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Veilleux M, Terrier JE, Bécu M, Lafon M, Bourmaud A, Martin P. Perceptions, expectations, and recommendations of trans adults on gender-affirming care in France: a qualitative study. BMC Public Health 2024; 24:2177. [PMID: 39135007 PMCID: PMC11318127 DOI: 10.1186/s12889-024-19593-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 07/26/2024] [Indexed: 08/16/2024] Open
Abstract
Trans people have diverse life experiences which may include gender-affirming care (GAC). GAC positively impacts the quality of life of trans adults. However, they are often met with barriers to care and are particularly vulnerable within the healthcare system. The needs and expectations surrounding GAC may vary between individual patients. This article aims to analyze trans adults' perceptions, expectations, and recommendations on GAC. Twenty-seven semi-structured interviews were conducted by a team of academic and peer researchers; transcribed interviews were then analyzed using a codebook and thematic analysis. Three main themes were identified; the liberating experience of GAC; the uneven distribution of knowledge and power between patients and providers; and the recommended practices in GAC. Additional training and research are necessary to facilitate high-quality care for trans adults accessing GAC.
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Affiliation(s)
| | | | | | | | - Aurélie Bourmaud
- Inserm CIC-EC1426 Robert Debré Hospital, Paris, France
- Université Paris Cité, Inserm U1123 ECEVE, Paris, France
| | - Philippe Martin
- Inserm CIC-EC1426 Robert Debré Hospital, Paris, France.
- Université Paris Cité, Inserm U1123 ECEVE, Paris, France.
- Institut National d'Etudes Démographiques (INED), UR14 - Sexual and Reproductive Health and Rights, Aubervilliers, France.
- GDID Santé, Paris, France.
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2
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Neri J, Vitelli R, Faccio E. Body-Related Existential Dilemmas During Gender Transition: Research in the Italian Context. JOURNAL OF HOMOSEXUALITY 2024:1-26. [PMID: 39101761 DOI: 10.1080/00918369.2024.2387085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
The scientific literature shows that gender transition is effective in improving the general well-being of transgender people. However, so far, little attention has been paid to the actual role of the body concerning the existential dilemma that holds the person hostage during transition. This study investigates the relationship between the body-here considered in its concrete, experienced, imagined, and intersubjective dimensions-and gender identity. Twenty-five transgender people who live in Italy were interviewed to identify interpretive repertoires and identity positionings. Four main repertoires and positionings emerged: 1) Interpretative repertoires on the body in transition, where an enduring influence of gender binarism and biological determinants were observed; 2) Expectations regarding medically induced modifications of the body ranging from self-confidence to uncertainty; 3) Positionings toward medically induced bodily modifications, ranging from enthusiasm to resignation; and 4) Inter- and Intrapersonal positionings, where the other than self was found to act as a self-confirming resource or as a constant unpredictable and potentially threatening source of disconfirmation. Practitioners need to develop a stronger awareness of the different dimensions, meanings, and discourses surrounding bodily experience to more effectively intervene in their clinical practice with transgender people.
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Affiliation(s)
- Jessica Neri
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Roberto Vitelli
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elena Faccio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
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3
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Mayer TK, Becker-Hebly I, Elaut E, Heylens G, Kreukels BPC, Nieder TO. Desired decision-making role and treatment satisfaction among trans people during medical transition: results from the ENIGI follow-up study. J Sex Med 2023; 20:893-904. [PMID: 37037786 DOI: 10.1093/jsxmed/qdad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/29/2023] [Accepted: 03/01/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Shared decision making (SDM) is particularly important in transition-related medical interventions (TRMIs) given the nature of treatment and history of gatekeeping in transgender health care. Yet few studies have investigated trans people's desired decision-making role within TRMI and factors that influence these desires. AIMS The study investigated trans people's desired level of decision making during medical transition as well as possible sociodemographic predictors and correlations between decision-making desires and satisfaction with treatment. METHODS Data were collected from a clinical sample from 3 trans health care centers, as part of the larger ENIGI study. The data consisted of 568 trans individuals (60.2% assigned male at birth) 20 to 82 years of age (mean age = 38.58 years) who took part in the study 4 to 6 years after initial clinical contact. Binary logistic regressions were conducted to determine whether independent variables predicted group membership in decision-making role subgroups while a Spearman rank-order correlation was conducted to determine the relationship between desired decision-making involvement and satisfaction with care. OUTCOMES Main measures were desired decision-making role, satisfaction with treatment, age, education level, country of residence, treatment status, individual treatment progress score (ITPS), gender identity, and sex assigned at birth. RESULTS The vast majority of participants wanted to make medical decisions themselves. Age, education level, country of residence, treatment status, gender identity, and sex assigned at birth showed no significant effects in desired level of decision making, while the ITPS neared significance. Satisfaction with treatment was overall very high. For participants assigned male at birth, desire for a more active role in decision making was negatively correlated with satisfaction of labia surgery. CLINICAL IMPLICATIONS A desired decision-making role cannot be predicted based on the trans person's sociodemographic characteristics. More involvement from health professionals addressing medical information and education obligations may be needed when offering surgical construction of labia to individuals assigned male at birth. STRENGTHS AND LIMITATIONS This study builds on the few existing analyses of desired levels of decision-making role among trans people during transition. It is the first to investigate the role of education level and treatment status/ITPS on the desire of decision-making role. Gender identity and influence of nonbinary identity were not investigated for treatment satisfaction as these items were presented based on sex assigned at birth. CONCLUSION This study highlights that trans people in 3 European trans health care centers during medical transition desire a more active role in decision making. Satisfaction with treatment received was overall very high.
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Affiliation(s)
- Toby K Mayer
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Inga Becker-Hebly
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Els Elaut
- Department of Experimental, Clinical and Health Psychology, Ghent University, 9000 Ghent, Oost-Vlaanderen, Belgium
- Center of Sexology and Gender, University Hospital Ghent, 9000 Ghent, Oost-Vlaanderen, Belgium
| | - Gunter Heylens
- Center of Sexology and Gender, University Hospital Ghent, 9000 Ghent, Oost-Vlaanderen, Belgium
| | - Baudewijntje P C Kreukels
- Department of Medical Psychology, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
| | - Timo O Nieder
- Interdisciplinary Transgender Health Care Center Hamburg, Department for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Jones A, Huslage M, Dalton M. "Any Reason is Valid:" How an Unexpected Abortion Disclosure is Received by an Online Community. SOCIAL WORK IN PUBLIC HEALTH 2023; 38:85-94. [PMID: 35796351 DOI: 10.1080/19371918.2022.2096736] [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
This study utilized a social media post by a well-known social media influencer and the accompanying 63 responses to explore feelings and experiences related to abortion. This study employed qualitative thematic analysis and identified three themes related to reasons for abortion (i.e., relationship issues, not being ready for pregnancy, and other reasons) and one supplemental theme of bystander support. Findings highlight the efforts of many respondents to normalize abortion as an issue of women's health and women's rights. In fact, in response to the original post's discussion regarding valid reasons for an abortion, most respondents remarked similarly that any reason is valid. While study limitations include concerns regarding generalizability, this study provides access to abortion experiences outside of a traditional health clinic survey and insight into the abortion beliefs of women, both who have and have not experienced an abortion. Findings are in line with previous studies which found that multiple reasons are cited for obtaining an abortion, but also revealed a more supportive climate than the divisive discourse typically portrayed in the media. This suggests the timing may be conducive for efforts aiming to normalize abortion and reduce stigma, including potential avenues for interventions (e.g., social networks and platforms). Lastly, the innovative use of social media to inform this study should be considered by others as they seek to understand and explore topics that can be challenging to study.
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Affiliation(s)
- Aubrey Jones
- College of Social Work, The University of Kentucky, Lexington, Kentucky, USA
| | - Melody Huslage
- College of Social Work, The University of Tennessee, Knoxville, Tennessee, USA
| | - Miranda Dalton
- College of Social Work, The University of Tennessee, Knoxville, Tennessee, USA
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5
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Cartujano-Barrera F, Cox LS, Catley D, Shah Z, Alpert AB, Cupertino AP. "I'm a transgender man… I have to quit smoking for treatment and surgery": Describing the experience of a Latino transgender man during his attempt to quit smoking. Explore (NY) 2023; 19:131-135. [PMID: 34823998 PMCID: PMC9110554 DOI: 10.1016/j.explore.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/13/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To describe the experience of a Latino transgender man during his attempt to quit smoking using a text messaging intervention. METHODS A Latino transgender man enrolled in a smoking cessation randomized controlled trial for Latino smokers. The participant was randomized to Decídetexto, a smoking cessation mobile intervention. The participant received a 24-week text messaging intervention. We assessed text messaging interactivity with the program, satisfaction, and self-reported abstinence at Week 12 and Month 6. RESULTS During the 24-week intervention period, the participant sent a total of 287 text messages to the program. When analyzing the content of the text messages sent by the participants, four important themes were identified: 1) gender identity, 2) low social support, 3) stressors (e.g., gender dysphoria), and 4) gender affirmation surgery as a reason to quit smoking. At both Week 12 and Month 6, the participant reported being extremely satisfied with the intervention and self-reported cigarette use. CONCLUSION A smoking cessation mobile intervention generated high satisfaction and frequent interactivity among a Latino transgender man. This case report provides important insights into the experience of one Latino transgender man during his attempt to quit smoking. There is an urgent need to develop or adapt existing smoking cessation interventions to better meet the needs of transgender people.
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Affiliation(s)
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, United States
| | - Zainab Shah
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
| | - Ash B Alpert
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
| | - Ana Paula Cupertino
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, United States
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6
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Roche K, Stephens S, Moss S, Seto MC. Online forum use in child attracted persons. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2022. [DOI: 10.3138/cjhs.2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Social support for child-attracted persons (CAPs) may be important for increasing well-being, thereby reducing the risk of committing child sexual abuse. Unfortunately, in-person social support may be difficult to obtain because of stigma. CAPs may instead turn to online forums for people who are sexually attracted to children. The present study looks at the emotional, informational, and tangible support CAPs offered and received through online forums. We recruited 353 CAPs from Twitter and multiple online forums. The survey covered basic demographics, frequency of forum use, reasons for forum use, social support received or offered, helpfulness of forums, and their quality of offline support. Most CAPs said that they initially sought out forums to avoid feeling alone in their attraction; the quality of offline support was rated as moderate. Emotional support and informational support were the most frequently endorsed forms of social support. CAPs who visited more forums reported forums to be less helpful, which could reflect “forum shopping.” A Poisson regression predicting online support from quality of offline support and various demographic and forum use variables did not reveal any significant results. This is the first quantitative study to look at the benefits of forums for CAPs regarding specific types of social support. The authors consider if certain forums, in addition to professional help, could be part of a repertoire of resources for CAPs who may be struggling.
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Affiliation(s)
- Kailey Roche
- Royal Ottawa Health Care Group, Ottawa, Ontario, Canada
| | - Skye Stephens
- Saint Mary’s University, Halifax, Nova Scotia, Canada
| | - Sarah Moss
- University of Guelph, Guelph, Ontario, Canada
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7
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Factors that drive mental health disparities and promote well-being in transgender and nonbinary people. NATURE REVIEWS PSYCHOLOGY 2022; 1:694-707. [PMID: 36187743 PMCID: PMC9513020 DOI: 10.1038/s44159-022-00109-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 01/09/2023]
Abstract
Transgender (or trans) is an umbrella term for individuals who experience their gender differently from what is associated with the sex they were assigned at birth. Individuals who are nonbinary experience their gender outside binary conceptions of gender. Although research has predominantly focused on negative mental health outcomes for transgender and non-binary (TNB) individuals, an emergent literature has begun to explore protective and health-promoting factors and dimensions of psychological well-being. In this Review, we discuss the sociocultural context for TNB people, beginning with a brief history of TNB identity before highlighting frameworks for understanding the higher prevalence of certain mental health concerns among TNB individuals. Next, we summarize the predictive factors associated with higher rates of depression, anxiety, suicidality, trauma-related concerns, disordered eating behaviours and substance use. We also review TNB coping, resilience and resistance to anti-trans stigma, as well as psychological well-being, flourishing and gender euphoria. Tying these topics together, we discuss affirming interventions for reducing mental health disparities and promoting psychological health in TNB individuals and communities. We conclude by discussing future research directions. Individuals who are transgender or nonbinary experience a higher prevalence of certain mental health concerns, including depression, anxiety and disordered eating behaviours. In this Review, Tebbe and Budge discuss these disparities along with factors that protect these individuals from negative outcomes and promote well-being.
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Neri J, Iudici A, Faccio E. Mental health practitioners' narratives about gender transition and the role of diagnosis: A qualitative study in the Italian context. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2678-e2689. [PMID: 35016261 DOI: 10.1111/hsc.13711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/29/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
In many European Countries, a diagnosis is needed to access the gender transition process, which has sparked debate about whether gender variance should be equated with a psychodiagnosis. This study explores mental health practitioners' perspectives about the implications of using the diagnosis for gatekeeping purposes. Semi-structured interviews were conducted with 11 Italian mental health specialists. The personal positions and interpretative repertoires emerging from the interviews centred on three thematic areas: the diagnosis, the practitioner's role, and the clinical relationship. In relation to the development of health promotion policies, findings underscore the importance of exercising reflexivity, adhering to theory and national and/or international guidelines, and analysing people's needs to ensure that the clinical setting is an affirmative space, especially for non-binary people.
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Affiliation(s)
- Jessica Neri
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Antonio Iudici
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Elena Faccio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
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9
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Rothbaum B, Etengoff C, Uribe E. Transgender community resilience on YouTube: Constructing an informational, emotional, and sociorelational support exchange. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2366-2384. [PMID: 34942028 PMCID: PMC9304180 DOI: 10.1002/jcop.22781] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 06/05/2023]
Abstract
This strength-based, mixed-methods study explored how trans individuals utilize transvlogs as a community building and resilience resource. Eighty-six transvlog viewers explained their motivation for viewing transvlogs and additionally rated their self-efficacy and well-being. Narrative analyses indicate that participants viewed transvlogs to gain informational, emotional, and sociorelational resources. Twelve percent of participants additionally shared those resources with others and contributed to a relational resilience exchange. In addition, transvlog viewers' self-efficacy and well-being scores were higher than previously reported means. While prior research has noted the benefits of transvlog creation, the present study furthers this study by suggesting that transvlog viewers interactionally benefit as well. Participants in this study were not passive viewers, but rather active, agentive contributors to a trans community resilience exchange. Building on this study, we conclude with a discussion of how therapists can incorporate extant trans-created resources to foster trans community resilience.
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Affiliation(s)
| | - Chana Etengoff
- Derner School of PsychologyAdelphi UniversityGarden CityNew YorkUSA
| | - Elizabeth Uribe
- Derner School of PsychologyAdelphi UniversityGarden CityNew YorkUSA
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10
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Fornander MJ, Roberts T, Egan AM, Moser CN. Weight Status, Medication Use, and Recreational Activities of Treatment-Naïve Transgender Youth. Child Obes 2022; 18:228-236. [PMID: 34762510 DOI: 10.1089/chi.2021.0155] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Studies of transgender/gender diverse (TGD) youth indicate a high prevalence of overweight/obesity and concern for unhealthy weight management behavior. This study describes the association of weight status with medication use and recreational activities among treatment-naïve, pediatric TGD patients. Methods: This study is a chart review of 277 patients [aged 9-18 years, 79.1% female sex assigned at birth (SAB), and 86.3% white] seen at a medical center from 2017 to 2020. BMI was calculated by age and SAB using CDC growth charts. BMI percentile (BMI%) and BMI z-score (BMIz) were used to define weight status. Results: By BMI% category, 3.6% patients were in the underweight range (BMI <5%); 50.5% had BMI >85%; and 30.3% had BMI >95%. Overweight and obesity rates were higher than national norms (χ2 = 15.152, p < 0.01). Female SAB participants had higher BMIz values than male SAB participants. Youth who reported watching/listening to media (t = 3.50, p < 0.01) and parent-reported creative arts involvement (t = 1.97, p = 0.05) were associated with higher BMIz values. Conversely, spending time with friends and family was associated with a lower BMIz. Over half of the patients were prescribed medications, and those patients taking medications had higher BMIz values than those not taking medications (t = -1.96, p < 0.05). Female SAB, involvement in sedentary recreational activities, and taking medications to treat gastrointestinal conditions were associated with elevated BMIz. Conclusions: Overweight/obesity is a common problem among TGD youth. TGD youth should be considered a high-risk group and targeted in obesity prevention and treatment efforts. Interventions to decrease sedentary activities and improve connections with friends and family are promising strategies to address overweight and obesity among TGD youth.
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Affiliation(s)
- Mirae J Fornander
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Timothy Roberts
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Anna M Egan
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Christine N Moser
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
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11
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Trilles J, Chaya BF, Brydges H, Parker A, Kimberly LL, Boczar D, Rodriguez Colon R, Rodriguez ED. Recognizing Racial Disparities in Postoperative Outcomes of Gender Affirming Surgery. LGBT Health 2022; 9:333-339. [PMID: 35451878 DOI: 10.1089/lgbt.2021.0396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Given the increasing frequency with which gender affirming surgery (GAS) is performed, understanding risk factors for poor outcomes is imperative. Recent investigations highlight inferior health outcomes experienced by Black transgender and gender expansive (TGE) individuals. Herein, we evaluate the relationship between race and postoperative outcomes in TGE patients undergoing GAS, utilizing the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Methods: We conducted a retrospective review of ACS NSQIP from 2010 to 2018. Patients with a primary diagnosis of gender dysphoria undergoing GAS were identified and grouped by race. Patient characteristics and 30-day postoperative outcomes were recorded. Univariate analysis was used to compare patient characteristics and postoperative outcomes across groups. Multivariate logistic regression was used to determine independent predictors of complications. Results: We included 2308 patients (1780 White, 419 Black, 109 Asian). Gender, body mass index, smoking status, and type of surgery performed differed significantly between groups (p < 0.001). Univariate analysis revealed significant differences in 30-day readmission and organ space surgical site infection (SSI) across groups (p = 0.03). Multivariate logistic regression, adjusted for confounders, revealed that Black patients had higher odds of reoperation (odds ratio [OR] 1.82, p = 0.047), 30-day readmission (OR 2.46, p = 0.003), and organ space SSI (OR 4.65, p = 0.024) than White patients. Conclusion: We found that race was an independent predictor of important short-term postoperative outcomes in GAS. Inclusive clinical research, effective engagement with the TGE community, and surgery-specific enhanced recovery after surgery protocols may help address disparities, but we must acknowledge race as a social determinant of health.
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Affiliation(s)
- Jorge Trilles
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York, USA
| | - Bachar F Chaya
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York, USA
| | - Hilliard Brydges
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York, USA
| | - Augustus Parker
- NYU Grossman School of Medicine, New York University Langone Health, New York, New York, USA
| | - Laura L Kimberly
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York, USA
| | - Daniel Boczar
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York, USA
| | - Ricardo Rodriguez Colon
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York, USA
| | - Eduardo D Rodriguez
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York, USA
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12
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Austin A, Papciak R, Lovins L. Gender euphoria: a grounded theory exploration of experiencing gender affirmation. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2022.2049632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ashley Austin
- Barry University School of Social Work, Miami Shores, FL, USA
| | - Ryan Papciak
- Barry University School of Social Work, Miami Shores, FL, USA
| | - Lindsay Lovins
- Barry University School of Social Work, Miami Shores, FL, USA
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13
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Need for Inclusive Consideration of Transgender and Gender Diverse People in E-Health Services: A Systematic Review. J Clin Med 2022; 11:jcm11041090. [PMID: 35207359 PMCID: PMC8880545 DOI: 10.3390/jcm11041090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/07/2022] [Accepted: 02/16/2022] [Indexed: 02/01/2023] Open
Abstract
Many transgender and gender diverse (TGD) people use the internet to find ways out of isolation, network, and share information on health-related topics. Thus, e-health services could reduce the health burden of TGD people and facilitate access to health care. Following the PRISMA guidelines, we conducted a systematic review on e-health approaches that could improve trans health care (i.e., services directly for TGD people or training programs for health care professionals, HCPs) and their effectiveness, acceptability, and feasibility. We searched PubMed, Web of Science, and PubPsych databases for publications from January 2000 to June 2021 with final updates before publication. The systematic review identified e-health services across 27 studies from 8 different countries. Few studies evaluated e-health services exclusively for TGD people. However, use of an e-health service was found to be effective and beneficial: TGD people improved in health-related outcomes, and HCPs improved in professional expertise. Service users find e-health services helpful and easy to integrate into their daily lives. Recommendations for further development of e-health services in trans health care are provided. In the future, given the rapidly evolving e-health research and care field, new treatment approaches for TGD people should be subject to ongoing evaluation and development.
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14
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Laza-Vásquez C, Gea-Sánchez M, Briones-Vozmediano E. Qualitative evaluation of a support group for women with children with Zika congenital syndrome in Southern Colombia. Disabil Rehabil 2021; 44:6009-6016. [PMID: 34355616 DOI: 10.1080/09638288.2021.1955308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To qualitatively evaluate the perceived benefits of participation in a support group (SG) for mothers of children with Congenital Zika Syndrome (CZS) in Southern Colombia. METHODS The "Women of Zika" SG was running in Sourthern Colombia from August 2018 to December 2019. The evaluation was carried out between October and December 2019, 21 women participated and the information was collected in three group discussions and non-participant observation. A thematic content analysis of the data was carried out with the support of Atlas ti-v8. RESULTS Women's discourses assessing the perceived benefits of participating in the SG were organized under three categories according to the three dimensions of social support: "Teaching and learning from each other: the SG as a source of information support," "Coping with adversity: the SG as a source of emotional support" and "Creating your own identity: the SG as a source of relational support." CONCLUSION The SG has been an important source of social support for women with children with CZS and it meant had a shared space where they developed individual and collective agency capacities. SGs can be a useful strategy for social and therapeutic support for families with children with multiple disabilities, such as CZS.Implications for rehabilitationCaring after children with CZS has negative implications on the mental health and quality of life of these women.Specific interventions need to be developed to improve the quality of life of mothers of children with CZS.Support groups are an effective strategy for providing social support to women with children with different disabilities such as CZS.
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Affiliation(s)
- Celmira Laza-Vásquez
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Care Research Group (GRECS), IRBLleida [Lleida Institute for Biomedical Research Dr. Pifarré Foundation], Lleida, Spain.,Nursing Program, Surcolombiana University, Neiva, Colombia
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Care Research Group (GRECS), IRBLleida [Lleida Institute for Biomedical Research Dr. Pifarré Foundation], Lleida, Spain.,Health, Education and Culture research Group (GESEC) of the University of Lleida, Lleida, Spain
| | - Erica Briones-Vozmediano
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Health Care Research Group (GRECS), IRBLleida [Lleida Institute for Biomedical Research Dr. Pifarré Foundation], Lleida, Spain.,Health, Education and Culture research Group (GESEC) of the University of Lleida, Lleida, Spain
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Network Characteristics Associated with HIV Testing Conversations Among Transgender Women in Los Angeles County, California. AIDS Behav 2021; 25:2336-2347. [PMID: 33609204 DOI: 10.1007/s10461-021-03196-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
This study examined associations between transgender women's social network characteristics, perceived network member HIV risk/protective behaviors and HIV testing conversations between transgender women and their network members. From July 2015 to September 2016, 264 transgender women who nominated 2529 social network members completed surveys on sociodemographic characteristics, HIV risk/protective behaviors, and egocentric social networks. Mixed-effects logistic regression evaluated discussion of HIV testing with network member characteristics and perceived HIV risk/protective behaviors. HIV testing conversations were positively associated with being named as a trans "mother" (aOR 2.05; 95% CI 1.03-4.06) relationships of longer duration, and the following network member characteristics: perception as a confidant (3.09; 1.89-5.05), discussion of condom use (29.65; 16.75-52.49), knowledge of HIV pre-exposure prophylaxis (4.14; 2.11-8.15), and receipt of HIV testing (22.13; 11.47-42.69). HIV testing conversations were negatively associated with relationships where stimulants were used (aOR 0.32; 95% CI 0.12-0.84). These results indicate the importance of leveraging close relationship networks to increase HIV testing and the potential role for network-based HIV prevention strategies among transgender women.
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16
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De Meulenaere J, Baccarne B, Courtois C, Ponnet K. Disentangling social support mobilization via online neighborhood networks. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:481-498. [PMID: 33190240 DOI: 10.1002/jcop.22474] [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: 07/02/2020] [Revised: 10/13/2020] [Accepted: 10/19/2020] [Indexed: 06/11/2023]
Abstract
This paper proposes and tests a theoretical model to investigate the mechanism underpinning local social support exchange via online neighborhood networks (ONNs). We drew on community psychology, social support, and social media literature and used a survey conducted in the Dutch-speaking part of Belgium among 561 ONN users (nfemales = 409; 72.9%) between 18 and 82 years old (Mage = 43.73; SDage = 15.37). We found that engaging in online neighboring behaviors was associated to both online and offline neighborhood sense of community. Subsequently, these provide access to perceived local social support and the intention to mobilize local social support online. The latter was predominantly explained via the path along online sense of community. ONNs facilitate local bridging behavior, connecting otherwise distinct local networks and ties. At the same time, online neighboring behaviors provide the normative context that supports the exchange process.
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Affiliation(s)
- Jonas De Meulenaere
- Department of Communication Sciences, imec-mict-Ghent University, Ghent, Belgium
| | - Bastiaan Baccarne
- Department of Communication Sciences, imec-mict-Ghent University, Ghent, Belgium
| | - Cédric Courtois
- Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane St Lucia, Australia
| | - Koen Ponnet
- Department of Communication Sciences, imec-mict-Ghent University, Ghent, Belgium
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Reisner SL, Moore CS, Asquith A, Pardee DJ, Mayer KH. The Pre-Exposure Prophylaxis Cascade in At-Risk Transgender Men Who Have Sex with Men in the United States. LGBT Health 2021; 8:116-124. [PMID: 33567245 DOI: 10.1089/lgbt.2020.0232] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: This analysis was designed to characterize the pre-exposure prophylaxis (PrEP) cascade in a U.S. national sample of transgender men and trans masculine adults who have sex with cisgender men (trans MSM) at-risk for HIV acquisition. Methods: From November to December 2017, 843 HIV-negative trans MSM self-reporting past-6-month receptive sex with a cisgender man were recruited via peer referrals, dating apps, listservs, and social media. A computer-assisted self-interview assessed demographics, health care, and the PrEP cascade. Descriptive statistics and multivariable regression models evaluated factors associated with PrEP uptake and persistence. Results: Mean age was 28.1 years (standard deviation = 7.1); 4.8% were Black, 21.7% Latinx, and 25.6% another race/ethnicity. A total of 84.1% had heard of PrEP, with 67.3% reporting interest. More than half (55.2%) were PrEP indicated, of which 50.8% were PrEP naive. Approximately 1/4 (28.0%) reported PrEP use, of which 65.3% were PrEP persistent. PrEP modality preferences were injectable (51.2%), daily oral pill (22.1%), and anal gel/lube (14.6%). Reasons for PrEP noninterest were no HIV risk (68.5%), cost (24.2%), and side effects (20.1%). Surgical gender affirmation, no health care discrimination, and social media as a primary health information source were associated with increased odds of PrEP uptake and persistence (all p < 0.05). PrEP adherence difficulties were reported by 52.6%, due to busy/inconsistent schedule (53.1%), side effects (27.4%), and too many medical visits (11.6%). Conclusion: PrEP uptake was modest among the trans MSM sampled, given prevalent HIV risk behaviors. The limited PrEP uptake in at-risk trans MSM suggests the need to develop culturally tailored community education and interventions.
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Affiliation(s)
- Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA.,Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Department of Epidemiology and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chiara S Moore
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Andrew Asquith
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Dana J Pardee
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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18
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Cipolletta S, Tomaino SCM, Lo Magno E, Faccio E. Illness Experiences and Attitudes towards Medication in Online Communities for People with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228683. [PMID: 33238467 PMCID: PMC7700602 DOI: 10.3390/ijerph17228683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/16/2022]
Abstract
Fibromyalgia is a chronic disabling syndrome, and the legitimacy of its diagnosis is still debated. Internet and online communities may become a relevant resource for affected people. This present study aims to understand the role of online communities relating to fibromyalgia syndrome (FMS) patients' illness experiences and their attitudes towards medication. A qualitative content analysis based on the grounded theory approach was conducted on 19 conversations from an online forum, and 14 online interviews. Illness experience, lack of reference points, online communities, personal role and attitude towards medication were the five categories identified, with the search for recognition as the core category. The study highlighted that online communities represent a resource that allows users to express and share their needs, especially in terms of legitimacy and recognition.
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Affiliation(s)
- Sabrina Cipolletta
- Department of General Psychology, University of Padua, 35131 Padua, Italy; (S.C.M.T.); (E.L.M.)
- Correspondence: ; Tel.: +39-49-8277423
| | | | - Eliana Lo Magno
- Department of General Psychology, University of Padua, 35131 Padua, Italy; (S.C.M.T.); (E.L.M.)
| | - Elena Faccio
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, 35131 Padua, Italy;
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Bowling J, Barker J, Gunn LH, Lace T. "It just feels right": Perceptions of the effects of community connectedness among trans individuals. PLoS One 2020; 15:e0240295. [PMID: 33017435 PMCID: PMC7535036 DOI: 10.1371/journal.pone.0240295] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 08/18/2020] [Indexed: 11/28/2022] Open
Abstract
Trans individuals (e.g. trans men and women, non-binary, gender fluid) are at higher risk for mental health concerns, in part due to marginalization. Previous work has documented the effects of social support and community engagement on health outcomes. However, individuals’ perceptions of community engagement effects may point to opportunities for intervention. This mixed methods study examines trans individuals’ perceived effects of participating in trans communities on health outcomes. Semi-structured in-person interviews were conducted with 20 individuals, and 60 individuals participated in cross-sectional online surveys. Perceived discrimination had a strong negative association with self-assessed mental health. Effects of participation included a) positive: contextualization and normalization of experience, self-appraisal, safety, and relief; and b) neutral/negative: energy drain and stigmatization. Effects of not participating included loneliness, depression, isolation, hiding identity, and losing resources. Both discrimination and non-participation in trans communities had negative effects on mental health. Though community participation is often discussed as positive for marginalized populations, it may be important to include possible negative effects (such as energy drain) in research.
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Affiliation(s)
- Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, United States of America
- * E-mail:
| | - Jordan Barker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Laura H. Gunn
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, United States of America
- School of Public Health, Imperial College London, London, United Kingdom
| | - Tatim Lace
- Independent Researcher, Charlotte, NC, United States of America
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Brandt SA, Carmichael CL. Does online support matter? The relationship between online identity-related support, mattering, and well-being in sexual minority men. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2020.106429] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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21
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Cipolletta S, Malighetti C, Cenedese C, Spoto A. How Can Adolescents Benefit from the Use of Social Networks? The iGeneration on Instagram. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6952. [PMID: 32977532 PMCID: PMC7579040 DOI: 10.3390/ijerph17196952] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 12/21/2022]
Abstract
In the last few years, Instagram has been a topic of much contention, as it has been shown to be associated with both risks and benefits for young users. This study explores the influence of the use of Instagram on adolescents' constructions of self and interpersonal experience. Forty Italian adolescents aged between 11 and 16 years were interviewed and completed repertory grids. The results showed that the adolescents' self-construction and distance from others were mostly influenced by receiving, or not receiving, positive feedback, rather than by using Instagram itself. Specifically, there was an increase in self-acceptance and social desirability after receiving a "like" and an increase in social isolation after receiving no "likes". The regression model also showed a decrease in self-acceptance on Instagram in the case of female adolescents, and in participants who edited photos. These findings are useful for understanding the constant need for approval adolescents require today and could be used as a guiding tool for future studies and intervention policies. The present study offers an innovative methodology that refers to the relevant dimensions of adolescents' self-construction rather than investigating the more general relationship between personality traits and social networks' use.
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Affiliation(s)
- Sabrina Cipolletta
- Department of General Psychology, University of Padua, 35100 Padua, Italy; (C.C.); (A.S.)
| | - Clelia Malighetti
- Department of Psychology, Catholic University of the Sacred Heart, 20019 Milan, Italy;
| | - Chiara Cenedese
- Department of General Psychology, University of Padua, 35100 Padua, Italy; (C.C.); (A.S.)
| | - Andrea Spoto
- Department of General Psychology, University of Padua, 35100 Padua, Italy; (C.C.); (A.S.)
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22
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Austin A, Craig SL, Navega N, McInroy LB. It's my safe space: The life-saving role of the internet in the lives of transgender and gender diverse youth. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 21:33-44. [PMID: 33015657 PMCID: PMC7430466 DOI: 10.1080/15532739.2019.1700202] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background: Public awareness of Transgender and Gender Diverse (TGD) identities has grown significantly; however, acceptance and support remain elusive for many TGD youth. Resultant experiences of marginalization and stigmatization contribute to elevated rates of psychological distress and suicidality among TGD youth. Emergent evidence suggests that the internet may offer TGD youth safety, support, and community previously unavailable. Aim: The primary aim of this qualitative inquiry is to engage in an in-depth exploration of the online experiences and processes which help protect against psychological distress and promote well-being among TGD youth. Methods: Data were culled from a mixed-methods, online study of sexual and gender minority youth from across the United States and Canada which followed Institutional Review Board approved protocols. Participants for this study represent a sample (n = 260) of TGD participants aged 14-22 (x̄ = 17.30). Data were analyzed using Charmaz' grounded theory strategies. Results: Data revealed that the internet offers TGD youth affirming spaces that, for the most part, do not exist in their offline lives. Online, TGD youth were able to engage meaningfully with others as their authentic selves, often for the first time. These experiences fostered well-being, healing, and growth through five processes: 1. Finding an escape from stigma and violence, 2. Experiencing belonging, 3. Building confidence, 4. Feeling hope, and 5. Giving back. Discussion: The unique and innovative ways in which participants use online spaces to foster resilience offer important insights to inform affirmative practices with TGD young people.
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Affiliation(s)
- Ashley Austin
- School of Social Work, Barry University, Miami Shores, Florida, USA
| | - Shelley L. Craig
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Navega
- School of Social Work, Barry University, Miami Shores, Florida, USA
| | - Lauren B. McInroy
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
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Phanuphak N, Anand T, Jantarapakde J, Nitpolprasert C, Himmad K, Sungsing T, Trachunthong D, Phomthong S, Phoseeta P, Tongmuang S, Mingkwanrungruang P, Meekrua D, Sukthongsa S, Hongwiangchan S, Upanun N, Barisri J, Pankam T, Phanuphak P. What would you choose: Online or Offline or Mixed services? Feasibility of online HIV counselling and testing among Thai men who have sex with men and transgender women and factors associated with service uptake. J Int AIDS Soc 2019; 21 Suppl 5:e25118. [PMID: 30033644 PMCID: PMC6055119 DOI: 10.1002/jia2.25118] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 05/12/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction HIV testing coverage remains low among men who have sex with men (MSM) and transgender women (TGW). We studied characteristics of Thai MSM and TGW who chose online and/or offline platforms for HIV counselling and testing and the feasibility of integrating online technologies and HIV self‐testing to create service options. Methods From December 2015 to June 2017, MSM and TGW enrolled from Bangkok Metropolitan Region and Pattaya could choose between: 1 offline HIV counselling and testing (Offline group), 2 online pre‐test counselling and offline HIV testing (Mixed group), and 3 online counselling and online, supervised, HIV self‐testing (Online group). Sociodemographic data, risk behaviour and social network use characteristics were collected by self‐administered questionnaires. Logistic regression models identified covariates for service preferences. Results Of 472 MSM and 99 TGW enrolled, 202 self‐selected the Offline group, 158 preferred the Mixed group, and 211 chose the Online group. The Online group had the highest proportion of first‐time testers (47.3% vs. 42.4% vs. 18.1%, p < 0.001) and reported highest HIV prevalence (15.9% vs. 13.0% vs. 3.4%, p = 0.001) as compared to Offline and Mixed groups, respectively. Having tested for HIV twice or more (OR 2.57, 95% CI 1.03 to 6.41, p = 0.04) increased the likelihood to choose online pre‐test counselling. Being TGW (OR 6.66, 95% CI 2.91 to 15.25, p < 0.001) and using social media from four to eight hours (OR 2.82, 95% CI 1.48 to 5.37, p = 0.002) or >8 hours (OR 2.33, 95% CI 1.05 to 5.16, p = 0.04) increased selection of online, supervised, HIV self‐testing. Providers primarily used smartphones (79.2%) and laptops (37.5%) to deliver online services. Self‐testing strip image sharpness and colour quality were rated “good” to “excellent” by all providers. Most participants (95.1%) agreed that online supervision and HIV self‐testing guidance offered were satisfactory and well delivered. Conclusions Online HIV services among MSM and TGW are feasible in Thailand and have the potential to engage high proportions of first‐time testers and those with high HIV prevalence. When designing public health interventions, integrating varied levels of online HIV services are vital to engage specific sections of MSM and TGW populations in HIV services. Clinical Trial Number NCT03203265
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Affiliation(s)
- Nittaya Phanuphak
- PREVENTION, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Tarandeep Anand
- PREVENTION, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | | | - Kanittha Himmad
- PREVENTION, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Thanthip Sungsing
- PREVENTION, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | - Sangusa Phomthong
- PREVENTION, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Petchfa Phoseeta
- PREVENTION, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Sumitr Tongmuang
- PREVENTION, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | - Dusita Meekrua
- Service Workers IN Group (SWING) Foundation, Bangkok, Thailand
| | | | | | | | - Jiranuwat Barisri
- Anonymous Clinic Laboratory, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Tippawan Pankam
- Anonymous Clinic Laboratory, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Praphan Phanuphak
- PREVENTION, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
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How Gender Identity and Treatment Progress Impact Decision-Making, Psychotherapy and Aftercare Desires of Trans Persons. J Clin Med 2019; 8:jcm8050749. [PMID: 31130679 PMCID: PMC6572165 DOI: 10.3390/jcm8050749] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 11/17/2022] Open
Abstract
The gender identity of trans individuals influences their treatment preferences, and this in turn seems to affect their individual treatment progress. However, there has been no research which—next to the impact of gender identity on treatment desires—has also investigated the influence of treatment progress using a measure which assumes various possible transition pathways of trans persons.Therefore, an online community survey of trans people was conducted in Germany in 2015. Data were collected via an online survey from a non-clinical sample of n = 415 trans individuals (over half assigned female at birth), aged 16–76 (Mean (M) = 38.12). Almost one fifth of participants embraced non-binary or genderqueer (NBGQ) identities. Participants progressed 60.77% (standard deviation (SD) = 35.21) through treatment at point of data collection, as measured by the individual treatment progress score (ITPS). All participants, especially participants assigned male at birth, differed significantly in desire to participate in decision-making processes based on transition progress; individuals without treatment experience had less desire to decide treatment plans. NBGQ participants assigned male at birth in early stages of transition had significantly more desire for psychotherapy during transition than participants of the same identity in later transition stages. All participants, especially binary participants, significantly differed in desire for aftercare based on transition progress; individuals without treatment experience indicated more desire for aftercare. Results indicate health professionals should expect changing treatment desires in trans individuals at various stages of transition, particularly at treatment start, and based on gender identity.
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25
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Cipolletta S, Simonato C, Faccio E. The Effectiveness of Psychoeducational Support Groups for Women With Breast Cancer and Their Caregivers: A Mixed Methods Study. Front Psychol 2019; 10:288. [PMID: 30833920 PMCID: PMC6387958 DOI: 10.3389/fpsyg.2019.00288] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/29/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Previous studies on the effectiveness of psychological interventions in oncology mainly used quantitative measures and no study was conducted with regard to both caregivers and patients. Aim: This study evaluates the effectiveness of psychoeducational support groups, both for women with breast cancer, and for their informal caregivers through the use of quantitative and qualitative measures. Methods: A longitudinal design was used comparing two psychoeducational support groups with other two groups in a standard care control condition. Participants were 28 women with a diagnosis of breast cancer in the care of a hospital in Northern Italy, and 21 family caregivers. The quantitative data were collected by Cognitive Behavioral Assessment for Outcome Evaluation (CBA-OE) and the qualitative data through the use of semi-structured interviews. Results: The statistical analysis showed a significant change attributable to the psychological intervention that proves the effectiveness of such an intervention in the patients’ and caregivers’ group. The qualitative analysis allowed us to interpret the behavioral and psychological profile emerging from CBA-OE, by considering the subjective experience of the treatment groups. The group experience offered affective, relational and informative support, and allowed participants to create a network and to feel understood and reassured. Conclusion: The results suggest the usefulness of psychoeducational support groups for women with breast cancer and for their caregivers. The value of this kind of intervention is not only at an individual level but also at a systems level, and family involvement ensures the best positive outcomes.
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Affiliation(s)
| | - Camilla Simonato
- Department of General Psychology, University of Padua, Padua, Italy
| | - Elena Faccio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
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26
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Laoch A, Holmes CM. Serving Transgender Clients in the Digital Age. JOURNAL OF LGBT ISSUES IN COUNSELING 2019. [DOI: 10.1080/15538605.2018.1488233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ari Laoch
- Mental Health & Wellness, Health Brigade, Richmond, Virginia, USA
| | - Courtney M. Holmes
- Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond, Virginia, USA
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27
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van der Tier M, Potting M, Hermans K. Stimulating the problem-solving abilities of users in an online environment. A study of a Dutch online social casework intervention. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:988-994. [PMID: 30062754 DOI: 10.1111/hsc.12632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 06/08/2023]
Abstract
Despite the growing interest of users in online services, social workers are still reluctant to offer their services in an online environment. Moreover, little is known about online working methods and their contribution to an effective online session. This paper reports on the findings of a Dutch case study of the online intervention "Clickforhelp". The first aim of this paper is to explore whether social workers believe that they are able to stimulate the problem-solving abilities of the users in an online working environment. The analysis pertaining to this question was based on the results of a qualitative online survey completed by 26 online social workers. The second aim is to examine how social workers implement the five essential components of a solution-focused approach in a chat and email environment. A qualitative content analysis of 50 online cases was carried out based on analytical questions derived from the problem-solving method. The findings illustrate that the social workers of "Clickforhelp" believe that they are able to stimulate the problem-solving abilities of users in an online environment, but prefer a face-to-face setting. They rarely implement all five components of a solution-focused approach. They predominantly stimulate the self-esteem and the power position of the user, while relatively little attention is given to the strengths of the user and the social support system. Neither do they translate the problem-solving process into concrete and achievable steps or evaluate the progress and the user's experience. It is necessary to further develop knowledge relating to online working skills and methods.
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Affiliation(s)
- Michelle van der Tier
- Centre for Sociological Research, KU Leuven, Leuven, Belgium
- Research Centre Social integration, Zuyd University of Applied Sciences, Sittard, The Netherlands
| | - Marianne Potting
- Research Centre Social integration, Zuyd University of Applied Sciences, Sittard, The Netherlands
| | - Koen Hermans
- Centre for Sociological Research, KU Leuven, Leuven, Belgium
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Cipolletta S, Gammino GR, Francescon P, Palmieri A. Mutual support groups for family caregivers of people with amyotrophic lateral sclerosis in Italy: A pilot study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:556-563. [PMID: 29479773 DOI: 10.1111/hsc.12558] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2018] [Indexed: 06/08/2023]
Abstract
Family caregivers of people with amyotrophic lateral sclerosis (ALS) live stressful lives in which they spend most of their time caring for their loved ones and managing difficult situations, thereby reducing the time spent in taking care of themselves. This situation may last several years. Previous literature has widely highlighted that this situation reduces caregivers' quality of life and increases their psychological distress and risk of health problems, but there is a lack of studies that focus on psychological interventions for these situations. This qualitative study examined a pilot experience of two mutual support groups for family caregivers of people with ALS. The aim was to identify caregivers' needs, the prominent aspects of their experience, and to understand whether and how this intervention strategy might help them. Six partners (four men and two women) and six adult children (five women and one man) participated in the groups, which were conducted in northern Italy. After the support groups finished, participants underwent semi-structured interviews. The authors conducted a content analysis of the transcripts of the interviews and the 20 group sessions. The thematic areas identified were "caregiving," "being the son/daughter of a person with ALS," "being the partner of a person with ALS," "group experience" and "group evaluation." The caregiving experience was profoundly different depending on whether the caregiver was a son/daughter or a partner of a patient with ALS. Moreover, comparison with peers and mutual support helped participants to better cope with ALS and its consequences, to improve their care for their relatives and to overcome typical caregiver isolation. These results suggest the usefulness of involving communities in caregiver support in order to create new networks and activate personal and social resources for well-being.
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Affiliation(s)
| | | | | | - Arianna Palmieri
- Department of Philosophy, Sociology, Education and Applied Psychology, Padova Neuroscience Center, University of Padova, Padova, Italy
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30
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Hargreaves S, Bath PA, Duffin S, Ellis J. Sharing and Empathy in Digital Spaces: Qualitative Study of Online Health Forums for Breast Cancer and Motor Neuron Disease (Amyotrophic Lateral Sclerosis). J Med Internet Res 2018; 20:e222. [PMID: 29903695 PMCID: PMC6024105 DOI: 10.2196/jmir.9709] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/17/2018] [Accepted: 05/08/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The availability of an increasing number of online health forums has altered the experience of living with a health condition, as more people are now able to connect and support one another. Empathy is an important component of peer-to-peer support, although little is known about how empathy develops and operates within online health forums. OBJECTIVE The aim of this paper is to explore how empathy develops and operates within two online health forums for differing health conditions: breast cancer and motor neuron disease (MND), also known as amyotrophic lateral sclerosis. METHODS This qualitative study analyzed data from two sources: interviews with forum users and downloaded forum posts. Data were collected from two online health forums provided by UK charities: Breast Cancer Care and the Motor Neurone Disease Association. We analyzed 84 threads from the breast cancer forum and 52 from the MND forum. Threads were purposively sampled to reflect varied experiences (eg, illness stages, topics of conversation, and user characteristics). Semistructured interviews were conducted with 14 Breast Cancer Care forum users and five users of the MND forum. All datasets were analyzed thematically using Braun and Clarke's six-phase approach and combined to triangulate the analysis. RESULTS We found that empathy develops and operates through shared experiences and connections. The development of empathy begins outside the forum with experiences of illness onset and diagnosis, creating emotional and informational needs. Users came to the forum and found their experiences and needs were shared and understood by others, setting the empathetic tone and supportive ethos of the forum. The forum was viewed as both a useful and meaningful space in which they could share experiences, information, and emotions, and receive empathetic support within a supportive and warm atmosphere. Empathy operated through connections formed within this humane space based on similarity, relationships, and shared feelings. Users felt a need to connect to users who they felt were like themselves (eg, people sharing the same specific diagnosis). They formed relationships with other users. They connected based on the emotional understanding of ill health. Within these connections, empathic communication flourished. CONCLUSIONS Empathy develops and operates within shared experiences and connections, enabled by structural possibilities provided by the forums giving users the opportunity and means to interact within public, restricted, and more private spaces, as well as within groups and in one-to-one exchanges. The atmosphere and feeling of both sites and perceived audiences were important facilitators of empathy, with users sharing a perception of virtual communities of caring and supportive people. Our findings are of value to organizations hosting health forums and to health professionals signposting patients to additional sources of support.
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Affiliation(s)
- Sarah Hargreaves
- Health Informatics Research Group, Information School, University of Sheffield, Sheffield, United Kingdom
| | - Peter A Bath
- Health Informatics Research Group, Information School, University of Sheffield, Sheffield, United Kingdom
| | - Suzanne Duffin
- Health Informatics Research Group, Information School, University of Sheffield, Sheffield, United Kingdom
| | - Julie Ellis
- Department of Sociological Studies, University of Sheffield, Sheffield, United Kingdom
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Carroll-Beight D, Larsson M. Exploring the Needs, Expectations, and Realities of Mental Healthcare for Transgender Adults: A Grounded Theory Study on Experiences in Sweden. Transgend Health 2018; 3:88-104. [PMID: 29806033 PMCID: PMC5967416 DOI: 10.1089/trgh.2017.0033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Transgender persons experience a disproportionate representation in adverse mental health conditions globally. In Sweden, there are tangible efforts to improve mental healthcare overall, but transgender persons still struggle with meeting their mental healthcare needs and there is an absence of understanding the role of mental healthcare for this population and how services are being utilized. Thus, the aim of this study was to gain knowledge from transgender individuals in Sweden concerning their mental healthcare, their needs, expectations, and realities, regardless of transition status. Methods: Eleven in-depth interviews were conducted with persons who identified as transgender, older than 18 years, at some stage of transition in Sweden. Data were collected, analyzed, and interpreted using constructivist ground theory. Results: Three categories emerged from the analysis, Feeling Objectification Rather than Subjectivity, Constructing the Narrative, and Reflecting on Aspects of Care that illustrate the dual tensions at play in transgender visibility, communication with mental healthcare professionals, and expectations of care. Six subcategories further delineate the specific forces at work that construct the mental healthcare experiences for trans persons. Conclusion: Increased knowledge and visibility of transgender persons are needed to adequately serve the mental healthcare needs for this population. Currently, there are barriers that inhibit transgender persons from getting the mental healthcare assistance desired and needed, as they do not view the healthcare system as safe space. As steps are being taken to depathologize transgender identities, momentum should be continued to create space for trans persons that enables unencumbered mental health assistance.
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Affiliation(s)
| | - Markus Larsson
- Division for Social Medicine and Global Health, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
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Hochdorn A, Faleiros VP, Valerio P, Vitelli R. Narratives of Transgender People Detained in Prison: The Role Played by the Utterances "Not" (as a Feeling of Hetero- and Auto-rejection) and "Exist" (as a Feeling of Hetero- and Auto-acceptance) for the Construction of a Discursive Self. A Suggestion of Goals and Strategies for Psychological Counseling. Front Psychol 2018; 8:2367. [PMID: 29387034 PMCID: PMC5776140 DOI: 10.3389/fpsyg.2017.02367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 12/27/2017] [Indexed: 11/13/2022] Open
Abstract
Purpose: Understanding how transgender people, who committed criminal offenses and are detained in prison, produce a narrative representation of self within different prison contexts. More specifically, this study has been based on two sub-aims: On a paradigmatic level, it has been aimed at critically investigating how the discursive positioning among the Self and the Other might promote the internalization of positive and/or negative attitudes toward the self. On a pragmatic level, it intends to offer some suggestions for goals and strategies of psychological counseling with these inmates inside such highly institutionalized contexts. Method and Materials: In total, 23 in-depth interviews were conducted with transgender women detained in either female or male prison contexts in Italy and Brazil. The lexical, semantic, and semiotic structure of the transcribed interviews has been investigated by adopting the quali-quantitative software Iramuteq for performing statistical text-mining analysis. Frequency, correspondences, and distribution of the most representative utterances across the corpus of data have been accessed and critically analyzed. Results: The findings showed that transgender inmates in Brazil made repeated use of the adverb "not," while the verb "exist" became the most representative word for the Italian sample. In Brazil, indeed, transgender women assumed masculine-driven behavior due to a common imprisonment with cis-gender men. On the contrary, transgender women in Italy are detained in protected sections, where they are allowed to wear female clothing and continue hormonal treatments. Surprisingly, transgender inmates in Italy suffered more violence in a female sector when compared to exclusively male jails. Conclusions: Transgender people represent a challenge for prison administration because it is not clear in which penitentiary context they should be detained. They should receive special attentions in order to face their special needs, which are radically different when compared to other typologies of inmates. Within penitentiary contexts, psychological counseling with transgender women should pay a special attention to the several psycho-social dimensions of this existential condition. In particular, psychological counselors should consider its inner complex articulation within different social, cultural and normative contexts.
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Affiliation(s)
- Alexander Hochdorn
- Post-graduation Program in Psychology, Catholic University of Brasília, Brasília, Brazil
| | - Vicente P Faleiros
- Post-graduation Program in Psychology, Catholic University of Brasília, Brasília, Brazil
| | - Paolo Valerio
- Department of Neuroscience and Reproductive and Dental Sciences, University of Naples Federico II, Napoli, Italy
| | - Roberto Vitelli
- Department of Neuroscience and Reproductive and Dental Sciences, University of Naples Federico II, Napoli, Italy
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Faccio E, Iudici A, Turco F, Mazzucato M, Castelnuovo G. What Works for Promoting Health at School: Improving Programs against the Substance Abuse. Front Psychol 2017; 8:1743. [PMID: 29075214 PMCID: PMC5643503 DOI: 10.3389/fpsyg.2017.01743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 09/20/2017] [Indexed: 01/20/2023] Open
Affiliation(s)
- Elena Faccio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Antonio Iudici
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Francesca Turco
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Matteo Mazzucato
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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