1
|
Charles NE, Strong SJ, Floyd PN, Burns LC, Sigurdson L, Barry CT. Test-Retest Reliability of Self-Reported Substance Use and Sexual Risk Behavior Among at-Risk Adolescents. Psychol Rep 2024; 127:432-446. [PMID: 35699603 DOI: 10.1177/00332941221100459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescents often engage in behaviors such as substance use and risky sexual activity that can lead to negative health and psychological consequences for themselves and others. Accurate measurement of these behaviors in surveys is challenging given that the behaviors are often viewed as undesirable and/or are illegal, so it is important to test the psychometric properties of instruments used to assess adolescent risk behaviors. The current study aimed to assess the test-retest reliability of a widely used measure of youth risk-taking behavior, the Youth Risk Behavior Survey (YRBS). A sample of 156 at-risk adolescents aged 16-18 years (81% male; 61% White) completed the YRBS retrospectively across intervals ranging from 3 to 12 days during their stay in a residential program at which they were under close supervision and had limited ability to engage in new risk behaviors. Participants were asked to complete the YRBS based on their "typical" (pre-program) behavior at both administrations, which were 10-14 weeks into their stay. The reliability of responses was assessed using kappa and weighted kappa analyses. Findings indicate moderate to substantial reliability for nearly all items, suggesting that at-risk youth reliably reported their engagement in health risk behaviors across multiple administrations and supporting the psychometric strength of the YRBS measure for use with this population.
Collapse
Affiliation(s)
- Nora E Charles
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Stephanie J Strong
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Paula N Floyd
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Lauren C Burns
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Lydia Sigurdson
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | | |
Collapse
|
2
|
Wang C, Butler G, Szczepanowski MRJ, Betancourt MT, Roberts KC. Physical activity, organized sport participation and active transportation to school among Canadian youth by gender identity and sexual attraction. Health Promot Chronic Dis Prev Can 2024; 44:47-55. [PMID: 38353939 PMCID: PMC11013025 DOI: 10.24095/hpcdp.44.2.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Regular physical activity is associated with a wide range of health benefits in youth. While previous studies have identified disparities in physical activity among youth by gender identity and sexual attraction, these have seldom been explored in Canadian youth. METHODS Data from the 2019 Canadian Health Survey on Children and Youth were used to assess prevalence of and time spent in organized sports participation, total physical activity and active transportation by gender identity (non-cisgender vs. cisgender) among youth aged 12 to 17, and by sexual attraction (nonheterosexual attraction vs. heterosexual attraction) among youth aged 15 to 17. RESULTS There was no difference in average minutes of total physical activity per week between non-cisgender and cisgender Canadian youth. Non-cisgender youth (which represent 0.5% of the population) averaged significantly fewer minutes of organized sports per week than their cisgender counterparts. There was some evidence of increased active transportation to school among non-cisgender youth, but insufficient power to detect significant differences. Canadian youth reporting any nonheterosexual attraction (which represent 21.2% of the population, including mostly heterosexual youth) were less likely to be regularly physically active and participate in organized sports than youth reporting exclusive heterosexual attraction. Differences were larger among males than females. Males reporting nonheterosexual attraction were more likely to use active transportation to get to school than their heterosexual counterparts. CONCLUSION Non-cisgender youth and youth reporting nonheterosexual attraction tended to participate less in organized sports than their counterparts, but may have engaged in more active transportation. Mitigating the barriers associated with sport participation could increase physical activity among these groups.
Collapse
Affiliation(s)
- Chinchin Wang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montréal, Quebec, Canada
| | - Gregory Butler
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - McKenna R J Szczepanowski
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Marisol T Betancourt
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Karen C Roberts
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| |
Collapse
|
3
|
Shebl FM, Qian Y, Foote JHA, Wattananimitgul N, Reddy KP, Neilan AM, Ciaranello AL, Losina E, Freedberg KA, Hyle EP. The association between all-cause mortality and HIV acquisition risk groups in the United States, 2001-2014. PLoS One 2023; 18:e0290113. [PMID: 37590260 PMCID: PMC10434931 DOI: 10.1371/journal.pone.0290113] [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: 03/08/2023] [Accepted: 08/01/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE To investigate associations between all-cause mortality and human immunodeficiency virus (HIV) acquisition risk groups among people without HIV in the United States. METHODS We used data from 23,657 (NHANES) participants (2001-2014) and the Linked Mortality File to classify individuals without known HIV into HIV acquisition risk groups: people who ever injected drugs (ever-PWID); men who have sex with men (MSM); heterosexually active people at increased risk for HIV (HIH), using low income as a proxy for increased risk. We used Cox proportional hazards models to estimate adjusted and unadjusted all-cause mortality hazard ratios (HR) with 95% confidence intervals (CI). RESULTS Compared with sex-specific heterosexually active people at average risk for HIV (HAH), the adjusted HR (95% CI) were: male ever-PWID 1.67 (1.14, 2.46), female ever-PWID 3.50 (2.04, 6.01), MSM 1.51 (1.00, 2.27), male HIH 1.68 (1.04, 2.06), female HIH 2.35 (1.87, 2.95), and male ever-PWID 1.67 (1.14, 2.46). CONCLUSIONS Most people at increased risk for HIV in the US experience higher all-cause mortality than people at average risk. Strategies addressing social determinants that increase HIV risk should be incorporated into HIV prevention and other health promotion programs.
Collapse
Affiliation(s)
- Fatma M. Shebl
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, Unite States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Yiqi Qian
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, Unite States of America
| | - Julia H. A. Foote
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, Unite States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Nattanicha Wattananimitgul
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, Unite States of America
| | - Krishna P. Reddy
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, Unite States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Anne M. Neilan
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, Unite States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Division of General Academic Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Andrea L. Ciaranello
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, Unite States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard University Center for AIDS Research (CFAR), Cambridge, Massachusetts, United States of America
| | - Elena Losina
- Harvard University Center for AIDS Research (CFAR), Cambridge, Massachusetts, United States of America
- Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Kenneth A. Freedberg
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, Unite States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard University Center for AIDS Research (CFAR), Cambridge, Massachusetts, United States of America
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Emily P. Hyle
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, Unite States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard University Center for AIDS Research (CFAR), Cambridge, Massachusetts, United States of America
| |
Collapse
|
4
|
Mehta TS, Thompson J, Applegate JM, Wahab RA. Cultural Competence in the Care of LGBTQ+ Patients: A Primer for Breast/Chest Centers. JOURNAL OF BREAST IMAGING 2023; 5:473-479. [PMID: 38416897 DOI: 10.1093/jbi/wbad012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Indexed: 03/01/2024]
Abstract
The number of individuals identifying as lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) has doubled over the past 10 years, and this figure continues to rise. The LGBTQ+ community is diverse, encompassing a vast array of differences in gender identity and sexual orientation. Additionally, it is inclusive of people from all races, ethnicities, religions, and socioeconomic backgrounds. This intersectionality of identities and experiences impacts both access to health care and its delivery. Barriers to care for this population are multifactorial and include stigma, discrimination, bias, limited role models, issues with insurance coverage, lack of education and training for health care providers, and lack of research on LGBTQ+ health-related issues. Specific to breast cancer, the screening recommendations for this group are influenced not only by risk but also by gender-affirming hormonal and surgical therapies. This article will provide an overview of the LGBTQ+ population, review breast cancer screening compliance and recommendations, summarize the multitude of health disparities, and offer potential interventions to improve care delivery at the individual, facility, organizational, and health policy levels.
Collapse
Affiliation(s)
- Tejas S Mehta
- UMass Memorial Medical Center, Department of Radiology, Worcester, MA, USA
| | | | - Julia M Applegate
- The Ohio State University, Department of Women's, Gender and Sexuality Studies, Columbus, OH, USA
| | - Rifat A Wahab
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
| |
Collapse
|
5
|
Blanc A, Díaz-Batanero C, Sánchez-García M, Dacosta D. Comparison of Different Sexual Behaviors According to Sexual Orientation and the Mediating Role of Attitudes toward Sexual Behaviors between Sexual Orientation and Sexual Behaviors in Young Adults. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:284-295. [PMID: 38595857 PMCID: PMC10903581 DOI: 10.1080/19317611.2023.2193596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 02/13/2023] [Accepted: 03/16/2023] [Indexed: 04/11/2024]
Abstract
Objectives To explore the relationship between sexual orientation and specific sexual and risk behaviors, compare the number of sexual behaviors and attitudes among people of different sexual orientations, and test the mediating effect of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors. Methods A total of 2288 participants completed a checklist of sexual behaviors, indicators of sexual risk behaviors, and a scale of attitudes toward sexual behaviors. Results Bisexual women engaged in a greater number of sexual behaviors and had more positive attitudes toward sexual behaviors than heterosexual women. Homosexual men engaged in a greater number of sexual behaviors than heterosexual men, and homosexual and bisexual men had more positive attitudes toward sexual behaviors than heterosexuals. Finally, we show the mediating role of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors engaged in. Conclusions The importance of considering sexual orientation when analyzing sexual behaviors and attitudes is highlighted.
Collapse
Affiliation(s)
- Andrea Blanc
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| | - Carmen Díaz-Batanero
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| | - Manuel Sánchez-García
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| | - Daniel Dacosta
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| |
Collapse
|
6
|
Sharwood LN, Martiniuk A, Sarrami Foroushani P, Seggie J, Wilson S, Hsu J, Burns B, Logan DB. Intentions and willingness to engage in risky driving behaviour among high school adolescents: evaluating the bstreetsmart road safety programme. Inj Prev 2023; 29:1-7. [PMID: 35961770 DOI: 10.1136/ip-2022-044571] [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: 03/07/2022] [Accepted: 07/31/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To investigate the impact of a road safety programme on adolescents' willingness to engage in risky behaviour as probationary drivers, adjusted for covariates of interest. METHOD The bstreetsmart is a road safety programme delivered to around 25 000 adolescent students annually in New South Wales. Using a smartphone-based app, student and teacher participation incentives, students were surveyed before and after programme attendance. Mixed-methods linear regression analysed pre/post-modified Behaviour of Young Novice Driver (BYNDS_M) scores. RESULTS 2360 and 1260 students completed pre-event and post-event surveys, respectively. Post-event BYNDS_M scores were around three points lower than pre-event scores (-2.99, 95% CI -3.418 to -2.466), indicating reduced intention to engage in risky driving behaviours. Covariates associated with higher stated intentions of risky driving were exposure to risky driving as a passenger (1.21, 95% CI 0.622 to 2.011) and identifying as non-binary gender (2.48, 95% CI 1.879 to 4.085), adjusting for other predictors. CONCLUSIONS Trauma-informed, reality-based injury prevention programmes can be effective in changing short-term stated intentions to engage in risky driving, among a pre-independent driving student population. The adolescent novice driver age group is historically challenging to engage, and injury prevention action must be multipronged to address the many factors influencing their behaviour.
Collapse
Affiliation(s)
- Lisa Nicole Sharwood
- John Walsh Centre for Rehabilitation Research, The University of Sydney-Camperdown and Darlington Campus, Sydney, New South Wales, Australia .,Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - A Martiniuk
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Pooria Sarrami Foroushani
- Institute of Trauma and Injury Management, New South Wales Agency for Clinical Innovation, Chatswood, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Warwick Farm, New South Wales, Australia
| | - Julie Seggie
- Trauma, Westmead Hospital, Westmead, New South Wales, Australia
| | | | - Jeremy Hsu
- Trauma, Westmead Hospital, Westmead, New South Wales, Australia
| | - Brian Burns
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,GSA-HEMS Research, Helicopter Emergency Medical Service, SWSLHD, Sydney, New South Wales, Australia
| | - David Bruce Logan
- Road Safety Programs, Monash University Accident Research Centre, Clayton, Victoria, Australia
| |
Collapse
|
7
|
Parnes JE, Mereish EH, Meisel SN, Treloar Padovano H, Miranda R. In the Presence of Parents: Parental Heterosexism and Momentary Negative Affect and Substance Craving Among Sexual Minority Youth. J Adolesc Health 2023; 72:230-236. [PMID: 36473778 PMCID: PMC10262696 DOI: 10.1016/j.jadohealth.2022.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/15/2022] [Accepted: 09/23/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE We examined the influence of parental heterosexism on in vivo negative affect and substance craving among sexual minority youth (SMY) who use nicotine and other substances, and if that relation was strengthened when in the presence of their parent(s). METHODS SMY (n = 42, ages 15-19) completed baseline assessments, including experiences of parental heterosexism (PH), and a 30-day ecological momentary assessment. Ecological momentary assessment reports included affective states (i.e., anger, anxiety, depression), substance craving (i.e., nicotine, cannabis, alcohol), and other contextual factors (e.g., presence of parents). Multilevel logistic regression models evaluated the study hypotheses. RESULTS PH was associated with greater odds of reporting in-the-moment anger, depression, cannabis craving, and alcohol craving. Parental presence was associated with lower odds of reporting anxiety or depression, and greater odds of reporting nicotine craving. There was a significant interaction when predicting the odds of reporting anxiety. For SMY low in PH, parental presence was related to lower odds of reporting anxiety. As PH increased, parental presence had diminishing associations with the odds of reporting anxiety. DISCUSSION Parenting behaviors can serve as protective and risk factors for negative affect and substance craving among SMY. Improving family-based interventions for SMY may be integral for enhancing healthy development and reducing health disparities.
Collapse
Affiliation(s)
- Jamie E Parnes
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island; E. P. Bradley Hospital, Riverside, Rhode Island
| | - Ethan H Mereish
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island; Department of Psychology, University of Maryland, College Park, Maryland; Department of Health Studies, American University, Washington, District of Columbia.
| | - Samuel N Meisel
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island; E. P. Bradley Hospital, Riverside, Rhode Island
| | - Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Department of Behavioral & Social Sciences, Brown University, Providence, Rhode Island; E. P. Bradley Hospital, Riverside, Rhode Island
| |
Collapse
|
8
|
Baishya ML, Martinasek M, Bell L, Wheldon CW. Adverse Childhood Experiences and Adult Tobacco Use Among Sexual and Gender Minority Populations: Examining the Role of Mental, Social, and Community Health. LGBT Health 2022; 10:211-219. [PMID: 36520611 DOI: 10.1089/lgbt.2021.0343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: We sought to evaluate the relationship between adverse childhood experiences (ACEs) and tobacco use, to assess the intersection of sexual orientation or gender identity (SOGI), and to explore risk and protective aspects of mental, social, and community health. Methods: This was a secondary analysis of the sexual and gender minorities (SGM) subsample (n = 1102) from a 2019 Community Health Needs Assessment. Nested binary logistic regression models were created to evaluate associations between ACEs and type of tobacco use: (1) cigarette use versus no cigarette or electronic nicotine delivery systems (ENDS) use, (2) ENDS use versus no cigarette or ENDS use, and (3) dual use versus use of either cigarettes or ENDS. Results: The sample population that reported four or more ACEs and ENDS use had statistically significant adjusted odds ratios (aORs) when adjusting the models for sociodemographic variables (aOR = 2.55; 95% confidence intervals [CIs]: 1.54-4.22), SOGI (aOR = 2.44; 95% CI: 1.46-4.10), current mental health (aOR = 2.23; 95% CI: 1.32-3.75), and social and community health (aOR = 2.19; 95% CI: 1.30-3.71). The sample population that reported poor mental health had statistically significant aORs when adjusting the models for sociodemographic variables, SOGI, and mental health (aOR = 2.26; 95% CI: 1.32-3.89) and social and community health (aOR = 2.06; 95% CI: 1.17-3.54). There was no statistically significant finding related to the other tobacco use variables (tobacco use and dual use). Conclusion: We found that high-risk ACEs were positively associated with cigarette use and ENDS use. SGM populations have differing experiences when considering community and social support.
Collapse
Affiliation(s)
- Mona L. Baishya
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Mary Martinasek
- Department of Health Sciences and Human Performance, University of Tampa, Tampa, Florida, USA
| | - Lisa Bell
- Community Benefit, BayCare Health System, Clearwater, Florida, USA
| | - Christopher W. Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
9
|
Burns RD, Fu Y. Parental Perceived Discrimination and Youth Participation in Out-Of-School Sports. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121808. [PMID: 36553252 PMCID: PMC9777264 DOI: 10.3390/children9121808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022]
Abstract
The aim of this study was to determine the associations between perceived parental discrimination and youth participation in out-of-school sports. We analyzed a representative sample of US children and adolescents from the 2020 National Survey of Children’s Health (N = 30,656; 6−17 years old; 49.0% female). The dependent variable was a (No/Yes) response item asking parents about their child’s participation in out-of-school sports. Two binary response items asked parents if they perceived that their child was ever treated or judged unfairly because of their race/ethnicity and because of their sexual orientation/gender identity. Weighted multiple logistic regressions examined correlations between the discrimination variables and out-of-school sports controlling for demographics covariates including family income. After covariate adjustment, perceived parental discrimination because of race/ethnicity associated with 1.57 times higher odds of child participation in sports (Adjusted Odds Ratio (AOR) = 1.57, 95%CI: 1.17−2.03, p = 0.002). Conversely, discrimination because of sexual orientation/gender identity correlated with 57% lower odds of child participation in sports (AOR (Adjusted Odds Ratio) = 0.43, 95%CI: 0.27−0.69, p < 0.001). After family income and other covariates were considered, perceived discrimination by parents because of their child’s race/ethnicity associated with higher probability of sports participation. Perceived discrimination by parents because of their child’s sexual orientation/gender identity associated with a lower probability of participating in sports.
Collapse
Affiliation(s)
- Ryan D. Burns
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT 84112, USA
- Correspondence: ; Tel.: +1-801-695-5035
| | - You Fu
- School of Public Health, University of Nevada, Reno, NV 89557, USA
| |
Collapse
|
10
|
Gannon T, Phillips B, Saunders D, Berner AM. Knowing to Ask and Feeling Safe to Tell - Understanding the Influences of HCP-Patient Interactions in Cancer Care for LGBTQ+ Children and Young People. Front Oncol 2022; 12:891874. [PMID: 35814480 PMCID: PMC9263369 DOI: 10.3389/fonc.2022.891874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background Lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) people experience healthcare inequalities in cancer care. Previous studies have focused on knowledge, attitudes and behaviours of healthcare professionals (HCPs) treating adults with cancer and how these contribute to inequalities. To date, no research has focused on HCPs treating LGBTQ+ children and adolescents with cancer in the UK. This is important given that this group may be at a critical time for exploring their gender identity and sexual orientation, whilst also facing a cancer diagnosis. We aimed to explore the knowledge, attitudes and behaviours of paediatric, teenage and young adult oncology HCPs treating LGBTQ+ patients in the UK. Methods We carried out semi-structured interviews with 8 HCPs in paediatric, teenage and young adult (TYA) oncology from the Royal Marsden NHS Foundation Trust. Eight questions were asked, which centred around participants' knowledge, attitudes and behaviours regarding management of LGBTQ+ patients in oncology. Interview transcripts were analysed by inductive thematic analysis. Results We identified 10 themes, including novel themes (how HCPs acquire knowledge and expectations of a 'third party' to be the expert) which may underlie previously observed trends in knowledge, attitudes and behaviours of HCPs. We highlight other themes and HCP concerns specific to care of LGBTQ+ patients in paediatrics (influence of the parental-carer dynamic, concerns around patient age and development as a barrier to disclosure) which require further research. We found evidence of the interrelatedness of HCP knowledge, attitudes and behaviours and the ability of these elements to positively influence each other. We mapped our themes across these elements to form a new suggested framework for improving HCP-patient interactions in LGBTQ+ Cancer Care. We found a need both for individual HCP education and organisational change, with creation of a culture of psychological safety to improve patient care. Conclusion Knowledge, attitudes and behaviours of HCPs are closely interdependent when providing care to young LGBTQ+ patients with cancer. The authors suggest that future efforts to improve care of these patients address this complexity by spanning the domains of our suggested framework. Whilst HCP education is essential, change must also occur at an organisational level.
Collapse
Affiliation(s)
- Tamsin Gannon
- Paediatric and Teenage and Young Adult Oncology, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom,*Correspondence: Tamsin Gannon,
| | - Bob Phillips
- Paediatric and Teenage and Young Adult (TYA) Oncology, Leeds Children’s Hospital, Leeds, United Kingdom
| | - Daniel Saunders
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Alison May Berner
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom,Gender Identity Clinic, Tavistock and Portman NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
11
|
Prestemon CE, Grummon AH, Rummo PE, Taillie LS. Differences in Dietary Quality by Sexual Orientation and Sex in the United States: NHANES 2011-2016. J Acad Nutr Diet 2022; 122:918-931.e7. [PMID: 34896299 PMCID: PMC9038656 DOI: 10.1016/j.jand.2021.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 11/10/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND There are persistent disparities in weight- and diet-related diseases by sexual orientation. Lesbian and bisexual females have a higher risk of obesity and cardiovascular disease compared with heterosexual females. Gay and bisexual males have a higher risk of diabetes and cardiovascular disease compared with heterosexual males. However, it remains unknown how sexual orientation groups differ in their dietary quality. OBJECTIVE This study aimed to determine whether dietary quality differs by sexual orientation and sex among US adults. DESIGN This was a cross-sectional study of 24-hour dietary recall data from a nationally representative sample of adults aged 20 through 65 years participating in the 2011-2016 National Health and Nutrition Examination Survey. PARTICIPANTS/SETTING Study participants were adults (n = 8,851) with complete information on dietary intake, sexual orientation, and sex. MAIN OUTCOME MEASURES The main outcome measures were daily energy intake from 20 specific food and beverage groups and Healthy Eating Index-2015 (HEI-2015) scores for sexual orientation groups (heterosexual vs gay/lesbian/bisexual). STATISTICAL ANALYSES PERFORMED Ordinary least squares regressions were used to calculate adjusted means for each food and beverage group and HEI-2015, stratified by sex and controlling for covariates (eg, age and race/ethnicity) and survey cycles (2011-2012, 2013-2014, and 2015-2016). RESULTS Among males, red and processed meat/poultry/seafood (P = .01) and sandwiches (P = .02) were smaller contributors to energy intake for gay/bisexual males compared with heterosexual males. Among females, cereals (P =.04) and mixed dishes (P = .02) were smaller contributors to energy intake for lesbian/bisexual females compared with heterosexual females. Gay/bisexual males had significantly higher total HEI-2015 scores than heterosexual males (mean ± standard deviation 53.40 ± 1.36 vs 49.29 ± 0.32, difference = 4.14; P = .004). Lesbian/bisexual females did not differ in total or component HEI-2015 scores from heterosexual females. CONCLUSIONS Although gay/lesbian/bisexual groups were similar for a variety of dietary outcomes compared with heterosexual groups, gay and bisexual men displayed healthier dietary quality for processed meat (by consuming smaller amounts) and overall dietary quality (according to HEI-2015) compared with heterosexual males.
Collapse
Affiliation(s)
- Carmen E Prestemon
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
| | - Anna H Grummon
- Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health, Cambridge, MA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Pasquale E Rummo
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
| |
Collapse
|
12
|
Hu D, Zhang L, Zhang W. Analysis of Methods to Reduce Jogging Injuries from the Perspective of Risk Cognition. Am J Health Behav 2022; 46:114-123. [PMID: 35501961 DOI: 10.5993/ajhb.46.2.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Injuries are common events that impair the function of joggers; it is important to take effective measures to reduce the incidence of jogging injuries to maximize its benefits. Methods: We collected questionnaires from 3468 Chinese exercisers using a stratified random sampling method. We analyzed these data using AMOS 22.0 (IBM) and SPSS 26.0 (IBM). Results: We constructed a relationship model of jogging risk cognition, jogging risk behaviors, and jogging injury incidence, and the indicators fit well. The path coefficient between jogging risk cognition and jogging risk behaviors of joggers was -0.64; the path coefficient between jogging risk behaviors and jogging injuries incidence was 0.44; and the path coefficient between jogging risk cognition and jogging injuries incidence was -0.23. Conclusions: The higher the level of jogging risk cognition of joggers, the lower their jogging risk behaviors, leading to a lower incidence of jogging injuries. Based on the generally low level of jogging risk cognition of joggers, the construction of a jogging risk cognitive education system that can be integrated into universities, middle schools and primary schools, as well as family, school and society, is conducive to comprehensively improve the level of jogging risk cognition of joggers.
Collapse
Affiliation(s)
- Degang Hu
- Degang Hu, Associate Professor, Department of Physical Education, Beijing University of Civil Engineering and Architecture, Beijing, China
| | - Linteng Zhang
- Linteng Zhang, Graduate student Majored in Physical Education of Teacher's College, Columbia University, New York, United States
| | - Wulong Zhang
- Wulong Zhang, Professor, College of P. E. and Sports, Beijing Normal University, Beijing, China;,
| |
Collapse
|
13
|
Abstract
It is widely assumed that LGBT+ people may feel insecure and unwelcome in sports settings, which are often characterized by a binary gender order and a culture of heteronormativity. Previous research also suggests that LGBT+ individuals experience homophobia in the context of sport. Despite these findings, reliable quantitative data on the sports participation levels of sexual minority groups are scarce. The paper addresses this academic void by analyzing sports activity data of sexual minority groups. The 2019 wave of the German Socio-Economic Panel (SOEP) study is analyzed, which includes a novel LGBT+ boost sample of respondents who self-identify as lesbian, gay, bisexual, transgender, or non-binary with regard to gender. The analysis of this sample shows that sports activity levels (with regard to frequency and duration) of homo- and bisexual individuals are comparable to the heterosexual majority. Although findings show that a high share of homo- and bisexual individuals experience sexual discrimination, discrimination is not associated with lower participation rates in sports. We thus conclude that the domain of sport—although by no means free of discrimination—offers sufficient participation opportunities for LGBT+ people.
Collapse
|
14
|
Skye M, Craig S, Donald C, Kelley A, Morgan B, Rajani K, Singer M, Zaback T, Lambert W. Are American Indian/Alaska Native Adolescent Health Behaviors Different? A Review of AI/AN Youth Involved in Native STAND Curriculum, 2014-2017 United States. Matern Child Health J 2021; 25:1893-1902. [PMID: 34705192 PMCID: PMC8599210 DOI: 10.1007/s10995-021-03256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To explore health behavior profiles of AI/AN youth involved in native students together against negative decisions (STAND), a national culture-based curriculum. METHODS We analyzed data from 1236 surveys conducted among AI/AN youth at 40 native STAND implementation sites located in 16 states throughout the US from 2014 to 2017. Health profiles included demographics, sexual orientation, sexual activity, STI testing, cigarette use, and suicide attempts in the past 12-months. We used t-tests and chi square tests of independence to compare risk behavior prevalence among the sample. RESULTS Health behavior profiles of AI/AN youth indicate that 45.6% of youth did not use condoms the last time they had sex, and 82.7% have never been tested for STIs. Differences in cigarette smoking were observed in questioning youth (questioning: 80.3%, straight/heterosexual: 63.8%, LGBTQ2S + : 49.9%, p = 0.03). CONCLUSIONS FOR PRACTICE Health behaviors related to sex, substance, violence and self-harm, are at least as common for AI/AN youth as those observed in other US teens. Future research should consider similarities and differences in health profiles of AI/AN youth when designing interventions that affect them. Further, our findings underscore the need for culturally-relevant curricula like native STAND, not because their health behavior is different, but because their socio-ecologic environment is different.
Collapse
Affiliation(s)
- Megan Skye
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA.
| | - Stephanie Craig
- Northwest Portland Area Indian Health Board, Portland, OR, 97201, USA
| | - Caitlin Donald
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | | | - Brittany Morgan
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | - Kavita Rajani
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | - Michelle Singer
- Northwest Portland Area Indian Health Board, Portland, OR, 97201, USA
| | - Tosha Zaback
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | - William Lambert
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| |
Collapse
|
15
|
Odrovakavula L, Mohammadnezhad M. "Everything else is going to be ok if your spiritual wellness is well". A qualitative exploration of wellness amongst secondary school students in Fiji. Int J Qual Stud Health Well-being 2021; 16:2001895. [PMID: 34806562 PMCID: PMC8843379 DOI: 10.1080/17482631.2021.2001895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Purpose Adolescent wellness over the years has been a major public health concern. The adolescent period is stated to be a critical phase as developments occur in all areas of the individual. This study aims to explore secondary school students’ perceptions on knowledge of wellness, influences of wellness, prioritization of wellness dimensions and ideal adolescent wellness programmes in Fiji. Method This study qualitatively investigates adolescents in four purposively selected schools in Suva, Fiji. 31 students who enrolled into years 11 to 13 in the selected schools were interviewed in-depthly using a semi-structured, open-ended questionnaire. Data was transcribed and classified into categories, sub-themes and major themes. Results Participants’ responses indicated wellness perceived as multidimensional with no regard to dimensional balance. Family, peers and school support, social media, nutrition and physical activities are factors perceived to influence wellness. The availability of school counsellors, facilitation of effective school health programmes, and incorporation of wellness into the school curriculum were perceived as ideal ways to increase adolescent wellness. Conclusions This study provides important research findings of adolescent wellness for Fiji’s health sector, its policymakers and programme developers. Further studies are needed to understand the broad concept of wellness and its several dimensions.
Collapse
Affiliation(s)
- Latileta Odrovakavula
- Public Health, School of Public Health and Primary Care, Fiji National University, Suva Fiji Islands
| | - Masoud Mohammadnezhad
- Public Health (Health Promotion), School of Public Health and Primary Care, Fiji National University, Suva Fiji Islands
| |
Collapse
|
16
|
Rodríguez-Bolaños R, Arillo-Santillán E, Guzmán-Rodríguez C, Barrientos-Gutiérrez I, Gallegos-Carrillo K, Titus A, Cruz-Jiménez L, Thrasher JF. Similarities and Differences in Substance Use Patterns Among Lesbian, Gay, Bisexual, and Heterosexual Mexican Adult Smokers. LGBT Health 2021; 8:545-553. [DOI: 10.1089/lgbt.2020.0457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rosibel Rodríguez-Bolaños
- Tobacco Research Department, Population Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Mexico
| | - Edna Arillo-Santillán
- Tobacco Research Department, Population Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Mexico
| | | | - Inti Barrientos-Gutiérrez
- Center for Evaluation and Survey Research, Mexican National Institute of Public Health, Cuernavaca, Mexico
| | - Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit, Mexican Institute of Social Security, Cuernavaca, Mexico
| | - Andrea Titus
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Lizeth Cruz-Jiménez
- Center for Evaluation and Survey Research, Mexican National Institute of Public Health, Cuernavaca, Mexico
| | - James F. Thrasher
- Tobacco Research Department, Population Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Mexico
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
17
|
Kendrick D, Hughes M, Coutts R, Ardzejewska K. Older gay men's engagement with physical activity: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e457-e466. [PMID: 34260772 DOI: 10.1111/hsc.13480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/24/2021] [Accepted: 05/29/2021] [Indexed: 06/13/2023]
Abstract
Older gay men experience an elevated prevalence of adverse health conditions that may be compounded by age-related deterioration. Some of these conditions may be ameliorated by regular adherence to physical activity (PA). However, many gay men participate in less PA than their age-matched heterosexual counterparts. With a focus on gay men aged 60 and over, the aims of this review were to examine the evidence for older gay men's engagement with PA and the research approaches used to describe this group. A systematic search of six academic databases (Academic Search Premier, Cinahl, PubMed, Sport Discus, APA PsychInfo and APA PsychArticles) generated 23 papers from 1970 to 2020 that focused on older gay men's engagement with PA. Although surveys were well represented in the literature, further studies utilising qualitative methodological frameworks have the potential to inform targeted interventional programs aimed at reducing less health disparities. The value of PA in older adults lies principally in improved performance of activities of daily living, independent living, increased longevity, decreased cognitive decline and improved mental well-being.
Collapse
Affiliation(s)
- Damon Kendrick
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Mark Hughes
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Rosanne Coutts
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Kathie Ardzejewska
- Learning and Teaching Office, The University of Notre Dame, Sydney, NSW, Australia
| |
Collapse
|
18
|
Reisner SL, Mateo C, Elliott MN, Tortolero S, Davies SL, Lewis T, Li D, Schuster M. Analysis of Reported Health Care Use by Sexual Orientation Among Youth. JAMA Netw Open 2021; 4:e2124647. [PMID: 34714346 PMCID: PMC8556619 DOI: 10.1001/jamanetworkopen.2021.24647] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IMPORTANCE In the United States, adolescents who are lesbian, gay, or bisexual (LGB) face disparities across physical and mental health outcomes compared with non-LGB youth, yet few studies have looked at patterns of health care utilization by sexual orientation. OBJECTIVE To compare health care utilization indicators for LGB and non-LGB youth. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed wave 3 data from Healthy Passages, a longitudinal observational study of diverse public school students in Birmingham, Alabama; Houston, Texas; and Los Angeles County, California. Multivariable logistic regression models tested sexual-orientation differences in the past 12-month health care utilization measures, controlling for youth age, gender, race and ethnicity, household education, income, and marital status. Data collection began in 2010 when students were in the 5th grade (mean [SE] age, 11.13 [0.01] years) (wave 1) and continued 2 years later (wave 2, 7th grade) and 5 years later (wave 3, 10th grade). Permission to be contacted was provided for 6663 children, and 5147 (77%) participated in audio computer-assisted self-administered interviews. This study included 4256 youth (640 LGB, 3616 non-LGB) who completed interviews at wave 1 and wave 3 and answered key items used in this analysis. Analyses were completed in June 2021. EXPOSURES Sexual orientation (LGB vs non-LGB). MAIN OUTCOMES AND MEASURES Health care utilization and communication difficulty with a physician in the past 12 months. RESULTS Among 4256 youths included in the study at baseline in 5th grade (wave 1), 2171 (48.9%) were female; 1502 (44.5%) were Hispanic or Latino; 1479 (28.9%) were Black; the mean (SE) age was 11.19 (0.03) years; and 640 (14.5%) were LGB at wave 3. Compared with non-LGB youth, a higher proportion of LGB youth reported not receiving needed medical care in the last 12 months (adjusted odds ratio [aOR], 1.68; 95% CI,1.38-2.05), most commonly for sexually transmitted infections, contraception, and substance use. LGB youth more frequently reported difficulty communicating with their physician (aOR, 1.71; 95% CI, 1.27-2.30) than non-LGB youth. CONCLUSIONS AND RELEVANCE This study's results found that health care utilization differs by sexual orientation for youth. These findings suggest that clinician training is needed to address the health care needs of LGB youth. Routinely capturing sexual orientation data might enable tracking of health care utilization indicators for LGB youth.
Collapse
Affiliation(s)
- Sari L. Reisner
- Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Division of Endocrinology, Diabetes & Hypertension, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Camila Mateo
- Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | | | | | | | - Dennis Li
- Northwestern University, Evanston, Illinois
| | - Mark Schuster
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| |
Collapse
|
19
|
Luk JW, Goldstein RB, Yu J, Haynie DL, Gilman SE. Sexual Minority Status and Age of Onset of Adolescent Suicide Ideation and Behavior. Pediatrics 2021; 148:e2020034900. [PMID: 34580171 PMCID: PMC9446478 DOI: 10.1542/peds.2020-034900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine if sexual minority adolescents have earlier onset of suicidality and faster progressions from ideation to plan and attempt than heterosexual adolescents. METHODS A population-based longitudinal cohort of 1771 adolescents participated in the NEXT Generation Health Study. Participants reported sexual minority status (defined by sexual attraction) in 2010-2011 and retrospectively reported age at onset of suicidality in 2015-2016. RESULTS Sexual minority adolescents (5.8% of weighted sample) had higher lifetime risk of suicide ideation (26.1% vs 13.0%), plan (16.6% vs 5.4%), and attempt (12.0% vs 5.4%) than heterosexual adolescents. Survival analyses adjusted for demographic characteristics and depressive symptoms revealed positive associations of sexual minority status with time to first onset of suicide ideation (hazard ratio [HR] = 1.77; 95% confidence interval [CI] 1.03-3.06) and plan (HR = 2.69; 95% CI 1.30-5.56). The association between sexual minority status and age at onset of suicide attempt was stronger at age <15 (HR = 3.26; 95% CI 1.25-8.47) than age ≥15 (HR = 0.59; 95% CI 0.21-1.66). The association between sexual minority status and progression from ideation to plan was stronger in the same year of first ideation (HR = 2.01; 95% CI 1.07-3.77) than ≥1 year after first ideation (HR = 1.33; 95% CI 0.26-6.77). CONCLUSIONS Sexual minority adolescents had earlier onset of suicidality and faster progression from suicide ideation to plan than heterosexual adolescents. The assessment of sexual minority status in routine pediatric care has the potential to inform suicide risk screening, management, and intervention efforts among early sexual minority adolescents.
Collapse
Affiliation(s)
- Jeremy W Luk
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| | - Risë B Goldstein
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Jing Yu
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
20
|
Mann I, Jenzer T, Miranda R, Mereish EH. Minority Stress and Nicotine Use and Dependence among Sexual Minority Youth. Subst Use Misuse 2021; 56:2264-2268. [PMID: 34519262 PMCID: PMC8753784 DOI: 10.1080/10826084.2021.1972315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Sexual minority youth (SMY), especially those who are plurisexual (e.g. bisexual, pansexual, queer), are more likely to use nicotine or develop nicotine dependence than their heterosexual peers, and this disparity is often attributed to minority stress (e.g. discrimination). This study tested the association between minority stress and nicotine use and dependence among SMY and examined the moderating role of impulsivity. A sample of SMY (N = 85; aged 14-19; 80.6% White; 80% plurisexual) who were active nicotine users were recruited from the community. Results indicated that greater discrimination experiences were associated with more nicotine use days and higher nicotine dependence symptoms. However, impulsivity did not moderate the relationship between discrimination and nicotine use or dependence. These results highlight the potential importance of minority stress in understanding SMY's risk for nicotine use and dependence. This research suggests the need for identifying factors that could place some SMY at greater risk for nicotine use and dependence and points to potential clinical implications for nicotine cessation interventions for SMY.
Collapse
Affiliation(s)
- Iris Mann
- Skidmore College, Saratoga Springs, New York, USA
| | | | - Robert Miranda
- Brown University Center for Alcohol and Addiction Studies, Providence, Rhode Island, USA
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington DC, USA
| |
Collapse
|
21
|
Drysdale K, Cama E, Botfield J, Bear B, Cerio R, Newman CE. Targeting cancer prevention and screening interventions to LGBTQ communities: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1233-1248. [PMID: 33316150 DOI: 10.1111/hsc.13257] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/13/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
Although some people within LGBTQ communities are at risk of developing some cancers at higher rates than non-LGBTQ people, there is limited evidence of the outcomes of targeted cancer prevention and screening interventions for these communities. This scoping review examined key findings regarding the feasibility, acceptability and efficacy of evaluated intervention studies conducted in high income settings and published in peer reviewed literature (2014-2020) by combining evidence of both cancer risk-reducing behavioural interventions and screening and preventative practice interventions. While there is limited evidence of stronger outcomes from targeted interventions with cohorts of gender and sexuality diverse communities, compared with the use of mainstream or untailored interventions, there is stronger evidence that targeted interventions are more acceptable to these communities and may be more feasible in some contexts. Thus, there is benefit in understanding what targeting entails in these interventions, and to understand what influences acceptability, to inform the design and delivery of such interventions.
Collapse
Affiliation(s)
- Kerryn Drysdale
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Elena Cama
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Jessica Botfield
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | | | - Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| |
Collapse
|
22
|
Paviani G, Chrisostomo KR, Sandrin NM, Hilgert MR, Skare T, Nisihara R. Sexual orientation and gynecologic medical care: A cross-sectional study with Brazilian women. Int J Gynaecol Obstet 2021; 157:458-465. [PMID: 34418094 DOI: 10.1002/ijgo.13893] [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: 04/26/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To study a sample of Brazilian lesbian, bisexual, and heterosexual women concerning their gynecologic history and their experience with gynecologic care. METHODS An internet-based survey for women aged 18 years or older was conducted to gather epidemiologic data on sexual habits, primary gynecologic diseases, and patient-gynecologist relationships. RESULTS The survey was answered by 1201 women, with 571 reporting being heterosexual, 272 lesbian, and 358 bisexual. The lesbian/bisexual (LB) group contained fewer Caucasian individuals, used more public health resources, and had more individuals consuming tobacco, alcohol, and recreational drugs. No significant differences were found in the number of individuals with diabetes mellitus, obesity, hypertension, and sexually transmitted diseases. Depression was more common in the LB group. Endometriosis and vaginismus were more common in bisexual women, whereas polycystic ovary syndrome was more frequent in lesbians. Questions on the patient-gynecologist relationship revealed that most LB women felt uncomfortable and dissatisfied with the treatment received. CONCLUSION The LB group had different epidemiologic characteristics from the heterosexual group. Differences in morbid antecedents were found only in endometriosis, vaginismus, and polycystic ovary syndrome. Most LB Brazilian women are dissatisfied with treatment received from gynecologists.
Collapse
Affiliation(s)
- Gislaine Paviani
- Post Graduate Program in Gynecology and Obstetrics, Federal University of Paraná, Curitiba, Brazil
| | - Kadija R Chrisostomo
- Post Graduate Program in Gynecology and Obstetrics, Federal University of Paraná, Curitiba, Brazil
| | - Najila M Sandrin
- Department of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - Mariana R Hilgert
- Department of Medicine, Pontifical Catholic University of Paraná, Curitiba, Brazil
| | - Thelma Skare
- Mackenzie Evangelical School of Medicine, Curitiba, Brazil
| | - Renato Nisihara
- Post Graduate Program in Gynecology and Obstetrics, Federal University of Paraná, Curitiba, Brazil.,Mackenzie Evangelical School of Medicine, Curitiba, Brazil
| |
Collapse
|
23
|
Semlyen J, Curtis TJ, Varney J. Sexual orientation identity in relation to unhealthy body mass index: individual participant data meta-analysis of 93 429 individuals from 12 UK health surveys. J Public Health (Oxf) 2021; 42:98-106. [PMID: 30786282 PMCID: PMC8414914 DOI: 10.1093/pubmed/fdy224] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/16/2018] [Accepted: 12/18/2018] [Indexed: 01/01/2023] Open
Abstract
Background Lesbian, gay and bisexual adults are more likely than heterosexual adults to experience
worse health outcomes. Despite increasing public health interest in the importance of
maintaining a healthy body weight, no study has considered sexual orientation identity
(SOI) and unhealthy BMI categories among adults in the UK population. Methods Individual participant data meta-analysis using pooled data from population health
surveys reporting on 93 429 adults with data on SOI, BMI and study covariates. Results Adjusting for covariates and allowing for between-study variation, women identifying as
lesbian (OR = 1.41, 95% CI: 1.16, 1.72) or bisexual (OR = 1.24, 95% CI: 1.03, 1.48) were
at increased risk of overweight/obesity compared to heterosexual women, but men
identifying as gay were at decreased risk (OR = 0.72, 95% CI: 0.61, 0.85) compared to
heterosexual men. Increased risk of being underweight was seen for women identifying as
‘other’ (OR = 1.95, 95% CI: 1.07, 3.56), and men identifying as gay (OR = 3.12, 95% CI:
1.83, 5.38), bisexual (OR = 2.30, 95% CI: 1.17, 4.52), ‘other’ (OR = 3.95, 95% CI: 1.85,
8.42). Conclusions The emerging picture of health disparities in this population, along with well
documented discrimination, indicate that sexual orientation should be considered as a
social determinant of health.
Collapse
Affiliation(s)
- J Semlyen
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK
| | - T J Curtis
- Centre for Population Research in Sexual Health and HIV, Institute for Global Health, University College London, London, UK
| | - J Varney
- Public Health England, London, UK
| |
Collapse
|
24
|
Ong C, Tan RKJ, Le D, Tan A, Tyler A, Tan C, Kwok C, Banerjee S, Wong ML. Association between sexual orientation acceptance and suicidal ideation, substance use, and internalised homophobia amongst the pink carpet Y cohort study of young gay, bisexual, and queer men in Singapore. BMC Public Health 2021; 21:971. [PMID: 34022843 PMCID: PMC8141135 DOI: 10.1186/s12889-021-10992-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 05/06/2021] [Indexed: 01/22/2023] Open
Abstract
Background Gay, bisexual and queer (GBQ) men are frequently subjected to minority stressors that have negative impacts on their health. Milestones that include the acceptance and disclosure of sexual identity amongst GBQ men are hence key instruments in understanding the prevalence of internalised homophobia and predicting health outcomes. As such, this work takes a novel approach to deduce the correlates of delayed acceptance of sexual orientation in young GBQ men as a measure of internalised homophobia through retrospective self-reporting and age-based analysis. Methods Participants were recruited as part of a cohort study exploring the syndemic risks associated with HIV acquisition among young GBQ men in Singapore. We examined their levels of internalised, perceived, experienced homophobia, as well as their health behaviours and suicidal tendencies. Two separate variables were also self-reported by the participants – the age of questioning of sexual orientation and the age of acceptance of sexual orientation. We subsequently recoded a new variable, delayed acceptance of sexual orientation, by taking the difference between these two variables, regressing it as an independent and dependent variable to deduce its psychosocial correlates, as well as its association with other measured instruments of health. Results As a dependent variable, delayed acceptance of sexual orientation is positively associated with an increase of age and internalised homophobia, while being negatively associated with reporting as being gay, compared to being bisexual or queer. As an independent variable, delayed acceptance of sexual orientation was associated with a delayed age of coming out to siblings and parents, suicide ideation, historical use of substances including smoking tobacco cigarettes and consuming marijuana, as well as reporting higher levels of experienced, internalised and perceived homophobia. Conclusion Greater levels of early intervention and efforts are required to reduce the heightened experience of minority stress resulting from communal and institutional hostilities. Areas of improvement may include community-based counselling and psychological support for GBQ men, while not forsaking greater education of the social and healthcare sectors. Most importantly, disrupting the stigma narrative of a GBQ ‘lifestyle’ is paramount in establishing an accepting social environment that reduces the health disparity faced by GBQ men. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10992-6.
Collapse
Affiliation(s)
- Clarence Ong
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore
| | - Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore.
| | - Daniel Le
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore.,National University Hospital, National University Health System, Singapore, Singapore
| | - Avin Tan
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Adrian Tyler
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Calvin Tan
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Chronos Kwok
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Sumita Banerjee
- Action for AIDS Singapore, 9 Kelantan Lane #03-01, Singapore, 208628, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, 117549, Singapore
| |
Collapse
|
25
|
Variation in diet quality across sexual orientation in a cohort of U.S. women. Cancer Causes Control 2021; 32:645-651. [PMID: 33846853 DOI: 10.1007/s10552-021-01418-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 03/16/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE Extensive prior research has shown that sexual minority women are more likely to have a number of cancer risk factors, thereby putting them at higher risk for cancer than heterosexual women. However, there has been little research evaluating the association between sexual orientation and diet quality. METHOD Data come from participants (aged 24-54 years) enrolled in Nurses' Health Study 3, an ongoing, U.S.-based cohort study (N = 15,941). We measured diet using recommendations from the Dietary Approach to Stop Hypertension (DASH) and American Health Association (AHA) 2020 Strategic Impact Goals. RESULTS We found limited evidence of differences across diet quality by sexual orientation. When examining predicted DASH scores, mostly heterosexual [predicted mean score (95% confidence interval), 24.0 (23.8, 24.3)] and lesbian [24.3 (23.8, 24.9)] women had healthier predicted DASH scores than the reference group of completely heterosexual women with no same-sex partners [23.6 (23.5, 23.7)]. Even though certain sexual minority women had overall healthier predict DASH scores, their consumption of certain food groups-low-fat dairy and fruit-was lower than completely heterosexual women with no same-sex partners. When measuring AHA scores, most sexual minority groups (completely heterosexual women with same-sex partners, mostly heterosexual women, and lesbian women) had higher diet quality compared to the reference group of completely heterosexual women with no same-sex partners. CONCLUSION Sexual minority women, particularly mostly heterosexual women and lesbian women, had healthier diet quality than completely heterosexual women with no same-sex partners. These data suggest that cancer risk factors (e.g., smoking, drinking, and inactivity) other than diet would drive higher cancer rates among sexual minority compared to heterosexual women. Nonetheless, it is critical for all women to improve their diet quality since diet quality was poor among participants of all sexual orientations.
Collapse
|
26
|
Sutter ME, Simmons VN, Sutton SK, Vadaparampil ST, Sanchez JA, Bowman-Curci M, Duarte L, Schabath MB, Quinn GP. Oncologists' experiences caring for LGBTQ patients with cancer: Qualitative analysis of items on a national survey. PATIENT EDUCATION AND COUNSELING 2021; 104:871-876. [PMID: 32981814 PMCID: PMC7982350 DOI: 10.1016/j.pec.2020.09.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 09/06/2020] [Accepted: 09/15/2020] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Sexual and gender minority (SGM) individuals experience cancer-related health disparities and reduced quality of cancer care compared to the general population in part due to a lack of knowledgeable providers. This study explored oncologists' experiences and perspectives in providing patient-centered care for SGM individuals with cancer. METHODS We conducted a qualitative analysis of oncologists' responses to four open-ended items on a national survey eliciting their experiences, reservations, and suggestions in treating SGM patients. RESULTS Over 50 % of the 149 respondents of the national survey responded to at least one open-ended item. Many oncologists reported positive experiences reflecting personal growth and affirmative care practices, such as open, non-judgmental communication, compassion, competence, and supporting patients' identity. There was a notable lack of experience with transgender patients in particular. Lack of knowledge, interpersonal communication concerns (e.g., fear of offending patients), and microaggressions ("don't ask, don't tell") were identified as barriers to providing affirming care. CONCLUSIONS Oncologists recognize their knowledge deficits and need strategies to overcome communication barriers and microaggressions among the cancer care team to provide SGM-affirming care. PRACTICE IMPLICATIONS Curricula are needed to train oncologists in SGM healthcare needs and affirming communication skills to facilitate patient-centered care for SGM individuals with cancer.
Collapse
Affiliation(s)
- Megan E Sutter
- Departments of Obstetrics and Gynecology and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA; Morsani School of Medicine, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Morsani School of Medicine, University of South Florida, Tampa, FL, USA; Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA; Morsani School of Medicine, University of South Florida, Tampa, FL, USA
| | - Julian A Sanchez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Meghan Bowman-Curci
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Luisa Duarte
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Matthew B Schabath
- Morsani School of Medicine, University of South Florida, Tampa, FL, USA; Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Gwendolyn P Quinn
- Departments of Obstetrics and Gynecology and Population Health, New York University Grossman School of Medicine, New York, NY, USA; Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA.
| |
Collapse
|
27
|
Clark CM, Kosciw JG. Engaged or excluded: LGBTQ youth's participation in school sports and their relationship to psychological well‐being. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22500] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
28
|
Ybarra M, Goodenow C, Rosario M, Saewyc E, Prescott T. An mHealth Intervention for Pregnancy Prevention for LGB Teens: An RCT. Pediatrics 2021; 147:e2020013607. [PMID: 33568491 PMCID: PMC7924142 DOI: 10.1542/peds.2020-013607] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although lesbian, gay, bisexual and other sexual minority (LGB+) girls are more likely than heterosexual girls to be pregnant during adolescence, relevant pregnancy prevention programming is lacking. METHODS A national randomized controlled trial was conducted with 948 14- to 18-year-old cisgender LGB+ girls assigned to either Girl2Girl or an attention-matched control group. Participants were recruited on social media between January 2017 and January 2018 and enrolled over the telephone. Between 5 and 10 text messages were sent daily for 7 weeks. Both experimental arms ended with a 1-week booster delivered 12 weeks subsequently. RESULTS A total of 799 (84%) participants completed the intervention end survey. Participants were, on average, 16.1 years of age (SD: 1.2 years). Forty-three percent were minority race; 24% were Hispanic ethnicity. Fifteen percent lived in a rural area and 29% came from a low-income household. Girl2Girl was associated with significantly higher rates of condom-protected sex (adjusted odds ratio [aOR] = 1.48, P < .001), current use of birth control other than condoms (aOR = 1.60, P = .02), and intentions to use birth control among those not currently on birth control (aOR = 1.93, P = .001). Differences in pregnancy were clinically but not statistically significant (aOR = 0.43, P = .23). Abstinence (aOR = 0.82, P = .34), intentions to be abstinent (aOR = 0.95, P = .77), and intentions to use condoms (aOR = 1.09, P = .59) were similar by study arm. CONCLUSIONS Girl2Girl appears to be associated with increases in pregnancy preventive behaviors for LGB+ girls, at least in the short-term. Comprehensive text messaging-based interventions could be used more widely to promote adolescent sexual health behaviors across the United States.
Collapse
Affiliation(s)
- Michele Ybarra
- Center for Innovative Public Health Research, San Clemente, California
| | | | - Margaret Rosario
- City College and Graduate Center, The City University of New York, New York, New York; and
| | - Elizabeth Saewyc
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Tonya Prescott
- Center for Innovative Public Health Research, San Clemente, California
| |
Collapse
|
29
|
Jackson SE, Brown J, Grabovac I, Cheeseman H, Osborne C, Shahab L. Smoking and Quitting Behavior by Sexual Orientation: A Cross-Sectional Survey of Adults in England. Nicotine Tob Res 2021; 23:124-134. [PMID: 32115647 PMCID: PMC7789956 DOI: 10.1093/ntr/ntaa042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 02/27/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess associations between sexual orientation and smoking and quitting behavior among adults in England. METHODS Data were collected from 112 537 adults (≥16 years) participating in a nationally representative monthly cross-sectional survey between July 2013 and February 2019. Sexual orientation was self-reported as heterosexual, bisexual, lesbian/gay, or prefer-not-to-say. Main outcomes were smoking status, e-cigarette use, cigarettes per day, time to first cigarette, motivation to stop smoking, motives for quitting, use of cessation support, and past-year quit attempts. Associations were analyzed separately for men and women using multivariable regression models adjusted for relevant covariates. RESULTS Smoking prevalence is now similar between gay (21.6%), prefer-not-to-say (20.5%) and heterosexual men (20.0%), and lesbian (18.3%) and heterosexual women (16.9%), but remains higher among bisexual men (28.2%, adjusted odds ratio [ORadj] = 1.41, 95% confidence interval [CI] = 1.11 to 1.79) and bisexual women (29.8%, ORadj = 1.64, 95% CI = 1.33 to 2.03) and lower among prefer-not-to-say women (14.5%, ORadj = 0.85, 95% CI = 0.72 to 0.99). Among smokers, bisexuals were less addicted than heterosexuals, with bisexual men smoking fewer cigarettes per day (Badj = -2.41, 95% CI = -4.06 to -0.75) and bisexual women less likely to start smoking within 30 min of waking (ORadj = 0.66, 95% CI = 0.45 to 0.95) than heterosexuals. However, motivation to stop smoking and quit attempts did not differ significantly. CONCLUSIONS In England, differences in smoking prevalence among people with different sexual orientations have narrowed, primarily driven by a larger decline in smoking rates among sexual minority groups than heterosexuals. Bisexual men and women remain more likely to smoke but have lower levels of addiction while being no less likely to try to quit. IMPLICATIONS This population-based study provides an up-to-date picture of smoking and quitting behavior in relation to sexual orientation among adults in England. Findings suggest that widely documented disparities in smoking prevalence have narrowed over recent years, with gay men and lesbian women no longer significantly more likely to smoke than heterosexuals, although smoking remains more common among bisexual men and women. Insights into differences in level of addiction, use of cessation support, and motives for quitting may help inform the development of targeted interventions to further reduce smoking among sexual minority groups.
Collapse
Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | | | | | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
| |
Collapse
|
30
|
Rosario M, Goodenow C, Ybarra M, Saewyc E, Prescott T. Reasons Lesbian and Bisexual Adolescent Girls Have or Might Have Sex with Females or Males: Implications for Discordance between Sexual Identity and Behaviors and for Prevention of Pregnancy and STIs. JOURNAL OF SEX RESEARCH 2020; 57:966-978. [PMID: 32425068 DOI: 10.1080/00224499.2020.1753638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We examined reasons lesbian and bisexual adolescent girls have sex or, if sexually inexperienced, might have sex with girls or boys, and the role of internalized homonegativity in these relations and among lesbians. Girls were recruited online and classified as lesbian (n = 129) or bisexual (n = 193); the classification was validated. Love and pleasure were common reasons for having sex with girls, although more lesbian girls (LG) than bisexual girls (BG) endorsed love. BG, relative to LG, had sex with girls because they were curious or wanted to verify their sexual identity. Love and pleasure were motives for having sex with boys for BG. They were common reasons for potentially having sex with either sex among sexually inexperienced girls, but both were more likely for BG than LG for sex with boys. Internalized homonegativity did not mediate the relation between sexual identity and reasons for sex, but LG just with male partners were more homonegative than LG just with female partners. The findings indicate that LG and BG should not be combined into a single group, provide insights into the discordance between sexual identity and behaviors, and have implications for reducing risk for pregnancy and sexually transmitted infections among sexual minority girls.
Collapse
Affiliation(s)
- Margaret Rosario
- Department of Psychology, The City University of New York-City College and Graduate Center
| | | | | | - Elizabeth Saewyc
- Stigma and Resilience among Vulnerable Youth Centre, School of Nursing, University of British Columbia
| | | |
Collapse
|
31
|
Sensation seeking, sexual orientation, and drug abuse symptoms in a community sample of emerging adults. Behav Pharmacol 2020; 31:102-107. [PMID: 31833968 DOI: 10.1097/fbp.0000000000000523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Increased use of drugs is associated with a number of factors including high sensation seeking and sexual minority status (through group-specific minority stress). We sought to examine how personality traits like sensation seeking may influence drug abuse among sexual minority individuals. Participants were 217 emerging adults (Mage = 20.23, SD = 0.85) recruited from Amazon Mechanical Turk (MTurk). Of these participants, 67.7% identified as heterosexual, 9.7% as gay or lesbian, 21.2% as bisexual, and 1.4% indicated other sexual orientations. Sensation seeking and drug abuse were self-reported using the Brief Sensation Seeking Scale and the Drug Abuse Screening Test, respectively. A preliminary multiple analysis of variance indicated no significant mean differences for these variables as a function of sex or sexual orientation. Next, sexual minority status, Brief Sensation Seeking Scale scores, sex and their interactions were entered into a linear regression predicting Drug Abuse Screening Test scores. Results revealed a significant moderation, such that the positive relationship between Brief Sensation Seeking Scale total scores and Drug Abuse Screening Test total scores was stronger for sexual minorities (β = 0.14, P = 0.00) compared to heterosexuals (β = 0.04, P = 0.04), controlling for sex. These results demonstrate, while sensation seeking and sexual minority status may selectively indicate risk for drug use, sexual minorities high in sensation seeking may be at especially high risk for problems related to drug abuse. More research examining the addiction etiology of sexual minority individuals would inform targeted interventions for this population.
Collapse
|
32
|
Everett BG, Turner B, Hughes TL, Veldhuis CB, Paschen-Wolff M, Phillips G. Sexual Orientation Disparities in Pregnancy Risk Behaviors and Pregnancy Among Sexually Active Teenage Girls: Updates from the Youth Risk Behavior Survey. LGBT Health 2020; 6:342-349. [PMID: 31618165 DOI: 10.1089/lgbt.2018.0206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose: The purpose of this study was to determine the extent to which sexual identity and/or sexual behaviors were associated with pregnancy risk factors (condom use, alcohol or other drug use before sex, and World Health Organization [WHO] Tier 1 [i.e., intrauterine device, implant] or Tier 2 [i.e., injectable, pill, patch, or ring] contraception use) and teen pregnancy among female high school students who reported having a sexual relationship with a male partner. Methods: Data were from the Youth Risk Behavior Survey (YRBS; 2005-2015) (n = 63,313). Logistic regression was used to analyze sexual identity and behavior disparities in pregnancy risk behaviors and teen pregnancy. Interactions between sexual identity and behavior were also tested. All models adjusted for the YRBS complex sampling frame. Results: Girls who reported being unsure of their sexual identity were less likely to use condoms or a WHO Tier 1 or Tier 2 contraceptive method at last sex, and more likely to report alcohol or other drug use at last sex than heterosexual girls. Girls who identified as lesbian were also less likely to use a condom at last sex, and girls who reported both male and female sexual partners were more likely to report alcohol or other drug use and less likely to use condoms at last sex. Girls who identified as bisexual were more likely to report pregnancy during teenage years than girls who identified as heterosexual. Conclusion: Our results support the need to assess both sexual identity and sexual behavior in research on teen pregnancy and pregnancy risk. Furthermore, the finding that girls who were unsure of their sexual identity showed heightened risk highlights the need for additional research that includes this group.
Collapse
Affiliation(s)
| | - Blair Turner
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Tonda L Hughes
- School of Nursing, Columbia University, New York, New York.,Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York
| | | | - Margaret Paschen-Wolff
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York
| | - Gregory Phillips
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| |
Collapse
|
33
|
Solazzo AL, Austin SB, Rosario M, Corliss HL, Charlton BM. Maternal Comfort with Lesbian, Gay, and Bisexual People and Their Children's Drinking, Smoking, and Disordered Weight Control Behaviors as Adults. LGBT Health 2020; 7:375-384. [PMID: 32877268 DOI: 10.1089/lgbt.2019.0315] [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: 11/12/2022] Open
Abstract
Purpose: We investigated associations between maternal comfort with lesbian, gay, and bisexual (LGB) people during the participant's adolescence and their health indicators in adulthood. Methods: Data came from a prospective cohort, Growing Up Today Study (N = 7476), limited to men and women who provided information during their adulthood about recent binge drinking, cigarette smoking, or disordered weight control behaviors (DWCB) and whose mothers provided information during the participant's adolescence about her comfort with LGB people. Results: Increased maternal comfort with LGB people was associated with increased engagement in health indicators for heterosexual but not sexual minority adults (binge drinking, cigarette smoking, and DWCB for women; binge drinking for men). No association existed between maternal comfort with LGB people and binge drinking or cigarette smoking for sexual minority women, and binge drinking for sexual minority men. This resulted in statistically smaller differences across sexual orientation in cigarette smoking for women when their mothers were highly comfortable with LGB people compared with those whose mothers were uncomfortable with LGB people. There were no differences in binge drinking (women and men) and DWCB (women only) across sexual orientation when mothers were highly comfortable with LGB people. Conclusion: Maternal comfort with LGB people is associated with certain sexual orientation-related disparities in health indicators through adulthood, due to increased engagement in health indicators by heterosexual adults. Exposure to sexual orientation stigma in adolescence, measured as maternal comfort with LGB people, possibly drives well-known differences in drinking, smoking, and DWCB during adulthood between heterosexual and sexual minority adults.
Collapse
Affiliation(s)
- Alexa L Solazzo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Margaret Rosario
- Department of Psychology, City College and The Graduate Center, City University of New York, New York, New York, USA
| | - Heather L Corliss
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, California, USA
| | - Brittany M Charlton
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
34
|
Gordon JR, Baik SH, Schwartz KTG, Wells KJ. Comparing the Mental Health of Sexual Minority and Heterosexual Cancer Survivors: A Systematic Review. LGBT Health 2020. [PMID: 31314662 DOI: 10.1089/lgbt.2018.0204:10.1089/lgbt.2018.0204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
Purpose: Sexual minority (SM) individuals are more likely to experience mental health concerns than heterosexual individuals. However, little is known to date about the psychological needs of SM cancer survivors. The objective of this systematic review was to identify whether SM cancer survivors experience disparate psychological outcomes compared with heterosexual cancer survivors. Methods: PubMed/MEDLINE, PsycINFO, CINAHL, Web of Science, and ProQuest databases were searched systematically to identify studies that compared mental health outcomes between SM and heterosexual survivors. A standardized data extraction form was used to extract data from eligible articles. The Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies was used to assess study quality. Results: Twelve studies met the inclusion criteria and assessed distress, depression, anxiety, perceived stress, and mental and emotional quality of life (QOL). Most studies enrolled survivors diagnosed either with female breast cancer or with prostate cancer. Most studies reporting on mental health among women found no differences between SM and heterosexual survivors. Studies conducted among men found that SM survivors experienced higher distress, depression, and anxiety, and lower emotional/mental QOL than heterosexual survivors. Conclusion: The findings of the present synthesis suggest that mental health disparities may exist among SM men diagnosed with cancer, particularly prostate cancer. More research is required to identify mental health disparities among SM survivors diagnosed with other cancers, as well as predisposing and protective factors. In addition, mental health screening and interventions are needed for SM men after cancer diagnosis.
Collapse
Affiliation(s)
- Janna R Gordon
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Sharon H Baik
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Karen T G Schwartz
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Kristen J Wells
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California.,Department of Psychology, San Diego State University, San Diego, California
| |
Collapse
|
35
|
Yi X, Liu Z, Qiao W, Xie X, Yi N, Dong X, Wang B. Clustering effects of health risk behavior on mental health and physical activity in Chinese adolescents. Health Qual Life Outcomes 2020; 18:211. [PMID: 32620107 PMCID: PMC7333302 DOI: 10.1186/s12955-020-01468-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 06/30/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Risk behaviors are significantly impacting physical and psychological health among adolescents, resulting in a tremendous public health issue. The aim of this study is to examine the association of clustered risk behaviors with mental health and physical activity, and identify to what extent the clustering of various risk behaviors is associated with psychological health and physical activity in Chinese adolescents. METHODS Students aged 16-18 years, male 16.2 ± 1.03, female 16.3 ± 1.56, were recruited from 30 high schools to complete an online questionnaire in fall semester 2017. A structured questionnaire, 2017 state and local youth risk behavior survey was revised, modified, and translated into Chinese. Five questions were designed to assess physical activity times of the last 7 days. Symptom checklist 90 (SCL-90) was used to investigate the mental health status of the participants. Statistical analyses were done employing chi-square tests, two step cluster analysis, logistic regression. RESULT Results illustrate that girls report a significantly higher mean of being bullied in school, electronically bullied, feeling sad or hopeless, and trying cigarette smoking. Two-step cluster analysis and regression analysis find that alcohol use, smoking and sedentary behavior have significant effect on adolescent health. Logic regression demonstrated that risk behaviors have significantly associated with mental health and physical activity in specific cluster. CONCLUSION This study finds that a specific behavior cluster has significant impact on mental health and physical activity among adolescents. Integrating risk behaviors cluster with factors can be employed to target high-risk adolescents who have poor physical and psychosocial health. The research suggest that more effective and feasible school intervention programs can be designed to promote adolescent health-related behavior in terms of those pathways.
Collapse
Affiliation(s)
- Xiangren Yi
- Department of Sport and Health, School of Physical Education, Shandong University, Jinan, 250061 China
| | - Zongyu Liu
- Department of Sport and Health, School of Physical Education, Shandong University, Jinan, 250061 China
| | - Wenzhen Qiao
- Department of Science and Technology, Shandong Institute of Commerce and Technology, Jinan, 250103 China
| | - Xiuye Xie
- Department of Human Performance and Health Education, Western Michigan University, Kalamazoo, MI 49008 USA
| | - Nuo Yi
- Department of Kinesiology, College of Health Science, University of Wisconsin- Milwaukee, Milwaukee, WI 53201 USA
| | - Xiaosheng Dong
- Department of Sport and Health, School of Physical Education, Shandong University, Jinan, 250061 China
| | - Baozhen Wang
- School of Public Health, Shandong University, Jinan, 250061 Shandong China
| |
Collapse
|
36
|
Dai H, Ingram DG, Taylor JB. Hierarchical and Mediation Analysis of Disparities in Very Short Sleep among Sexual Minority Youth in the U.S., 2015. Behav Sleep Med 2020; 18:433-446. [PMID: 31068017 DOI: 10.1080/15402002.2019.1607738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Insufficient sleep is associated with increased risk of chronic diseases, substance use, and unintentional injuries. Little is known about the disparities in short sleep among sexual minority youth. METHODS A nationally representative sample of U.S. students in grades 9-12 (n = 14,703) from the 2015 Youth Risk Behavior Survey was analyzed to examine the prevalence and risk factors of short sleep. Self-reported sleep duration (very short: ≤5 h, short: 6-7 h, normal: ≥8 h per day) were compared by sex group (male vs. female) and sexual orientation (heterosexual, gay, lesbian, bisexual, and unsure). RESULTS Of all respondents, 88.8% were heterosexual/straight, 2.0% were lesbian or gay, 6.0% were bisexual, and 3.2% were unsure about their sexual identity. Bisexual and unsure girls (36.2%, 95% CI [31.3-41.0] and 33.7%, CI [25.6-41.8], respectively) had a higher prevalence of very short sleep duration than straight girls (19.8%, CI [18.3-21.4]). Gay and unsure boys (38.5%, CI [25.6-51.5] and 33.3%, CI [23.5-32.1], respectively) had a higher prevalence of very short sleep duration than straight boys (16.5%, CI [15.1-17.9]). The effects of sexual minority status on very short sleep duration attenuated when incrementally adjusting for influencing factors, and further analysis identified that feeling sad/hopeless had the largest standardized mediation effect. CONCLUSIONS AND RELEVANCE Sexual minority adolescents had a higher prevalence of reporting very short sleep duration as compared to their straight peers, and the effects were mediated by influencing variables including demographic factors, substance use, excessive media use, and experiences of victimization/mental health problems.
Collapse
Affiliation(s)
- Hongying Dai
- College of Public Health, University of Nebraska Medical Center , Omaha, Nebraska
| | - David G Ingram
- Department of Pediatrics, University of Missouri-Kansas City , Kansas City.,Sleep Center, Children's Mercy Hospital , Kansas City, Missouri
| | - Jane B Taylor
- Department of Pediatrics, University of Missouri-Kansas City , Kansas City.,Pulmonology, Children's Mercy Hospital , Kansas City, Missouri
| |
Collapse
|
37
|
Luk JW, Parker EO, Richardson LP, McCarty CA. Sexual attraction and experiences in the primary care setting: Examining disparities in satisfaction with provider and health self-efficacy. J Adolesc 2020; 81:96-100. [PMID: 32408116 DOI: 10.1016/j.adolescence.2020.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION To test whether sexual minority males and females report lower satisfaction with primary care providers and lower health self-efficacy relative to heterosexual males and females. METHODS Data from 535 adolescents who participated in one of two randomized clinical trials conducted in a primary care setting were analyzed. Multiple linear regressions controlling for demographic characteristics and treatment condition were used to examine sexual attraction differences in indicators of satisfaction with provider and health self-efficacy. RESULTS Sexual minority and heterosexual youth both endorsed high satisfaction with providers. Relative to heterosexual males, sexual minority males reported lower self-efficacy in reaching their health goals. Relative to heterosexual females, sexual minority females reported lower confidence in positively impacting their own health, and lower self-efficacy in setting goals and working actively to improve their health. CONCLUSIONS Sexual minority youth may benefit from additional support from health care providers to enhance their health self-efficacy and reach their health goals.
Collapse
Affiliation(s)
- Jeremy W Luk
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | | | - Laura P Richardson
- Seattle Children's Research Institute, Seattle, WA, USA; Division of Adolescent Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Carolyn A McCarty
- Seattle Children's Research Institute, Seattle, WA, USA; Division of Adolescent Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| |
Collapse
|
38
|
Paceley MS, Fish JN, Thomas MMC, Goffnett J. The Impact of Community Size, Community Climate, and Victimization on the Physical and Mental Health of SGM Youth. JOURNAL OF YOUTH STUDIES 2020; 52:427-448. [PMID: 34413699 PMCID: PMC8372682 DOI: 10.1177/0044118x19856141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sexual and gender minority (SGM) youth experience high rates of victimization leading to health disparities. Community size and community climate are associated with health outcomes among SGM youth; however, we lack studies that include them as covariates alongside victimization to understand their collective impact on health. This study utilized minority stress theory to understand how community context shapes experiences of victimization and health among SGM youth. SGM youth in one Midwestern U.S. state completed an online survey (n = 201) with measures of physical health, mental health, community context, and victimization. Data were analyzed via multiple regression using a path analysis framework. Results indicate that perceived climate was associated with mental, but not physical, health; Community size was unrelated to health outcomes. Victimization mediated the association between community climate and mental health.
Collapse
|
39
|
Halkitis PN, Maiolatesi AJ, Krause KD. The Health Challenges of Emerging Adult Gay Men: Effecting Change in Health Care. Pediatr Clin North Am 2020; 67:293-308. [PMID: 32122561 PMCID: PMC8690571 DOI: 10.1016/j.pcl.2019.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This article focuses on the health and health care challenges experienced by young and emerging adult gay men. Evidence is provided on the extent to which young and emerging adult gay men are disproportionally burdened by multidimensional health disparities, barriers to health care access, and inadequate provider-patient interactions. Recommendations are provided for health care providers and public health officials working with populations of emerging adult gay men that might have the greatest overall impact on improving this population's well-being and access to competent health care by increasing providers' awareness of the unique needs of young and emerging adult gay men.
Collapse
Affiliation(s)
- Perry N. Halkitis
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers School of Public Health, One Riverfront Plaza, Newark, NJ 07102, USA,Department of Biostatistics, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA,Department of Urban-Global Health, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA,Corresponding author. Departments of Biostatistics, Epidemiology and Urban-Global Health, School of Public Health, Rutgers University, 683 Hoes Lane West, Piscataway, NJ 08854.
| | - Anthony J. Maiolatesi
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers School of Public Health, One Riverfront Plaza, Newark, NJ 07102, USA,Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA,Center for Interdisciplinary Research on AIDS, Yale University, 135 College Street, New Haven, CT 06510, USA
| | - Kristen D. Krause
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers School of Public Health, One Riverfront Plaza, Newark, NJ 07102, USA,Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA
| |
Collapse
|
40
|
Pöge K, Dennert G, Koppe U, Güldenring A, Matthigack EB, Rommel A. The health of lesbian, gay, bisexual, transgender and intersex people. JOURNAL OF HEALTH MONITORING 2020; 5:2-27. [PMID: 35146279 PMCID: PMC8734091 DOI: 10.25646/6449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/07/2020] [Indexed: 11/18/2022]
Abstract
Sex, gender and sexual orientation are diverse, as are the ways of living associated with them. The extent to which people can live a free and self-determined life according to their own body, gender, sexuality and way of life influences their social resources, opportunities for participation and discrimination and has an influence on their life situation and health. A narrative review of lesbian, gay, bisexual, transgender and intersex (LGBTI) health was conducted including international and German reviews, meta-analyses and population-based studies. The focus of this article is the legal, social and medical recognition as well as health status of LGBTI people in Germany. While the legal framework in Germany for homosexual and bisexual people has gradually improved, many civil society stakeholders have pointed to major deficits in the medical and legal recognition of transgender and intersex people. In addition, scientific findings frequently have not yet found its way into medical practice to an adequate extent. Available data on LGBTI health indicate a need for action in the areas of mental health and health care provision. However, due to a lack of comprehensive data, conclusions cannot be drawn on the general health situation and health resources of LGBTI people. For the concrete planning and implementation of measures as well as the differentiated portrayal of the situation in Germany, the databases must be expanded, not least via population-representative surveys.
Collapse
Affiliation(s)
- Kathleen Pöge
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring,Corresponding author Dr Kathleen Pöge, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
| | - Gabriele Dennert
- Fachhochschule Dortmund – University of Applied Scienes and Arts, Social medicine and public health with a focus on gender and diversity
| | - Uwe Koppe
- Robert Koch Institute, Berlin Department of Infectious Disease Epidemiology
| | - Annette Güldenring
- Westküstenkliniken Heide/Brunsbüttel, Department of Psychiatry, Psychotherapy and Psychosomatics
| | - Ev B. Matthigack
- German chapter of the International Association of Intersex People (IVIM), Organisation Intersex International (OII Germany), Berlin
| | - Alexander Rommel
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| |
Collapse
|
41
|
Ybarra ML, Parrilla JS, Wolowic J, Rosario M, Goodenow C, Saewyc E. A National, Qualitative Study of Sexual Decision Making by Teenage Girls who are Lesbian, Gay, Bisexual, or who have Another Nonheterosexual Identity. J Pediatr 2020; 217:177-183. [PMID: 31843216 PMCID: PMC9166675 DOI: 10.1016/j.jpeds.2019.10.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/26/2019] [Accepted: 10/14/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To address the significant dearth of literature that examines how girls who are lesbian, gay, bisexual, or who have another nonheterosexual identity (LGB+) decide when and with whom to have sex; and to explore why inexperienced LGB+ girls might have sex with girls or boys. STUDY DESIGN We conducted 8 online, asynchronous, bulletin board-style focus groups with 160 adolescent girls 14-18 years of age. The transcripts were analyzed using a thematic analysis of each girls' responses to the questions. Analyses were focused on increasing our understanding of sexual health decision making among LGB+ teenage girls (eg, "What was the reason you had sex for the first time?"). Participants' responses reflected their day-to-day experiences and roles of cisgender LGB+ girls inside a dominant heteronormative social structure. RESULTS Some LGB+ girls talked about the perception that LGB+ girls were presumed or expected to be hypersexual, and that they did not feel they could be accepted as LGB+ without being sexually active. Developmental aspects of identity were also salient: Girls considered or engaged in sexual encounters as a way of figuring out to whom they were attracted as well as confirming or disconfirming the identity labels they used for themselves. Same-sex encounters could be offered as "proof" that one really was LGB+. Similarly, unsatisfying experiences with guys could serve as evidence that they were not attracted to guys. CONCLUSION Sexual decision making among LGB+ girls is often driven by aspects of their sexual minority identity.
Collapse
Affiliation(s)
- Michele L. Ybarra
- Center for Innovative Public Health Research, 555 N El Camino Real, San Clemente, CA 92672,CORRESPONDING AUTHOR: Center for Innovative Public Health Research, 555 N El Camino Real, San Clemente, CA 92672, , 877 302 6858 Extension 801
| | - Julia Santana Parrilla
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), University of British Columbia, School of Nursing, T201-2211 Wesbrook Mall, Vancouver BC V6T 2B5 Canada
| | - Jennifer Wolowic
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), University of British Columbia, School of Nursing, T201-2211 Wesbrook Mall, Vancouver BC V6T 2B5 Canada
| | - Margaret Rosario
- Colin Powell School for Civic and Global Leadership, Department of Psychology, The City University of New York—City College and Graduate Center, New York, New York
| | | | - Elizabeth Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), University of British Columbia, School of Nursing, T201-2211 Wesbrook Mall, Vancouver BC V6T 2B5 Canada
| |
Collapse
|
42
|
Watson RJ, Park M, Taylor AB, Fish JN, Corliss HL, Eisenberg ME, Saewyc EM. Associations Between Community-Level LGBTQ-Supportive Factors and Substance Use Among Sexual Minority Adolescents. LGBT Health 2020; 7:82-89. [PMID: 31985327 DOI: 10.1089/lgbt.2019.0205] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Purpose: Using representative school-based data and community-level primary data, we investigated how environmental factors (e.g., school and community climate) might be protective against substance use behaviors among a vulnerable population of adolescents. Methods: We analyzed a sample of 2678 sexual minority adolescents using a combination of student-level data (British Columbia Adolescent Health Survey) and primary community-level data (assessing lesbian, gay, bisexual, transgender, and queer [LGBTQ]-specific community and school environments). Using multilevel logistic regression models, we examined associations between lifetime substance use (alcohol, illegal drugs, marijuana, nonmedical use of prescription drugs, and smoking) and community-level predictors (community and school LGBTQ supportiveness). Results: Above and beyond student characteristics (e.g., age and years living in Canada), sexual minority adolescents residing in communities with more LGBTQ supports (i.e., more supportive climates) had lower odds of lifetime illegal drug use (for boys and girls), marijuana use (for girls), and smoking (for girls). Specifically, in communities with more frequent LGBTQ events (such as Pride events), the odds of substance use among sexual minority adolescents living in those communities was lower compared with their counterparts living in communities with fewer LGBTQ supports. Conclusions: The availability of LGBTQ community-level organizations, events, and programs may serve as protective factors for substance use among sexual minority adolescents. In particular, LGBTQ-supportive community factors were negatively associated with substance use, which has important implications for our investment in community programs, laws, and organizations that advance the visibility and rights of LGBTQ people.
Collapse
Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut
| | - Minjeong Park
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, The University of British Columbia, Vancouver, Canada
| | - Ashley B Taylor
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, The University of British Columbia, Vancouver, Canada
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland
| | - Heather L Corliss
- School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego, California
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Elizabeth M Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, The University of British Columbia, Vancouver, Canada
| |
Collapse
|
43
|
Miller JM, Pereira MA, Wolfson J, Laska MN, Nelson TF, Neumark-Sztainer D. Are Correlates of Physical Activity in Adolescents Similar Across Ethnicity/Race and Sex: Implications for Interventions. J Phys Act Health 2019; 16:1163-1174. [PMID: 31651411 PMCID: PMC8191572 DOI: 10.1123/jpah.2018-0600] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 07/22/2019] [Accepted: 08/27/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study tested for differences in personal, social, and environmental correlates of moderate to vigorous physical activity (MVPA) across ethnicity/race in male and female adolescents. METHODS Self-reported MVPA and 47 potential correlates of MVPA were measured in an ethnically/racially diverse cross-sectional sample of adolescents, in Minnesota, who participated in EAT-2010 (Eating and Activity in Teens). Interactions of potential correlates with ethnicity/race on MVPA were tested in linear hierarchical regression models in boys and girls. RESULTS Boys reported 1.7 more weekly hours of MVPA than girls. White adolescents reported 1.1 to 2.1 more weekly hours of MVPA than nonwhite adolescents. Among girls, neighborhood road connectivity was negatively correlated with MVPA among Hispanic and Asian participants. Among boys, sports participation was positively correlated with MVPA among all ethnicities/races, except Asians. Home media equipment was positively correlated with MVPA among Hispanic boys, but negatively correlated among white boys. CONCLUSIONS A few correlates of physical activity among adolescents differed intersectionally by ethnicity/race and sex. Sports participation and home media equipment may have differing impacts on physical activity across ethnicities and races in boys, whereas neighborhood features like road connectivity may have differing impacts on physical activity across ethnicities and races in girls.
Collapse
|
44
|
Luk JW, Sita KR, Lewin D, Simons-Morton BG, Haynie DL. Sexual Orientation and Sleep Behaviors in a National Sample of Adolescents Followed Into Young Adulthood. J Clin Sleep Med 2019; 15:1635-1643. [PMID: 31739854 PMCID: PMC6853407 DOI: 10.5664/jcsm.8030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sexual minority adolescents experience mental and physical health disparities attributable to increased discrimination and minority stress. These same factors may also impair sleep health, although available literature on this topic is limited. This study examined longitudinal associations between adolescent sexual minority status and seven sleep behaviors in young adulthood and tested depressive symptoms and overweight as mediators. METHOD Data were drawn from Waves 2 (11th grade) to 7 (4 years after high school) of the NEXT Generation Health Study, a national longitudinal cohort study of US adolescents (n = 1946; 6.3% sexual minorities). RESULTS There were no significant sexual orientation disparities in sleep duration, trouble falling asleep, trouble staying asleep, or trouble waking up during young adulthood. Relative to heterosexual females, sexual minority females had higher odds of snoring/stop breathing (36.6% versus 19.2%; adjusted odds ratio = 2.57; 95% confidence interval = 1.30, 5.09) and reported more frequent daytime sleepiness (b = 0.66, 95% confidence interval = 0.05, 1.27). Mediation analyses revealed that female sexual minority status was associated with increased risk of snoring/stop breathing though overweight status (mediated 43.6% of total effect) and was also associated with increased daytime sleepiness through higher depressive symptoms (mediated 70.8% of total effect). CONCLUSIONS Among US youth, no sexual orientation disparities were found except for snoring/stop breathing and daytime sleepiness among females. Sexual orientation disparities in these aspects of sleep are partially due to worse mental and physical health among sexual minority females, highlighting depressive symptoms and overweight problems as potential intervention targets. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Title: Health Behavior in School-Aged Children: NEXT Longitudinal Study 2009-2016; Identifier: NCT01031160.
Collapse
Affiliation(s)
- Jeremy W Luk
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
- Department of Medical and Clinical Psychology, Suicide Care, Prevention, and Research Initiative, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Kellienne R Sita
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Daniel Lewin
- Children's National Health System, Washington, District of Columbia
| | - Bruce G Simons-Morton
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| |
Collapse
|
45
|
Allen-Leigh B, Rivera-Rivera L, Yunes-Díaz E, Portillo-Romero AJ, Brown B, León-Maldonado L, Vargas-Guadarrama G, Salmerón J, Lazcano-Ponce EC. Uptake of the HPV vaccine among people with and without HIV, cisgender and transgender women and men who have sex with men and with women at two sexual health clinics in Mexico City. Hum Vaccin Immunother 2019; 16:981-990. [PMID: 31657665 DOI: 10.1080/21645515.2019.1675456] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Our aim was to better understand Human Papillomavirus (HPV) vaccine acceptance among Mexican adults including people with and without HIV, cisgender men who have sex with men (MSM) or with women (MSW), cisgender and transgender women. A computer-assisted, self-administered questionnaire was completed by healthcare users and participants recruited through community organizations, and the first dose of the quadrivalent HPV vaccine was offered at no cost at a large sexual health clinic in Mexico City, from May to December 2018. Socio-demographic characteristics and factors associated with HPV vaccine acceptance were analyzed using logistic regression.The sample of 1915 participants included 1341 cisgender men (70.9%, 1247 MSM and 94 MSW), 396 (20.7%) cisgender women and 178 (9.3%) transwomen; 615 people (32.1%) were HIV positive. Uptake of the HPV vaccine was higher in men and transwomen (91.5% and 87%, respectively) than among cisgender women (81.8%; p < .001). Cisgender women (OR 0.43, 95%CI 0.30-0.61, p < .05) were less likely to accept HPV vaccination than men. Married/partnered people were less likely to accept HPV vaccination compared to those who were single (OR 0.70, 95%CI 0.51-0.97). People living with HIV were not significantly more likely to accept HPV vaccination (OR 1.7; 95%CI 0.86-1.61).HPV vaccine acceptance was high among adult Mexican study participants; it may be higher than among other Mexican adults given most of these individuals are engaged in care. Modifications will be needed in national and international recommendations on HPV vaccination in adults if healthcare personnel are to recommend the vaccine to the population groups studied.
Collapse
Affiliation(s)
- Betania Allen-Leigh
- Reproductive Health Division, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Leonor Rivera-Rivera
- Reproductive Health Division, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Elsa Yunes-Díaz
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Brandon Brown
- School of Medicine, University of California at Riverside, Riverside, California, USA
| | - Leith León-Maldonado
- Cátedra CONACYT-Center for Population Health Research, National Institute of Public Health, Mexico City, Mexico.,Academic Unit in Epidemiological Research. Center for Research in Policies, Population, and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Galileo Vargas-Guadarrama
- Center for the Prevention and Comprehensive Care of HIV/AIDS in Mexico City, Condesa Clinic, Mexico City, Mexico
| | - Jorge Salmerón
- Academic Unit in Epidemiological Research. Center for Research in Policies, Population, and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | | |
Collapse
|
46
|
Kaestle CE. Sexual Orientation Trajectories Based on Sexual Attractions, Partners, and Identity: A Longitudinal Investigation From Adolescence Through Young Adulthood Using a U.S. Representative Sample. JOURNAL OF SEX RESEARCH 2019; 56:811-826. [PMID: 31030560 DOI: 10.1080/00224499.2019.1577351] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Defining sexual minority status longitudinally over critical developmental periods is essential for understanding the roots of health disparities. Theory supports multidimensional continuums, but current research often examines single measures of sexual activity, sexual attractions, or self-labeled identity separately. Here, a new typology of longitudinal latent classes describes dynamic multidimensional processes continuing from late adolescence (ages 16 to 18) through the late 20s. Using Add Health data (N = 6,864), longitudinal latent class analysis (LLCA), a person-centered approach, showed significant differences between the orientation experiences of males and females (invariance tests led to stratification by sex). The male LLCA model predicted four classes: straight males (87.4%), minimal sexual expression males (6.5%), mostly straight and bi males (3.8%), and emerging gay males (2.4%). The female LLCA model predicted five classes: straight females (73.8%), minimal sexual expression females (7%), mostly straight discontinuous females (10.2%), emerging bi females (7.5%), and emerging lesbian females (1.5%). Some classes represent generally consistent indicators across dimensions over time, while other classes describe more emerging or discontinuous trajectories. Substantial changes were common not only from late adolescence to the early 20s but also from the early 20s to the late 20s, indicating that sexual orientation development continues throughout emerging adulthood.
Collapse
|
47
|
Canuto R, Fanton M, Lira PICD. Iniquidades sociais no consumo alimentar no Brasil: uma revisão crítica dos inquéritos nacionais. CIENCIA & SAUDE COLETIVA 2019; 24:3193-3212. [DOI: 10.1590/1413-81232018249.26202017] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 02/07/2018] [Indexed: 11/22/2022] Open
|
48
|
Johnson SE, O'Brien EK, Coleman B, Tessman GK, Hoffman L, Delahanty J. Sexual and Gender Minority U.S. Youth Tobacco Use: Population Assessment of Tobacco and Health (PATH) Study Wave 3, 2015-2016. Am J Prev Med 2019; 57:256-261. [PMID: 31326009 DOI: 10.1016/j.amepre.2019.03.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Tobacco use disparities by sexual identity are well characterized among adults, but relatively less is known about tobacco use disparities in sexual minority youth. Moreover, no national study has reported tobacco use behaviors among gender minority (e.g., transgender) youth. METHODS Data from Wave 3 (2015-2016) of the Population Assessment of Health Study from youth aged 14-17 years (n=7,772), analyzed in 2018, were stratified by transgender identity, sex, and sexual identity to describe tobacco product use. RESULTS Transgender youth (n=79) were more likely to report ever use of tobacco products compared with nontransgender youth (electronic nicotine products, 40.2% vs 23.0%; cigarettes, 33.9% vs 14.1%; and smokeless tobacco, 21.5% vs 6.0%, respectively) and more likely to report past 30-day use of these products. Similarly, female sexual minority youth, compared with straight female youth, were more likely to report ever use of electronic nicotine products (37.9% vs 20.1%); cigarettes (28.9% vs 12.0%); cigars (11.3% vs 5.2%); hookah (12.7% vs 7.6%); and past 30-day use of electronic nicotine products, cigarettes, and cigars. Among male youth, sexual minority youth were more likely to report ever use of cigarettes compared with straight youth (25.1% vs 13.5%), but they did not differ in ever or past 30-day use of any other tobacco products. CONCLUSIONS Sexual minority youth and transgender youth are more likely to use tobacco products compared with their nonminority peers. Similar to patterns among adults, this is especially true for female sexual minority youth. This information is useful for developing communication and education efforts to prevent youth tobacco initiation in these high-risk groups.
Collapse
Affiliation(s)
- Sarah E Johnson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland.
| | - Erin Keely O'Brien
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Blair Coleman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Greta K Tessman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Leah Hoffman
- Office of Health Communication and Education, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Janine Delahanty
- Office of Health Communication and Education, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| |
Collapse
|
49
|
VanKim NA, Corliss HL, Jun HJ, Calzo JP, AlAwadhi M, Austin SB. Gender Expression and Sexual Orientation Differences in Diet Quality and Eating Habits from Adolescence to Young Adulthood. J Acad Nutr Diet 2019; 119:2028-2040. [PMID: 31375461 DOI: 10.1016/j.jand.2019.05.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 05/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Diet and eating habits during youth have implications on diet and eating habits during adulthood, however, little longitudinal research has examined sexual orientation and gender expression differences in diet. OBJECTIVE Our aim was to examine sexual orientation and gender expression differences in diet quality and eating habits from adolescence to young adulthood. DESIGN Data across multiple time points from the longitudinal Growing Up Today Study cohorts (1997 to 2011) were used. PARTICIPANTS/SETTING Participants (n=12,880; aged 10 to 23 years) were the children of women from the Nurses' Health Study II cohort. MAIN OUTCOME MEASURES Diet quality scores were assessed using the Alternative Healthy Eating Index-2010. In addition, breakfast consumption (≥5 days/wk) and family dinners (≥5 days/wk) were assessed. STATISTICAL ANALYSES PERFORMED Multivariable generalized estimating equation regression models were fit to estimate sexual orientation and gender expression differences in diet quality scores, breakfast consumption, and family dinners, stratified by sex assigned at birth over available repeated measures. RESULTS "Gender-nonconforming" males had significantly higher diet quality scores than "very gender-conforming" males (P<0.05). Diet quality scores did not differ by gender expression among females. "Mostly heterosexual" females and gay males had higher diet quality scores than their same-sex completely heterosexual counterparts (P<0.05). Adjustment for mother's diet quality scores attenuated effects, except for gay males (P<0.05). "Gender-nonconforming" females were less likely to consume breakfast than "very gender-conforming" females (P<0.05). Similar results were found for "mostly heterosexual" and bisexual compared to completely heterosexual females. There were no gender expression or sexual orientation differences in family dinners among males and females. CONCLUSIONS Sexual orientation and gender expression have independent effects on diet quality scores and eating habits for both males and females. Very gender-conforming and completely heterosexual males had the lowest diet quality scores compared to other gender expression and sexual orientation groups. Additional research to explore the effects of sexual orientation and gender expression on diet-related health is needed to build upon these findings.
Collapse
|
50
|
Gordon JR, Baik SH, Schwartz KTG, Wells KJ. Comparing the Mental Health of Sexual Minority and Heterosexual Cancer Survivors: A Systematic Review. LGBT Health 2019; 6:271-288. [PMID: 31314662 DOI: 10.1089/lgbt.2018.0204] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose: Sexual minority (SM) individuals are more likely to experience mental health concerns than heterosexual individuals. However, little is known to date about the psychological needs of SM cancer survivors. The objective of this systematic review was to identify whether SM cancer survivors experience disparate psychological outcomes compared with heterosexual cancer survivors. Methods: PubMed/MEDLINE, PsycINFO, CINAHL, Web of Science, and ProQuest databases were searched systematically to identify studies that compared mental health outcomes between SM and heterosexual survivors. A standardized data extraction form was used to extract data from eligible articles. The Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies was used to assess study quality. Results: Twelve studies met the inclusion criteria and assessed distress, depression, anxiety, perceived stress, and mental and emotional quality of life (QOL). Most studies enrolled survivors diagnosed either with female breast cancer or with prostate cancer. Most studies reporting on mental health among women found no differences between SM and heterosexual survivors. Studies conducted among men found that SM survivors experienced higher distress, depression, and anxiety, and lower emotional/mental QOL than heterosexual survivors. Conclusion: The findings of the present synthesis suggest that mental health disparities may exist among SM men diagnosed with cancer, particularly prostate cancer. More research is required to identify mental health disparities among SM survivors diagnosed with other cancers, as well as predisposing and protective factors. In addition, mental health screening and interventions are needed for SM men after cancer diagnosis.
Collapse
Affiliation(s)
- Janna R Gordon
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Sharon H Baik
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Karen T G Schwartz
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Kristen J Wells
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
- Department of Psychology, San Diego State University, San Diego, California
| |
Collapse
|