictors of shingles vaccination changed after the rollout of a new vaccine in 2017.

METHODS

Data come from the 2017 and 2020 waves of the Behavioral Risk Factor Surveillance System survey, using a subset of older adults aged 60-plus (N = 389,165). We use logistic regression models to test for associations between individual-level characteristics and vaccine uptake.

RESULTS

One, when compared to Whites, Black respondents had approximately 30 % lower odds of having received the annual influenza vaccine (Odds Ratios  [OR] = 0.72 [95 % CI 0.66-0.78] in 2017, and 0.66 [0.60-0.72] in 2020). For the shingles vaccine, these racial differences were starker (OR = 0.53 [0.48-0.59] in 2017, and OR = 0.55 [0.49-0.60] in 2020). Two, self-rated health was negatively associated with having received the influenza vaccine, but showed little relationship with shingles vaccination. Three, men were less likely than women to receive both vaccines in 2020 (OR = 0.88 [0.83-0.94] for influenza, and OR = 0.80 [0.75-0.85] for shingles). Four, older adults who abstained from alcohol were, generally, less likely to receive either vaccine, when compared to both moderate and heavy drinkers. Finally, we found that the release of a new shingles vaccine in 2017 (Shingrix) had little effect on vaccination prevalence or its social determinants.

CONCLUSION

The importance of social groups, health, and health behaviors on vaccination status may be disease-dependent. This study also provides possible guidance to health care providers and health organizations looking to increase vaccine uptake among older adults, which may have more urgency since the arrival of COVID-19.

A Comparison of Women's and Men's Online Information Seeking Behaviors about Gender-Related Health Information: A German Stratified Online Survey (Preprint)

BACKGROUND

Gender-sensitive approaches to health communication aim to integrate gender perspectives at all levels of communication, as an individual's biological sex and socially assigned gender identity have an impact on whether and how one acquires what type of health information. Due to the fast and low-cost opportunity to search for a wide range of information, the internet seems to be a particularly suitable place for gender-related health information about diseases of sex-specific organs and diseases where biological differences are associated with different health risks.

OBJECTIVE

This study aims to inform gender-related information provision and acquisition in 2 ways. The first objective was to provide a theory-driven analysis of web-based health information-seeking behavior (HISB) regarding gender-related issues. Therefore, the Planned Risk Information Seeking Model (PRISM), which is one of the most integrative models of HISB, was adapted and applied. Second, we asked for gender-specific motivational determinants of gender-related web-based HISB comparing the predictors in the groups of women and men.

METHODS

Data from a stratified web-based survey of the German population (N=3000) explained gender-related web-based HISB and influencing patterns comparing women and men. The applicability of PRISM to gender-related web-based HISB was tested using structural equation modeling and a multigroup comparison.

RESULTS

The results revealed PRISM as an effective framework for explaining gender-related web-based HISB. The model accounted for 28.8% of the variance in gender-related web-based HISB. Gender-related subjective norms provided the most crucial explanatory power, followed by perceived seeking control. The multigroup comparison revealed differences in the model's explanatory power and the relevance of predictors of gender-related web-based HISB. The share of explained variances of web-based HISB is higher in men than in women. For men, norms were a more relevant promoting factor, whereas web-based HISB of women was more strongly associated with perceived seeking control.

CONCLUSIONS

The results are crucial for gender-sensitive targeting strategies and suggest gender-related health information interventions that address gender-related subjective norms. Furthermore, programs (eg, web-based learning units) should be developed and offered to improve individuals' (perceived) abilities to perform web-based searches for health information, as those with higher control beliefs are more likely to access web-based information.

Gender inequality in source country modifies sex differences in stroke incidence in Canadian immigrants

Research suggests that gender inequality, measured using the gender inequality index (GII), influences stroke mortality in women compared to men. We examine how source country GII modifies the rate of ischemic stroke in women compared to men after immigration to Canada, a country with low gender inequality. We used linked health data and immigration records of 452,089, stroke-free immigrants aged 40-69 year who migrated from 123 countries. Over 15 years of follow-up, 5991 (1.3%) had an incident ischemic stroke. We demonstrate (a) a lower adjusted rate of stroke in women compared to men (hazard ratio 0.64; 95% CI 0.61-0.67); (b) that sex differences in stroke incidence were modified by source country GII, as the hazard of stroke in women vs. men attenuated by a factor of 1.06 for every 0.1 increase in the GII of the source country (P_sex*GII = 0.002); and (c) migration to a country with low GII attenuates the adverse effect of source country GII on sex differences in stroke incidence. Evaluating pathways through which source country gender inequality differentially influences stroke risk in immigrant women compared to men could help develop strategies to mitigate the effects of early-life gender inequality on stroke risk.

Associations between wives' and husbands' attitudes towards women's economic participation and depressive symptoms, poor subjective health, and unemployment status in married women: A Korean longitudinal study (2014–2020)

Introduction

Previous research has investigated the relationship between an individuals' gender role attitudes (GRAs) and their psychological health. We hypothesized that holding traditional GRAs or having a husband who holds traditional GRAs may adversely affect a woman's health.

Methods

Data were obtained from a nationally representative longitudinal survey. Women's negative attitudes towards women's economic participation and husbands' negative attitudes towards their wives' economic participation were measured. The associations between the two and depressive symptoms, poor subjective health, and unemployment status in married women was estimated using a generalised estimating equation. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated.

Results

Women's negative attitudes towards women's economic participation was associated with depressive symptoms (OR [95% CI]: 1.19 [1.09–1.31]), poor subjective health (1.14 [1.04–1.25]) and unemployment status (1.10 [1.05–1.15]) in married women. In addition, there were significant associations between husbands' negative attitudes towards their wives working and depressive symptoms (1.41 [1.23–1.60]), poor subjective health (1.69 [1.48–1.92]), and unemployment (1.80 [1.69–1.92]) in their wives. The effect was strongest when both wives and their husbands have negative attitudes. In addition, the models considering cumulative years of negative attitudes showed that wives holding negative attitudes towards women's economic participation for 3 years or more was associated with depressive symptoms (1.70 [1.42–2.04]), poor subjective health (1.28 [1.04–1.57]), and unemployment status (1.39 [1.22–1.58]). Similarly, husbands' holding 3 years or more of negative attitudes towards their wives' economic participation was associated with depressive symptoms (1.32 [1.02–1.72])), poor subjective health (1.81 [1.40–2.35]), and unemployment status (9.02 [7.97–10.21]) in their wives.

Conclusions

Our results show that one's own or one's husband's attitude towards women's economic participation affects not only the employment status of married women but also their mental and subjective health. Policymakers should implement policies that encourage positive attitudes towards women's economic activities.

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Traditional gender role attitudes increase the odds of depressive symptoms.

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Traditional gender role attitudes increase the odds of poor subjective health.

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Husbands who oppose their wives working increase their wives' risk for depression.

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Husbands who oppose their wives working increase their wives' risk for poor health.

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A longer duration of traditional or negative attitudes increases the impact.

Analysis of the anomie behavior and external motivation of college students in sports: A cross-sectional study among gender

Objective

In the context of Healthy China, the effect of external motivation on sports anomie behavior from the perspective of gender among Chinese college students was investigated.

Participants

In total, 2,340 college students were involved in this study.

Methods

The self-made scales were used, which were about anomie behavior and external motivation in sports. The independent sample T-test was used to compare the sports anomie behavior between male and female students. Then, multiple linear regression analysis was adopted to examine the effects of external motivation on sports anomie behavior.

Results

Girls’ sports anomie behavior was lower than boys. There were significant gender differences in honor motivation, obedience motivation, and economic motivation; girls’ motivations were lower than boys. The academic motivation was negatively correlated with the sports anomie behavior of college students of both genders. The economic motivation was positively correlated with their sports anomie behavior. The honor motivation was negatively correlated with the sports anomie behavior of female college students.

Conclusion

Female college students’ sports anomie behavior and external motivation are lower than that of male college students. External motivation had a significant influence on college students’ sports anomie behavior.

Take the Day Off: Examining the Sick Role for Chronic Back Pain by Race and Gender

Research has largely overlooked the public’s willingness to validate entrance to the sick role for individuals experiencing chronic pain. To fill this gap, we conducted a survey experiment to assess how race, gender, and their intersection impact (1) the legitimation of missing work due to pain and (2) recommendations for help seeking, examining the role of both respondents and vignette characters. We find that respondent characteristics are associated with perceived acceptability of missing work due to pain, and both respondent and vignette characteristics are associated with help-seeking endorsements. White females are least likely to view pain as an acceptable excuse to miss work but are most likely to endorse help-seeking measures, while black women are recommended the most treatments for pain. We theorize how results provide evidence to counter assumptions of objectivity and linearity of the sick role and how gender and race influence the social response to pain.

“Broken”—How Identities as Women, Mothers and Partners Are Intertwined with the Experience of Living with and Seeking Treatment for Pelvic Organ Prolapse

Pelvic Organ Prolapse (POP) occurs when one or more pelvic organs descend into or through the vaginal opening, significantly impacting physical and mental health. POP affects the female reproductive tract and, overwhelmingly, people who identify as women. However, little research has examined the impact of gendered expectations on women’s treatment-seeking for POP and their decision-making around surgery for POP. To address this gap, we conducted semi-structured interviews with 26 women seeking surgery for POP in Alberta, Canada. Data were analyzed from a gender-based lens, using the Framework Method. Participants reported the need to balance their identities as women, partners, and mothers in their pursuit of treatment and faced many barriers to treatment related to their gendered responsibilities. Findings highlight the gendered experiences of prolapse in the context of healthcare needs and can inform policies and practices which promote more equitable access to prolapse treatment.

The influence of social support on self-care is mediated by self-efficacy and depression in chronic illness: key findings from the 'SODALITY' observational study

Objectives: Family is a major source of support for older chronically-ill patients and known to be associated with better self-care. Depression and self-care self-efficacy are associated with healthy behaviors and thus may serve as mechanisms by which family support influences self-care.We explored depression and self-care self-efficacy as mediators of the relationship between perceived family support and self-care.Methods: Five hundred forty-one older adults with multiple chronic illnesses were recruited from outpatients and community settings. Three structural equation models (SEM) were fit on cross-sectional data. We measured perceived family support (subscale of the Multidimensional Scale of Perceived Social Support, scores range 1-7), depression (Patient Health Questionnaire, scores range 0-27), selfcare self-efficacy (Self-Care Self Efficacy Scale, standardized scores range 0-100), and self-care maintenance, monitoring, and management (Self-care of Chronic Illness Inventory, standardized scores range 0-100).Results: Participants (mean age = 76.6±7.3 yrs) were predominantly females (55.6%). In the full sample, depression and self-care self-efficacy mediated the relationship between perceived family support and self-care; in the gender-stratified SEM, men's depression was no longer a significant mediator. Depression and self-care self-efficacy were significant mediators of the relation between perceived family support and self-care.Conclusion: In older chronically-ill patients, interventions addressing perceived family support may facilitate a rapid improvement in self-care self-efficacy and a decrease in depressive symptoms, particularly among women.

Age at first exposure to violence and later mental health outcomes: A sex-disaggregated, multi-country analysis in sub-Saharan Africa

BACKGROUND

A growing body of research has begun examining the relationship between a child's age at first exposure to violence and outcomes of mental wellbeing, though no studies have assessed these relationships in the sub-Saharan African (SSA) region.

OBJECTIVE

Given known gender and sex differences in violence exposure and mental health symptomology, this study conducts a multi-country, gender-stratified analysis of the relationship between age at first incident of physical violence and outcomes of wellbeing in SSA.

PARTICIPANTS AND SETTING

This study uses data from the Violence Against Children Surveys on 13-24-year-old males and females in five SSA countries (Kenya (2010), Malawi (2013), Nigeria (2014), Tanzania (2009), and Uganda (2015)).

METHODS

The predictor of interest is a categorical variable indicating whether a respondent's first exposure to physical violence took place from 0 to 5, 6-11, 12 and older, or never. Outcomes of interest include: sadness, anxiety, suicide ideation, smoking, drug use, and alcohol use. Employing both country-specific and pooled data, gender-stratified, multiple logistic regressions are used to estimate the effect of age at first exposure to physical violence on the six outcomes of interest.

RESULTS

Findings show significant variation across countries in age at first exposure to physical violence. For females, findings reveal no association between age at first exposure and outcomes of wellbeing; all periods were equally associated with poor outcomes. For males, results show increased likelihood of anxiety, suicide ideation, and alcohol use when the first violence exposure occurred from 0 to 5 years.

CONCLUSIONS

This study advances the literature on gender and sex differences in mental health symptomology, suggesting that boys and girls may exhibit different symptomology in response to comparable exposures to violence.

A cross-sectional study of disability and quality of life in patients with low back pain: Focus on sex and gender

BACKGROUND

Sex and gender affect responses to pain, but little is known about disability and quality of life.

OBJECTIVES

To investigate the effects of sex and gender on disability and health-related quality of life (HRQOL) in patients with low back pain.

METHODS

Ninety-three patients with low back pain were included in this cross-sectional survey study. Disability, HRQOL and gender identity were respectively assessed with the Oswestry Disability Index, Short Form-36 and Bem Sex Role Inventory. The participants were classified into four gender role orientations (masculinity, femininity, androgyny and undifferentiated). One-way analysis of variance was used to analyze both the sex and the gender role orientation.

RESULTS

Females had higher disability than males (p< 0.05), but in gender identity, no significant difference was found. Seven domains of HRQOL were lower than the healthy norms. Males experienced greater impacts than females on vitality and mental health (p< 0.05). For gender identity, five domains of HRQOL had significant differences (p< 0.05). Masculinity orientation had the least impact on four domains (p< 0.05), while undifferentiated orientation had the largest impact on all domains.

CONCLUSION

Sex and gender effects can be used to analyze disability and HRQOL in patients with low back pain. Females have higher disability, while HRQOL is greatly influenced by different gender role orientations.

Chronic pain and masculine identity: life-world interviews with men at a South African Pain Clinic

PURPOSE

The purpose was to investigate experiences of men who were living with chronic pain in relation to masculine identity and their experiences of treatment at a Chronic Pain Clinic in South Africa.

METHODS

A purposive sample of 14 male patients from an outpatient Chronic Pain Clinic participated in the study in 2019. Qualitative inquiry followed a life-world dialogical interview approach. Respondent validation interviews further engaged participant perspectives. Team data analysis, thematic network diagrams and tabulations were used for analysis of the interview data. .

RESULTS

The respondents described multiple challenges of the journey to chronic pain, living with chronic pain, experiences of treatment contexts, ways of coping and the experience of living with chronic pain in relation to masculinity. Three typologies were identified: (1) aligning with hegemonic ideals, (2) a yielding masculinity or (3) an adjusted masculine identity. The findings revealed how masculine identity was positioned by the perceptions of others, interpersonally and within the individual.

CONCLUSIONS

Healthcare practitioners and public health can be responsive to the gendered context of living with difficult and long-term pain conditions. Treatment should be supportive and inclusive..

Unveiling Associations of COVID-19 Vaccine Acceptance, Hesitancy, and Resistance: A Cross-Sectional Community-Based Adult Survey

COVID-19 vaccines are essential to limit and eliminate the infectious disease. This research aims to identify strong vaccination resistance profiles and/or hesitation considering health, psychosocial, and COVID-related variables. A cross-sectional online survey (N = 300) was conducted in the context of strict COVID-related gathering and mobility restrictions (January–March 2021). Data collected were vaccine acceptance, hesitancy and resistance rates, general psychosocial status, and preventive practices and beliefs regarding COVID-19 and its vaccination, among other factors. Logistic regression was applied to a real-world data set and a significant model (χ² (7, N = 278) = 124.548, p < 0.001) explaining 51.3% (R² Nagelkerke) of attitudes towards vaccination was obtained, including the following predictors for acceptance: to have greater confidence in the COVID vaccine security (OR = 0.599) and effectiveness (OR = 0.683), older age (OR = 0.952), to be a healthcare professional (OR = 0.363), to have vulnerable individuals in charge (OR = 0.330), and sustain the belief that the vaccine will end the pandemic situation (OR = 0.346) or not being sure but give some credence to that belief (OR = 0.414). Findings could help understand the rate and determinants of COVID-19 vaccine resistance/hesitancy among a Spanish population sample and facilitate multifaceted interventions to enhance vaccine acceptance.

Gender-based eating norms, the family environment and food intake among Costa Rican adolescents

OBJECTIVE

To examine the association between family environment variables (parenting styles, family meal atmosphere), gender-based stereotypes and food intake in Latin American adolescents.

DESIGN

Structural equation modelling applied to cross-sectional data, 2017.

SETTING

Urban and rural sites of San José, Costa Rica.

PARTICIPANTS

n 813; 13-18 years old.

RESULTS

Data suggest direct associations between gender-based stereotypes and intake of fruits and vegetables (FV) (β = 0·20, P < 0·05), unhealthy foods (fast food (FF)) (β = -0·24, P < 0·01) and ultra-processed foods (β = -0·15, P < 0·05) among urban girls; intake of legumes among rural girls (β = 0·16, P < 0·05) and intake of sugar-sweetened beverages (SSB) among rural boys (β = 0·22, P < 0·05). Family meal atmosphere was associated with legume intake (β = 0·19, P <·05) among rural girls. Authoritative parenting style was associated with FV intake (β = 0·23, P < 0·05) among urban boys and FF intake (β = 0·17, P < 0·05) among urban girls. Authoritarian parenting style was associated with FV consumption (β = 0·19, P < 0·05) among rural boys, and with SSB and FF consumption (β = 0·21, P < 0·05; β = 0·14, P < 0·05, respectively) among urban girls.

CONCLUSIONS

Findings are the first to describe the complex family environment and gender-based stereotypes within the context of a Latin American country. They emphasise the need for culturally relevant measurements to characterise the sociocultural context in which parent-adolescent dyads socialise and influence food consumption.

Measuring Men's Gender Norm Beliefs Related to Contraception: Development of the Masculine Norms and Family Planning Acceptance Scale

Male partner resistance is identified as a key factor that influences women's contraceptive use. Examination of the masculine norms that shape men's resistance to contraception-and how to intervene on these norms-is needed. To assess a gender-transformative intervention in Kenya, we developed and evaluated a masculinity-informed instrument to measure men's contraceptive acceptance-the Masculine Norms and Family Planning Acceptance (MNFPA) scale. We developed draft scale items based on qualitative research and administered them to partnered Kenyan men (n = 150). Item response theory-based methods were used to reduce and psychometrically evaluate final scale items. The MNFPA scale had a Cronbach's α of 0.68 and loaded onto a single factor. MNFPA scores were associated with self-efficacy and intention to accept a female partner's use of contraception; scores were not associated with current contraceptive use. The MNFPA scale is the first rigorously developed and psychometrically evaluated tool to assess men's contraceptive acceptance as a function of male gender norms. Future work is needed to test the MNFPA measure in larger samples and across different contexts. The scale can be used to evaluate interventions that seek to shift gender norms to increase men's positive engagement in pregnancy spacing and prevention.

Explaining the Voluntary Compliance to COVID-19 Measures: An Extrapolation on the Gender Perspective

The discourse of gender amidst the COVID-19 pandemic had been a big fuss. Amongst the discussions is the gender-related responses to COVID-19 that generally assume females to better respond to COVID-19 than males. Despite the converging assumptions, previous studies tend to conceptualize gender as binary biological sex, and consequently, there is little understanding of the gender-COVID-19 measures compliance relationship. By taking gender as a multidimensional perspective, this research aims to examine the relationship between sex, gender psychology, and gender-role with voluntary compliance to COVID-19 measures as well as the moderating role of situational aspects that can activate individuals' responses toward COVID-19. A survey had been conducted in Indonesia, as Indonesia represents a country with relaxed COVID-19 restrictions making voluntary compliance is deemed important. Consistent with our predictions and previous studies, females tend to better comply with COVID-19 when gender is treated as dichotomous sex. However, a closer look at the gender dimensions revealed that gender psychology (feminine vs masculine) and gender-role (traditional vs egalitarian) provide a better explanation of the specific compliance behaviour toward COVID-19 measures. Interestingly, although situational pathogen avoidance (SPA) directly leads to adherence to several compliance behaviours, it does not moderate the four compliance behaviour of COVID-19 measures. Theoretical and practical contributions are further discussed.

Latent Class Analysis of Self-directed Violence and Indirect Self-harm Behaviors: Gender Differences and Associations With Mental Health Symptoms

OBJECTIVE

This study aimed to (1) examine whether the latent class structure of individuals engaging in self-directed violence and indirect self-harm behaviors (eg, substance use, disordered eating) varied by gender in a sample of US veterans, and (2) test the associations of posttraumatic stress disorder (PTSD) and depressive symptoms with the resulting classes.

STUDY DESIGN

Cross-sectional data from 3581 veterans, ages 18-50 (51.9% identified as women) were analyzed. Veterans self-reported histories of self-directed violence, substance use, and disordered eating. Latent class analysis and latent class regression were used to explore class structure by gender and examine association of class membership with PTSD and depressive symptoms.

RESULTS

A 4-class model was supported in the sample. Class 1 (20.0%) was characterized by substance use and self-directed violent thoughts and behaviors. Class 2 (8.3%) was characterized by substance use, disordered eating, and self-directed violent thoughts and behaviors. Class 3 (12.6%) was distinguished by indirect self-harm behaviors (substance use and disordered eating). Class 4 (59.6%) reflected low likelihood of behavioral dysregulation. Classes were partially invariant across gender; endorsement of substance use behaviors was generally higher for men in each class. Comorbid clinically significant depressive and PTSD symptoms were associated with the class characterized by highest behavioral dysregulation.

CONCLUSIONS

Self-directed violent thoughts and behaviors present comorbidly with indirect self-harm in men and women veterans, although patterns of indirect self-harm behaviors differ slightly by gender. Such comorbidity may be associated with more severe presentations of psychiatric concerns.

Masculine norms and mental health of African men: what can psychology do?

In Africa, internalisation of masculine norms among men has been reported to make them more susceptible to mental health problems. In this chapter, social construction and role theories are used to explore the relationships between masculine norms and mental health among men in Africa. The authors argued that due to traditional and institutionalised beliefs, men engage in restrictive emotionality through defence mechanisms by denying their mental health challenges and status. Hence, an inclusive model of remedy was suggested that targets men's traditional beliefs as a way of aiding help-seeking behaviour among them to make them less susceptible to mental health problems.

Gender and psychological well-being in older adults

OBJECTIVES

Gender is an important social determinant of health, but gender has played only a marginal role in the geriatric and gerontology research and practice. The aim of this study was to examine the relevance of gender to the psychological well-being of older adults.

DESIGN

A cross-sectional study was conducted.

SETTING

The study was carried out in Spain.

PARTICIPANTS

A total of 1,201 people aged between 65 and 94.

MEASUREMENTS

The participants completed sociodemographic data and four questionnaires: The Bem sex role inventory, the Ryff's psychological well-being scale, the York self-esteem inventory, and the Social support scale.

RESULTS

Men scored higher than women in self-acceptance, autonomy, purpose in life, and environmental mastery. Hierarchical multiple regression analyses showed that, although the most important predictors of psychological well-being in both women and men were self-esteem and social support, both masculine/instrumental and feminine/expressive traits were associated with higher psychological well-being, although the effect size was higher for the masculine/instrumental trait. Furthermore, education was associated with psychological well-being in the case of females.

CONCLUSIONS

Gender plays an important role in the psychological well-being of older adults. The results of this research are relevant for healthcare providers and policy-makers interested in promoting successful aging and increasing the well-being of older people.

Time of pandemic: Temporal perspectives related to compliance with public health regulations concerning the COVID-19 pandemic

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Female gender and Carpe Diem predict compliance with health regulations.

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Men complied with public health regulations significantly less often than women.

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Greater awareness of danger predicts compliance with COVID-19 directives.

One of the main determinants of the spread of epidemics in human population centres is the degree of compliance with public health regulations. The aim of this study was to investigate the relationships between time perspective and compliance with public health regulations concerning the COVID-19 pandemic. The participants were 500 adults (275 women, 225 men) aged 18 to 82 years. Sociodemographic surveys, surveys concerning knowledge about COVID-19 and compliance with public health regulations, the Polish Short Version of the Zimbardo Time Perspective Inventory, the Present-Fatalistic Scale, the Dark Future Scale, and the Carpe Diem Scale were used. Female gender and Carpe Diem were predictors of compliance with public health regulations. Men complied with public health regulations significantly less often than women. The results of our study suggest that in announcements communicating public health regulations concerning COVID-19 pandemic, emphasis should be placed on stressing the significance of focusing on ‘here and now’ and the importance of current behaviours for the future.

Factors Associated with Health Behaviors in Thyroid Cancer Survivors

In this study, we compared health behaviors, including current smoking, drinking, and physical inactivity, in thyroid cancer survivors and non-cancer controls and investigated the factors associated with unhealthy behaviors among survivors. Baseline data from the Health Examinees study, collected from 2004 to 2013, were used. Thyroid cancer survivors (n = 942), defined as those who had received a clinical diagnosis of thyroid cancer, and 9,420 matched non-cancer controls without past history of any cancer were included in the analysis. The prevalence of smoking, alcohol consumption, and physical inactivity in thyroid cancer survivors were 2.3%, 26.6%, and 52.0%, respectively, with adjusted OR (aOR) and 95% CI between survivors and non-cancer controls of 0.35 (95% CI = 0.08-1.56), 0.46 (95% CI = 0.29-0.74), and 0.65 (95% CI = 0.44-0.96). The prevalence of unhealthy behaviors was higher among male thyroid cancer survivors than female thyroid cancer survivors. In thyroid cancer survivors, those who smoked were more likely to drink (aOR = 4.55 [95% CI = 1.61-12.85]) and those who were physically inactive were less likely to drink (aOR = 0.58 [95% CI = 0.42-0.82]). Current drinking and physical inactivity contributed to a higher likelihood of smoking (aOR = 4.31 [95% CI = 1.35-13.73] and 6.34 [95% CI = 1.65-24.34]). Thyroid cancer survivors had better health behaviors than the non-cancer controls. However, some survivors still had unhealthy lifestyles, especially displaying a clustering of unhealthy behaviors. Thus, health behavior promotion through medical intervention is important for thyroid cancer survivors.

Stress and Psychological Distress in Emerging Adulthood: A Gender Analysis

Emerging adulthood is a critical period of life that entails many life transitions in living arrangements, relationships, education and employment, which can generate stress and psychological distress in the emerging adult. The aim of the present study was to assess the relevance of stress, coping styles, self-esteem and perceived social support in the distress of emerging adult women and men. The sample consists of 4816 people (50% females) from the Spanish general population, ranging in age from 18 to 29 years old. All participants were assessed through questionnaires and scales that assess psychological distress, stress, coping styles, self-esteem and social support. Women scored higher than men in psychological distress, chronic stress, minor daily hassles, emotional coping style and social support, whereas men scored higher than women in rational and detachment coping styles and in self-esteem. Psychological distress was significantly predicted in women and men by high emotional coping style, lower self-esteem, high number of life events, and less social support. Another statistically significant predictor in men was less detachment coping style, whereas in women it was high chronic stress. The results of this research are relevant to healthcare professionals interested in improving the mental health of the emerging adult.

Comparing smoking behavior between female-to-male and male-to-female transgender adults

INTRODUCTION

This study aimed to assess the association between current smoking and gender identity among transgender individuals.

METHODS

Data were collected using a cross-sectional survey distributed among transgender individuals attending the Houston Pride Festival and those seeking care at a local transgender health clinic. Relevant variables were compared between female-to-male (FTM) and male-to-female (MTF) transgender individuals using χ², Fisher’s exact, and two-sample t-tests, when appropriate. Gender identity was used to predict current smoking status using logistic regression, adjusting for other sociodemographic determinants.

RESULTS

The study sample (N=132) comprised 72 MTF (54.5%) and 60 FTM (45.5%) transgender individuals. Mean age of participants was 31.8 years. The sample was racially and ethnically diverse: 45.8% Caucasian, 25.2% Hispanic/Latino, 16.8% African American, and 12.2% other. Current smoking prevalence was 26.7% and 13.9% among FTM and MTF individuals, respectively. Transgender individuals were more likely to self-report current smoking if they were FTM (OR=3.76; 95% CI: 1.17–12.06; p=0.026) or were insured (OR=4.49; 95% CI: 1.53–13.18; p=0.006).

CONCLUSIONS

This study reports on important findings by examining intragroup differences in smoking behavior among the transgender population. However, further research is needed for tailoring smoking prevention and cessation interventions for transgender subgroups.

Masculine/Instrumental and Feminine/Expressive Traits and Health, Well-Being, and Psychological Distress in Spanish Men

Many studies have explored the relationship between masculine norms and men's health outcomes. There are few recent studies published on the relationship between masculine/instrumental and feminine/expressive traits and men's health and well-being. The current cross-sectional study examines whether masculine/instrumental and feminine/expressive traits are associated to men's health and well-being. Participants were 1,870 Spanish men, aged 21 to 64 years. Results from hierarchical multiple regression analysis indicated that the masculine/instrumental trait and the feminine/expressive trait were positively related to men's psychological well-being and self-rated health, so that men whose self-concept includes both masculine/instrumental and feminine/expressive characteristics presented greater psychological well-being and better self-rated health. The feminine/expressive trait was associated with lower psychological distress yet only in case of men with low social support. Self-esteem and social support were important predictors of men's health, in such a way that men who had high self-esteem and social support reported higher ratings of psychological well-being, better self-rated health, and less psychological distress. The implications of these findings for promoting men's health and well-being are discussed.

Examination of Gender Stereotypes and Norms in Health-Related Content Posted to Snapchat Discover Channels: Qualitative Content Analysis

BACKGROUND

Snapchat has seen one of the most rapid, and unprecedented, growths in the history of social networking sites and social media with 3 billion Snapchats sent daily. In 2015, Snapchat introduced a new feature, Snapchat Discover, providing a unique way for publishers, such as magazines, to connect their content to Snapchat users.

OBJECTIVE

This study aimed to evaluate qualitatively the health-related content distributed among male-focused and female-focused Discover channels and to determine whether differences exist between the content posted to these channels.

METHODS

Magazine Discover channels with male and female target audiences were identified based on the magazine's claimed audience and a search of Snapchat Discover's magazine publishers, resulting in the selection of two male-focused and two female-focused channels. Stories were collected daily from each of the selected channels during a 4-week period. Using the constant comparative method, 406 Discover stories were collected and analyzed.

RESULTS

Differences in health content coverage existed between male- and female-focused channels. General health stories from male channels comprised 7.5% (10/134) of total stories compared with 22.8% (62/272) for female channels. Sexual health stories from male channels comprised 3.0% (4/134) of total stories compared with 18.8% (51/272) for female channels. Moreover, female-focused channels' content was more comprehensive. Female audiences were portrayed as being health information seekers, concerned with sexual health and male satisfaction, primarily responsible for contraception and pregnancy prevention, and less informed about sex. Male audiences were portrayed as being less likely to seek health information, obsessed with and driven by sex, and less concerned with sexual health.

CONCLUSIONS

Understanding the content shared to social media is important, especially when considering the implications content may have for behavior. In terms of content, these findings suggest Discover channels appear to promote gender stereotypes and norms for health and sexual health through the information posted.

Sexual Orientation Differences in Gun Ownership and Beliefs About Gun Safety Policy, General Social Survey 2010-2016

The aim of this study was to investigate sexual orientation differences in gun ownership and gun safety beliefs among U.S. adults. We used information from the General Social Survey (2010-2016) to assess presence of guns in the household, personal gun ownership, and endorsement of a gun safety law among sexual minority (n = 195) versus heterosexual (n = 4359) respondents. Methods employed multivariate logistic regression analyses adjusted for confounding including gender, age, race/ethnicity, education level, size of household, urbanicity, military veteran status, and political views. Gay/bisexual men were more likely to endorse a gun safety law (adjusted odds ratio [aOR] = 3.24, 95% confidence interval [CI] = 1.79-5.88) and less likely to report guns in the household (aOR = 0.34, 95% CI = 0.18-0.65) than heterosexual men. In contrast, lesbian/bisexual and heterosexual women similarly endorsed a gun safety law and reported household guns. However, among women reporting a household gun, lesbian/bisexual women were more likely to be the personal gun owner (aOR = 3.97, 95% CI = 1.43-11.03). Attitudes toward a gun safety law and gun ownership differ by sexual orientation, but patterns vary by gender. We recommend that clinicians inquire about gun ownership and gun storage practices with both heterosexual and sexual minority patients.

Masculine gender norms, male circumcision, and men's engagement with health care in the Dominican Republic

Overall, adult men are less likely to seek and receive health care than women, but male circumcision for HIV prevention has been successful in engaging men in health services. The purpose of this paper is to examine the relationship between masculine norms and health care-seeking among men participating in a voluntary male medical circumcision (VMMC) programme in the Dominican Republic (DR). We employed a mixed methods approach integrating survey data collected 6-12 months post-circumcision (n = 293) and in-depth interviews with a sub-sample of these men (n = 30). In our qualitative analysis, we found that health care-seeking is connected to masculine norms among men in the DR, including the perceptions of medical facilities as feminine spaces. Participants' narratives demonstrate that male circumcision programmes may facilitate men overcoming masculinity-related barriers to health care engagement. In quantitative analysis, we found that being concerned about being perceived as masculine was associated with health care-seeking behaviour in the past five years, though this association was not retained in multivariable analyses. Findings indicate that male circumcision programmes can familiarise men with the healthcare system and masculinise health care-seeking and utilisation, easing associated discomfort.

Caring for a spouse with advanced cancer: similarities and differences for male and female caregivers

Most caregiving literature has focused on women, who have traditionally taken on caregiving roles. However, more research is needed to clarify the mixed evidence regarding the impact of gender on caregiver/patient psychological outcomes, especially in an advanced cancer context. In this paper, we examine gender differences in caregiver stress, burden, anxiety, depression, and coping styles, as well as how caregiver gender impacts patient outcomes in the context of advanced cancer. Eighty-eight patients with advanced cancer and their caregivers completed psychosocial surveys. All couples were heterosexual and most caregivers were women (71.6%). Female caregivers reported significantly higher levels of perceived stress, depression, anxiety, and social strain compared with male caregivers, and female patients of male caregivers were more likely to use social support as a coping style compared with male patients of female caregivers. These findings highlight the potential differences between male and female caregivers' needs and psychological health.

Mapping the Social-Norms Literature: An Overview of Reviews

The theoretical literature on social norms is multifaceted and at times contradictory. Looking at existing reviews, we aimed to offer a more complete understanding of its current status. By investigating the conceptual frameworks and organizing elements used to compare social-norms theories, we identified four theoretical spaces of inquiry that were common across the reviews: what social norms are, what relationship exists between social norms and behavior, how social norms evolve, and what categories of actors must be considered in the study of social norms. We highlight areas of consensus and debate in the reviews around these four themes and discuss points of agreement and disagreement that uncover trajectories for future empirical and theoretical investigation.