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Williamson IR, Papaloukas P, Jaspal R. A Mixed-Methods Evaluation of "The Quest," A Health and Well-Being Intervention for British-Based Black, Asian and Minority Ethnic Gay and Bisexual Men. JOURNAL OF HOMOSEXUALITY 2024; 71:478-497. [PMID: 36190698 DOI: 10.1080/00918369.2022.2122363] [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: 06/16/2023]
Abstract
This article provides an evaluation of a health and well-being workshop-based intervention, "The Quest" for gay and bisexual men from British Black Asian and Minority Ethnic (BAME) communities. A quantitative component assessed reported and intended sexual risk, drugs and alcohol use alongside measures of psychological well-being with pre and post-program data collected from 26 men. Fourteen men participated in focus groups that discussed experiences of the intervention. Significant improvements were found on measures of internalized homophobia, self-esteem and self-efficacy but not for health behaviors including safer sex or substance use. Qualitative feedback was generally positive especially around enhanced psychological well-being, identity integration, and enhanced self-awareness. There were some concerns over group size and whether non-BAME gay men were appropriate as facilitators. Theoretically informed, culturally competent interventions can demonstrate significant potential in enhancing the well-being of BAME gay and bisexual men but follow-up data are needed to show longer-term benefits.
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Affiliation(s)
| | | | - Rusi Jaspal
- Vice-Chancellor's Office, University of Brighton, Brighton, UK
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2
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Gizamba JM, Wilson JP, Mendenhall E, Ferguson L. A review of place-related contextual factors in syndemics research. Health Place 2023; 83:103084. [PMID: 37437495 DOI: 10.1016/j.healthplace.2023.103084] [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: 05/15/2023] [Revised: 06/16/2023] [Accepted: 07/04/2023] [Indexed: 07/14/2023]
Abstract
This review investigates the extent to which a place-based approach has been used to conceptualize context, as well as the place-related contextual factors explored in studies that explicitly invoked a syndemic framework. The literature search focused on 29 peer-reviewed empirical syndemic studies. Only 11 studies used a place-based approach to define and measure contextual factors and the spatial context was denoted using administrative boundaries such as census tracts, counties, and countries. A narrow range of place-related contextual factors were explored and most of them were related to social and economic factors that were used to define a place. Methodological gaps like a paucity of multilevel studies and studies using a place-based approach to measure context were identified. Future syndemics research should leverage multidimensional geospatial approaches to decipher the role of place-related contextual factors in syndemic dynamics.
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Affiliation(s)
| | - John P Wilson
- Spatial Science Institute, University of Southern California, Los Angeles, USA
| | - Emily Mendenhall
- School of Foreign Service, Georgetown University, Washington, DC, USA
| | - Laura Ferguson
- Institute on Inequalities in Global Health, Keck School of Medicine, University of Southern California, Los Angeles, USA
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Newman PA, Akkakanjanasupar P, Tepjan S, Boborakhimov S, van Wijngaarden JWDL, Chonwanarat N. Peer education interventions for HIV prevention and sexual health with young people in Mekong Region countries: a scoping review and conceptual framework. Sex Reprod Health Matters 2022; 30:2129374. [DOI: 10.1080/26410397.2022.2129374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Peter A. Newman
- Professor, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada; Senior Advisor, VOICES-Thailand Foundation, Chiang Mai, Thailand. Correspondence:
| | | | - Suchon Tepjan
- Research Manager, VOICES-Thailand Foundation, Chiang Mai, Thailand
| | - Sharafdzhon Boborakhimov
- Research Assistant, VOICES-Thailand Foundation, Chiang Mai, Thailand; Consultant, United Nations Population Fund, Berlin, Germany
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Rovito KE, Herring RP, Beeson WL, Gamboa-Maldonado T, Lee JW. Social-Ecological Correlates of Social Isolation as a Structural Indicator of Social Connectedness Among Young Adult U.S. Males. Am J Health Promot 2022; 36:1284-1295. [PMID: 35606679 DOI: 10.1177/08901171221103755] [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: 02/01/2023]
Abstract
PURPOSE We examined the intrapersonal, interpersonal, community, and societal correlates of a structural indicator of social connectedness (ie, social isolation) among a sample of young adult U.S. males. DESIGN Cross-sectional. Setting: Online survey. SUBJECTS Males (n = 495) aged 18-25 years residing in the U.S. MEASURES Social isolation was assessed as an index measure of social integration (inverse scored). The correlates consisted of the following variables: 1) intrapersonal (eg, social-demographic characteristics), 2) interpersonal (eg, adverse childhood experiences; marital status), 3) community (eg, county-level mental distress rates), and 4) societal (eg, how powerful is society's image of the 'masculine man'). ANALYSIS Four-block hierarchical regression. RESULTS The intra- and interpersonal variables significantly shared 17% and an incremental 5%, respectively, of the explained variance in social isolation. Several intra- (eg, financial vulnerability β = -2.76, [95% CI: -4.40, -1.13]) and inter-personal (ie, childhood household dysfunction β = -.66, [95% CI: -1.18, -.14]) factors were significantly associated with greater social isolation. Four intrapersonal factors (eg, gay or bisexual β = 2.31, [95% CI: .29, 4.33]) were significantly associated with lower social isolation. CONCLUSIONS The current study's findings have important implications for understanding and shaping social connectedness in young adult U.S. males, with micro-level influences potentially being most important in predicting social isolation in this population.
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Affiliation(s)
| | - R Patti Herring
- School of Public Health, 4608Loma Linda University, Loma Linda, CA, USA
| | - W Lawrence Beeson
- School of Public Health, 4608Loma Linda University, Loma Linda, CA, USA
| | | | - Jerry W Lee
- School of Public Health, 4608Loma Linda University, Loma Linda, CA, USA
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Mendenhall E, Kohrt BA, Logie CH, Tsai AC. Syndemics and clinical science. Nat Med 2022; 28:1359-1362. [PMID: 35864249 DOI: 10.1038/s41591-022-01888-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/07/2022] [Indexed: 01/10/2023]
Abstract
The theory of syndemics has received increasing attention in clinical medicine since the onset of the COVID-19 pandemic, due to the synergistic interactions of the disease with pre-existing political, structural, social and health conditions. In simple terms, syndemics are synergistically interacting epidemics that occur in a particular context with shared drivers. When policymakers ask why some communities have higher death rates from COVID-19 compared with other communities, those working from a syndemics framework argue that multiple factors synergistically work in tandem, and populations with the highest morbidity and mortality experience the greatest impact of these interactions. In this Perspective, we use specific case examples to illustrate these concepts. We discuss the emergence of syndemics, how epidemics interact, and what scientists, clinicians and policymakers can do with this information.
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Affiliation(s)
- Emily Mendenhall
- Edmund A. Walsh School of Foreign Service, Georgetown University, Washington, DC, USA. .,SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa.
| | - Brandon A Kohrt
- Department of Psychiatry, George Washington University, Washington, DC, USA
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.,Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada.,United Nations University Institute for Water, Environment and Health, Hamilton, Ontario, Canada
| | - Alexander C Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Mbarara University of Science and Technology, Mbarara, Uganda
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Strongylou DE, Flowers P, McKenna R, Kincaid RA, Clutterbuck D, Hammoud MA, Heng J, Kerr Y, McDaid L, Frankis JS. Understanding and responding to remote mental health help-seeking by gay, bisexual and other men who have sex with men (GBMSM) in the U.K. and Republic of Ireland: a mixed-method study conducted in the context of COVID-19. Health Psychol Behav Med 2022; 10:357-378. [PMID: 35402086 PMCID: PMC8986177 DOI: 10.1080/21642850.2022.2053687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Gay, bisexual and other men who have sex with men (GBMSM) are at far greater risk of experiencing poor mental health (MH) than wider society. This disparity was exacerbated by additional ‘unique to sexual minority status’ COVID-19 stressors. Objective: This sequential, mixed-methods study examined remote MH help-seeking among GBMSM in the U.K. and Ireland during the first COVID-19 lockdown. Methods and Results: Quantitative survey data (n = 1368), analysed with logistic regression, suggested GBMSM experiencing moderate-to-severe anxiety and those with a past MH diagnosis were most likely to seek MH support. Thematic analysis of qualitative interview (n = 18) data identified multiple barriers and enablers to GBMSM seeking remote MH help, with the help primarily sought from GBMSM-facing organisations and generic online resources. Finally, the behaviour change wheel was used to generate theoretically informed recommendations to promote MH help-seeking among GBMSM in Scotland. Implications: We discuss how applying these recommendations in the short, medium and long term will begin to address GBMSM’s MH needs, post COVID-19.
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Affiliation(s)
| | - Paul Flowers
- Department of Psychology, University of Strathclyde, Glasgow, UK
| | | | | | | | | | - Julian Heng
- Public Health Department, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Yvonne Kerr
- Public Health and Health Policy Department, NHS Lothian, Edinburgh, UK
| | - Lisa McDaid
- Institute for Social Sciences Research, The University of Queensland, Brisbane, Australia
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McGarty A, McDaid L, Flowers P, Riddell J, Pachankis J, Frankis J. Mental health, potential minority stressors and resilience: evidence from a cross-sectional survey of gay, bisexual and other men who have sex with men within the Celtic nations. BMC Public Health 2021; 21:2024. [PMID: 34742262 PMCID: PMC8572060 DOI: 10.1186/s12889-021-12030-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gay, bisexual and other men who have sex with men (GBMSM) are at a greater risk of mental health problems, such as anxiety and depression, than heterosexual adults. Numerous factors and stressors have been reported to impact men's mental health, although it has been suggested that resilience could have a protective effect. The aim of this study is to explore mental health, minority stressors, and resilience among a large online cross-sectional survey of GBMSM in the Celtic nations. METHODS Data for this cross-sectional study were collected from the Social Media, GBMSM and Sexual and Holistic Health (SMMASH2) self-report online survey. Participants (n = 3077) were recruited via gay sociosexual media in Scotland, Wales, Northern Ireland, and the Republic of Ireland. Binary logistic regression analyses were conducted to identify factors that increased the odds of moderate-to-severe anxiety and depression. Potentially relevant variables (p < 0.05) were carried forward in hierarchal logistic regression analyses. RESULTS The prevalence of moderate-to-severe anxiety and depression was 19.9 and 14.4%, respectively. Having a disability (OR = 1.73) and having financial worries sometimes/all of the time (OR = 1.93) increased the odds of having moderate-to-severe depression and anxiety, respectively. No minority stressors were associated with depression, whereas experiencing any form of relationship abuse in the last 12 months significantly increased the odds of anxiety (OR = 1.50). Resilience, namely a sense of coherence, had a protective effect and significantly reduced the odds of moderate-to-severe depression (OR = 0.85) and anxiety (OR = 0.89). CONCLUSIONS Disability and financial worries were associated with increased depression and anxiety, respectively, while resilience had a protective effect for GBMSM in the SMMASH2 study. Future research is needed to better understand the role of resilience and the challenges and stresses of everyday life and intersecting health problems. Future research is also needed that incorporates the perspectives of those most affected by mental ill-health to co-develop effective solutions that respond to their contextual surroundings.
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Affiliation(s)
- Arlene McGarty
- Institute of Health & Wellbeing, University of Glasgow, 1st floor Admin Building, Gartnavel Royal Hospital, 1055 Great Western Road, G12 0XH, Glasgow, Scotland, UK.
| | - Lisa McDaid
- grid.1003.20000 0000 9320 7537Institute for Social Science Research, The University of Queensland, Long Pocket Precinct, 80 Meiers Rd, Indooroopilly, Brisbane, QLD 4068 Australia ,grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Top Floor, 200 Renfield Street, G2 3AX, Glasgow, Scotland UK
| | - Paul Flowers
- grid.11984.350000000121138138School of Psychological Sciences & Health, University of Strathclyde, 40 George Street, G1 1QE, Glasgow, UK
| | - Julie Riddell
- grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Top Floor, 200 Renfield Street, G2 3AX, Glasgow, Scotland UK
| | - John Pachankis
- grid.47100.320000000419368710Yale School of Public Health, 60 College St, New Haven, CT USA
| | - Jamie Frankis
- grid.5214.20000 0001 0669 8188School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road G4 0BA, Glasgow, Scotland UK
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Dimova ED, Elliott L, Frankis J, Drabble L, Wiencierz S, Emslie C. Alcohol interventions for LGBTQ+ adults: A systematic review. Drug Alcohol Rev 2021; 41:43-53. [PMID: 34333818 DOI: 10.1111/dar.13358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/10/2021] [Accepted: 06/27/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Gender and sexual minority populations are more likely to drink excessively compared to heterosexual and cisgender people. Existing reviews of alcohol interventions focus on specific subgroups within the lesbian, gay, bisexual, trans*, queer, questioning or otherwise gender or sexuality diverse (LGBTQ+) population and neither identify their theoretical basis nor examine how interventions are tailored to meet the needs of specific subgroups. METHODS This systematic review includes published studies reporting the effectiveness of interventions to reduce alcohol use in LGBTQ+ people. The review followed PRISMA guidelines. Quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. RESULTS The review includes 25 studies, with the earliest published in 2005. The majority (n = 20) focused on men who have sex with men; only two included sexual minority women and three included trans* people. Most studies were conducted in the USA (n = 21) and used a randomised design (n = 15). Five studies were assessed to be of strong quality, seven moderate and 13 weak. Interventions were mainly delivered face-to-face (n = 21). The most common approaches used to inform interventions were Motivational Interviewing (n = 8) and Cognitive Behavioural Therapy (n = 8). Nineteen studies reported a significant reduction in alcohol consumption. DISCUSSION AND CONCLUSIONS This review suggests that for interventions to be effective in reducing alcohol consumption in LGBTQ+ people, they need to be informed by theory and adapted for the target population. Alcohol interventions that focus on sexual minority women, trans* people and people with other gender identities are needed. The findings have implications for professionals who need to identify when gender and/or sexuality are peripheral or central to alcohol use.
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Newman PA, Prabhu SM, Akkakanjanasupar P, Tepjan S. HIV and mental health among young people in low-resource contexts in Southeast Asia: A qualitative investigation. Glob Public Health 2021; 17:1200-1214. [PMID: 33977867 DOI: 10.1080/17441692.2021.1924822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Young people aged 15-24 years comprise one-fourth of incident HIV infections in Southeast Asia. Given the high prevalence and impact of mental health issues among young people, we explored intersections of HIV and mental health, with a focus on adolescent and young key populations (AYKP) in Indonesia, the Philippines, Thailand, and Vietnam. Sixteen focus group discussions (4/country) with young people (n = 132; 16-24 years) and 41 key informant interviews with multisectoral HIV experts explored young people's lived experiences and unmet needs, existing programmes, and strategic directions for local and regional HIV responses. Cross-cutting challenges emerged in healthcare, family, school, and peer domains amid fragmented and under-resourced HIV and mental health services in socio-politically fraught environments. We identified strategic opportunities and initiatives in development and integration of youth-friendly HIV and mental health services; programmes to promote parent-adolescent communication about sex and HIV; and teacher training and resources to advance HIV and mental health awareness, serve as first-responders, and provide community referrals. Youth-led peer education programmes and LGBT-networks were central to the HIV response-promoting HIV prevention, sexual health, and mental health awareness for young people, and resilience and socioeconomic empowerment of peer educators themselves-thereby transforming sociocultural and political contexts of vulnerability.
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Affiliation(s)
- Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.,VOICES-Thailand Foundation, Chiang Mai, Thailand
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McDaid L, Flowers P. Pandemics have psychosocial and sociocultural burdens. Lancet HIV 2020; 7:e801-e802. [PMID: 33039008 PMCID: PMC7544435 DOI: 10.1016/s2352-3018(20)30239-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 01/07/2023]
Affiliation(s)
- Lisa McDaid
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD 4068, Australia.
| | - Paul Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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