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Lim G, Bourne A, Hill A, McNair R, Lyons A, Amos N. Community connection is associated with lower psychological distress for sexual minority women who view community connection positively. CULTURE, HEALTH & SEXUALITY 2024; 26:513-530. [PMID: 37452686 DOI: 10.1080/13691058.2023.2231043] [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: 12/14/2022] [Accepted: 06/26/2023] [Indexed: 07/18/2023]
Abstract
We examined factors associated with sexual minority women's evaluations of belonging to the lesbian, gay, bisexual, transgender and queer (LGBTQ) community in Australia, and assessed whether a positive view of community participation impacted levels of psychological distress. 2424 cisgender sexual minority women participated in a national, online, cross-sectional survey of LGBTIQ adult Australians' health and well-being. Multivariable regression analyses were conducted to investigate sociodemographic factors associated with sexual minority women's belonging to the LGBTQ community, feelings towards community connection, and associations between community connection and recent psychological distress. Most sexual minority women (58.9%) reported feeling that they are part of the LGBTQ community, and a majority of the participants felt positive about being connected to this community (68.5%). Participants who were bisexual, non-university educated, and who resided in an outer-suburban location were least likely to evaluate participation in the LGBTQ community positively. Feeling positive about community connection was associated with lower levels of psychological distress. Feeling a part of LGBTQ community was associated with lower psychological distress, but this link appears contingent upon positive feelings about community participation. Sexual minority women's' relationships to the LGBTQ community are often complex, and community connection and participation in and of itself is not a panacea for the negative outcomes associated with sexual minority stressors.
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Affiliation(s)
- Gene Lim
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Adam Bourne
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Adam Hill
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Ruth McNair
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony Lyons
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Natalie Amos
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
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Zucker R, Wolff-Sagy Y, Ramot N, Raviv Y, Lavie G, Netzer D, Hammerman A, Arbel R. Examining the Patterns of Mpox Vaccine Uptake in a Vulnerable Population. Sex Transm Dis 2023; 50:680-684. [PMID: 37255258 DOI: 10.1097/olq.0000000000001839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The current Mpox outbreak presents unique vaccination challenges in vulnerable populations. Understanding factors associated with vaccine uptake in vulnerable populations is required for a successful vaccination campaign. METHODS This population-based cohort study was conducted in Clalit Health Services and included all individuals eligible for the Modified Vaccinia Ankara vaccine. Cox proportional hazards models were used to assess the characteristics associated with uptake of the first vaccine dose. RESULTS Attendance to a primary healthcare clinic in the Tel Aviv district, repeated sexually transmitted infection screening, and the recent purchase of HIV-PrEP or PDE5 inhibitors were associated with higher vaccine adherence, whereas previous nonadherence with recommended vaccines, low sociodemographic status, and history of HIV were associated with lower adherence. CONCLUSIONS These findings highlight the need for proactive patient and healthcare provider-oriented educational campaigns to curb vaccine hesitancy, and may help direct resources toward underserved populations, hence increasing equality in vaccine enrollment.
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Affiliation(s)
| | | | - Noga Ramot
- Branch of Planning and Strategy, Clalit Health Services
| | - Yuval Raviv
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv
| | | | - Doron Netzer
- From the Community Medical Services Division, Clalit Health Services
| | - Ariel Hammerman
- From the Community Medical Services Division, Clalit Health Services
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Adeyemi OA, Nowak RG, Marzinke M, Morgan D, Sam-Agudu N, Craddock J, Zhan M, Crowell TA, Baral S, Ndembi N, Adebajo S, Charurat ME. Correlates of self-reported and biomarker based adherence to daily oral HIV pre-exposure prophylaxis among a cohort of predominantly men who have sex with men in Nigeria. PLoS One 2023; 18:e0282999. [PMID: 36928630 PMCID: PMC10019705 DOI: 10.1371/journal.pone.0282999] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
INTRODUCTION HIV pre-exposure prophylaxis (PrEP) significantly reduces the risk of HIV acquisition. However, studies have demonstrated discordance between self-reported measures and biomedical benchmarks of PrEP adherence. We estimated the correlation between self-reported PrEP adherence and PrEP biomarkers and explored factors associated with adherence among men who have sex with men (MSM) in Nigeria. METHODS TRUST-PrEP, an open-label, prospective study; conducted in Abuja between April 2018 and May 2019. MSM ≥ 18 years with substantial HIV risk were enrolled. Participants reported PrEP adherence in the last month using a 4-point scale from "poor" to "perfect" and serum samples for PrEP biomarkers were collected at months 3 and 9. Serum tenofovir concentration was measured by liquid chromatography-tandem mass spectrometry and considered protective for adherence if ≥ 4.2 ng/ml. Spearman's rank correlation was used to estimate correlation between self-reported adherence and measured tenofovir levels. Generalized estimating equations with a logit link was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between self-reported adherence and laboratory-measured adherence. RESULTS A total of 219 MSM with median age 23 (interquartile range 20-27) years had at least one PrEP biomarker assay. Only 66/219 (30%) had at least one record of protective tenofovir concentration. Correlation between tenofovir and self-reported adherence at 3 and 9 months were 0.1 and 0.02 respectively. Furthermore, 17/219 (8%,) and 49/219 (22%) had serum tenofovir of 4.2-35.4 ng/mL and ≥ 35.5 ng/mL, corresponding to at least 4 and 7 days' PrEP use in a week, respectively. PrEP adherence was higher among participants introduced to PrEP in the clinics compared with communities (aOR: 8.35, 95%CI: [3.24, 21.5]) and those with same-sex practices family disclosure (aOR: 3.60 95% CI: [1.73, 7.51]). CONCLUSION Self-reported PrEP adherence poorly correlated with biomarkers. Facilitating clinic-based PrEP introduction and disclosure of same-sex practices to family among MSM may improve PrEP adherence.
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Affiliation(s)
- Olusegun A. Adeyemi
- Department of Public Health and Epidemiology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
- * E-mail:
| | - Rebecca G. Nowak
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Mark Marzinke
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Daniel Morgan
- Department of Public Health and Epidemiology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Nadia Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Jaih Craddock
- School of Social Work, University of Maryland, Baltimore, MD, United States of America
| | - Min Zhan
- Division of Biostatistics and Bioinformatics, Department of Public Health and Epidemiology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Trevor A. Crowell
- Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States of America
- U.S Military HIV Research Program, Silver Spring, Maryland, United States of America
| | - Stefan Baral
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Nicaise Ndembi
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Sylvia Adebajo
- Center for International Health, Education, and Biosecurity, Abuja, Nigeria
| | - Manhattan E. Charurat
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
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Gao Q, Antfolk J, Santtila P. An experimental study using a sexual strategies explanation to reduce homophobia toward gay men among lay people and healthcare professionals in China. Front Psychol 2023; 14:1143584. [PMID: 37151342 PMCID: PMC10157027 DOI: 10.3389/fpsyg.2023.1143584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Homophobic discrimination and stigmatization, especially from healthcare professionals, are important stressors for gay men. Homophobia may be partly rooted in seeing some gay men having casual sex and many sexual partners as a signal of mental problems. Sexual Strategies Theory (SST) suggests that such sexual behavior is a result of different sexual strategies men and women tend to adopt and is unrelated to sexual orientation per se. This study aimed to investigate (1) the effectiveness of providing an SST explanation for gay men's sexual behavior in reducing homophobia among both lay persons and healthcare professionals; (2) differences in homophobia between healthcare professionals and lay people and also between medical and non-medical professionals. Methods The main analyses included 492 heterosexual participants recruited online via Chinese social media and sample services in 2021. Of these, 227 were healthcare professionals (128 medical, 99 non-medical) and 265 were lay people. The participants were randomly assigned into an experimental group given the SST explanation (n = 126), an active control group given a Minority Stress (MS) explanation (n = 184), and a control group (n = 182). After the manipulation, homophobia, knowledge about homosexuality, professional homophobic attitude, gay affirmative practice, and contact with gay men were assessed. Results The results of factor analysis suggested dividing homophobia into Oppressing Homophobia (Oppressing HP) describing believing that gay men should have fewer rights and Pathologizing Homophobia (Pathologizing HP) describing believing that the sexual behavior of gay men is a signal of mental problem. Importantly, the SST explanation reduced Pathologizing HP while the MS explanation reduced Oppressing HP. Healthcare professionals reported more Oppressing HP than lay people, and medical professionals conducted less gay affirmative practice than non-medical professionals. Conclusion An SST explanation can potentially reduce some aspects of homophobia among both healthcare professionals and lay people. Also, worryingly, Chinese healthcare professionals, especially medical professionals, reported more homophobia than lay individuals.
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Affiliation(s)
- Qianhui Gao
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Faculty of Arts and Sciences, New York University Shanghai, Shanghai, China
| | - Jan Antfolk
- Faculty of Arts, Psychology, and Theology, Åbo Akademi University, Turku, Finland
| | - Pekka Santtila
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Faculty of Arts and Sciences, New York University Shanghai, Shanghai, China
- *Correspondence: Pekka Santtila,
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Diaz JE, Sandh S, Schnall R, Garofalo R, Kuhns LM, Pearson CR, Bruce J, Batey DS, Radix A, Belkind U, Hidalgo MA, Hirshfield S. Predictors of Past-Year Health Care Utilization Among Young Men Who Have Sex with Men Using Andersen's Behavioral Model of Health Service Use. LGBT Health 2022; 9:471-478. [PMID: 35867076 PMCID: PMC9587774 DOI: 10.1089/lgbt.2021.0488] [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: 11/13/2022] Open
Abstract
Purpose: This study examined factors associated with past-year health care utilization among young gay, bisexual, and other men who have sex with men (YMSM) using Andersen's behavioral model of health service use. Methods: From 2018 to 2020, 751 YMSM (aged 13-18) recruited online and offline for the MyPEEPS mHealth HIV prevention study completed an online survey. Hierarchical logistic regression models assessed associations between past-year health care utilization (i.e., routine checkup) and predisposing (parental education, race/ethnicity, age, and internalized homonegativity), enabling (health literacy, health care facility type, U.S. Census Divisions), and need factors (ever testing for HIV). Results: The sample included 31.8% Hispanic, 23.9% White, and 14.6% Black YMSM; median age was 16. Most (75%) reported past-year health care utilization, often from private doctor's offices (29.1%); 6% reported no regular source of care. In the final regression model, higher odds of past-year health care utilization were found for younger participants (age 13-14, adjusted odds ratio [AOR] = 1.91; 95% confidence interval [CI]: 1.07-3.43; age 15-16 AOR = 1.55; 95% CI: 1.04-2.30; reference: 17-18) and those with increasing health literacy (AOR = 1.71; 95% CI: 1.36-2.16). YMSM with lower parental education had lower odds of past-year health care utilization (AOR = 0.56; 95% CI: 0.38-0.84), as did those relying on urgent care facilities (AOR = 0.60; 95% CI: 0.41-0.87; reference: routine care facilities) and those who identified as Mixed/Other race (AOR = 0.50; 95% CI: 0.28-0.91; reference: White). Conclusions: Findings highlight opportunities to intervene in YMSM's health risk trajectory before age 17 to reduce drop-off in routine health care utilization. Interventions to improve routine health care utilization among YMSM may be strengthened by building resilience (e.g., health literacy) while removing barriers maintained through structural disadvantage, including equity in education. Clinical Trial Registration Number: NCT03167606.
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Affiliation(s)
- José E Diaz
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Center for Research on AIDS, Yale School of Public Health, New Haven, Connecticut, USA
| | - Simon Sandh
- Department of Epidemiology, School of Global Public Health, New York University, New York, New York, USA
| | - Rebecca Schnall
- Columbia University School of Nursing, New York, New York, USA.,Department of Population and Family Health, Mailman School of Public Health, New York, New York, USA
| | - Robert Garofalo
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lisa M Kuhns
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Cynthia R Pearson
- Indigenous Wellness Research Institute, University of Washington School of Social Work, Seattle, Washington, USA
| | - Josh Bruce
- Birmingham AIDS Outreach, Birmingham, Alabama, USA
| | - D Scott Batey
- Department of Social Work, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Asa Radix
- Callen-Lorde Community Health Center, New York, New York, USA
| | - Uri Belkind
- Callen-Lorde Community Health Center, New York, New York, USA
| | - Marco A Hidalgo
- Medicine-Pediatrics Division, General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Sabina Hirshfield
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
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Sex Trafficking: A Literature Review With Implications for Health Care Providers. Adv Emerg Nurs J 2022; 44:248-261. [PMID: 35900246 DOI: 10.1097/tme.0000000000000419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sex trafficking often goes unrecognized, yet is a pervasive issue that disproportionately affects marginalized populations. Survivors suffer adverse health effects and often present to health care facilities while still under control of their traffickers. Health care providers, including nurses and advanced practice nurses, lack understanding of risk factors, signs and symptoms, and means of offering assistance. A comprehensive literature search was conducted utilizing EBSCOhost and WorldCat. Studies were considered eligible for inclusion if subject matter dealt directly with domestic sex trafficking and included implications for health care or health care education. There are some identified risk factors that place people at higher risk for victimization and survivors may present for care with a common symptom, including physical and mental health issues. Barriers to care include both survivor and health care system characteristics; however, health care providers can undertake specific actions to help overcome these barriers. Health care providers are in a prime position to identify and assist sex trafficking survivors. However, they need to be aware of common risk factor presentations, and they need to be trained to offer assistance. Ongoing research is needed to determine the best way to develop, introduce, and evaluate these trainings.
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Lyu H, Zhou Y, Dai W, Zhen S, Huang S, Zhou L, Huang L, Tang W. Solidarity and HIV Testing Willingness During the COVID-19 Epidemic: A Study Among Men Who Have Sex With Men in China. Front Public Health 2021; 9:752965. [PMID: 34957014 PMCID: PMC8695798 DOI: 10.3389/fpubh.2021.752965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Solidarity, such as community connectedness and social cohesion, may be useful in improving HIV testing uptake among men who have sex with men (MSM). This study aimed to evaluate the impact of solidarity on HIV testing before the coronavirus disease 2019 (COVID-19) and HIV testing willingness during COVID-19 among MSM in China. Materials and Methods: An online survey was conducted to collect sociodemographic, sexual behavioral, and solidarity items' information from the participants. We first used factor analysis to reveal the principal component of the solidarity items and then used logistic regression to study the impact of solidarity on HIV testing, by adjusting the possible confounding factors, such as age and education. Results: Social cohesion and community connectedness were revealed by the factor analysis. MSM with high community connectedness were more willing to undergo HIV testing before the epidemic adjusted by age [odds ratio (OR): 1.07, 95% CI: 1.01-1.13]. The community connectedness was also related to the willingness of HIV testing during the epidemic, with adjustments of 1.09 (95% CI: 1.03-1.15). People who did not test for HIV before the COVID-19 epidemic were more willing to have the HIV test during the epidemic, which was correlated with the community connectedness, and the OR value was 1.14 (95%: 1.03-1.25). Conclusion: A high level of community connectedness helped to increase the HIV testing rate before COVID-19 and the willingness of HIV testing during the epidemic among MSM. Strategies can strengthen the role of the community in the management and service of MSM.
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Affiliation(s)
- Hang Lyu
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Yi Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Wencan Dai
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | | | - Shanzi Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Lanlan Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Liqun Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,University of North Carolina Project-China, Guangzhou, China
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Kittiteerasack P, Matthews AK, Park C. Psychometric properties of the Thai version of the Internalized sexual stigma scale for research on lesbian, gay, bisexual, and transgender (LGBT) populations. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.2000013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Alicia K. Matthews
- College of Nursing, The University of Illinois at Chicago, Illinois, United States
| | - Chang Park
- College of Nursing, The University of Illinois at Chicago, Illinois, United States
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Jackson KJ, Tomlinson S. A review of top performing rural community and critical access hospitals' web resources for transgender patients in the United States. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100627. [PMID: 33957342 DOI: 10.1016/j.srhc.2021.100627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/10/2021] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This cross-sectional study examined the prevalence of "LGBT" and "transgender" terminology and type of resources available to transgender patients on the websites of top performing rural/community hospitals and critical access hospitals in the U.S. The effect of hospital control (e.g. type of operating parent organization) on the presence of transgender resources on these websites was also evaluated. METHODS The rural and critical access hospitals selected for inclusion in this study were those published on the Chartis Group's 2020 "top performing" hospital lists. Each hospital website was reviewed for the presence of "transgender" and "LGBT" terminology, as well several control terms commonly found on hospital websites. RESULTS Findings suggest a lack of resources for sexual and gender minorities among rural community and critical access hospitals within this sample; the term "transgender" appeared on 26% of rural community hospitals and 21% of critical access hospitals (N = 200). There was no significant relationship between hospital classification and the type of transgender resources offered by the hospitals (p = 0.248). There was a significant relationship between hospital control and presence of the term "transgender" on the websites of critical access hospitals (p = 0.002, Fisher's Exact Test). CONCLUSIONS Few facilities provided links to external resources for transgender patients, advertised LGBT-friendly providers, or provided any information pertaining to gender-affirming healthcare. Additional research is needed to determine what barriers or social forces prevent these hospitals from using their websites to create a more inclusive environment for transgender patients within the communities they serve.
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Affiliation(s)
- Kristopher J Jackson
- College of Nursing, University of New Mexico, Albuquerque, NM, United States; University of California San Francisco Medical Center, San Francisco, CA, United States.
| | - Starr Tomlinson
- College of Nursing, University of New Mexico, Albuquerque, NM, United States; University of California San Francisco Medical Center, San Francisco, CA, United States
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Scott D. Stigma in place: Black gay men's experiences of the rural South. Health Place 2021; 68:102515. [PMID: 33515909 DOI: 10.1016/j.healthplace.2021.102515] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/23/2020] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
Black gay men (MSM) in the rural United States South are inequitably burdened by stigmatization and the HIV epidemic. Drawing from twelve oral history interviews with middle-aged and older Black gay narrators from rural North Carolina, this research explores the impact of sexual marginalization and the HIV epidemic on lived experiences of the rural South. Despite describing increasingly empowered views of HIV and sexual health, narrators expressed persistent difficulty managing social determinants of HIV vulnerability-sexual stigma and disconnection from LGBTQ collectivity. Narrators reported better managing sexual marginalization over their lifetimes in urban settings and places outside of the South such as New York (NY). This research suggests stressful structural and interpersonal experiences of stigma may define lived experiences of particular settings.
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Affiliation(s)
- Darius Scott
- Department of Geography, Dartmouth College Hanover, New Hampshire, 03755, USA.
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Menkin D, Tice D, Flores D. Implementing inclusive strategies to deliver high-quality LGBTQ+ care in health care systems. J Nurs Manag 2020; 30:O46-O51. [PMID: 32869409 DOI: 10.1111/jonm.13142] [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: 06/22/2020] [Revised: 08/06/2020] [Accepted: 08/18/2020] [Indexed: 11/30/2022]
Abstract
AIM There is a growing recognition of the need to provide inclusive care for LGBTQ+ individuals. Our aim is to provide guidance for nurse managers contemplating similar inclusive changes in their workplace. The role of nurse managers as change agents is discussed based on our experience transforming a traditional suburban health care system to one that is now more LGBTQ+ inclusive. BACKGROUND LGBTQ+ individuals require and deserve high-quality care. Nurse managers can serve as patient advocates by recognizing their capacity to initiate and sustain changes in care settings. METHODS From our reflective nursing practice, we detail essential components that enabled an incorporation of LGBTQ+ inclusive care practices. To undertake structural changes, we highlight the significance of organisational buy-in, customer service and engagement, changes to physical environment, forms and data collection, initiating staff training and a review of health system policies. RESULTS Systemic change in health care is daunting but is achievable. With support from key stakeholders, nurse managers should be capable of initiating organisational changes that would benefit a patient population in receiving optimal care. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers are in optimum positions to initiate practice changes for inclusive LGBTQ+ health care. This commentary can serve as a template for meaningful organisational changes.
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Affiliation(s)
- Dane Menkin
- Divisional Director, LGBTQ Services Main Line Health, Bryn Mawr, PA, USA
| | - Dawn Tice
- VP, Clinical Operations Main Line HealthCare, Newtown Sq, PA, USA
| | - Dalmacio Flores
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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