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Kuhlemeier A, Willging CE. A Multigroup Structural Equation Modeling Approach for Analyzing Differences Among Sexually Diverse Youth. JOURNAL OF HOMOSEXUALITY 2024:1-25. [PMID: 39186323 DOI: 10.1080/00918369.2024.2389903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
High rates of negative behavioral health outcomes among sexually diverse (SD) youth are consistently documented, but population-level trends obscure within-group differences. Social dynamics intersect in youths' lives in ways that cannot be accounted for by summing their independent effects. An intersectional perspective is essential to understanding the behavioral health outcomes of SD youth. We performed multigroup structural equation modeling using an SD subset of New Mexico Youth Risk and Resiliency Survey (N = 10,037) respondents to examine the moderating role of supportive adult relationships for lesbian, gay, and bisexual youth across 12 intersecting (sexual orientation by race/ethnicity by sex) identity categories. Standardized estimates show that supportive relationships are associated with moderate reductions in psychological distress among lesbians (β = -0.459 for Native, β = -0.303 for Hispanic, and β = -0.421 for white) and female bisexual youth (β = -0.352 for Native, β = -0.376 for Hispanic, and β = -0.393 for white). Among male youth, supportive relationships are associated with reduced likelihood of substance use for gay (β = -0.330 for Native, β = -0.464 for Latinx and β = -0.591 for white) and bisexual youth (β = -0.442 for Native, β = -0.306 for Latinx and β = -0.290 for white). This study challenges monolithic characterizations of SD youth, illustrating that the health-promotive benefits of support differ based on sexual orientation, race/ethnicity, and sex.
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Affiliation(s)
- Alena Kuhlemeier
- College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Cathleen E Willging
- Pacific Institute for Research and Evaluation-Southwest Center, Albuquerque, NM, USA
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2
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DeMaio DM, Barerra EP, Post J, Boskey ER, Guss CE. Understanding Gaps of HIV Knowledge Among Transgender Young Adults: A Pilot Interview Study. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2024; 36:229-243. [PMID: 39189961 DOI: 10.1521/aeap.2024.36.4.229] [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: 08/28/2024]
Abstract
Many transgender young adults are unaware of the role of pre-exposure prophylaxis (PrEP) in HIV prevention. Our aim was to understand where transgender and gender-diverse young adults receive health information about HIV and PrEP and their preferences for future learning. Semistructured, qualitative individual and group interviews were done with 14 transgender and gender-diverse young adults. Interviews were transcribed verbatim and analyzed using thematic analysis. Four themes emerged from the interviews related to (1) making trustworthy education materials, (2) the importance of communities, (3) knowledge needed about PrEP, and (4) a lack of early and diverse classroom education. Transgender and genderdiverse persons are at higher risk for HIV than their cisgender peers, yet they have information gaps and hold misconceptions about preventative measures like PrEP. Such misconceptions may be addressed by early, inclusive conversations about HIV transmission and prevention.
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Affiliation(s)
- Danielle M DeMaio
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
| | - Ellis P Barerra
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
| | - Julian Post
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
| | - Elizabeth R Boskey
- Division of Gynecology, Boston Children's Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health
| | - Carly E Guss
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital
- Harvard Medical School
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3
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Zamor RL, Liberman DB, Hall JE, Rees CA, Hartford EA, Chaudhari PP, Portillo EN, Johnson MD. Collecting Sociodemographic Data in Pediatric Emergency Research: A Working Group Consensus. Pediatrics 2024; 154:e2023065277. [PMID: 39044723 PMCID: PMC11291964 DOI: 10.1542/peds.2023-065277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 07/25/2024] Open
Abstract
Understanding and addressing health care disparities relies on collecting and reporting accurate data in clinical care and research. Data regarding a child's race, ethnicity, and language; sexual orientation and gender identity; and socioeconomic and geographic characteristics are important to ensure equity in research practices and reported outcomes. Disparities are known to exist across these sociodemographic categories. More consistent, accurate data collection could improve understanding of study results and inform approaches to resolve disparities in child health. However, published guidance on standardized collection of these data in children is limited, and given the evolving nature of sociocultural identities, requires frequent updates. The Pediatric Emergency Care Applied Research Network, a multi-institutional network dedicated to pediatric emergency research, developed a Health Disparities Working Group in 2021 to support and advance equitable pediatric emergency research. The working group, which includes clinicians involved in pediatric emergency medical care and researchers with expertise in pediatric disparities and the conduct of pediatric research, prioritized creating a guide for approaches to collecting race, ethnicity, and language; sexual orientation and gender identity; and socioeconomic and geographic data during the conduct of research in pediatric emergency care settings. Our aims with this guide are to summarize existing barriers to sociodemographic data collection in pediatric emergency research, highlight approaches to support the consistent and reproducible collection of these data, and provide rationale for suggested approaches. These approaches may help investigators collect data through a process that is inclusive, consistent across studies, and better informs efforts to reduce disparities in child health.
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Affiliation(s)
- Ronine L. Zamor
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
- Division of Emergency Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Danica B. Liberman
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, California
- Departments of Pediatrics
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jeanine E. Hall
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, California
- Departments of Pediatrics
| | - Chris A. Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
- Division of Emergency Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Emily A. Hartford
- Division of Emergency Medicine, Department of Pediatrics, University of Washington, Seattle, Washington
| | - Pradip P. Chaudhari
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, California
- Departments of Pediatrics
| | - Elyse N. Portillo
- Division of Pediatric Emergency medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
| | - Michael D. Johnson
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
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Caba AE, Fish JN, Wheldon CW, Watson RJ. The Association of Stigma, School, and Family Factors with Patterns of Substance Use Among LGBTQ Youth. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024:10.1007/s11121-024-01703-9. [PMID: 38970724 DOI: 10.1007/s11121-024-01703-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/08/2024]
Abstract
Polysubstance use is associated with myriad short- and long-term health outcomes. Although prior research has documented differences in polysubstance use between lesbian, gay, bisexual, transgender, queer/questioning, and other sexual and gender minoritized (LGBTQ +) youth and their heterosexual/cisgender counterparts, as well as between subgroups of LGBTQ + youth, it is unknown how personal, family, and school factors are associated with substance use patterns among LGBTQ + youth. Using a large, national sample of 9646 LGBTQ + youth ages 13-17, we used latent class analysis to examine patterns of alcohol, tobacco, and marijuana use and to determine whether personal, family, and school factors predict class membership. We identified five classes of substance use: polysubstance use, polysubstance experimentation, dual alcohol and cannabis, alcohol, and no use. Greater depression and LGBTQ + victimization, and an ability to be oneself at school, were associated with greater odds of membership in the polysubstance use class, while higher levels of family connection and having a Gender Sexuality Alliance (GSA) at school were associated with lower odds of membership in the polysubstance use class. Our analysis also revealed sociodemographic differences in class membership. These findings highlight potential mechanisms for intervention to reduce polysubstance use among LGBTQ + youth.
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Affiliation(s)
- Antonia E Caba
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
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Ferstad JO, Aslam M, Wang LY, Henaghan K, Zhao J, Li J, Salomon JA. State-level population estimates of sexual minority adolescents in the United States: A predictive modeling study. PLoS One 2024; 19:e0304175. [PMID: 38935807 PMCID: PMC11210845 DOI: 10.1371/journal.pone.0304175] [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: 07/11/2023] [Accepted: 05/08/2024] [Indexed: 06/29/2024] Open
Abstract
PURPOSE The Youth Risk Behavior Survey (YRBS) among high school students includes standard questions about sexual identity and sex of sexual contacts, but these questions are not consistently included in every state that conducts the survey. This study aimed to develop and apply a method to predict state-level proportions of high school students identifying as lesbian, gay, or bisexual (LGB) or reporting any same-sex sexual contacts in those states that did not include these questions in their 2017 YRBS. METHODS We used state-level high school YRBS data from 2013, 2015, and 2017. We defined two primary outcomes relating to self-reported LGB identity and reported same-sex sexual contacts. We developed machine learning models to predict the two outcomes based on other YRBS variables, and comparing different modeling approaches. We used a leave-one-out cross-validation approach and report results from best-performing models. RESULTS Modern ensemble models outperformed traditional linear models at predicting state-level proportions for the two outcomes, and we identified prediction methods that performed well across different years and prediction tasks. Predicted proportions of respondents reporting LGB identity in states that did not include direct measurement ranged between 9.4% and 12.9%. Predicted proportions of respondents reporting any same-sex contacts, where not directly observed, ranged between 7.0% and 10.4%. CONCLUSION Comparable population estimates of sexual minority adolescents can raise awareness among state policy makers and the public about what proportion of youth may be exposed to disparate health risks and outcomes associated with sexual minority status. This information can help decision makers in public health and education agencies design, implement and evaluate community and school interventions to improve the health of LGB youth.
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Affiliation(s)
- Johannes O. Ferstad
- Department of Management Science and Engineering, Stanford University School of Engineering, Stanford, California, United States of America
| | - Maria Aslam
- Office of the Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Li Yan Wang
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Katherine Henaghan
- Department of Health Policy, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Jiayi Zhao
- Department of Health Policy, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Jingjing Li
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Joshua A. Salomon
- Department of Health Policy, School of Medicine, Stanford University, Stanford, California, United States of America
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Caba AE, Mallory AB, Simon KA, Renley BM, Rathus T, Watson RJ. Sexual Identity Disclosure and Alcohol Experiences Among LGBTQ+ Adolescents. Behav Med 2024; 50:170-180. [PMID: 37036276 PMCID: PMC10562512 DOI: 10.1080/08964289.2023.2190078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 02/23/2023] [Accepted: 03/04/2023] [Indexed: 04/11/2023]
Abstract
Sexual and gender minority youth (SGMY) report greater alcohol use in comparison to their heterosexual counterparts. Prior research has found that elevated alcohol use among SGMY can be explained by minority stress experiences. Sexual identity outness may be another factor that drives alcohol use among SGMY, given that outness is associated with alcohol use among older sexual and gender minority samples. We examined how patterns of sexual identity outness were associated with lifetime alcohol use, past-30-day alcohol use, and past-30-day heavy episodic drinking. Data were drawn from the LGBTQ National Teen Survey (N = 8884). Participants were SGMY aged 13 to 17 (mean age = 15.59) years living in the US. Latent class analysis was used to identify sexual identity outness patterns. Multinomial regressions were used to examine the probability of class membership by alcohol use. Six outness classes were identified: out to all but teachers (n = 1033), out to siblings and peers (n = 1808), out to siblings and LGBTQ+ peers (n = 1707), out to LGBTQ+ peers (n = 1376), mostly not out (n = 1653), and very much not out (n = 1307). SGMY in classes characterized by greater outness to peers, friends, and family had greater odds of lifetime alcohol use compared with SGMY in classes characterized by lower outness. These findings suggest that SGMY with greater sexual identity outness may be a target for alcohol use prevention programming. Differences in sexual identity outness may be explained by minority stress factors.
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Affiliation(s)
- Antonia E. Caba
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Allen B. Mallory
- Department of Human Sciences, The Ohio State University, Campbell Hall 151H, 1787 Neil Ave, Columbus, OH 43210
| | - Kay A. Simon
- Department of Family Social Science, University of Minnesota, 1985 Buford Ave, St Paul, MN 55108
| | - Benton M. Renley
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Taylor Rathus
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
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Kruse MI, Bigham BL, Phillips SP. A novel online training program for sexual and gender minority health increases allyship in cisgender, heterosexual paramedics. AEM EDUCATION AND TRAINING 2024; 8:e10958. [PMID: 38516255 PMCID: PMC10951873 DOI: 10.1002/aet2.10958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 01/02/2024] [Accepted: 01/18/2024] [Indexed: 03/23/2024]
Abstract
Introduction Sexual and gender minorities (SGM) make up 4% of the Canadian population. Due to existing barriers to care in the community, SGM patients may seek more help and be sicker at presentation to hospital. Paramedics occupy a unique role and can remove or decrease these barriers. There are no existing evaluations of training programs in SGM health for prehospital providers. A training program to develop better allyship in paramedics toward SGM populations was developed and assessed. Methods A 70- to 90-min mandatory, asynchronous, online training module in SGM health in the prehospital environment was developed and delivered via the emergency medical service (EMS) system's learning management system. A before-and-after study of cisgender, heterosexual, frontline paramedics was performed to measure the impact of the training module on the care of SGM patients. The validated Ally Identity Measure (AIM) tool was used to identify success of training and includes subscales of knowledge and skills, openness and support, and oppression awareness. Demographics and satisfaction scores were collected in the posttraining survey. Matched and unmatched pairs of surveys and demographic associations were analyzed using nonparametric statistics. Results Of 609 paramedics, 571 completed the training, and 239 surveys were completed before and 105 (n = 344) surveys after the training; 60 surveys were paired. Overall AIM scores of matched pairs (n = 60) improved by 12% (p < 0.001), with knowledge and skills accounting for most of the increase (21%, p < 0.001). Unmatched pairs (n = 344) were similar in demographics and scores. Rural paramedics also had significantly lower pretraining oppression awareness scores and had lower posttraining AIM scores compared to suburban paramedics (6% difference). Satisfaction scores rated the training as relevant and applicable (87% and 82%, respectively). Conclusions A novel prehospital training program in the care of SGM patients resulted in a statistically significant increase in allyship in cisgender, heterosexual-identified frontline paramedics.
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Affiliation(s)
- Michael I. Kruse
- Department of Family MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Blair L. Bigham
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Susan P. Phillips
- Department of Family MedicineQueen's UniversityKingstonOntarioCanada
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Parchem B, Wheeler A, Talaski A, Molock SD. Comparison of anxiety and depression rates among LGBTQ college students before and during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:31-39. [PMID: 34919495 DOI: 10.1080/07448481.2021.2013238] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 09/16/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare rates of anxiety and depression among LGBTQ college students before and during the COVID-19 pandemic and examine pandemic-related stressors and protective factors. PARTICIPANTS Two cohorts of LGBTQ college students, aged 18-25, sampled before (N = 3,484) and during (N = 1,647) the pandemic. METHODS The Healthy Minds Study (HMS) is an annual mental health survey administered to college students in the United States, which included additional items related to the COVID-19 pandemic. RESULTS Mean anxiety symptoms were significantly lower mid-pandemic compared to pre-pandemic, but no differences in mean depressive symptoms were detected. Results varied by sexual and gender minority status. Financial stress, pandemic-related concerns, and witnessing discrimination were risk factors while academic persistence, positive mental health, and formal support were protective factors. CONCLUSIONS Mental health and instrumental support from institutions will be critical for college students during the pandemic. Affirming and empowering spaces for LGBTQ college students may leverage protective factors.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Adam Wheeler
- Healthy Minds Network, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Amber Talaski
- Healthy Minds Network, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sherry Davis Molock
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
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Lozano A, Estrada Y, Scott D, Tapia MI, Santos Jr. HP, Carrico AW, Zolobczuk J, Manker A, Prado G. Familias con Orgullo: Study protocol for an efficacy study of a family-based intervention for Hispanic sexual minority youth. PLoS One 2023; 18:e0295683. [PMID: 38100451 PMCID: PMC10723681 DOI: 10.1371/journal.pone.0295683] [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: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 12/17/2023] Open
Abstract
This manuscript describes the rationale and design of a family-based, Hispanic sexual minority youth (HSMY) specific preventive intervention, Familias con Orgullo (Families with Pride). HSMY (N = 306) and their primary caregivers will be recruited in South Florida and be randomized to Familias con Orgullo or prevention as usual. The intervention will be delivered by trained study facilitators. Outcomes will be measured at baseline and 6-, 18-, and 30-months post-baseline. The goals of this study are to evaluate whether the Familias con Orgullo intervention, compared to community practice, is effective in reducing drug use and depressive symptoms through the improvement of parent support for the youth, parent acceptance, family functioning, youth stress, and sexual minority stress. Additionally, we will explore whether gender and baseline levels of parent support for the youth, parent acceptance, family functioning, youth stress, and sexual minority stress moderate intervention effects on the youth outcomes. ClinicalTrials.gov identifier: NCT06057337, First posted September 28, 2023.
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Affiliation(s)
- Alyssa Lozano
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States of America
| | - Yannine Estrada
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States of America
| | - Dalton Scott
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States of America
| | - Maria I. Tapia
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States of America
| | - Hudson P. Santos Jr.
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States of America
| | - Adam W. Carrico
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | | | - Amber Manker
- Alliance for LGBTQ Youth, Miami, Florida, United States of America
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States of America
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Vieira A, Sheerin KM, Williamson-Butler S, Pederson CA, Thompson EC, Soriano S, Wolff JC, Spirito A, Kemp K. Non-suicidal Self-Injury, Suicidal Behaviors, and Mental Health Symptoms among Sexual Minority Youth with Juvenile Justice System Involvement. CHILDREN AND YOUTH SERVICES REVIEW 2023; 155:107196. [PMID: 37982096 PMCID: PMC10653268 DOI: 10.1016/j.childyouth.2023.107196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Sexual minority youth have long remained an understudied population within the juvenile justice system, despite emerging evidence suggesting that sexual minority youth are overrepresented. Recent literature indicates that system-involved sexual minority youth may have more behavioral health concerns than their heterosexual counterparts. Even so, more work is needed to elucidate the unique needs of sexual minority youth who become involved in the system, especially as it pertains to suicidal behaviors and non-suicidal self-injury (NSSI). The present study provided a descriptive evaluation of the prevalence of sexual minority youth making early system contact and their mental health concerns. Of the 218 justice-involved youth from a Northeastern family court in the sample, over a quarter identified as a sexual minority (n = 58). Our findings indicated that these youth evidenced significantly higher scores on a mental health screener compared to their heterosexual counterparts, evidencing greater symptomology on scales indicative of depression/anxiety, thought disturbance, etc. Further, sexual minority youth reported higher rates of lifetime, past year, and past month NSSI as well as lifetime and past year suicide attempts. These findings highlight the need to support the well-being of sexual minority youth in the juvenile justice system by screening for and addressing their mental health needs in this unique setting.
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Affiliation(s)
- Alyssa Vieira
- Rhode Island Hospital, Department of Child and Adolescent Psychiatry, Bradley Hasbro Children’s Research Center, Providence, Rhode Island, United States
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, Rhode Island, United States
| | - Kaitlin M. Sheerin
- Rhode Island Hospital, Department of Child and Adolescent Psychiatry, Bradley Hasbro Children’s Research Center, Providence, Rhode Island, United States
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, Rhode Island, United States
| | - Shannon Williamson-Butler
- Rhode Island Hospital, Department of Child and Adolescent Psychiatry, Bradley Hasbro Children’s Research Center, Providence, Rhode Island, United States
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, Rhode Island, United States
| | - Casey A. Pederson
- Indiana University School of Medicine, Department of Pediatrics Adolescent Behavioral Health, Bloomington, Indiana, United States
| | - Elizabeth C. Thompson
- Rhode Island Hospital, Department of Child and Adolescent Psychiatry, Bradley Hasbro Children’s Research Center, Providence, Rhode Island, United States
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, Rhode Island, United States
| | - Sheiry Soriano
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, Rhode Island, United States
| | - Jennifer C. Wolff
- Rhode Island Hospital, Department of Child and Adolescent Psychiatry, Bradley Hasbro Children’s Research Center, Providence, Rhode Island, United States
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, Rhode Island, United States
| | - Anthony Spirito
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, Rhode Island, United States
| | - Kathleen Kemp
- Rhode Island Hospital, Department of Child and Adolescent Psychiatry, Bradley Hasbro Children’s Research Center, Providence, Rhode Island, United States
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, Rhode Island, United States
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Ferrero EM, Yunker AG, Cuffe S, Gautam S, Mendoza K, Bhupathiraju SN, Mattei J. Nutrition and Health in the Lesbian, Gay, Bisexual, Transgender, Queer/Questioning Community: A Narrative Review. Adv Nutr 2023; 14:1297-1306. [PMID: 37536566 PMCID: PMC10721458 DOI: 10.1016/j.advnut.2023.07.009] [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: 02/12/2023] [Revised: 07/16/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023] Open
Abstract
Sexual and gender minorities have a higher risk for health and nutrition-related disparities across the life course compared to the heterosexual or cisgender population. Experiences of stigmatization and discrimination are associated with diminished mental health quality and psychological distress, which are risk factors for developing various eating disorders. Other nutrition disparities include increased risk for food insecurity, body dissatisfaction, and weight complications, such as those experienced by the transgender population in association with gender-affirming hormone therapies. Despite the need for tailored nutrition recommendations that address the unique needs of the lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) community, there are currently no such guidelines in North America. The purpose of this review is to summarize major LGBTQ+ nutrition disparities and highlight the need for tailored recommendations. We examine the evidence on mental health and social disparities in this group, including vulnerabilities to disordered eating, food insecurity, and healthcare provider discrimination. Importantly, we identify a scarcity of literature on dietary concerns and nutrition care guidelines for LGBTQ+ groups, including studies that address intersectionality and differences among specific gender and sexual orientations. These gaps underline the urgency of prioritizing nutrition for LGBTQ+ health needs and for developing tailored public health nutrition recommendations for this underserved population. Our review suggests that future LGBTQ+ health and nutrition research agendas should include personalized and precision nutrition, social determinants of health, diet quality, body image, and healthcare provider cultural competency and responsiveness. Moreover, the current evidence on LGBTQ+ nutrition and health will be strengthened when research studies (including clinical trials) with robust methodologies amplify inclusion and representation of this community to elucidate health and nutrition disparities in sexual and gender minorities.
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Affiliation(s)
- Elisabetta M Ferrero
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Alexandra G Yunker
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sherri Cuffe
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Saloni Gautam
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Kenny Mendoza
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
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Leonard S, Sotindjo T, Brophy J, Tan DHS, Nashid N. HIV pre-exposure prophylaxis: It is time to consider harm reduction care for adolescents in Canada. Paediatr Child Health 2023; 28:338-343. [PMID: 37744752 PMCID: PMC10517249 DOI: 10.1093/pch/pxac115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 10/10/2022] [Indexed: 09/26/2023] Open
Abstract
Youth (aged 15 to 29 years) account for one quarter of new HIV cases in Canada. Of those, men-who-have-sex-with-men make up one third to one half of new cases in that age range. Moreover, Indigenous youth are over-represented in the proportion of new cases. The use of emtricitabine/tenofovir disoproxil fumarate as pre-exposure prophylaxis (PrEP) significantly reduces the risk of HIV acquisition in adults. Its use was expanded to include youth over 35 kg by the U.S. Food and Drug Administration in 2018. However, PrEP uptake remains low among adolescents. Prescriber-identified barriers include lack of experience, concerns about safety, unfamiliarity with follow-up guidelines, and costs. This article provides an overview of PrEP for youth in Canada, and its associated safety and side effect profiles. Hypothetical case vignettes highlight some of the many demographics of youth who could benefit from PrEP. We present a novel flow diagram that explains the baseline workup, prescribing guidelines, and follow-up recommendations in the Canadian context. Additional counselling points highlight some of the key discussions that should be elicited when prescribing PrEP.
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Affiliation(s)
- Sean Leonard
- Department of Paediatrics, Western University, London, Ontario, Canada
| | - Tatiana Sotindjo
- Division of Adolescent Medicine and Division of Paediatric Infectious Diseases, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jason Brophy
- Division of Paediatric Infectious Diseases, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Darrell H S Tan
- Division of Infectious Diseases, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Nancy Nashid
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Western University, London, Ontario, Canada
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13
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Hong JS, Valido A, Hahm HC, VanHook CR, Espelage DL, Voisin DR. Would Caring Teachers Buffer the Link Between Violence Victimization and Early Sexual Initiation? Comparing Heterosexual and Non-Heterosexual African American Youth. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2789-2798. [PMID: 36810635 DOI: 10.1007/s10508-023-02557-y] [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: 12/04/2021] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
This study investigated the relationship between youth violence exposures (i.e., peer and neighborhood) and early sexual initiation. It also explored whether caring relationships with teachers might moderate this relationship and whether results differed for heterosexual versus non-heterosexual African American youth. The study sample (N = 580) comprised 475 heterosexual and 105 non-heterosexual youths, 319 female and 261 male, ages 13 to 24 years (M age = 15.8). Students were assessed for peer and neighborhood violence, relationship with teachers, early sexual initiation, sexual orientation, and socioeconomic status. Major results indicated a positive relationship between exposure to peer and neighborhood violence and early sexual initiation for heterosexual youth but not those who identified as non-heterosexual. Further, identifying as female (vs. male) was significantly associated with later sexual initiation for both heterosexual and non-heterosexual youth. In addition, caring teachers moderated the relationship between exposure to peer violence and age of sexual initiation among non-heterosexual youth. Programs and interventions to curtail violence sequelae would need to consider the unique effects of various types of youth violence exposures and the significance of sexual orientation.
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Affiliation(s)
- Jun Sung Hong
- School of Social Work, Wayne State University, 5447 Woodward Avenue, Detroit, MI, 48202, USA.
- Department of Social Welfare, Ewha Womans University, 52 Ewha Yeodae-Gil, Seodaemun-Gu, Seoul, South Korea.
| | - Alberto Valido
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Cortney R VanHook
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dorothy L Espelage
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dexter R Voisin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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14
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Saidinejad M, Duffy S, Wallin D, Hoffmann JA, Joseph MM, Schieferle Uhlenbrock J, Brown K, Waseem M, Snow S, Andrew M, Kuo AA, Sulton C, Chun T, Lee LK. The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies. Pediatrics 2023; 152:e2023063256. [PMID: 37584106 DOI: 10.1542/peds.2023-063256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 08/17/2023] Open
Abstract
Mental and behavioral health (MBH) visits of children and youth to emergency departments are increasing in the United States. Reasons for these visits range from suicidal ideation, self-harm, and eating and substance use disorders to behavioral outbursts, aggression, and psychosis. Despite the increase in prevalence of these conditions, the capacity of the health care system to screen, diagnose, and manage these patients continues to decline. Several social determinants also contribute to great disparities in child and adolescent (youth) health, which affect MBH outcomes. In addition, resources and space for emergency physicians, physician assistants, nurse practitioners, and prehospital practitioners to manage these patients remain limited and inconsistent throughout the United States, as is financial compensation and payment for such services. This technical report discusses the role of physicians, physician assistants, and nurse practitioners, and provides guidance for the management of acute MBH emergencies in children and youth. Unintentional ingestions and substance use disorder are not within the scope of this report and are not specifically discussed.
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Affiliation(s)
- Mohsen Saidinejad
- Department of Clinical Emergency Medicine & Pediatrics, David Geffen School of Medicine at UCLA, Institute for Health Services and Outcomes Research, The Lundquist Institute for Biomedical Innovation at Harbor UCLA, and Department of Emergency Medicine, Harbor UCLA Medical Center, Los Angeles, California
| | - Susan Duffy
- Department of Emergency Medicine, Brown University School of Medicine, Providence, Rhode Island
| | - Dina Wallin
- Department of Emergency Medicine, University of California San Francisco, UCSF Benioff Children's Hospital, San Francisco, California
| | - Jennifer A Hoffmann
- Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Evanston, Illinois
| | - Madeline M Joseph
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, University of Florida Health Sciences Center, Jacksonville, Jacksonville, Florida
| | | | - Kathleen Brown
- Emergency Medicine and Trauma Center, Children's National Hospital, Washington, District of Columbia
| | - Muhammad Waseem
- Department of Emergency Medicine, Lincoln Medical Center, Bronx, New York
| | - Sally Snow
- Independent Consultant, Pediatric Emergency and Trauma Nursing
| | | | - Alice A Kuo
- Departments of Medicine and Pediatrics, University of California, Los Angeles, Los Angeles, California
| | - Carmen Sulton
- Departments of Pediatrics and Emergency Medicine, Emory University School of Medicine, CPG Sedation Services, Children's Healthcare of Atlanta, Egleston, Atlanta, Georgia
| | - Thomas Chun
- Division of Pediatric Emergency Medicine, Departments of Emergency Medicine and Pediatrics, Hasbro Children's Hospital, Warren Alpert Medical School of Medicine at Brown University, Providence, Rhode Island
| | - Lois K Lee
- Division of Emergency Medicine, Boston Children's Hospital, Department of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts
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15
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Ruvalcaba Y, Mercer Kollar LM, Jones SE, Mercado MC, Leemis RW, MA ZQ. Adolescent Sexting, Violence, and Sexual Behaviors: An Analysis of 2014 and 2016 Pennsylvania Youth Risk Behavior Survey Data. THE JOURNAL OF SCHOOL HEALTH 2023; 93:690-697. [PMID: 36544265 PMCID: PMC10544782 DOI: 10.1111/josh.13290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Sexting is common among adolescents and is associated with numerous health risk behaviors and negative psychosocial constructs. This study examined the relationships between high school students' experiences with sexual violence victimization, dating violence victimization, and engagement in risky sexual behaviors with experiences of receiving sexts. METHODS Cross-sectional data from the 2014 to 2016 data from Pennsylvania Youth Risk Behavior. Participants were selected using an independent 2-stage cluster sample design to produce a statewide population-based sample. The pencil and paper surveys were conducted in school. Participants included 6734 Pennsylvania high school students in grades 9-12. RESULTS Overall, 29.0% of Pennsylvania high school students had received a sext, which varied by sex, race/ethnicity, school grade, and sexual identity. Students who engaged in sexual risk behaviors, experienced dating violence, or experienced lifetime sexual violence outside of the dating context had a significantly higher prevalence of receiving a sext than students who did not engage in those behaviors or have those experiences. CONCLUSIONS Early screening and prevention efforts that include discussions about sexting behaviors may help prevent other negative outcomes, such as risky sexual behaviors and interpersonal violence. Addressing sexting in the education and health sectors may help to prevent other related harmful health and violence experiences during adolescence.
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Affiliation(s)
- Yanet Ruvalcaba
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA; Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN
| | - Laura M. Mercer Kollar
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sherry Everett Jones
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Melissa C. Mercado
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ruth W. Leemis
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Zhen-Qiang MA
- Division of Community Epidemiology, Bureau of Epidemiology, Pennsylvania Department of Health, Harrisburg, PA
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16
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Fields EL. Achieving Health Equity for Sexual and Gender-Diverse Youth. Pediatr Clin North Am 2023; 70:813-835. [PMID: 37422316 DOI: 10.1016/j.pcl.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
Compared to their heterosexual and cisgender peers, sexual and gender diverse (SGD) youth, especially those from minoritized racial/ethnic groups, experience significant disparities in health, health care, and social conditions that can threaten their health and well-being. This article describes the disparities impacting SGD youth, their differential exposure to the stigma and discrimination that foster these disparities, and the protective factors that can mitigate or disrupt the impact of these exposures. On the final point, the article specifically focuses on pediatric providers and inclusive, affirming, medical homes as critical protective factors for SGD youth and their families.
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Affiliation(s)
- Errol L Fields
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics Johns Hopkins School of Medicine, 200 North Wolfe Street, Room 2015, Baltimore, MD 21287, USA.
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17
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Barnett ML, Salem H, Rosas YG, Feinberg E, Nunez-Pepen R, Chu A, Belmont-Ryu H, Matsuno E, Broder-Fingert S. Adapting Community Health Worker Care Models to Advance Mental Health Services Among LGBTQ Youth. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:658-672. [PMID: 37071315 PMCID: PMC10258167 DOI: 10.1007/s10488-023-01268-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/19/2023]
Abstract
Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth of color experience high rates of mental health disorders, yet they experience challenges to accessing mental health services. Community health worker (CHW) models of care have potential to promote equitable mental health services among LGBTQ youth. Our aim was to understand how CHW models could be adapted to better support LGBTQ youth of color in accessing mental health services. Semi-structured qualitative interviews were conducted with LGBTQ youth of color (n = 16), caregivers of LGBTQ youth (n = 11), and CHWs (n = 15) in Massachusetts and California. Interviews were coded by 8 members of the research team. A Rapid Qualitative Analysis was conducted to identify themes. Caregivers, youth, and CHWs all endorsed the value of CHW models for this population. They also almost universally suggested multiple adaptations are needed for the model to be effective. Four main categories of themes emerged related to intervention adaptations: (1) Why adaptations are needed for LGBTQ youth, (2) Who should serve as CHWs providing care, (3) How CHWs should be trained, and (4) What content needs to be included in the intervention. Broadly, findings suggest the relevance of having CHW models for LGBTQ youth of color to address stigma and discrimination experienced, access to culturally and linguistically relevant services, and the need for caregiver support of LGBTQ youth. CHWs need increased training in these areas.
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Affiliation(s)
- Miya L Barnett
- Department of Counseling, Clinical, and School Psychology, Gervitz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA.
| | - Hanan Salem
- Department of Counseling, Clinical, and School Psychology, Gervitz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA
| | - Yessica Green Rosas
- Department of Counseling, Clinical, and School Psychology, Gervitz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA
| | - Emily Feinberg
- Boston University School of Medicine, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
- Boston Medical Center, Boston, MA, USA
| | | | | | - Hana Belmont-Ryu
- Department of Counseling, Clinical, and School Psychology, Gervitz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA
| | - Em Matsuno
- Arizona State University, Tempe, AZ, USA
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18
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Rees CA, Stewart AM, Portillo EN, Mehta S, Avakame E, Jackson J, McKay J, Michelson KA, Duggan CP, Fleegler EW. Reporting of Important Social Determinants of Health in Pediatric Clinical Trials. Am J Prev Med 2023; 64:918-926. [PMID: 36610922 PMCID: PMC10200735 DOI: 10.1016/j.amepre.2022.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION The objective of this study was to determine the rates and trends in the reporting of preferred language, socioeconomic factors, sexual orientation, and gender identity in published pediatric clinical trials. METHODS A cross-sectional study of pediatric clinical trials conducted in the U.S. published from January 1, 2011 through December 31, 2020 in 5 general pediatric and 5 general medical journals with the highest impact factor in their respective fields was performed. Outcomes were reporting of preferred language, socioeconomic factors, sexual orientation, and gender identity. In late 2021, descriptive statistics and logistic regression to understand how reporting of preferred language and socioeconomic factors changed over time were performed. RESULTS Of 612 trials, 29.6% (n=181) reported preferred language. Among these, 64.6% (n=117 of 181) exclusively enrolled participants whose preferred language was English. From 2011 to 2020, there was a relative increase in the reporting of preferred language (8.6% per year, 95% CI=1.8, 16.0). Socioeconomic factors were reported in 47.9% (n=293) of trials. There was no significant change in the reporting of socioeconomic factors (8.2% per year, 95% CI= -1.9, 15.1). Only 5.1% (9 of 179) of published trial results among adolescent participants reported any measure of sexual orientation, and 1.1% (2 of 179) reported gender identity. CONCLUSIONS Preferred language, socioeconomic factors, sexual orientation, and gender identity were infrequently reported in pediatric clinical trial results despite these characteristics being increasingly recognized as social determinants of health. To achieve more inclusiveness and to reduce unmeasured disparities, these characteristics should be incorporated into routine trial registration, design, funding decisions, and reporting.
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Affiliation(s)
- Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia; Children's Healthcare of Atlanta, Atlanta, Georgia.
| | - Amanda M Stewart
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Elyse N Portillo
- Division of Emergency Medicine, Texas Children's Hospital, Houston, Texas; Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Sagar Mehta
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia; Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Elorm Avakame
- NewYork Presbyterian Hospital, Columbia University, New York City, New York
| | - Jasmyne Jackson
- Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Jheanelle McKay
- Joe DiMaggio Children's Hospital, Memorial Healthcare System, Miami, Florida
| | - Kenneth A Michelson
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Christopher P Duggan
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Eric W Fleegler
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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19
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Noel JK, Tudela SE, Rosenthal SR. Sexual minority status, illicit drug use, and depressive symptoms. JOURNAL OF LGBT YOUTH 2023; 21:490-506. [PMID: 38798775 PMCID: PMC11114600 DOI: 10.1080/19361653.2023.2187918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/28/2023] [Indexed: 05/29/2024]
Abstract
Youth who are lesbian, gay, bisexual, and who identify with other sexual orientations (LGB+) are at higher risk for illicit drug use and have higher rates of mental illness. The current study examined the prevalence of illicit drug use among LGB+ persons and assessed the moderating effect of mental illness. Cross-sectional data from the 2015, 2017, and 2019 Youth Risk Behavioral Surveillance System were aggregated. The outcome was any reported use of cocaine, inhalants, heroin, methamphetamines, ecstasy, or hallucinogens. The primary exposure was self-reported sexual orientation category (i.e., heterosexual, gay/lesbian, bisexual, not sure). Self-reported depressive symptoms were tested as a moderator. Logistic regression models assessed main and interactive effects. Gay or lesbian students [AOR=1.87 95%CI: 1.45,2.43], bisexual students [AOR=2.07 95%CI: 1.77,2.42], and those unsure of their sexual orientation [AOR=1.99 95%CI: 1.65,2.39] had increased odds of illicit drug use. Odds were higher among LGB+ youth who did not have depressive symptoms (p<0.001). Odds of illicit substance use was significantly greater in youth identifying as gay and lesbian, bisexual, and students who were not sure about their sexual orientation and among LGB+ youth without depressive symptoms. Targeted, but non-stigmatizing, prevention programs are needed.
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Affiliation(s)
- Jonathan K. Noel
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, RI, USA 02903
| | - Stephanie E. Tudela
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, RI, USA 02903
| | - Samantha R. Rosenthal
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, Providence, RI, USA 02903
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20
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Zu P, Xu SJ, Shi CY, Zhao YQ, Huang ZH, Tao FB. Perceived rather than objective weight status is associated with suicidal behaviors among Chinese adolescents: a school-based study. J Public Health (Oxf) 2023; 45:75-83. [PMID: 35226755 DOI: 10.1093/pubmed/fdac015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/22/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND We aimed to explore the relationship between body mass index (BMI) and body weight perception (BWP) with suicidal behaviors among mainland Chinese adolescents. METHODS A nationally representative sample (N = 10 110) of Chinese adolescents was assessed in this study. Suicidal behaviors (ideation, plan and attempt) were evaluated by four self-reported questions. Generalized linear mixed model was used to estimate the adjusted odds ratios (ORs) for the association between BWP/BMI with suicidal behaviors. RESULTS The prevalence of suicidal ideation, suicidal plan and suicidal attempt was 12, 5 and 2.1%, respectively. After adjusting potential covariates, perceiving oneself as obese was significantly associated with increased risks of suicidal ideation (OR: 2.4, 95% confidence intervals, CI: 1.6-4.0, P = 0.001), suicidal plan (OR: 3.1, 95% CI: 1.5-6.3, P = 0.002) and suicidal attempt (OR: 3.7, 95% CI: 1.5-9.1, P = 0.001) compared with perceiving as normal weight among male adolescents; the effect attenuated to null among female adolescents. Perceiving oneself as underweight and overweight both exhibited significant adverse effect on suicidal behaviors (only suicidal ideation and suicidal plan) compared with perceiving oneself as normal weight among male adolescents, but not among female adolescents. The actual measured BMI was not significantly associated with suicidal behaviors among neither gender. CONCLUSIONS Self-perception of their body image rather than actual measured weight may have a gender-specific adverse effect on suicidal behaviors among Chinese adolescents.
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Affiliation(s)
- Ping Zu
- Department of Economic Management, Anhui Vocational College of Press and Publishing. Hefei 230601, Anhui, China
| | - Shao-Jun Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Cheng-Ying Shi
- Department of Economic Management, Anhui Vocational College of Press and Publishing. Hefei 230601, Anhui, China
| | - Yu-Qiu Zhao
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, Anhui, China
| | - Zhao-Hui Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
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21
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Bishop MD, Ioverno S, Russell ST. Sexual minority youth's mental health and substance use: The roles of victimization, cybervictimization, and non-parental adult support. CURRENT PSYCHOLOGY 2023; 42:5075-5087. [PMID: 38344657 PMCID: PMC10857851 DOI: 10.1007/s12144-021-01812-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 01/03/2023]
Abstract
Victimization is a well-established driver of sexual minority youth's (SMY) mental health and substance use risk. The current study examined and extended this research by exploring how victimization, cybervictimization, and non-parental supportive adults contribute to SMY's vulnerability to poor mental health and substance use. Using data from the first representative sample of Texas youth that measures sexual identity, we analyzed sex-stratified models of the association between sexual identity, mental health, and substance use, and the confounding effects of victimization, cybervictimization, and non-parental adult support. Victimization was more common among SMY and accounted for a greater proportion of sexual identity disparities on mental health and substance use, especially for males. Sexual minority females were more likely to report cybervictimization than heterosexual youth, and cybervictimization was associated with mental health risk. SMY reported fewer available non-parental supportive adults, which was associated with more sadness, suicidality, and polysubstance use. Our study adds to extant evidence that victimization drives SMY's increased susceptibility to mental health and substance use risk. Schools should implement inclusive policies that prohibit bullying based on sexual minority identity and offer professional development opportunities for supporting SMY.
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Affiliation(s)
- Meg D. Bishop
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX 78712, USA
| | - Salvatore Ioverno
- Department of Sociology, Ghent University, St. Pietersnieuwstraat 33, 9000 Ghent, Belgium
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX 78712, USA
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22
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Argenyi MS, Mereish EH, Watson RJ. Mental and Physical Health Disparities Among Sexual and Gender Minority Adolescents Based on Disability Status. LGBT Health 2023; 10:130-137. [PMID: 36301253 PMCID: PMC9986008 DOI: 10.1089/lgbt.2022.0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Sexual and gender minority (SGM) youth and youth with disabilities both experience health disparities. Little data exist on whether SGM youth with disabilities have worse health outcomes compared with SGM youth without disabilities. This study aimed to examine differences in health behaviors and outcomes among a sample of SGM youth by different types of disabilities. Methods: Secondary analyses were conducted with a subset (N = 9418) of the LGBTQ National Teen Survey, a comprehensive survey of risk and protective factors and health outcomes of SGM youth across the United States collected in 2017. Multiple types of disabilities (physical, cognitive, or psychiatric) and mental, behavioral, and physical health outcomes were self-reported. Results: Of the sample, 18.3% reported a disability. Significant findings included higher odds of exercise avoidance, greater depressive symptoms and sleep concerns, and lower self-esteem and overall health ratings among SGM youth who reported any form of disability compared with SGM youth who reported no disability. Youth with cognitive disabilities had lower odds of alcohol use than youth with no disability. Youth with psychiatric disabilities had higher odds of cannabis and cigarette use, and lower physical activity than youth with no disability. Youth with either psychiatric or physical disabilities reported higher body mass index than youth with no disability. Conclusion: SGM youth with disabilities experience greater health disparities than SGM youth with no reported disabilities. Results provide groundwork evidence about the impact of disability status on SGM adolescents. Disability-inclusive or -specific frameworks are needed for future interventions and studies of SGM youth.
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Affiliation(s)
- Michael S Argenyi
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington, District of Columbia, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
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23
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Berry KR, Gliske K, Schmidt C, Cray LDE, Killian M, Fenkel C. LGBTQIA+ Adapted Telehealth Intensive Outpatient Program for Youth and Young Adults: Subgroup Analysis of Acuity and Improvement Following Treatment (Preprint). JMIR Form Res 2023; 7:e45796. [PMID: 37083637 PMCID: PMC10163404 DOI: 10.2196/45796] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other minoritized gender and sexual identities (LGBTQIA+) youth have disproportionately high levels of depression, self-harm, and suicidal thoughts and behaviors. In addition, LGBTQIA+ youth frequently report lower levels of satisfaction or comfort with their health care providers because of stigmatization, which may prevent continuation of care, yet there is a lack of mental health treatment and outcome research addressing these disparities. However, there is some indication that LGBTQIA+ individuals feel more comfortable with web-based formats, indicating that telehealth services may be beneficial for this population. OBJECTIVE This program evaluation explored the effectiveness of a remote intensive outpatient program with a curriculum tailored specifically to LGBTQIA+ youth with high-acuity depression, anxiety, and suicidality. This study sought to understand baseline acuity differences between LGBTQIA+ and non-LGBTQIA+ youth and young adult patients and to determine if there were differences in clinically significant improvement by subtypes within the LGBTQIA+ population following participation in LGBTQIA+-specific programming. METHODS Data were collected from intake and discharge outcome surveys measuring depression, suicidality, and nonsuicidal self-injury (NSSI) in 878 patients who attended at least six sessions of a remote intensive outpatient program for youth and young adults. Of these 878 clients, 551 (62.8%) were identified as having at least one LGBTQIA+ identity; they participated in an LGBTQIA+-adapted program of the general curriculum. RESULTS LGBTQIA+ patients had more clinically severe intake for depression, NSSI, and suicidal ideation. Nonbinary clients had greater NSSI within the LGBTQIA+ sample at intake than their binary counterparts, and transgender clients had significantly higher depressive scores at intake than their nontransgender counterparts. LGBTQIA+ patients demonstrated improvements in all outcomes from intake to discharge. The Patient Health Questionnaire for Adolescents depression scores improved from 18.15 at intake to 10.83 at discharge, representing a 41.5% reduction in depressive symptoms. Overall, 50.5% (149/295) of the LGBTQIA+ youth who endorsed passive suicidal ideation at intake no longer reported it at discharge, 72.1% (160/222) who endorsed active suicidal ideation at intake no longer reported it at discharge, and 55.1% (109/198) of patients who met the criteria for clinical NSSI no longer met the criteria at discharge. In the subgroup analysis, transgender patients were still 2 times more likely to report clinical NSSI at discharge. CONCLUSIONS This program evaluation found substantial differences in rates of depression, NSSI, and suicidal ideation between LGBTQIA+ clients compared with their non-LGBTQIA+ counterparts. In addition, this evaluation showed a considerable decrease in symptoms when clients attended LGBTQIA+-affirming care. The findings provide support for the role of LGBTQIA+-specific programming to meet the elevated mental health needs of these youth and that more research is needed to understand barriers that may negatively affect transgender clients, specifically.
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Affiliation(s)
| | - Kate Gliske
- Charlie Health, Inc, Bozeman, MT, United States
| | | | | | - Michael Killian
- College of Social Work, Florida State University, Tallahassee, FL, United States
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Mereish EH, Fish JN, Watson RJ. Intersectional Minority Stress and Alcohol, Tobacco, and Cannabis Use Among Sexual and Gender Minority Adolescents of Color: Moderating Role of Family Support. LGBT Health 2023; 10:18-25. [PMID: 35914084 PMCID: PMC10024056 DOI: 10.1089/lgbt.2021.0430] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Purpose: We examined the associations between intersectional minority stress and substance use among sexual and gender minority (SGM) adolescents of color and the moderating role of family support on these associations. Methods: Data were from a national U.S. sample of SGM adolescents of color (N = 3423). Intersectional minority stress was assessed with the LGBT People of Color Microaggressions Scale. Results: Intersectional minority stress was associated with greater odds of recent and heavy alcohol and recent cannabis use, but not tobacco use. When examining specific domains of intersectional minority stress, racism from SGM communities was associated with greater odds of recent and heavy alcohol, and recent cannabis use, whereas heterosexism from same racial/ethnic communities was associated with greater odds of recent cigarette and cigar use. Family support was associated with lower substance use. Family support was not a significant moderator. Conclusions: Findings underscore the need to examine intersectional stressors that SGM adolescents of color experience and to bolster family supports to prevent substance use. Family support did not buffer the effects of intersectional minority stress on substance use outcomes, suggesting that other strategies, such as other forms of family support (e.g., identity-specific support) and community-level and structural changes that target reducing and dismantling oppression are needed to reduce the deleterious impact of intersectional minority stress.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Health Studies, American University, Washington, District of Columbia, USA
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
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Karpel HC, Sampson A, Charifson M, Fein LA, Murphy D, Sutter M, Tamargo CL, Quinn GP, Schabath MB. Assessing Medical Students' Attitudes and Knowledge Regarding LGBTQ Health Needs Across the United States. J Prim Care Community Health 2023; 14:21501319231186729. [PMID: 37449447 PMCID: PMC10350786 DOI: 10.1177/21501319231186729] [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: 03/14/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community experiences health disparities. It is thus imperative that medical trainees receive training in the care of LGBTQ community. The objective of this study was to identify gaps in knowledge and comfort among medical school students in providing care for the LGBTQ community. METHODS An online survey was administered to medical students at 3 institutions in the United States from December 2020 to March 2021. Using a Likert scale, the survey assessed attitudes, comfort, and knowledge in providing care for the LGBTQ community. The survey included questions for each specific LGBTQ population. Results were quantified using descriptive and stratified analyses, and an exploratory factor analysis was used to calculate attitude summary measure (ASM) scores. A total knowledge score was calculated, with higher values indicating greater knowledge. RESULTS Among the 300 medical students who completed the survey, the majority were female (55.7%), White (54.7%), and heterosexual (64.3%). The majority of medical students felt comfortable (strongly agree/agree) participating in the care of lesbian (94.3%), gay (96.0%), and bisexual (96.3%) patients; this percentage dropped to 82.3% for non-binary and 71.3% for transgender patients. Only 27.0% of medical students reported confidence in their knowledge of health needs of transgender patients. LGBTQ self-identification, percent of core rotations completed in school, region of country, and friends and/or family who are part of the LGBTQ community were significantly associated with various ASM scores. Knowledge questions yielded high percentages of "neutral" responses, and medical students who identified as LGBTQ had significantly higher total knowledge scores. CONCLUSIONS Overall, the surveyed medical students feel comfortable and willing to provide care for LGBTQ persons. But, there is limited knowledge about specific LGBTQ health needs. More education and training in the needs of transgender and non-binary patients, in particular, is indicated.
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Affiliation(s)
| | | | | | - Lydia A. Fein
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Devin Murphy
- University of Texas Health, San Antonio, TX, USA
| | - Megan Sutter
- New York University, New York, NY, USA
- Emory University, Atlanta, GA, USA
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Aivadyan C, Slavin MN, Wu E. Inclusive State Legislation and Reduced Risk of Past-Year Suicide Attempts Among Lesbian, Gay, Bisexual, and Questioning Adolescents in the United States. Arch Suicide Res 2023; 27:63-79. [PMID: 34427167 PMCID: PMC8866533 DOI: 10.1080/13811118.2021.1967237] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study examines the relationship between state legislation relevant to equality for sexual minorities and past-year suicide attempts among lesbian, gay, bisexual, and questioning (LGBQ) adolescents in the United States. METHODS Data were aggregated from 24 states that participated in the 2017 Youth Risk Behavior Surveillance System (N = 70,599). We utilized multilevel logistic regression to determine whether observed positive associations between sexual minority identity and past-year suicide attempts differ as a function of 2016 State Equality Index (SEI), an objective measure of state laws and policies affecting equality for sexual minorities. RESULTS LGBQ adolescents were significantly more likely to report having made a suicide attempt in the past year than heterosexual youth (adjusted odds ratio [AOR]: 3.82; 95% confidence interval [CI]: 3.29-4.44). The 2016 SEI moderated the positive association between sexual minority identity and suicide attempts, with odds of past-year suicide attempts significantly reduced in states with more inclusive legislation (AOR: 0.91; CI: 0.85-0.97). Among sexual minority subgroups, significant effect modifications were found for bisexual (AOR: 0.88; CI: 0.77-0.99) and questioning (AOR: 0.87; CI: 0.78-0.96) - but not gay or lesbian (AOR: 1.10; CI: 0.97-1.24) - adolescents. The effect modification was strongest for bisexual males (AOR: 0.68; CI: 0.47-0.99). CONCLUSIONS State legislation relevant to equality for sexual minorities differentially affected associations between sexual minority identity and suicide attempts, such that past-year suicide attempts were substantially lower in states with more inclusive legislation. Inclusive state legislation may exert a protective effect on risk for suicide attempts among sexual minority youth.
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Russell ST, Mallory AB, Fish JN, Frost DM, Hammack PL, Lightfoot M, Lin A, Wilson BD, Meyer IH. Distribution and Prevalence of Health in a National Probability Sample of Three Cohorts of Sexual Minority Adults in the United States. LGBT Health 2022; 9:564-570. [PMID: 35856801 PMCID: PMC9734014 DOI: 10.1089/lgbt.2020.0505] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose: This study examined the health profile of a national probability sample of three cohorts of sexual minority people, and the ways that indicators of health vary among sexual minority people across age cohorts and other defining sociodemographic characteristics, including sexual identity, gender identity, and race/ethnicity. Methods: The Generations Study, the first national probability sample of three age cohorts of sexual minority people (n = 1507) in the United States collected in 2016-2017, was used to examine general health profiles across several broad domains: alcohol and drug abuse; general health, physical health, and health disability; mental health and psychological distress; and positive well-being, including general happiness, social well-being, and life satisfaction. Results: There were no cohort differences in substance abuse or positive well-being. The younger cohort was physically healthier, but had worse psychological health than both the middle and older cohorts. Conclusions: Cohort differences in physical health were consistent with patterns of aging, whereas for mental health, there were distinct cohort differences among sexual minority people. Given that compromised mental health in the early life course creates trajectories of vulnerability, these results point to the need for mental health prevention and intervention for younger cohorts of sexual minority people.
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Affiliation(s)
- Stephen T. Russell
- Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, Austin, Texas, USA.,Address correspondence to: Stephen T. Russell, PhD, Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, 108 E. Dean Keeton Street, Stop A2702, Austin, TX 78712-1248, USA
| | - Allen B. Mallory
- Department of Human Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Jessica N. Fish
- Department of Family Science, Prevention Research Center, University of Maryland, College Park, Maryland, USA
| | - David M. Frost
- Social Research Institute, University College London, London, United Kingdom
| | - Phillip L. Hammack
- Department of Psychology, University of California, Santa Cruz, Santa Cruz, California, USA
| | - Marguerita Lightfoot
- School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Andy Lin
- Office of Advanced Research Computing, University of California, Los Angeles, Los Angeles, California, USA
| | - Bianca D.M. Wilson
- The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California, USA
| | - Ilan H. Meyer
- The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California, USA
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Suarez NA, Cooper AC, Kaczkowski W, Li J, Robin L, Sims VM. Associations of a Multilevel School Health Program and Health Outcomes Among Lesbian, Gay, and Bisexual Youth. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:395-412. [PMID: 36181496 PMCID: PMC10009884 DOI: 10.1521/aeap.2022.34.5.395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Lesbian, gay, and bisexual (LGB) adolescents are often at higher risk than their heterosexual peers for adverse sexual health, violence, mental health, and substance use outcomes. Schools are a vital resource for enhancing protective behaviors and reducing risk behaviors. Sixteen school districts selected schools to implement a sexual health program (exposed) or usual programming (unexposed). We analyzed LGB student health outcomes using 2015 and 2017 Youth Risk Behavior Surveys. Analyses compared LGB student health outcomes by exposure status across time points using a multilevel approach. Program exposure was associated with decreased odds of ever having sex, ever testing for HIV, and using effective hormonal birth control, and an increased odds of condom use. There were no significant findings among secondary violence, mental health, and substance use outcomes. This evaluation highlights the potential for schools to reduce sexual risk behaviors among LGB youth, and opportunities to improve access to health services.
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Affiliation(s)
- Nicolas A Suarez
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adina C Cooper
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wojciech Kaczkowski
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jingjing Li
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Leah Robin
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Valerie M Sims
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Roth LT, Cooper MB, Lurie B, Wueste B. Developing an Entrustable Professional Activity to Improve the Care of LGBTQ+ Youth. Acad Pediatr 2022; 23:697-702. [PMID: 36122833 DOI: 10.1016/j.acap.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 11/01/2022]
Abstract
Despite the multitude of health inequities often experienced by lesbian, gay, bisexual, transgender, and queer (LGBTQ)+ youth, few training programs consistently and comprehensively address these disparities through education and assessment of learners. Over the past decade, programs have begun to incrementally increase the number of hours dedicated to LGBTQ+ health training; however, the lack of standardization for curricula and assessment remains a significant barrier. As medical education shifts to a competency-based approach, focusing on patient outcomes and the competencies trainees must achieve to meet those outcomes, we must take this opportunity to develop curricula and assessment tools that emphasize inclusive, affirming, equitable, and culturally humble care for LGBTQ+ youth. Entrustable professional activities (EPA) are increasingly used to educate and assess trainees on their progression from full supervision to unsupervised practice. Given their multifaceted use to standardize curricula, assess learners, and highlight programmatic gaps in education, we believe an EPA is the ideal tool to systematically improve LGBTQ+ health training in graduate medical education. Our team of national experts in this field developed an LGBTQ+ health EPA. We describe our methods of development, the functions and curricular components of the EPA, and the many applications for widespread program use.
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Affiliation(s)
- Lauren T Roth
- Department of Pediatrics (LT Roth), Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, NY.
| | - M Brett Cooper
- Department of Pediatrics (MB Cooper), UT Southwestern Medical Center/Children's Medical Center Dallas
| | - Brian Lurie
- Department of Pediatrics (B Lurie), Atrium Health/Levine Children's Hospital, NC
| | - Beth Wueste
- Department of Pediatrics (B Wueste), UT Health San Antonio, Tex
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Straka K, Blacketer AR, Martinez RL, Glover A, Winiarski DA, Karnik NS, Schueller SM, Zalta AK. Rates and correlates of well-being among youth experiencing homelessness. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3746-3759. [PMID: 35460583 PMCID: PMC9464689 DOI: 10.1002/jcop.22869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
Mental health concerns have been well studied among youth experiencing homelessness, yet few studies have explored factors that contribute to well-being in this population. The current cross-sectional study examined rates and correlates of well-being among youth experiencing homelessness. This is a descriptive, secondary analysis of the baseline data from a clinical intervention study. Ninety-nine youth (aged 16-25) who were experiencing homelessness were recruited in Chicago. Approximately 40% of the sample reported average or above average well-being relative to existing benchmarks. Having medical insurance, a mobile phone, and a history of more severe childhood trauma were unique cross-sectional predictors of worse well-being (all ps < 0.034). A significant portion of our sample experienced well-being. Having access to certain resources may be counterintuitive indicators of poorer well-being among youth experiencing homelessness, perhaps because they are indicators of greater need or increased social comparison among these youth.
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Affiliation(s)
- Kelci Straka
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Alexis R. Blacketer
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Ramona L. Martinez
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
| | - Angela Glover
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Dominika A. Winiarski
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Niranjan S. Karnik
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Stephen M. Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Alyson K. Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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Kiekens WJ, Baams L, Fish JN, Watson RJ. Associations of Relationship Experiences, Dating Violence, Sexual Harassment, and Assault With Alcohol Use Among Sexual and Gender Minority Adolescents. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP15176-NP15204. [PMID: 33719695 PMCID: PMC8917816 DOI: 10.1177/08862605211001469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual and gender minority (SGM) adolescents report higher rates of dating violence victimization compared with their heterosexual and cisgender peers. Research on dating violence often neglects diversity in sexual and gender identities and is limited to experiences in relationships. Further, given that dating violence and alcohol use are comorbid, research on experiences of dating violence could provide insights into alcohol use disparities among SGM adolescents. We aimed to map patterns of relationship experiences, sexual and physical dating violence, and sexual and physical assault and explored differences in these experiences among SGM adolescents. Further, we examined how these patterns explained alcohol use. We used a U.S. non-probability national web-based survey administered to 13-17-year-old SGM adolescents (N = 12,534). Using latent class analyses, four patterns were identified: low relationship experience, dating violence and harassment and assault (72.0%), intermediate dating experiences, sexual harassment, and assault and low levels of dating violence (13.1%), high dating experiences, dating violence, and sexual assault (8.6%), and high dating experiences, dating violence, and sexual harassment and assault (6.3%). Compared to lesbian and gay adolescents, bisexual adolescents reported more experiences with dating, dating violence, and sexual assault, whereas heterosexual adolescents reported fewer experiences with dating, dating violence, and sexual harassment and assault. Compared to cisgender boys, cisgender girls, transgender boys, and non-binary/assigned male at birth adolescents were more likely to experience dating violence inside and outside of relationship contexts. Experiences of dating, dating violence, and sexual harassment and assault were associated with both drinking frequency and heavy episodic drinking. Together, the findings emphasize the relevance of relationship experiences when studying dating violence and how dating violence and sexual harassment and assault might explain disparities in alcohol use.
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Affiliation(s)
| | - L Baams
- University of Groningen, The Netherlands
| | - J N Fish
- University of Maryland, College Park, USA
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Reyes MES, Escote AMD, Ferrer AVC, Marpuri JKO, Santos ACDR, Torres RFE, Cayubit RFO, Bacaoco JRA. Suicidality among bisexual youths: the role of parental sexual orientation support and concealment. CURRENT PSYCHOLOGY 2022; 42:1-13. [PMID: 35967510 PMCID: PMC9358384 DOI: 10.1007/s12144-022-03474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2022] [Indexed: 11/18/2022]
Abstract
Compared with the heterosexual population, the prevalence of mental health outcomes such as suicidality (suicidal ideation, suicide plans, and suicide attempts) is higher among sexual minority youth, particularly those who identify themselves as bisexuals. Bisexuals are at an even elevated risk within the LGB populations due to biphobia, monosexism, bisexual invisibility or erasure, and lack of support resources. These experiences may bring about issues regarding concealment of their sexual orientation linked to suicidality. Studies have also identified that parental support is a protective factor against suicidality among the youth, particularly their sexual orientation. The present study used a cross-sectional, predictive research design to examine parental sexual orientation support and concealment and their associations and predictive abilities in the suicidality of 151 Filipino bisexual youths aged 18-24 years old. The participants were recruited online within six months, from July 2021 to December 2021. As measured by the Parental Support for Sexual Orientation Scale, Sexual Orientation Concealment Scale, and Suicide Behaviors Questionnaire-Revised, results showed that among our bisexual participants, parental sexual orientation support and concealment did not have a significant relationship with and could not predict their risk for suicidality. Limitations and suggestions for further research were discussed, considering our findings.
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Affiliation(s)
- Marc Eric S. Reyes
- Department of Psychology, College of Science, University of Santo Tomas, 1008 Manila, Philippines
| | - Alyzza Meynell D. Escote
- Department of Psychology, College of Science, University of Santo Tomas, 1008 Manila, Philippines
| | | | - Judith Kate O. Marpuri
- Department of Psychology, College of Science, University of Santo Tomas, 1008 Manila, Philippines
| | | | | | - Ryan Francis O. Cayubit
- Department of Psychology, College of Science, University of Santo Tomas, 1008 Manila, Philippines
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McKinnish T, Hunt C, Weinberg S, Perry M, Seashore C, Gold S, Vander Schaaf EB. A Quality Improvement Approach to Enhance LGBTQ+ Inclusivity in Pediatric Primary Care. Pediatrics 2022; 150:188547. [PMID: 35909154 DOI: 10.1542/peds.2021-052125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) teens are at higher risk of illness as a result of bias but are less likely than peers to attend well visits. Medical organizations recommend improving care through staff education, visual cues, and routine inquiry of sexual orientation and gender identity (SO/GI) and pronouns. It is unknown how to do this confidentially in pediatrics. This quality improvement (QI) project aimed to confidentially collect and document SO/GI and pronouns early in at least 90% of teen acute care visits. METHODS A diverse, representative QI team in a resident primary care clinic conducted a series of staff and clinician trainings to improve knowledge, then displayed welcoming signage and offered staff pronoun and rainbow pins. Multiple Plan-Do-Study-Act cycles developed methods of routine and private collection of SO/GI and pronouns. Outcome measures included proportion of teen acute visits with such documentation collected via weekly chart reviews. Process measures included staff/clinician preparedness, assessed by surveys. RESULTS SO/GI and pronouns were documented in 0% of teen acute visits at baseline, 70% after 6 months, and 90% during the 20-week sustainment measurement phase. The proportion of staff and clinicians who felt prepared to provide care for LGB and transgender patients increased (53% to 68% for LGB, P = .07; and 30% to 57% for transgender, P = .002). CONCLUSIONS QI methods can create protocols for confidential, sustainable SO/GI and pronoun collection from teens early in acute visits. This allows clinicians and staff to address patients appropriately and for clinicians to better meet their needs.
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Affiliation(s)
| | - Candice Hunt
- Duke University Hospital, Durham, North Carolina
| | | | - Martha Perry
- University of North Carolina, Chapel Hill, North Carolina
| | - Carl Seashore
- University of North Carolina, Chapel Hill, North Carolina
| | - Stuart Gold
- University of North Carolina, Chapel Hill, North Carolina
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Stephenson R, Darbes LA, Rosso MT, Washington C, Hightow-Weidman L, Sullivan P, Gamarel KE. Perceptions of Contexts of Intimate Partner Violence Among Young, Partnered Gay, Bisexual and Other Men Who Have Sex With Men in the United States. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP12881-NP12900. [PMID: 33729057 DOI: 10.1177/08862605211001472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There has been a growth in research illustrating that gay, bisexual, and other men who have sex with men (GBMSM) experience intimate partner violence (IPV) at rates that are comparable to those among heterosexual women. However, the majority of research on IPV among same-sex male couples has focused on adults, and research on the experience of IPV among younger men (those aged under 18), remains at a nascent stage, despite knowledge that IPV is often common among younger men. This article adds to the growing body of literature on IPV among young GBMSM (YGBMSM) through of an analysis of qualitative data from in-depth interviews (IDI) with GBMSM aged 15-19 (n = 30) in romantic relationships partnerships. The study sought to explore issues of relationship development, relationship contexts, and understandings of IPV. More than one-half of the sample reported experiencing some form of IPV in their current or past relationships. Participants described a range of experiences of IPV, including physical IPV, emotional IPV, sexual IPV, and controlling behaviors. Emotional IPV in the form of negative comments and controlling behaviors such as jealousy were the most commonly reported forms of violence behaviors. Although few participants reported experiencing physical or sexual IPV, several discussed concerns about giving, and partners' acknowledging, sexual consent. Antecedents to IPV included wanting or feeling pressured to participate in normative development milestones, short-lived relationships, and societal stigma. Interventions that develop content on IPV and that reflect the lived realities of YGBMSM who are experiencing their first relationships are urgently needed. Study findings also support the need for training teachers, health care providers, and parents to identify signs of IPV and provide them with the knowledge and skills to talk to YGBMSM about relationships and violence to reduce IPV.
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Affiliation(s)
| | | | | | | | | | - Patrick Sullivan
- Emory University Rollins School of Public Health, Atlanta, GA, USA
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Tapia MI, Lozano A, Estrada Y, Fernandez A, Prado G, Austin A. Evaluating measurement properties of a modified affirmative counseling skills scale with social workers and school psychologists in South Florida. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2091705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Maria I. Tapia
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Alyssa Lozano
- Department of Public Health Sciences, University of Miami Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Yannine Estrada
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Alejandra Fernandez
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Center for Pediatric Population Health, Dallas, Texas, USA
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Ashley Austin
- Ellen Whiteside McDonnell School of Social Work, Barry University, Miami Shores, Florida, USA
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Spizzirri G, Eufrásio RÁ, Abdo CHN, Lima MCP. Proportion of ALGBT adult Brazilians, sociodemographic characteristics, and self-reported violence. Sci Rep 2022; 12:11176. [PMID: 35778514 PMCID: PMC9249838 DOI: 10.1038/s41598-022-15103-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/17/2022] [Indexed: 11/09/2022] Open
Abstract
Asexual, lesbian, gay, bisexual, and trans (ALGBT) individuals face worse life conditions and violence rates than their heterosexual cisgender counterparts. Brazil is often highlighted for having one of the highest rates of hate-related homicides against ALGBTs in the world. However, to date, Brazil's ALGBT population has not been investigated with a representative sample, and basic information such as population size or sociodemographic characteristics are mostly based in non-systematic data. We aimed to assess the proportion of asexual, lesbian, gay, bisexual, trans and non-binary adults in Brazil, their sociodemographic characteristics, and self-reported violence rates. In 2018, a sample (n = 6000) of the Brazilian adult population answered a face-to-face survey assessing sociodemographic characteristics, gender identity, sexual orientation, and self-reported psychological, physical, verbal, and sexual violence. Among Brazilian adults, 12.04% are ALGBT: 5.76% asexual, 0.93% lesbian, 1.37% gay, 2.12% bisexual, 0.68 trans, and 1.18% non-binary. Compared to heterosexual cisgender men, most ALGBT individuals have worse socioeconomic indicators and higher rates of self-reported psychological and verbal violence. All ALGBT groups and heterosexual cisgender women reported sexual violence more often than heterosexual cisgender men. It was reported between 4 up to 25 times more often by heterosexual cisgender women and trans individuals, respectively. The rates of the other ALGBT groups sit among the two. Our findings provide evidence of the important size of the ALGBT Brazilian population, as well as their socioeconomic vulnerability, and concerning violence levels experienced by the group. Policy makers may refer to the present article in order to mitigate this population's vulnerability and to better understand its sociodemographic characteristics.
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Affiliation(s)
- Giancarlo Spizzirri
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil.
| | | | | | - Maria Cristina Pereira Lima
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil
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Streed CG, Turner B, Beach LB, Marro R, Felt D, Wang X, Phillips G. Safety and Predictors of Sexual Minority Youth Carrying Weapons. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP8724-NP8746. [PMID: 33289455 PMCID: PMC8184859 DOI: 10.1177/0886260520978183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Prior research has revealed sexual minority youth are more likely to carry weapons both outside of and within school. However, to date, no study has examined the degree to which bullying and harassment is associated with weapon carrying among sexual minority youth. We utilized the Youth Risk Behavior Survey to examine the prevalence and likelihood of carrying weapons by sexual identity, adjusting for adverse experiences. From the Youth Risk Behavior Survey 2009-2015, we examined self-report of adverse experiences (e.g., being bullied, skipping school due to fear for personal safety) and performed Logistic regressions to estimate the odds of carrying a weapon and were adjusted to include demographics and adverse experiences. When surveyed by sexual identity, 14.0% of heterosexual, 21.8% of gay/lesbian, 18.5% of bisexual, and 17.4% of "not sure" students reported carrying a weapon in the past 30 days. Odds of carrying a weapon were significantly increased for youth who skipped school due to feeling unsafe at school, had ever been threatened with a weapon in the past year, and had ever been in a physical fight. Compared to heterosexual female peers, sexual minority women had increased odds of carrying a weapon. Pediatricians should recognize that experiencing bullying and feeling unsafe are associated with weapon carrying, particularly among sexual minorities. Pediatricians and professionals who work with youth should recognize that reported experiences of bullying may not be the most salient indicator of risk for weapon carrying among all youth, and that other fears of or experiences with bullying are crucial to screen for among sexual minorities in particular.
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Affiliation(s)
- Carl G. Streed
- Boston Medical Center, MA, USA
- Boston University School of Medicine, MA, USA
- Center for Transgender Medicine and Surgery, Boston, MA, USA
| | | | | | | | - Dylan Felt
- Northwestern University, Chicago, IL, USA
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Chen B, Shin S, Wu M, Liu Z. Visualizing the Knowledge Domain in Health Education: A Scientometric Analysis Based on CiteSpace. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6440. [PMID: 35682025 PMCID: PMC9180308 DOI: 10.3390/ijerph19116440] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/15/2022] [Accepted: 05/22/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study aimed to visualize the evidence in the global research on health education to better improve the nation's health literacy and to guide future research. METHOD We searched the Web of Science (Core Collection) electronic databases. The search strategies: topic: ("Health Education" OR "Education, Health" OR "Community Health Education" OR "Education, Community Health" OR "Health Education, Community") AND document: (Article) AND language:(English). Articles of evidence from January 2011 to December 2021 with those words in the title or abstract or keywords will be included in this review. We used the Citespace 5.6.R5 (64-bit) to investigate and determine the thematic patterns, and emerging trends of the knowledge domain, and presented a narrative account of the findings. RESULT We analyzed 10,273 eligible articles. It showed that BMC Public Health displays the most prolific journals. Author MARCO PAHOR is highlighted in health education. The University of Sydney has published the most studies about health education. The USA plays an important role in these studies. Specifically, the visualization shows several hotspots: disease prevalence surveys and a specific population of knowledge, attitude and practice surveys, health intervention, chronic and non-communicable management, youth-health action, sexual and reproductive health, and physical activity promotion. Furthermore, document co-citation analysis indicated that there are 10 main clusters, which means the research front in health education. Meanwhile, by the citation detected, COVID-19, has achieved universal health coverage in related studies, however, public health education and the health workforce might be more popular in the coming years. CONCLUSION Health education is an effective measure to shift the concept of public health and improve healthy living standards. The present study facilitates an extensive understanding of the basic knowledge and research frontiers that are pivotal for the developmental process of health education and allows scholars to visualize the identification modes and tendencies.
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Affiliation(s)
- Boyuan Chen
- Department of Physical Education, Henan University of Science and Technology, Luoyang 471023, China;
- School of Sport and Exercise Science, University of Ulsan, 93 Daehak-ro, Nam-gu, Ulsan 44610, Korea
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China; (M.W.); (Z.L.)
| | - Sohee Shin
- School of Sport and Exercise Science, University of Ulsan, 93 Daehak-ro, Nam-gu, Ulsan 44610, Korea
| | - Ming Wu
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China; (M.W.); (Z.L.)
| | - Zhihui Liu
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China; (M.W.); (Z.L.)
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Kline EA, Ortin-Peralta A, Polanco-Roman L, Miranda R. Association Between Exposure to Suicidal Behaviors and Suicide Attempts Among Adolescents: The Moderating Role of Prior Psychiatric Disorders. Child Psychiatry Hum Dev 2022; 53:365-374. [PMID: 33569742 DOI: 10.1007/s10578-021-01129-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Abstract
Theories suggest that adolescents exposed to suicide attempts and/or deaths are at higher risk of attempting suicide, themselves. However, research findings have been mixed, with most studies not accounting for psychiatric vulnerability. We examined past psychiatric diagnosis as a moderator of the association between lifetime exposure to suicide attempts and/or deaths and adolescents' suicide attempts. Adolescents (N = 518; 60% female; 45% White), ages 12-21, reported on prior suicide ideation and attempts, and mood, anxiety, and substance use disorders at baseline. Suicide attempts since baseline and exposure to suicidal behaviors were assessed 4-6 years later. Lifetime exposure to family suicide attempts and/or suicide deaths, but not to suicidal behaviors of peers/friends or others, was associated with a suicide attempt at follow-up among those with prior psychiatric disorders. Psychologically vulnerable adolescents may require additional support after exposure to suicidal behaviors of a family member to reduce their risk of attempting suicide.
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Affiliation(s)
- Emily A Kline
- Hunter College, City University of New York, New York, USA.,Montclair State University, Montclair, USA
| | - Ana Ortin-Peralta
- Hunter College, City University of New York, New York, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
| | - Lillian Polanco-Roman
- Columbia University Medical Center, New York State Psychiatric Institute, New York, USA.,The New School for Social Research, New York, USA
| | - Regina Miranda
- Hunter College, City University of New York, New York, USA. .,The Graduate Center, City University of New York, New York, USA. .,Department of Psychology, Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY, 10065, USA.
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Barnett AP, Houck CD, Barker D, Rizzo CJ. Sexual Minority Status, Bullying Exposure, Emotion Regulation Difficulties, and Delinquency Among Court-Involved Adolescent Girls. J Youth Adolesc 2022; 51:471-485. [PMID: 34826041 PMCID: PMC9159079 DOI: 10.1007/s10964-021-01542-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022]
Abstract
Sexual minority adolescent girls are overrepresented in the justice system. This study used the minority stress model and psychological mediation framework to investigate a pathway for this disparity among court-involved girls ages 14-18 (N = 226; mean age: 15.58; 48% sexual minority). The hypotheses were that sexual minority status would be associated with delinquency, bullying exposure would be associated with delinquency indirectly via emotion regulation difficulties, and the relationship between bullying exposure and emotion regulation difficulties would be stronger for sexual minority girls. Bullying exposure and emotion regulation difficulties were not related. Sexual minority status was related to delinquency, and emotion regulation difficulties mediated this relationship. The findings suggest interventions to build emotion regulation skills may reduce delinquency for sexual minority girls.
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Affiliation(s)
- Andrew P Barnett
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and Bradley/Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA.
| | - Christopher D Houck
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and Bradley/Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
| | - David Barker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and Bradley/Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
| | - Christie J Rizzo
- Department of Applied Psychology, Northeastern University, Boston, MA, USA
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Chilean University Teachers’ Social Representations and Attitudes about Students’ Sexual Diversity. SUSTAINABILITY 2022. [DOI: 10.3390/su14031722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study seeks to explore social representations and attitudes of university teachers in relation to sexual diversity. The study has a qualitative approach through content analysis. The research was collected through 62 critical incidents with university professors, with at least one year of experience in undergraduate teaching, in five universities located in the northern macro zone of Chile. The results highlight that there are teachers who take on three different types of roles when faced with situations of gender diversity.. Some are in favour of the inclusion of the sexual minority community, others are more like external observers and a third group, with little interest in inclusion, practice for the students belonging to sexual minorities, within the diversity of the university classrooms. Many teachers tend to contain and compensate for the scarce support that sexually diverse young people have within their families. Teachers demand more training than they currently have in order to be able to carry out adequate interventions in the classroom. Finally, the number of feelings and emotions described by teachers in the face of events and experiences related to sexual diversity in their university institutions is highly significant.
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Szucs LE, Barrios LC, Young E, Robin L, Hunt P, Jayne PE. The CDC's Division of Adolescent and School Health Approach to Sexual Health Education in Schools: 3 Decades in Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:223-234. [PMID: 34964130 PMCID: PMC10924689 DOI: 10.1111/josh.13115] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND School health education, including sexual health education, plays a crucial role in shaping adolescents' protective health behaviors, experiences, and outcomes. Adolescents need functional knowledge and skills to practice, adopt, and maintain healthy behaviors for preventing sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), and unintended pregnancy. METHODS The US Centers for Disease Control and Prevention's Division of Adolescent and School Health (CDC/DASH) has advanced school-based approaches to STI/HIV and pregnancy prevention through surveillance, research and evaluation, and program partnership and collaboration for over 3 decades. RESULTS CDC/DASH uses systematic and innovative strategies to identify the breadth of adolescent sexual health evidence; characterize key elements of effective educational curricula; and provide practical guidance to support school-based delivery. CDC/DASH's approach to effective health and sexual health education in schools has changed dramatically over the past 30 years and must continue to progress. CONCLUSION This paper describes how and why that approach has evolved and outlines directions for the future.
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Affiliation(s)
- Leigh E. Szucs
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA, 30329-4027
| | - Lisa C. Barrios
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA, 30329-4027
| | - Emily Young
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA 30329-4027; Oak Ridge Institute of Science and Education, 1299 Bethel Valley Road, TN, Oak Ridge, TN, 37830
| | - Leah Robin
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA 30329-4027
| | - Pete Hunt
- Research Application and Evaluation Branch, Division of Adolescent and School Health (Retired), The US Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, US8-1, Atlanta, GA, 30329-4027
| | - Paula E. Jayne
- Research Application and Evaluation Branch, Division of Adolescent and School Health (Retired); ICF, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1; ICF, 2635 Corporate Blvd NE Suite 1000, Atlanta, GA, 30345
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Turner VE, Demissie Z, Sliwa SA, Clayton HB. Food Insecurity and Its Association With Alcohol and Other Substance Use Among High School Students in the United States. THE JOURNAL OF SCHOOL HEALTH 2022; 92:177-184. [PMID: 34841533 PMCID: PMC8796201 DOI: 10.1111/josh.13118] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 06/07/2021] [Accepted: 06/23/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Studies show that food insecurity is associated with adverse health behaviors for children and adults. However, published data among adolescents are limited. The objective of this study was to examine the association between food insecurity and substance use behaviors among US high school students. METHODS Data from the 2017 Youth Risk Behavior Survey in 10 states were combined to examine the association between household food insecurity and adolescent use of alcohol, marijuana, prescription opioid misuse, and illicit drugs using logistic regression. RESULTS Among surveyed respondents, 12.3% of high school students reported experiencing food insecurity. In unadjusted analyses, the prevalence of substance use was higher among students with food insecurity compared to food secure students: current binge drinking (16.2% vs 11.5%), current marijuana use (24.0% vs 16.2%), lifetime prescription opioid misuse (21.3% vs 12.6%), and lifetime use of illicit drugs (12.3% vs 5.0%) (all p < .05). In adjusted models, food insecurity was associated with lifetime prescription opioid misuse and lifetime use of illicit drugs (aPR 1.38 and 1.70, respectively). CONCLUSION Students with food insecurity are a potential group at a higher rise of substance misuse and may benefit from prevention programs designed to address their needs.
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Affiliation(s)
- Victoria E Turner
- Andrew Young School of Policy Studies, Georgia State University, 14 Marietta St NW, Atlanta, GA, 30303, USA
| | - Zewditu Demissie
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
- U.S. Public Health Service Commissioned Corps, 1101 Wootton Parkway, Suite 300, Rockville, MD, 20852, USA
| | - Sarah A Sliwa
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Heather B Clayton
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329., USA
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Smith TE, Bauerband LA, Aguayo D, McCall CS, Huang FL, Reinke WM, Herman KC. School Bullying and Gender Minority Youth: Victimization Experiences and Perceived Prevalence. SCHOOL PSYCHOLOGY REVIEW 2022. [DOI: 10.1080/2372966x.2021.2002123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Inwards-Breland DJ, Johns NE, Raj A. Sexual Violence Associated With Sexual Identity and Gender Among California Adults Reporting Their Experiences as Adolescents and Young Adults. JAMA Netw Open 2022; 5:e2144266. [PMID: 35050356 PMCID: PMC8777565 DOI: 10.1001/jamanetworkopen.2021.44266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Disproportionate levels of violence exist in lesbian, gay, bisexual, queer, asexual, and other sexual identity (LGBQA+) communities, often starting in adolescence and young adulthood, but little research exists on the range of sexual violence (SV) experiences. OBJECTIVE To assess risk of experiences of sexual violence among California LGBQA+ adults during adolescence and young adulthood. DESIGN, SETTING, AND PARTICIPANTS This survey study analyzed data from Cal-VEX 2020, a state-representative survey of California residents aged 18 years and older, to assess associations between LGBQA+ identification and types of SV experienced in adolescence (ages 13-17 years) and young adulthood (ages 18-24 years) using gender-stratified adjusted logistic regression. Forms of SV included verbal, cyber, and coercion or physically aggressive sexual harassment; homophobic or transphobic slurs; and forced sex. EXPOSURE Sexual identity. MAIN OUTCOMES AND MEASURES The outcome of interest was experiences with any 5 forms of sexual violence (verbal sexual harassment, homophobic or transphobic slurs, cyber sexual harassment, sexual coercion or physically aggressive sexual harassment, and forced sex) during adolescence or young adulthood. RESULTS A total of 2102 contacted individuals (response rate, 26.2%) completed the Cal-VEX survey and were included in these analyses. Among these, the mean (SD) age was 46.6 (17.7) years, 1149 identified as female, 953 identified as male, and 214 respondents (9.6%) identified as LGBQA+. Compared with heterosexual individuals, LGBQA+ individuals had significantly higher odds of having experienced homophobic or transphobic slurs (women: AOR, 14.65; 95% CI, 5.14-41.77; men: AOR, 14.17; 95% CI, 6.96-28.86) and forced sex (women: AOR, 5.35; 95% CI, 2.74-10.43; men: AOR, 2.68; 95% CI, 1.01-7.10) in adolescence. LGBQA+ women also had higher odds of having experienced verbal and coercion or physically aggressive sexual harassment in adolescence (AOR, 2.33; 95% CI, 1.30-4.19). In young adulthood, LGBQA+ individuals also had higher odds of having experienced homophobic or transphobic slurs (women: AOR, 18.58; 95% CI, 7.12-48.49; men: AOR, 16.73; 95% CI, 8.26-33.92) in young adulthood. LGBQA+ men also had higher odds of having experienced homophobic or transphobic slurs (AOR, 16.73; 95% CI, 8.26-33.92); verbal (AOR, 3.29; 95% CI, 1.44-7.53), cyber (AOR, 6.32; 95% CI, 1.50-26.52), and coercion or physically aggressive (AOR, 5.54; 95% CI, 2.08-14) sexual harassment; and forced sex (AOR, 21.26; 95% CI, 5.63-80.35) in young adulthood. CONCLUSIONS AND RELEVANCE This survey study found that adult LGBQA+ individuals were at increased risk for having experienced SV across the continuum during adolescence and young adulthood, consistent with prior research. Multifold solutions are needed to support LGBQA+ youth, including altering social norms accepting SV and homophobia, creating safer schools and other institutional environments, and supporting healthy sexual and romantic partnerships.
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Affiliation(s)
- David J. Inwards-Breland
- Rady Children’s Hospital, San Diego, California
- School of Medicine, University of California, La Jolla
- Center on Gender Equity and Health, Department of Medicine, University of California, La Jolla
| | - Nicole E. Johns
- Center on Gender Equity and Health, Department of Medicine, University of California, La Jolla
| | - Anita Raj
- Center on Gender Equity and Health, Department of Medicine, University of California, La Jolla
- Division of Social Sciences, Department of Education Studies, University of California, La Jolla
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Lefevor GT, McGraw JS, Skidmore SJ. Suicidal ideation among active and nonactive/former Latter-day Saint sexual minorities. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:445-464. [PMID: 34021914 DOI: 10.1002/jcop.22591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/11/2021] [Accepted: 04/18/2021] [Indexed: 06/12/2023]
Abstract
Sexual minorities (SMs) in the Church of Jesus Christ of Latter-day Saints (LDS) experience a number of unique risks related to their religious/spiritual and SM experience that may increase their likelihood of experiencing suicidal ideation (SI) and ultimately dying by suicide. However, it is unclear which aspects of these experiences are responsible for elevated SI. It is further unclear whether religiousness/spirituality and minority stress relate to SI similarly for active and nonactive/former LDS SMs. To address this gap, we examined data from 602 active and nonactive/former LDS SMs. Active and nonactive LDS SMs reported similar degrees of SI and minority stress but differing degrees of religiousness/spirituality with active LDS SMs reporting more religiousness/spirituality than nonactive/former LDS SMs. Several variables were associated with increased SI in both groups including positive religious coping, interpersonal religious struggles, internalized homonegativity, and concealment. Other variables were associated with decreased SI in both groups including resolving conflict between sexual and religious identities, family support, and friend support. Our results suggest that whether LDS SMs are active in their faith is an important factor to consider when understanding how religiousness/spirituality and minority stress relate to SI.
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Affiliation(s)
- G Tyler Lefevor
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - James S McGraw
- Department of Psychology, Bowling Green State University, Green, Ohio, USA
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Ocasio MA, Lozano A, Lee TK, Feaster DJ, Carrico A, Prado G. Efficacy of a Family-Based Intervention for HIV Prevention with Hispanic Adolescents with Same Gender Sexual Behaviors. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:119-129. [PMID: 34173133 PMCID: PMC10642168 DOI: 10.1007/s11121-021-01272-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
Despite the availability of efficacious and effective family-based interventions, such interventions are scarce for sexual minority adolescents, particularly among ethnic/racial minorities. Prior to creating an entirely new intervention, a prudent first step may be to determine if existing interventions are efficacious in reducing risk behaviors in sexual minority adolescents. This study assesses the relative efficacy of a general, family-based intervention (Familias Unidas) on improving substance and condom use outcomes among Hispanic adolescents with same gender sexual behaviors (HASGB). Data across five distinct trials of Familias Unidas were synthesized. HASGB were randomized either to an intervention (n = 94) or control condition (n = 100). Mediation analyses tested for intervention efficacy on past 90-day substance (cigarette/alcohol/illicit drug) use and condomless sex at last intercourse in HASGB participants and whether family functioning indicators-parent-adolescent communication, positive parenting, and parental monitoring of peers-mediated the effects. Post hoc analyses explored the moderating role of study target population based on prior risk. Familias Unidas did not impact substance use but significantly reduced condomless sex postintervention relative to the control condition. Hypothesized mediators did not explain this effect. Post hoc analyses indicated that the effect was significant in studies that recruited based on prior risk but not studies that recruited universal samples. Our results suggest that a general, family-based intervention may have positive effects on condom use in HASGB, particularly those with prior indicated risk. Identifying intervention components that drive this effect in addition to developing tailored content for HASGB is needed.
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Affiliation(s)
- Manuel A Ocasio
- Section of Adolescent Medicine, Department of Pediatrics, Tulane University School of Medicine, 1440 Canal Street, Suite 966, New Orleans, LA, 70112, USA.
| | - Alyssa Lozano
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, 10th floor (R-669), Miami, FL, 33136, USA
| | - Tae Kyoung Lee
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, 10th floor (R-669), Miami, FL, 33136, USA
| | - Daniel J Feaster
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, 10th floor (R-669), Miami, FL, 33136, USA
| | - Adam Carrico
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, 10th floor (R-669), Miami, FL, 33136, USA
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA
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Abreu RL, Audette L, Mitchell Y, Simpson I, Ward J, Ackerman L, Gonzalez KA, Washington K. LGBTQ student experiences in schools from 2009–2019: A systematic review of study characteristics and recommendations for prevention and intervention in school psychology journals. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22508] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Roberto L. Abreu
- Department of Psychology University of Florida Gainesville Florida USA
| | - Lillian Audette
- Department of Psychology Tennessee State University Nashville Tennessee USA
| | - Y'Londa Mitchell
- Department of Psychology Tennessee State University Nashville Tennessee USA
| | - Ina Simpson
- Department of Psychology Tennessee State University Nashville Tennessee USA
| | - Jessica Ward
- Department of Psychology Tennessee State University Nashville Tennessee USA
| | - Lindsay Ackerman
- Department of Psychology Tennessee State University Nashville Tennessee USA
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49
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Bragard E, Macapagal K, Mustanski B, Fisher CB. Association of CAI Vulnerability and Sexual Minority Victimization Distress Among Adolescent Men Who Have Sex With Men. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2021; 8:496-505. [PMID: 34957315 DOI: 10.1037/sgd0000436] [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: 11/08/2022]
Abstract
Adolescent men who have sex with men (AMSM) are at high HIV risk. Condomless anal intercourse (CAI) increases HIV risk and has been associated with interpersonal power imbalances, such as asymmetries in decision-making authority, social status, and emotional dependence, between male sexual partners. AMSM experience high levels of psychological and physical victimization due to their sexual minority status. Sexual minority victimization (SMV) is similarly associated with low interpersonal power and may relate to the extent to which AMSM are vulnerable to partner influences to engage in CAI. This online survey study of AMSM 14-17 years (N = 143) tested the hypothesis that experiences and attitudes reflecting vulnerability to partner CAI influence (CAI Vulnerability) and distress in response to experienced sexual minority victimization (SMV Distress) would be positively associated with participant and partner condom non-use during anal sex (CAI frequency). Approximately 35% reported they or their partner(s) had never or rarely used a condom. Positive correlations were found among partners' CAI frequency during sex with the participant, CAI Vulnerability, and SMV Distress. Multiple regression indicated CAI Vulnerability significantly accounted for the relation between SMV Distress and partner's CAI frequency. Findings suggest that distress in response to SMV may be associated with a diminished sense of interpersonal control resulting in CAI Vulnerability and subsequent more frequent instances of partner CAI. HIV prevention strategies designed to increase condom use among AMSM have the potential to benefit from procedures aimed at increasing interpersonal sexual assertiveness and decreasing distress associated with sexual minority victimization.
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Affiliation(s)
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Celia B Fisher
- Department of Psychology, Fordham University.,Center for Ethics Education, Fordham University
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50
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Salazar AM, Barkan SE, Rankin LF, Woo CB, Rozekova I, Fowler NE, Haggerty KP, Shogren D, Salzer A. Evaluation of a Brief Foster Parent/ Case Worker Training to Support Relationship Building Skills and Acceptance of LGBTQ+ Youth in Care. JOURNAL OF PUBLIC CHILD WELFARE 2021; 17:213-237. [PMID: 36777313 PMCID: PMC9913886 DOI: 10.1080/15548732.2021.2011531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 06/18/2023]
Abstract
LGTBQ+ youth in foster care need unique support and acceptance; however, few case workers and caregivers receive specialized training. To address this, the Connecting: Sexual Orientation and Gender Identity Expression (SOGIE) eLearning was developed. This evaluation assesses whether attitudes and behavioral intentions regarding LGBTQ+ youth improved as a result of this training. Caregivers and child welfare professionals showed growth in many areas, including how important they felt it was to learn strategies and skills to support LGBTQ+ youth, as well as their confidence to care for LGBTQ+ youth. The Connecting: SOGIE eLearning is a promising tool for child welfare systems.
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Affiliation(s)
- Amy M Salazar
- Washington State University Vancouver, 14204 NE Salmon Creek Ave., Vancouver, WA 98686, United States of America
| | - Susan E Barkan
- University of Washington School of Social Work, 4101 15th Ave NE, Seattle, WA 98105, United States of America
| | - Leah F Rankin
- University of Washington School of Social Work, 4101 15th Ave NE, Seattle, WA 98105, United States of America
| | - Cossette B Woo
- University of Washington School of Social Work, 4101 15th Ave NE, Seattle, WA 98105, United States of America
| | - Ivana Rozekova
- University of Washington School of Social Work, 4101 15th Ave NE, Seattle, WA 98105, United States of America
| | - Nathan E Fowler
- University of Washington School of Social Work, 4101 15th Ave NE, Seattle, WA 98105, United States of America
| | - Kevin P Haggerty
- University of Washington School of Social Work, 4101 15th Ave NE, Seattle, WA 98105, United States of America
| | - Dae Shogren
- Washington State Department of Children, Youth, and Families, 1115 Washington Street SE, Olympia, WA 98504, United States of America
| | - Amber Salzer
- Washington State Department of Children, Youth, and Families, 1115 Washington Street SE, Olympia, WA 98504, United States of America
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