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Stoody VB, Glick HR, Murphey AC, Sturza JM, Selkie EM. A Content Analysis of Transgender Health and Wellness Themes Shared Through Social Media. Clin Pediatr (Phila) 2024; 63:1352-1363. [PMID: 38135918 DOI: 10.1177/00099228231219499] [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] [Indexed: 12/24/2023]
Abstract
Transgender and gender-diverse (TGD) adolescents experience limited access to gender-affirming care (GAC) and information and use social media platforms for informational and social support. We conducted conventional content analysis of posts on the platform, Tumblr and applied univariate statistics to characterize health and wellness themes represented by this content. Content was predominantly transmasculine-relevant. Posts addressing the trans health care paradigm often co-occurred with content referencing affirmation logs, the physical and emotional impact of affirmation, surgery, and unspecified medical interventions. Gender-affirming hormone therapy was the most prevalent intervention referenced in posts related to non-professional/non-licensed medical care and advice requests. Transgender and gender-diverse youth-serving individuals can use this information to mitigate harm, enhance patient education, and improve the overall well-being of TGD youth. Further research is needed to characterize the effect of content encountered on social media on pediatric patient experiences and on outcomes of GAC.
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Affiliation(s)
- Vishvanie B Stoody
- Division of Adolescent Medicine, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Hannah R Glick
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Annie C Murphey
- Section of Emergency Medicine, The University of Chicago, Chicago, IL, USA
| | - Julie M Sturza
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ellen M Selkie
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Machado S, Perez B, Papanicolas I. The role of race and ethnicity in health care crowdfunding: an exploratory analysis. HEALTH AFFAIRS SCHOLAR 2024; 2:qxae027. [PMID: 38756917 PMCID: PMC10986198 DOI: 10.1093/haschl/qxae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 05/18/2024]
Abstract
Medical crowdfunding is a key source of financing for individuals facing high out-of-pocket costs, including organ-transplant candidates. However, little is known about racial disparities in campaigning activity and outcomes, or how these relate to access to care. In this exploratory, nationwide, cross-sectional study, we examined racial disparities in campaigning activity across states and the association between US campaigners' race and ethnicity and crowdfunding outcomes using a novel database of organ-transplant-related campaigns, and an algorithm to identify race and ethnicity based on name and geographic location. This analysis suggests that there are racial disparities in individuals' ability to successfully raise requested funds, with Black and Hispanic campaigners fundraising lower amounts and less likely to achieve their monetary goals. We also found that crowdfunding among White, Black, and Hispanic populations exhibits different patterns of activity at the state level, and in relation to race-specific uninsurance and waitlist additions, highlighting potential differences in fundraising need across the 3 groups. Policy efforts should consider not only how inequalities in fundraising ability for associated costs influence accessibility to care but also how to identify clinical need among minorities.
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Affiliation(s)
- Sara Machado
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI 02903, United States
- Department of Health Policy, London School of Economics, London WC2A 2AE, United Kingdom
| | - Beatrice Perez
- Department of Computer Science, University of Massachusetts, Boston, MA 02125, United States
| | - Irene Papanicolas
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI 02903, United States
- Department of Health Policy, London School of Economics, London WC2A 2AE, United Kingdom
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
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Wardell S, Withey-Rila C. A critical analysis of trans-visibility through online medical crowdfunding. Soc Sci Med 2024; 345:116682. [PMID: 38413282 DOI: 10.1016/j.socscimed.2024.116682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 01/22/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Abstract
In contexts where many people face barriers to accessing gender-affirming care through public systems, some turn to online crowdfunding to fundraise for private care pathways. Crowdfunding platforms invite people to share personal information, stories, and photos publicly, in order to elicit donations. In this article we draw on empirical data from a multimethodological three-year study of medical crowdfunding in Aotearoa New Zealand, with a focus on people crowdfunding for medical transition services. We apply a lens of 'visibility' to analysis of focus groups, interviews, case studies, and campaign pages, presenting findings on who was present and absent (with a focus on binary gender, and whiteness), and who was the assumed or expected audience (with a focus on cis publics). We describe how campaigns were defined by efforts to make trans bodies legible, and campaign requests competitive, through reference to narrow and medicalised frames of dysphoria, suffering, and transformation via medical intervention. We contribute to more comparative work in the literature on crowdfunding by highlighting how these globalised digital technologies are situated in the particular (demographic, cultural, and structural) contexts of Aotearoa New Zealand. We call attention to crowdfunding as a relational practice, in which the public marketisation of the self can have both individual consequences related to privacy and outing, and social consequences, in the reinforcing of trans-normativities. Overall we argue that although crowdfunding represents an adaptive strategy for trans people trying meet their own needs, it ultimately contributes to a type of trans-visibility which is both risky and limiting.
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Waters AR, Easterly CW, Turner C, Ghazal L, Tovar I, Mulvaney M, Poquadeck M, Rains SA, Cloyes KG, Kirchhoff AC, Kent EE, Warner EL. LGBTQ+ inequity in crowdfunding cancer costs: The influence of online reach and LGBTQ+ state policy. Cancer Med 2024; 13:e6926. [PMID: 38275010 PMCID: PMC10905337 DOI: 10.1002/cam4.6926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/21/2023] [Accepted: 12/30/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Emerging literature suggests that LGBTQ+ cancer survivors are more likely to experience financial burden than non-LGBTQ+ survivors. However, LGBTQ+ cancer survivors experience with cost-coping behaviors such as crowdfunding is understudied. METHODS We aimed to assess LGBTQ+ inequity in cancer crowdfunding by combining community-engaged and technology-based methods. Crowdfunding campaigns were web-scraped from GoFundMe and classified as cancer-related and LGBTQ+ or non-LGBTQ+ using term dictionaries. Bivariate analyses and generalized linear models were used to assess differential effects in total goal amount raised by LGBTQ+ status. Stratified models were run by online reach and LGBTQ+ inclusivity of state policy. RESULTS A total of N = 188,342 active cancer-related crowdfunding campaigns were web-scraped from GoFundMe in November 2022, of which N = 535 were LGBTQ+ and ranged from 2014 to 2022. In multivariable models of recent campaigns (2019-2022), LGBTQ+ campaigns raised $1608 (95% CI: -2139, -1077) less than non-LGBTQ+ campaigns. LGBTQ+ campaigns with low (26-45 donors), moderate (46-87 donors), and high (88-240 donors) online reach raised on average $1152 (95% CI: -$1589, -$716), $1050 (95% CI: -$1737, -$364), and $2655 (95% CI: -$4312, -$998) less than non-LGBTQ+ campaigns respectively. When stratified by LGBTQ+ inclusivity of state level policy states with anti-LGBTQ+ policy/lacking equitable policy raised on average $1910 (95% CI: -2640, -1182) less than non-LGBTQ+ campaigns from the same states. CONCLUSIONS AND RELEVANCE Our findings revealed LGBTQ+ inequity in cancer-related crowdfunding, suggesting that LGBTQ+ cancer survivors may be less able to address financial burden via crowdfunding in comparison to non-LGBTQ+ cancer survivors-potentially widening existing economic inequities.
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Affiliation(s)
- Austin R. Waters
- Department of Health Policy and Management, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
- Cancer Control and Population SciencesHuntsman Cancer Institute at the University of UtahSalt Lake CityUtahUSA
| | - Caleb W. Easterly
- Department of Health Policy and Management, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Cindy Turner
- College of NursingUniversity of UtahSalt Lake CityUtahUSA
| | - Lauren Ghazal
- Crowdfunding Cancer Costs (C3) LGBTQ+ Study Advisory BoardHuntsman Cancer Institute at the University of UtahSalt Lake CityUtahUSA
- School of NursingUniversity of RochesterRochesterNew YorkUSA
| | - Ida Tovar
- College of NursingUniversity of UtahSalt Lake CityUtahUSA
| | - Megan Mulvaney
- Crowdfunding Cancer Costs (C3) LGBTQ+ Study Advisory BoardHuntsman Cancer Institute at the University of UtahSalt Lake CityUtahUSA
- School of Public HealthIndiana University BloomingtonBloomingtonIndianaUSA
| | - Matt Poquadeck
- Crowdfunding Cancer Costs (C3) LGBTQ+ Study Advisory BoardHuntsman Cancer Institute at the University of UtahSalt Lake CityUtahUSA
- Wilmot Cancer InstituteUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Stephen A. Rains
- Department of CommunicationUniversity of ArizonaTucsonArizonaUSA
| | - Kristin G. Cloyes
- School of NursingOregon Health and Science UniversityPortlandOregonUSA
| | - Anne C. Kirchhoff
- Cancer Control and Population SciencesHuntsman Cancer Institute at the University of UtahSalt Lake CityUtahUSA
- Department of PediatricsUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | - Erin E. Kent
- Department of Health Policy and Management, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Echo L. Warner
- Cancer Control and Population SciencesHuntsman Cancer Institute at the University of UtahSalt Lake CityUtahUSA
- College of NursingUniversity of UtahSalt Lake CityUtahUSA
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Waters AR, Turner C, Easterly CW, Tovar I, Mulvaney M, Poquadeck M, Johnston H, Ghazal LV, Rains SA, Cloyes KG, Kirchhoff AC, Warner EL. Exploring Online Crowdfunding for Cancer-Related Costs Among LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer, Plus) Cancer Survivors: Integration of Community-Engaged and Technology-Based Methodologies. JMIR Cancer 2023; 9:e51605. [PMID: 37902829 PMCID: PMC10644187 DOI: 10.2196/51605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/14/2023] [Accepted: 09/22/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Cancer survivors frequently experience cancer-related financial burdens. The extent to which Lesbian, Gay, Bisexual, Transgender, Queer, Plus (LGBTQ+) populations experience cancer-related cost-coping behaviors such as crowdfunding is largely unknown, owing to a lack of sexual orientation and gender identity data collection and social stigma. Web-scraping has previously been used to evaluate inequities in online crowdfunding, but these methods alone do not adequately engage populations facing inequities. OBJECTIVE We describe the methodological process of integrating technology-based and community-engaged methods to explore the financial burden of cancer among LGBTQ+ individuals via online crowdfunding. METHODS To center the LGBTQ+ community, we followed community engagement guidelines by forming a study advisory board (SAB) of LGBTQ+ cancer survivors, caregivers, and professionals who were involved in every step of the research. SAB member engagement was tracked through quarterly SAB meeting attendance and an engagement survey. We then used web-scraping methods to extract a data set of online crowdfunding campaigns. The study team followed an integrated technology-based and community-engaged process to develop and refine term dictionaries for analyses. Term dictionaries were developed and refined in order to identify crowdfunding campaigns that were cancer- and LGBTQ+-related. RESULTS Advisory board engagement was high according to metrics of meeting attendance, meeting participation, and anonymous board feedback. In collaboration with the SAB, the term dictionaries were iteratively edited and refined. The LGBTQ+ term dictionary was developed by the study team, while the cancer term dictionary was refined from an existing dictionary. The advisory board and analytic team members manually coded against the term dictionary and performed quality checks until high confidence in correct classification was achieved using pairwise agreement. Through each phase of manual coding and quality checks, the advisory board identified more misclassified campaigns than the analytic team alone. When refining the LGBTQ+ term dictionary, the analytic team identified 11.8% misclassification while the SAB identified 20.7% misclassification. Once each term dictionary was finalized, the LGBTQ+ term dictionary resulted in a 95% pairwise agreement, while the cancer term dictionary resulted in an 89.2% pairwise agreement. CONCLUSIONS The classification tools developed by integrating community-engaged and technology-based methods were more accurate because of the equity-based approach of centering LGBTQ+ voices and their lived experiences. This exemplar suggests integrating community-engaged and technology-based methods to study inequities is highly feasible and has applications beyond LGBTQ+ financial burden research.
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Affiliation(s)
- Austin R Waters
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
| | - Cindy Turner
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Caleb W Easterly
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Ida Tovar
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Megan Mulvaney
- Crowdfunding Cancer Costs LGBT Study Advisory Board, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Matt Poquadeck
- Crowdfunding Cancer Costs LGBT Study Advisory Board, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
| | - Hailey Johnston
- Crowdfunding Cancer Costs LGBT Study Advisory Board, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
| | - Lauren V Ghazal
- Crowdfunding Cancer Costs LGBT Study Advisory Board, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- School of Nursing, University of Rochester, Rochester, NY, United States
| | - Stephen A Rains
- Department of Communication, University of Arizona, Tucson, AZ, United States
| | - Kristin G Cloyes
- School of Nursing, Oregon Health & Science University, Portland, OR, United States
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Echo L Warner
- Cancer Control and Population Sciences, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
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Grassi L, Fantaccini S. An overview of Fintech applications to solve the puzzle of health care funding: state-of-the-art in medical crowdfunding. FINANCIAL INNOVATION 2022; 8:84. [PMID: 36158456 PMCID: PMC9483272 DOI: 10.1186/s40854-022-00388-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Crowdfunding is emerging as an alternative form of funding for medical purposes, with capital being raised directly from a broader and more diverse audience of investors. In this paper, we have systematically researched and reviewed the literature on medical crowdfunding to determine how crowdfunding connects with the health care industry. The health care industry has been struggling to develop sustainable research and business models for economic systems and investors alike, especially in pharmaceuticals. The research results have revealed a wealth of evidence concerning the way crowdfunding is applied in real life. Patients and caregivers utilize web platform-based campaigns all over the world to fund their medical expenses, generally on a spot basis, using donation-based or even reward-based schemes, regardless of the health care system archetype (public, private insurance-based or hybrid). Academics have also focused on funding campaigns and the predictors of success (which range from social behaviour and environment to the basic demographics of the campaigners and their diseases) and on social and regulatory concerns, including heightened social inequality and stigma. While equity crowdfunding is disrupting the way many ventures/businesses seek capital in the market, our research indicates that there are no relevant or consistent data on the practice of medical equity crowdfunding in health care, apart from a few anecdotal cases.
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Affiliation(s)
- Laura Grassi
- School of Management, Politecnico di Milano, Milan, Italy
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Hou X, Wu T, Chen Z, Zhou L. Success Factors of Medical Crowdfunding Campaigns: Systematic Review. J Med Internet Res 2022; 24:e30189. [PMID: 35315779 PMCID: PMC8984822 DOI: 10.2196/30189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/11/2021] [Accepted: 02/26/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Medical crowdfunding provides opportunities for individuals who lack financial resources to access the health services that they need. Despite the popularity of medical crowdfunding, the current understanding of the success of medical crowdfunding campaigns is fragmented and inadequate. OBJECTIVE We aimed to comprehensively investigate which factors lead to the success of medical crowdfunding campaigns. METHODS A search was conducted in PubMed, PsycINFO, Web of Science, ACM Digital Library, and ScienceDirect from 2010 to June 2020. Papers directly and indirectly related to the success of medical crowdfunding campaigns were included. Two reviewers independently extracted information on the success of medical crowdfunding campaigns. RESULTS Our search yielded 441 articles, of which 13 met the inclusion criteria. Medical crowdfunding is increasingly attracting academic attention, and most studies leverage text analysis as their research methods; however, there is a lack of consensus on the definition of medical crowdfunding among researchers. Four categories of factors that affect the success of medical crowdfunding were identified: platforms, raisers, donors, and campaigns. CONCLUSIONS Although some limitations exist in our systematic review, our study captured and mapped literatures of the success of medical crowdfunding campaigns systematically, which can be used as the basis for future research on this topic.
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Affiliation(s)
- Xiaoyan Hou
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China
| | - Tailai Wu
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Chen
- School of Economics, Faculty of Humanities and Social Sciences, University of Nottingham Ningbo, Ningbo, China
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States
| | - Liqin Zhou
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China
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Zenone MA, Snyder J, Crooks VA. What are the informational pathways that shape people's use of cannabidiol for medical purposes? J Cannabis Res 2021; 3:13. [PMID: 33957993 PMCID: PMC8103601 DOI: 10.1186/s42238-021-00069-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 04/19/2021] [Indexed: 12/27/2022] Open
Abstract
Background Cannabidiol (CBD) is commonly used to manage symptoms in conditions and diseases for which there is limited clinical research for its application. How consumers arrive and decide to use CBD for medical treatment, despite lacking clinical evidence, is largely unknown. In this paper, we seek to identify the informational pathways through which consumers arrive at CBD for medical purposes. Methods GoFundMe.com campaigns fundraising to purchase CBD between June 2017 and May 2019 were collected using the Crowdfunding for Health Research Portal (CHRP). Product descriptions were thematically analyzed to determine pathways leading to incorporation of CBD into medical treatment. Campaign characteristics such as fundraising ask, funding received, location, campaign title, description, Facebook shares, and number of donors were recorded. Specific medical uses of CBD proposed in campaigns were tabulated. Results The study identified 164 crowdfunding campaigns primarily from the USA (n=159), with several from Canada (n=5). The campaigns requested $2,219,284.24 (median, $7000) and raised $610,612.87 (median, $1805) from 6825 donors (median, 26). Many campaigns asked for other treatments or illness-related costs not specific to CBD. The campaigns were shared 42,299 times on Facebook (median, 156 shares). Three informational pathways were identified leading to incorporation of CBD into medical treatment, which were self-directed research (n=149), recommendations from a trusted care provider (n=36), and/or experiential insights shared by someone associated with or influencing the crowdfunders personal network (n=30). The proposed uses of CBD were for cancer (n=96), seizure-inducing diseases/conditions (n=48), other/unspecified (n=6), joint/inflammatory diseases (n=6), mental health disorders (n=3), nervous system diseases (n=3), and autoimmune diseases (n=2). Conclusions Our results suggest that consumers crowdfunding come to CBD through internally motivated reasons versus exposure to advertisements or other forms of marketing. Campaign beneficiaries generally had an unmet medical need that other forms of treatment were not satisfying. Then, through one or more of the informational pathways identified, CBD is considered a potential solution.
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Affiliation(s)
- Marco A Zenone
- Faculty of Health Sciences, Simon Fraser University, 8888 University Dr, Burnaby, British Columbia, V5A 1S6, Canada.
| | - Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, 8888 University Dr, Burnaby, British Columbia, V5A 1S6, Canada
| | - Valorie A Crooks
- Department of Geography, Simon Fraser University, 8888 University Dr, Burnaby, British Columbia, V5A 1S6, Canada
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Kimberly LL, Ramly EP, Alfonso AR, Diep GK, Berman ZP, Rodriguez ED. Equity in access to facial transplantation. JOURNAL OF MEDICAL ETHICS 2020; 47:medethics-2020-106129. [PMID: 33060187 DOI: 10.1136/medethics-2020-106129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 09/26/2020] [Accepted: 09/26/2020] [Indexed: 06/11/2023]
Abstract
We examine ethical considerations in access to facial transplantation (FT), with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to those in need. This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature.
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Affiliation(s)
- Laura L Kimberly
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, United States
- Division of Medical Ethics, Department of Population Health, NYU Langone Health, New York, NY, United States
| | - Elie P Ramly
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, United States
| | - Allyson R Alfonso
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, United States
| | - Gustave K Diep
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, United States
| | - Zoe P Berman
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, United States
| | - Eduardo D Rodriguez
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, United States
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Glick JL, Lopez A, Pollock M, Theall KP. Housing insecurity and intersecting social determinants of health among transgender people in the USA: A targeted ethnography. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 21:337-349. [PMID: 34993513 PMCID: PMC8726680 DOI: 10.1080/26895269.2020.1780661] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Background: Housing is an important social determinant of health (SDOH). Transgender people face a unique blend of discrimination and compromised social services, putting them at risk for housing insecurity and associated public health concerns. Aims: This targeted ethnography explores housing insecurity as a SDOH among transgender people in the U.S. Methods: In-depth interviews were conducted with transgender people (n = 41) throughout the U.S.A., identified through purposive sampling. A semi-structured guide was used to elicit personal stories and peer accounts of insecure housing experiences and coping strategies. Interviews were audio recorded and transcribed. Data was coded, sorted, and analyzed for key themes. Results: Responses revealed pervasive housing insecurity and inter-related challenges. Respondents discussed how intersecting identities create unique constellations of vulnerability, which "intersect like a star." Financial insecurity and interpersonal rejection were lead housing insecurity causes, often resulting in psychological strain, which was sometimes addressed with substances and sexual risk-taking. These factors were cyclically accompanied by financial and employment insecurity and a cascade of unmet social needs. Social support facilitated coping. Discussion: Findings support increasing transgender housing security intervention resources that address intersecting and cyclical discrimination, trauma, housing, employment, and health issues.
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Affiliation(s)
- Jennifer L. Glick
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alex Lopez
- Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Miranda Pollock
- School of Medicine, Section of Community and Population Medicine, Louisiana State University Health Sciences Center – New Orleans, New Orleans, Louisiana, USA
| | - Katherine P. Theall
- Global Community Health and Behavioral Sciences and LSUHSC Comprehensive Alcohol and HIV Research Center (CARC), Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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11
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Fong A, Jain M, Sacks W, Ho A, Chen Y. Crowdfunding Campaigns and Thyroid Surgery: Who, What, Where, and How Much? J Surg Res 2020; 253:63-68. [PMID: 32320898 DOI: 10.1016/j.jss.2020.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/30/2019] [Accepted: 01/19/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Crowdfunding has become a unique response to the challenge of health care expenses, yet it has been rarely studied by the medical community. We looked to describe the scope of crowdfunding in thyroid surgery and analyze the factors that contribute toward a successful campaign. METHODS In November 2018, active campaigns were retrieved from a popular crowdfunding Web site using search terms thyroidectomy and thyroid surgery and filtered to include only campaigns that originated in the United States. RESULTS About 1052 thyroid surgery-related campaigns were analyzed. About 836 (79.5%) involved female patients and 43 (4.1%) pediatric patients. About 792 campaigns (75.3%) referred to thyroid cancer as a primary condition, 163 (15.5%) benign thyroid disease, and 97 (9.2%) other conditions. The average amount raised per campaign was $2514.54 (range, $0-$53,160). About 338 (32.1%) campaigns were self-posted, 317 (30.1%) posted by family, and 397 (37.7%) posted by friends. Median campaign duration was 20 mo, with a median number of 16 donors, 17 hearts, and 136 social media shares. Campaigns related to thyroid cancer raised more funds ($2729.97) than benign ($1669.84) or other ($2175.03) conditions (P < 0.001). Campaigns submitted by friends ($3524.78) received more funding than those by self ($1672.48) or family ($2147.19) (P < 0.001). Campaign duration, donor number, share number, and hearts were also significant predictors of amount raised. CONCLUSIONS For thyroid surgery-related crowdfunding, campaigns referring to thyroid cancer had the highest amount of funds raised. Campaigns created by friends and other factors related to increased community engagement such as social media shares were also related to increased funds.
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Affiliation(s)
- Abigail Fong
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
| | - Monica Jain
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Wendy Sacks
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Allen Ho
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yufei Chen
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
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Vassell A, Crooks VA, Snyder J. What was lost, missing, sought and hoped for: Qualitatively exploring medical crowdfunding campaign narratives for Lyme disease. Health (London) 2020; 25:707-721. [PMID: 32202156 DOI: 10.1177/1363459320912808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lyme disease remains a contested illness in Canada, thereby making the diagnostic and treatment journeys difficult for some people. One outcome of this is that increasing numbers of people are turning to medical crowdfunding to support access to alternative therapies, non-local health care providers and assist with managing the costs of everyday life. In this analysis, we qualitatively explore the narratives shared in Canadians' crowdfunding campaigns to support Lyme disease treatment or diagnosis to identify whether or not any common elements shared in these narratives exist, and if so, what they are. We identified 238 campaigns for inclusion from three prominent crowdfunding platforms. Thematic analysis of the campaign narratives shows four consistent themes shared in these campaigns: what is lost (e.g. bodily ability), what is missing (e.g. local care options), what is sought (e.g. funds to cover treatment abroad) and what is hoped for (e.g. return to wellbeing). These themes demonstrate the highly personal and emotional nature of medical crowdfunding, particularly in the context of a contested illness that may lead some to question the legitimacy of one's financial need. This analysis contributes valuable new insights to the nascent scholarship on medical crowdfunding, and particularly to our understanding of how people communicate about their health and bodily needs on this public platform. It also identifies important directions for future research, including the potential for crowdfunding narratives to be used for advocacy.
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Exploring crowdfunding campaigns for abortion services. Contraception 2020; 102:18-22. [PMID: 32105655 DOI: 10.1016/j.contraception.2020.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To examine the use of crowdfunding to pay for abortion services for individuals in the United States. STUDY DESIGN Cross-sectional analysis of data abstracted from publicly available campaigns for abortion services on four major crowdfunding sites. RESULTS Among 92 crowdfunding campaigns, the median amount requested was $610 (IQR $500-$1000), the median raised was $0 (IQR $0-$444), and 19 (21%) campaigns successfully reached their fundraising goal. Campaign success did not differ by state abortion policy, but campaigns written in third person or describing maternal/fetal diagnoses raised significantly more money. CONCLUSIONS Although individuals use crowdfunding to finance abortion services, the success rate is low.
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