1
|
Decker H, Combs RM, Noonan EJ, Black C, Weingartner LA. LGBTQ+ Microaggressions in Health Care: Piloting an Observation Framework in a Standardized Patient Assessment. JOURNAL OF HOMOSEXUALITY 2024; 71:528-544. [PMID: 36190747 DOI: 10.1080/00918369.2022.2122367] [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
Microaggressions are subtle derogatory behaviors that unintentionally communicate hostility toward marginalized social groups. This article describes the preliminarily validation of a framework for observing LGBTQ+ microaggressions in health care, which can lead to distrust and disengagement from the healthcare system. Coders used the framework to observe microaggressions in video-recorded clinical-skills assessments with medical students who elicited health histories from standardized patients. Microaggression classifications were reviewed to determine construct reliability and the presence/absence among eight framework categories. Among 177 encounters with sexual and gender minority standardized patients, heteronormative/cisnormative language and assumptions occurred in the largest proportion of encounters (85.3%). Only identity-based referrals decreased significantly after a clinical skills intervention (20.0% to 4.9%, p = .01). These outcomes show that LGBTQ+ healthcare microaggressions are pervasive and will likely require nuanced training to address them. This groundwork can also be used to develop scales for patients and observers to identify microaggressions and assess perceived impact.
Collapse
Affiliation(s)
- Hallie Decker
- Health Promotion and Behavioral Sciences, University of Louisville School of Public Health and Information Sciences, Louisville, Kentucky, USA
| | - Ryan M Combs
- Health Promotion and Behavioral Sciences, University of Louisville School of Public Health and Information Sciences, Louisville, Kentucky, USA
| | - Emily J Noonan
- Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Caison Black
- Health Promotion and Behavioral Sciences, University of Louisville School of Public Health and Information Sciences, Louisville, Kentucky, USA
| | - Laura A Weingartner
- Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, Kentucky, USA
| |
Collapse
|
2
|
Hickey PM, Best LA, Speed D. Access to Healthcare and Unmet Needs in the Canadian Lesbian-Gay-Bisexual Population. JOURNAL OF HOMOSEXUALITY 2023:1-19. [PMID: 38019536 DOI: 10.1080/00918369.2023.2287034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Individuals who identify as a sexual minority, including those who are lesbian, gay, or bisexual (LGB), face barriers to healthcare as well as increased discrimination, stigmatization, and negative experiences during healthcare use. Further, few healthcare providers have education and training focused on the specific healthcare needs of individuals who are part of a sexual minority group. Given the limited research on Canadian healthcare access for sexual minorities, our purpose was to use data (n > 2,800) from the 2015-16 Canadian Community Health Survey (CCHS) to investigate the perceptions of healthcare access for LGB and non-LGB Canadians. Although non-LGB and LGB participants reported comparable access to a regular care provider and were equally likely to have consulted with a general practitioner in the past 12 months, LGB respondents were more likely to have seen a specialist and reported more unmet health needs. Although we expected the linear effects of both race and sex to vary by LGB status, this effect only occurred in one model. Current results have implications for addressing health inequalities for sexual minorities, including poorer health outcomes and greater discrimination.
Collapse
Affiliation(s)
- Patrick M Hickey
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| | - Lisa A Best
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| | - David Speed
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| |
Collapse
|
3
|
Rios O, Font-Palomar M, Flecha A, Valls R. Violence Against LGBTIQ+ People at Universities: The Need to Uncover a Silent Reality. TRAUMA, VIOLENCE & ABUSE 2023; 24:2680-2690. [PMID: 35762331 DOI: 10.1177/15248380221111471] [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: 06/15/2023]
Abstract
Violence against LGBT community can manifest in different forms and exists in all spheres of society, including education. The main purpose of this article is to deepen the understanding of the state of the art about violence grounded in sexual orientation or gender identity in higher education in order to identify gaps for further research. The topic of this state-of-the-art literature review is the presence and magnitude of these forms of violence in the Spanish higher education system. For this reason, the inclusion criteria were empirical studies about the prevalence of violence against LGBTIQ+ individuals in the Spanish educational system. After analyzing the 25 articles that met the inclusion criteria, the main findings point that despite the existence of numerous international studies of the presence of violence against LGBTIQ+ people at colleges, little is known about this reality in Spain. The Spanish university system continues to remain hermetic, and violence against LGBTIQ+ people is silenced and hidden. Practice, policy and research implications of the findings are discussed in this article, highlighting the need of further research in this field. In this context, the research project Uni4Freedom, addresses this social and educational problem to contribute to the creation of safer universities for the LGBTIQ+ community and people who support them.
Collapse
Affiliation(s)
- Oriol Rios
- Department of Pedagogy, Rovira i Virgili University, Tarragona, Spain
| | | | - Ainhoa Flecha
- Department of Sociology, Autonomous University of Barcelona, Spain
| | - Rosa Valls
- Department of Theories and History of Education, University of Barcelona, Spain
| |
Collapse
|
4
|
Edwards B, Froehle AW. Factors Affecting Anxiety-Related Symptoms, Diagnosis, and Treatment Among Collegiate Student-Athletes in the National College Health Assessment. J Athl Train 2023; 58:722-732. [PMID: 37737433 PMCID: PMC11215730 DOI: 10.4085/1062-6050-0334.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
CONTEXT Increased attention continues to be placed on best practices for assisting student-athletes who show symptoms of a mental health illness. One of the most common mental health concerns for student-athletes is feeling overwhelmed or anxious. Early recognition of these symptoms can help student-athletes find early intervention. OBJECTIVE To elucidate specific attributes associated with an increased likelihood of anxiety symptoms and treatment avoidance to help athletic trainers and other practitioners better identify and assist high-risk individuals. DESIGN Cross-sectional study. SETTING Colleges and universities in the United States. PATIENTS OR OTHER PARTICIPANTS A total of 51 882 varsity athletes who completed the National College Health Assessment between 2011 and 2019. MAIN OUTCOME MEASURE(S) Survey responses (self-report) to questions related to anxiety symptoms and disorders cross-sectioned into 9 predictors: year in school, gender, sexual orientation, race and ethnicity, international student status, school type, received information on stress reduction or depression or anxiety, anxiety about impeding academic performance, and history of mental health treatment in the last year. RESULTS More than three-fourths (82.9%, n = 43 016) of student-athletes reported feeling overwhelmed because of all that they had to do in their daily activities, whereas only half (47.5%, n = 24 645) of student-athletes described overwhelming anxiety as a symptom. Gender, sexual orientation, race and ethnicity, school type, and previous mental health treatment had large effects on these 2 symptoms. However, of the student-athletes who reported overwhelming anxiety as a symptom, only one-fourth (22.9%, n = 5649) indicated they received a diagnosis of anxiety with or without treatment. CONCLUSIONS Factors such as the year in school and availability of mental health information appeared to have little effect on the experience of anxiety-related symptoms and the propensity to seek treatment. However, other factors, including gender, sexual orientation, race and ethnicity, school type, and previous mental health treatment, did have important effects. Our study provides additional evidence that the stresses placed on collegiate student-athletes frequently led to feelings of being overwhelmed and, eventually, anxiety disorder diagnoses. However, most student-athletes experiencing anxiety-related symptoms still did not seek a diagnosis with or without treatment.
Collapse
Affiliation(s)
- Brian Edwards
- Department of Kinesiology and Health, Wright State University, Fairborn, OH
| | | |
Collapse
|
5
|
Gattamorta KA, Vega G, Kania V. Impact of Living Arrangements of LGBTQ College Students During COVID-19. JOURNAL OF STUDENT AFFAIRS RESEARCH AND PRACTICE 2023; 61:251-265. [PMID: 38586549 PMCID: PMC10997324 DOI: 10.1080/19496591.2023.2186241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
This study examines the relationships between living arrangements and educational outcomes, access to LGBTQ affirming care, sexual and gender minority (SGM) stressors, and mental health. Bivariate analyses were implemented to examine relationships between living arrangements and academic outcomes, SGM stressors, access to care, and alcohol and substance use. Differences between undergraduate and graduate students are also reported. Students who continued living on campus were less likely to report increased family rejection, transphobia, and identity concealment.
Collapse
|
6
|
Edwards B, Froehle AW, Fagan SE. Trends in Collegiate Student-Athlete Mental Health in the National College Health Assessment, 2011-2019. J Athl Train 2023; 58:361-373. [PMID: 37418561 PMCID: PMC11215639 DOI: 10.4085/1062-6050-0586.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
CONTEXT Recently, the athletic training community has paid increased attention to collegiate student-athlete mental health, mental health treatment-seeking behavior, and the effects of mental health factors on athletic and academic performance. Ongoing efforts to better educate and equip athletic trainers to help student-athletes in this regard should result in improved mental health-related outcomes. OBJECTIVE To examine changes in the mental health of student-athletes over the past decade compared with that of nonathlete students. DESIGN Cross-sectional study. SETTING Colleges and universities in the United States. PATIENTS OR OTHER PARTICIPANTS Varsity athletes (athletes; n = 54 479) and nonathlete students (nonathletes; n = 448 301) who completed the National College Health Assessment between 2011 and 2019. MAIN OUTCOME MEASURE(S) Surveys included responses (self-reported) to questions in 5 mental health-related categories: recent mental health symptoms, recent mental health diagnosis, mental health treatment-seeking behavior, receiving mental health information from the institution, and the recent effect of mental health factors on academic performance. RESULTS Athletes consistently described lower symptom and diagnosis rates compared with nonathletes, except for attempted suicide, substance abuse, and eating disorders. Rates of diagnosis increased over time in both groups but remained lower in athletes. Treatment-seeking behavior and openness to future treatment increased over time in both groups but remained lower in athletes. Athletes received more information on stress reduction, substance abuse, eating disorders, and handling distress or violence compared with nonathletes. Both groups received information more frequently over time. Athletes reported fewer academic effects, especially for depression and anxiety, but these effects grew over time in both groups. The effects of injuries and extracurricular activities on academic performance were greater in athletes than in nonathletes. CONCLUSIONS Athletes described overall lower levels of mental health symptoms, diagnoses, and academic effects compared with nonathletes. Whereas the rates in nonathletes climbed over the past decade, the rates in athletes broadly remained flat or climbed less rapidly. Increasingly positive attitudes toward treatment were encouraging, but the deficit in athletes relative to nonathletes persisted. Ongoing efforts of athletic trainers to educate athletes and guide them to mental health resources are needed to continue, or better yet to accelerate, the observed positive trends in information dissemination and treatment-seeking behavior.
Collapse
Affiliation(s)
- Brian Edwards
- Department of Kinesiology and Health, Wright State University, Dayton, OH
| | - Andrew W. Froehle
- Department of Kinesiology and Health, Wright State University, Dayton, OH
- Department of Orthopaedic Surgery, Wright State University, Dayton, OH
| | - Siobhan E. Fagan
- Department of Kinesiology and Health, Wright State University, Dayton, OH
| |
Collapse
|
7
|
Dunlop BJ, Lea J. It's not just in my head: An intersectional, social and systems-based framework in gender and sexuality diversity. Psychol Psychother 2023; 96:1-15. [PMID: 36351776 PMCID: PMC10099476 DOI: 10.1111/papt.12438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The mental health and well-being of gender and sexuality diverse (GSD) people needs to be understood within a socio-political and cultural context. AIMS In this paper, an intersectional, social and system-based framework for understanding the mental health and well-being of GSD people is presented, for practitioners within this field to consider GSD mental health experiences and challenges within context. MATERIALS AND METHODS Starting with a consideration of the current landscape of understanding, pivotal theories and understandings within the field are outlined. The need for a framework that centralises intersectionality and broader systemic considerations is presented. RESULTS The framework provided has an explicit focus on four key features: (1) intersectionality, (2) institutions, policies and laws, (3) people and groups and (4) social stories. DISCUSSION Consideration of each of these 'circles of influence' can help practitioners to understand the multi-layered and intersectional experience of GSD folk and allows for an understanding of potential intervention at both an individual and systemic and societal level. CONCLUSION Use of such a framework in practice goes above and beyond what is currently available by centralising the role and impact of such wider systemic variables through an intersectional lens. The framework can be applicable worldwide given its flexibility to consider and apply pertinent policies, laws, people, groups and social stories within a particular country or culture.
Collapse
Affiliation(s)
- Brendan J Dunlop
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - James Lea
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| |
Collapse
|
8
|
Willenbrock D, Santella AJ. Re-envisioning the role of student health centers in offering LGBTQIA + friendly and sex-positive services. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1-4. [PMID: 33759724 DOI: 10.1080/07448481.2021.1878190] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/22/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Objective: Offering comprehensive lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual (LGBTQIA+) friendly and sex-positive student health centers are central to institutions of higher education being able to retain and support students. Positive sexual experiences for LGBTQIA + students can have an impact on academic success but many LGBTQIA + students are discriminated against and are often victims of microaggressions. Participants: Twenty undergraduate students enrolled in a LGBTQIA+ health course. Methods: Students in an LGBTQIA + Health undergraduate course at a private Northeastern university assessed what mattered most to them when it came to creating a sex-positive healthcare environment that promotes LGBTQIA + inclusiveness and removes perceived barriers. Results: The themes included expanding mental health care, greater involvement of culturally-competent provider, establishing a stigma-free clinical environment, re-imagining the clinic waiting room, and facilitating sexual health advocacy. Conclusion: Re-envisioning the role of student health centers is critical for ensuring every student has a fair and just opportunity to achieve their full health potential.
Collapse
Affiliation(s)
- Donna Willenbrock
- Department of Graduate Nursing, School of Nursing and Physician Assistant Studies, Hofstra University, Hempstead, New York, USA
| | - Anthony J Santella
- Department of Health Professions, School of Health Professions and Human Services, Hofstra University, Hempstead, New York, USA
| |
Collapse
|
9
|
Kaufman CC, Hipp T. Sexual and gender minority university students in the wake of COVID-19: Unique risks and opportunities for intervention. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-5. [PMID: 36328782 DOI: 10.1080/07448481.2022.2135378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 09/01/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Emerging adulthood is a critical period of development as individuals explore their identities and embark on developmental trajectories. Emerging adulthood may be an especially important period for sexual and gender minority (SGM) individuals as they explore, learn, and seek out communities related to their sexuality and gender identity. College is a unique setting in which SGM students may have access to physical and mental healthcare, secure food and housing, and affirming spaces and community related to their identity. However, the COVID-19 pandemic has interrupted or ended many of the services and resources provided by colleges and universities, potentially exacerbating challenges faced by sexual and gender minority students. This article provides recommendations for colleges and universities to improve access to and mitigate potentially negative outcomes among SGM students during and in the wake of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Caroline C Kaufman
- Department of Psychiatry, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Tracy Hipp
- United States Department of Defense, Sexual Assault Prevention and Response Office, Washington, DC, USA
- Department of Psychology, The University of Memphis, Memphis, Tennesse, USA
| |
Collapse
|
10
|
Bosse JD, Dion KA, Campbell Galman S, Chiodo LM. Transgender and nonbinary young adults' perception of sibling and parental support for gender identity. Res Nurs Health 2022; 45:569-579. [DOI: 10.1002/nur.22251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 05/10/2022] [Accepted: 06/12/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Jordon D. Bosse
- School of Nursing Northeastern University Boston Massachusetts USA
- External Faculty Nurse Scientist Massachusetts General Hospital Boston Massachusetts USA
| | - Kimberly A. Dion
- Elaine Marieb College of Nursing University of Massachusetts Amherst Massachusetts USA
| | - Sally Campbell Galman
- Child and Family Studies, College of Education University of Massachusetts Amherst Massachusetts USA
| | - Lisa M. Chiodo
- Elaine Marieb College of Nursing University of Massachusetts Amherst Massachusetts USA
| |
Collapse
|
11
|
MacKinnon KR, Kia H, Salway T, Ashley F, Lacombe-Duncan A, Abramovich A, Enxuga G, Ross LE. Health Care Experiences of Patients Discontinuing or Reversing Prior Gender-Affirming Treatments. JAMA Netw Open 2022; 5:e2224717. [PMID: 35877120 PMCID: PMC9315415 DOI: 10.1001/jamanetworkopen.2022.24717] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE Medical education, research, and clinical guidelines are available to support the initiation of gender-affirming care for transgender and nonbinary people. By contrast, little is known about the clinical experiences of those who discontinue or seek to reverse gender-affirming medical or surgical interventions due to a change in gender identity, often referred to as detransition. OBJECTIVE To examine the physical and mental health experiences of people who initiated medical or surgical detransition to inform clinical practice. DESIGN, SETTING, AND PARTICIPANTS Using constructivist grounded theory as a qualitative approach, data were collected in the form of in-depth interviews. Data were analyzed using an inductive 2-stage coding process to categorize and interpret detransition-related health care experiences to inform clinical practice. Between October 2021 and January 2022, individuals living in Canada who were aged 18 years and older with experience of stopping, shifting, or reversing a gender transition were invited to partake in semistructured virtual interviews. Study advertisements were circulated over social media, to clinicians, and within participants' social networks. A purposive sample of 28 participants who discontinued, shifted, or reversed a gender transition were interviewed. MAIN OUTCOMES AND MEASURES In-depth, narrative descriptions of the physical and mental health experiences of people who discontinued or sought to reverse prior gender-affirming medical and/or surgical interventions. RESULTS Among the 28 participants, 18 (64%) were assigned female at birth and 10 (36%) were assigned male at birth; 2 (7%) identified as Jewish and White, 5 (18%) identified as having mixed race and ethnicity (which included Arab, Black, Indigenous, Latinx, and South Asian), and 21 (75%) identified as White. Participants initially sought gender-affirmation at a wide range of ages (15 [56%] were between ages 18 and 24 years). Detransition occurred for various reasons, such as an evolving understanding of gender identity or health concerns. Participants reported divergent perspectives about their past gender-affirming medical or surgical treatments. Some participants felt regrets, but a majority were pleased with the results of gender-affirming medical or surgical treatments. Medical detransition was often experienced as physically and psychologically challenging, yet health care avoidance was common. Participants described experiencing stigma and interacting with clinicians who were unprepared to meet their detransition-related medical needs. CONCLUSIONS AND RELEVANCE This study's results suggest that further research and clinical guidance is required to address the unmet needs of this population who discontinue or seek to reverse prior gender-affirming interventions.
Collapse
Affiliation(s)
| | - Hannah Kia
- School of Social Work, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
| | - Florence Ashley
- Faculty of Law & Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada
| | | | - Alex Abramovich
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Gabriel Enxuga
- School of Social Work, McGill University, Montreal, Québec, Canada
| | - Lori E. Ross
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
12
|
Gianelis KA, Butler JM. Improving equitable access to inclusive sexual healthcare in a small urban college health setting. Nurs Forum 2022; 57:686-693. [PMID: 35152433 DOI: 10.1111/nuf.12708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/02/2022] [Accepted: 02/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sexual and gender minorities (SGM) experience many disparities in sexual health. College health centers must address early inequities for this population. LOCAL PROBLEM Significant access disparity was noted for SGM students at a small urban college health center. The aim of this quality initiative was to increase equitable access by 20% over 90 days. METHODS A rapid-cycle quality improvement project was initiated using a Plan-Do-Study-Act model. INTERVENTIONS Templated nurse-led visits, a discussion starter tool, and an inclusive care checklist were introduced, with assurance of equity for each metric, and a focus on team collaboration. RESULTS Access to sexual health services increased by 22.6% over 8 weeks with SGM utilization increasing 2.7-fold. Guideline-concordant care improved by 94% for all students. Student comfort scores (Likert range 1-5) also improved, from a baseline of 3.53 to a project mean of 4.62. CONCLUSIONS This project addressed equity in a college health setting through improved student engagement, targeted workflow innovation, and enhanced team collaboration. Application of key findings to other health topics will continue to mitigate disparities in college health centers. Tools may also be applied to adolescent and adult primary care settings to improve patient comfort and SGM-inclusive sexual health service delivery.
Collapse
Affiliation(s)
- Kristin A Gianelis
- Doctor of Nursing Practice Program, Frontier Nursing University, Versailles, Kentucky, USA
| | - Judith M Butler
- Doctor of Nursing Practice Program, Frontier Nursing University, Versailles, Kentucky, USA
| |
Collapse
|
13
|
Campbell C, Mena JA. LGBTQ+ Structural Stigma and College Counseling Center Website Friendliness. JOURNAL OF COLLEGE COUNSELING 2021. [DOI: 10.1002/jocc.12194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
14
|
Santos TC, Mann ES, Pfeffer CA. Are university health services meeting the needs of transgender college students? A qualitative assessment of a public university. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:59-66. [PMID: 31483216 DOI: 10.1080/07448481.2019.1652181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 07/28/2019] [Accepted: 07/31/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This exploratory study sought to assess transgender college students' experiences accessing primary, gynecological, and/or mental health care through university health services (UHS). PARTICIPANTS AND METHODS Individual interviews were conducted with eleven transgender undergraduate students attending a large public university in the United States in Spring 2017. RESULTS The structure, organization, and practices of UHS are not adequately meeting transgender college students' health care needs. Students reported being repeatedly misgendered and addressed by the incorrect name by staff at UHS. Some providers asked inappropriate and irrelevant questions about their gender identity during clinical encounters. These and related experiences deterred many participants from returning to UHS for health care services. CONCLUSION UHS could improve health care delivery to transgender college students by adopting standardized and inclusive practices consistent with those recommended by The Fenway Institute.
Collapse
Affiliation(s)
- Theodore C Santos
- South Carolina Honors College, University of South Carolina, Columbia, SC, USA
| | - Emily S Mann
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
- Women's and Gender Studies Program, University of South Carolina, Columbia, SC, USA
| | - Carla A Pfeffer
- Women's and Gender Studies Program, University of South Carolina, Columbia, SC, USA
- Department of Sociology, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
15
|
"I'll Just Pick It Up…": Women's Acceptability of Self-Sampling Methods for Sexually Transmitted Infection Screening. Sex Transm Dis 2020; 46:762-767. [PMID: 31688722 DOI: 10.1097/olq.0000000000001077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Rates of sexually transmitted infection (STI) screening are suboptimal among college women. Self-sampling methods (SSMs) may improve STI screening rates, but critical gaps remain regarding the influential characteristics of SSM to prioritize in intervention development. The purpose of this study was to explore intervention characteristics influencing the decision to adopt SSM among college women. METHODS In-depth interviews (n = 24) were conducted with sexually active college women aged 18-24 years to explore preferred intervention characteristics of SSM. Interviews were stratified by screening status (screened or not screened). The instrument was guided by constructs from the Diffusion of Innovation theory and included characteristics of SSM, such as relative advantage, compatibility, complexity, adaptability, and risk and uncertainty. RESULTS Overall, women felt that the SSM was not complex and that the instructions were straightforward. Participants discussed their strong preference for receiving their results via text or e-mail rather than via telephone. In addition, women described their concerns about mailing their sample and described their concern about potential contamination and tampering. The most salient advantage to use of SSM was avoiding an interaction with a health care provider. CONCLUSIONS This study contributes to an understanding of the salient intervention characteristics influencing the use of SSM for STI screening, which can be leveraged to improve the health of students and improve rates of screening. Findings can be used to inform the development of a future innovative, theory-based intervention that promotes the use of SSM to improve STI screening rates, and ultimately decrease the burden of STI-related disease.
Collapse
|
16
|
Promoting Safer Sexual Behaviours by Employing Social Cognitive Theory Among Gay University Students: A Pilot Study of A Peer Modelling Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051804. [PMID: 32164309 PMCID: PMC7084672 DOI: 10.3390/ijerph17051804] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 11/16/2022]
Abstract
Unsafe and unprotected sexual behaviours are some of the significant challenges of health promotions and planning for current school environment. Although schools and health specialists constantly host conferences and workshops for adolescents and university students, the results are not significant. Particularly for sexual minorities, the heterosexual-oriented materials may not satisfy their needs due to the differences. As a recommendation, the current pilot study established a Peer Modelling Programme which engaged gay social workers and gay university students who have associated with unsafe and unprotected sexual activities. The outcomes of this Peer Modelling Programme indicated that gay undergraduate students tended to accept the recommendations and peer modelling exchanges from their gay social workers who understood their difficulties and sexual needs as sexual minorities based on the guideline of Social Cognitive Theory. In conclusion, this study may be used to develop additional social work materials, sexual health promotions and health plans for sexual minorities and people with special needs in the society. This research serves as a guideline to social workers who care about the issues of LGBT and sexual minorities.
Collapse
|
17
|
Todorinova L, Ortiz-Myers M. The role of the academic library in supporting LGBTQ students: A survey of librarians and library administrators at LGBTQ-friendly colleges and universities. COLLEGE & UNDERGRADUATE LIBRARIES 2019. [DOI: 10.1080/10691316.2019.1596857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Lily Todorinova
- Rutgers University Libraries, Rutgers University, New Brunswick, NJ, USA
| | - Maria Ortiz-Myers
- Rutgers University Libraries, Rutgers University, New Brunswick, NJ, USA
| |
Collapse
|