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Restar AJ, Layland EK, Davis B, Thompson H, Streed C. The Public Health Crisis State of Transgender Health Care and Policy. Am J Public Health 2024; 114:161-163. [PMID: 38335490 PMCID: PMC10862226 DOI: 10.2105/ajph.2023.307523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 02/12/2024]
Affiliation(s)
- Arjee Javellana Restar
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
| | - Eric K Layland
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
| | - Bee Davis
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
| | - Hale Thompson
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
| | - Carl Streed
- Arjee Javellana Restar is with the departments of Epidemiology and Health Systems and Population Health, School of Public Health, University of Washington, Seattle, as well as the Department of Social and Behavioral Sciences, Yale University, New Haven, CT. Eric K. Layland is with the Department of Human Development and Family Sciences, University of Delaware, Newark. Bee Davis is with the Digital Forensics, Brown University, Providence, RI. Hale Thompson is with Howard Brown Health, Chicago, IL. Carl Streed Jr is with the Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, and the GenderCare Center, Boston Medical Center, Boston, MA
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Watson RJ, Caba AE, Layland EK, Simon K, Morgan E, Edelman EJ, Chan PA, Eaton L. Co-occurring mental health and drug use experiences among Black and Hispanic/Latino sexual and gender diverse individuals. J Behav Med 2023; 46:986-995. [PMID: 37407904 DOI: 10.1007/s10865-023-00433-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 06/21/2023] [Indexed: 07/07/2023]
Abstract
Black and Hispanic/Latino sexual and gender diverse individuals disproportionately experience overlapping health disparities, such as drug use and elevated depressive symptoms, which are often driven by minority stressors. We sought to better understand the interaction between drug use and mental health, as it may be fruitful in developing effective interventions to address co-occurring health disparities. In a longitudinal, 5-wave sample of 300 Black and Hispanic/Latino sexual and gender diverse (SGD) individuals collected between March 2020 and March 2022, we found a within-person association between greater than average levels of psychological distress (depression and anxiety) and more frequent extra-medical use of cannabis, inhalants, methamphetamines, and opioids over the span of two years. These associations held after adjusting for the direct, within-person association of internalized homonegativity with drug use frequency. These results suggest that psychological distress explains at least some variance in drug use among Black and Hispanic/Latino SGD individuals. This highlights the importance of interventions that focus on mental health among Black and Hispanic/Latino SGD individuals who report drug use.
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Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA.
| | - Antonia E Caba
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
| | - Eric K Layland
- College of Education & Human Development, University of Delaware, Newark, DE, USA
| | - Kay Simon
- College of Education and Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Ethan Morgan
- College of Nursing, The Ohio State University, 1585 Neil Ave, Columbus, OH, 43210, USA
| | - E Jennifer Edelman
- Yale School of Medicine and Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
| | - Philip A Chan
- Department of Medicine, Brown University, Providence Rhode, Island
| | - Lisa Eaton
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
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Pachankis JE, Soulliard ZA, Layland EK, Behari K, Seager van Dyk I, Eisenstadt BE, Chiaramonte D, Ljótsson B, Särnholm J, Bjureberg J. Guided LGBTQ-affirmative internet cognitive-behavioral therapy for sexual minority youth's mental health: A randomized controlled trial of a minority stress treatment approach. Behav Res Ther 2023; 169:104403. [PMID: 37716019 PMCID: PMC10601985 DOI: 10.1016/j.brat.2023.104403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/16/2023] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE LGBTQ-affirmative cognitive-behavioral therapy (CBT) addresses the adverse impacts of minority stress. However, this treatment has rarely been tested in randomized controlled trials with LGBTQ youth and never using an asynchronous online platform for broad reach. This study examined the feasibility, acceptability, preliminary efficacy, and multi-level stigma moderators of LGBTQ-affirmative internet-based CBT (ICBT). METHOD Participants were 120 LGBTQ youth (ages 16-25; 37.5% transgender or non-binary; 75.8% assigned female at birth; 49.2% non-Latino White) living across 38 U.S. states and reporting depression and/or anxiety symptoms. Participants were randomized to receive 10 sessions of LGBTQ-affirmative ICBT or only complete 10 weekly assessments of mental and behavioral health and minority stress; all completed measures of psychological distress, depression, anxiety, suicidal thoughts, alcohol use, and HIV-transmission-risk behavior at baseline and 4 and 8 months post-baseline; 20 LGBTQ-affirmative ICBT participants completed a qualitative interview regarding intervention acceptability. RESULTS Participants randomized to LGBTQ-affirmative ICBT completed, on average, 6.08 (SD = 3.80) sessions. Participants reported that LGBTQ-affirmative ICBT was helpful and engaging and provided suggestions for enhancing engagement. Although most outcomes decreased over time, between-group comparisons were small and non-significant. LGBTQ-affirmative ICBT was more efficacious in reducing psychological distress than assessment-only for participants in counties high in anti-LGBTQ bias (b = -1.73, p = 0.001, 95% CI [-2.75, -0.70]). Session dosage also significantly predicted reduced depression and anxiety symptoms. CONCLUSIONS LGBTQ-affirmative ICBT represents a feasible and acceptable treatment. Future research can identify more efficacious approaches and modalities for engaging LGBTQ youth, especially those living under stigmatizing conditions, who might benefit most.
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Affiliation(s)
| | | | | | | | | | | | | | - Brjánn Ljótsson
- Division for Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Josefin Särnholm
- Division for Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Johan Bjureberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
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Layland EK, Bränström R, Murchison GR, Pachankis JE. Kept in the Closet: Structural Stigma and the Timing of Sexual Minority Developmental Milestones Across 28 European Countries. J Youth Adolesc 2023:10.1007/s10964-023-01818-2. [PMID: 37410349 DOI: 10.1007/s10964-023-01818-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/25/2023] [Indexed: 07/07/2023]
Abstract
Structural stigma's role in lesbian, gay, and bisexual (LGB) people's attainment of identity development milestones remains unknown. In a sample of 111,498 LGB people (ages 15 to 65+) living across 28 European countries, associations were investigated between structural stigma measured using an objective index of discriminatory country-level laws and policies affecting LGB people and the timing and pacing of LGB self-awareness, coming out, and closet duration, and subgroup differences in these associations. On average, self-awareness occurred at age 14.8 years old (SD = 5.1), coming out occurred at 18.5 years old (SD = 5.7), and the closet was 3.9 years long (SD = 4.9); thereby highlighting adolescence as a key period for sexual identity development and disclosure. Greater structural stigma was associated with higher odds of never coming out, later age of coming out, and longer closet duration. Gender identity, transgender identity, and sexual identity moderated associations between structural stigma and these developmental milestones. Reducing structural stigma can plausibly promote sexual identity development among LGB populations, especially during adolescence when identity related milestones are often attained.
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Affiliation(s)
- E K Layland
- Department of Human Development and Family Sciences, University of Delaware, 111 Alison Hall West, Newark, DE, 19716, USA.
- Yale School of Public Health, Yale University, 60 College St, New Haven, CT, 06510, USA.
| | - R Bränström
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77, Stockholm, Sweden
| | - G R Murchison
- Yale School of Public Health, Yale University, 60 College St, New Haven, CT, 06510, USA
| | - J E Pachankis
- Yale School of Public Health, Yale University, 60 College St, New Haven, CT, 06510, USA
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Mitsdarffer ML, McColl R, Nescott E, Bianchetta J, Layland EK, Tóth T. LGBTQ+ Youth Homelessness in Delaware:: Building a Case for Targeted Surveillance and Assessment of LGBTQ+ Youth Needs and Experiences. Dela J Public Health 2023; 9:80-86. [PMID: 37622145 PMCID: PMC10445598 DOI: 10.32481/djph.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
Objective In this article, we examine the issue of LGBTQ+ youth homelessness in Delaware, summarize current services available and prior research work that has been done, examining the number, needs, and experiences of unaccompanied unhoused LGBTQ+ youth. Methods We provide a literature review detailing risks associated with LGBTQ+ youth homelessness, resources available, and prior studies and surveys examining this population. Results LGBTQ+ youth experiencing homelessness are particularly vulnerable to physical and mental health challenges, abuse, and violence. The unique needs of this population necessitate specialized resources, yet there are a limited number of such resources available in Delaware and a dearth of information on youth homelessness in general, including LGBTQ+ youth. For example, administrative barriers exist for unaccompanied queer youth seeking shelter services, such as need for legal identification or being grouped in shelter populations based on sex assigned at birth rather than gender identity. Exposure to unsafe environments is a general problem for queer youth. This can make public spaces feel unsafe and increase risk of physical or mental harm, mistreatment, or abuse when seeking shelter outside of agency services and resources. In order to accurately identify and appropriately serve this population, additional research is necessary. Conclusions Evidence building is a critical first step in creating an effective study to examine the issue of LGBTQ+ youth homelessness in Delaware. With the evidence acquired in our literature review our next step to establish an informed methodology is to hold service provider and LGBTQ+ lived experience focus groups. Through a qualitative approach we aim to learn how to appropriately utilize the quantitative tools identified in our analysis and to assess what questions are missing to advance the needs of this population.
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Affiliation(s)
- Mary Louise Mitsdarffer
- Assistant Professor, Center for Community Research & Service, Joseph R. Biden, Jr. School of Public Policy and Administration, University of Delaware
| | - Rebecca McColl
- Associate Policy Scientist, Center for Community Research & Service, Joseph R. Biden, Jr. School of Public Policy and Administration, University of Delaware
| | - Erin Nescott
- Associate Policy Scientist, Center for Community Research & Service, Joseph R. Biden, Jr. School of Public Policy and Administration, University of Delaware
| | | | - Eric K Layland
- Assistant Professor, Department of Human Development and Family Sciences, University of Delaware
| | - Tibor Tóth
- Assistant Professor, Joseph R. Biden, Jr. School of Public Policy and Administration, University of Delaware
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Bray BC, Layland EK, Stull SW, Vasilenko SA, Lanza ST. Estimating the Effects of a Complex, Multidimensional Moderator: An Example of Latent Class Moderation to Examine Differential Intervention Effects of Substance Use Services. Prev Sci 2023; 24:493-504. [PMID: 36223045 PMCID: PMC10090219 DOI: 10.1007/s11121-022-01448-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 11/28/2022]
Abstract
Improvements in substance use disorder recovery may be achieved by recognizing that effective interventions do not work equally well for all individuals. Heterogeneity of intervention effects is traditionally examined as a function of a single variable, such as gender or baseline severity. However, responsiveness to an intervention is likely a result of multiple, intersecting factors. Latent class moderation enables the examination of heterogeneity in intervention effects across subgroups characterized by profiles of characteristics. This study analyzed data from adolescents (aged 13 to 18 years old) who needed treatment for cannabis use (n = 14,854) and participated in the Global Appraisal of Individual Needs to evaluate differential effects of substance use services on cannabis use outcomes. We demonstrate an adjusted three-step approach using weights that account for measurement error; sample codes in Mplus and Latent Gold are provided and data are publicly available. Indicators of the latent class moderator comprised six contextual (e.g., recovery environment risk) and individual (e.g., internal mental distress) risk factors. The latent class moderator comprised four subgroups: low risk (21.1%), social risk (21.1%), environmental risk (12.5%), and mixed risk (45.2%). Limited moderation of associations between level of care and any past 90-day cannabis use were observed. In predicting number of cannabis use-days, compared to individuals with low risk, those with environmental risk showed improved outcomes from intensive outpatient care whereas individuals with social risk and mixed risk showed improved outcomes from residential care (all compared to early intervention/outpatient care). Latent class moderation holds potential to elucidate heterogeneity in intervention effectiveness that otherwise may go undetected.
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Affiliation(s)
- Bethany C Bray
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd., IL, 60608, Chicago, USA.
| | - Eric K Layland
- Department of Human Development and Family Sciences, University of Delaware, 111 Alison Hall West, Newark, DE, 19716, USA
| | - Samuel W Stull
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State Univerity, 314 Biobehavioral Health Bldg., PA, 16802, University Park, USA
- Department of Biobehavioral Health, The Pennsylvania State University, 314 Biobehavioral Health Bldg, University Park, PA, 16802, USA
| | - Sara A Vasilenko
- Department of Human Development and Family Science, Syracuse University, 144 White Hall, Syracuse, NY, 13244, USA
| | - Stephanie T Lanza
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State Univerity, 314 Biobehavioral Health Bldg., PA, 16802, University Park, USA
- Department of Biobehavioral Health, The Pennsylvania State University, 314 Biobehavioral Health Bldg, University Park, PA, 16802, USA
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Matsick JL, Kruk M, Palmer L, Layland EK, Salomaa AC. Extending the social category label effect to stigmatized groups: Lesbian and gay people’s reactions to “homosexual” as a label. J Soc Polit Psych 2022. [DOI: 10.5964/jspp.6823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The social category label effect describes how labels influence people’s perceptions of social groups. Though the label “homosexual” versus “lesbian/gay” decreases some heterosexual people’s support for sexual minorities, it is unknown how lesbian and gay (LG) people respond to “homosexual” as a label used to describe them. Across three experiments in a largely U.S. context (Total N = 831), we examined how use of “homosexual” influenced people’s responses on psychological instruments, preferences for demographic questions, and evaluations of individuals who use “homosexual.” The use of different labels in psychological measures did not influence LG people’s responses (Study 1). However, LG people reacted less positively to “homosexual” compared to “lesbian/gay” in demographic questions and in interpersonal exchanges (Studies 2-3), whereas heterosexual people’s reactions were largely unaffected (Study 2). LG people’s more negative reactions to “homosexual” than “lesbian/gay” were partially explained by them perceiving the “homosexual” label user as less culturally competent (i.e., less inclusive, less engaged in LGBTQ activism). In this article, we make progress in new empirical territory (sexual orientation-based cues research), propose the notion of linguistic heterosexism, and discuss the sociopolitical implications of people’s language choices.
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Pachankis JE, Soulliard ZA, Seager van Dyk I, Layland EK, Clark KA, Levine DS, Jackson SD. Training in LGBTQ-affirmative cognitive behavioral therapy: A randomized controlled trial across LGBTQ community centers. J Consult Clin Psychol 2022; 90:582-599. [PMID: 35901370 DOI: 10.1037/ccp0000745] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This randomized controlled trial examined whether an 11-week synchronous (i.e., real-time) online training in lesbian, gay, bisexual, transgender, queer, and other sexual or gender diverse (LGBTQ)-affirmative cognitive behavioral therapy (CBT) could lead to increased uptake of this practice at LGBTQ community centers across 20 U.S. states and internationally. METHOD A total of 121 mental health providers (Mage = 37.74; 78.5% LGBTQ; 60.3% non-Hispanic/Latinx White) were randomized to receive the 11-week training either immediately (n = 61) or after a 4-month wait (n = 60). At baseline and 4 and 8 months after baseline, participants self-reported their LGBTQ-affirmative competency, cultural humility, and knowledge of the minority stress theory and practice skills underlying LGBTQ-affirmative CBT. To objectively assess uptake of LGBTQ-affirmative CBT, participants demonstrated, through simulated practice, how they would respond to two video-based clinical vignettes. RESULTS Compared to wait-list, participants in the immediate training condition reported greater improvements in self-reported cultural competence (d = 1.24), minority stress knowledge (d = 0.78), LGBTQ-affirmative CBT knowledge (d = 0.78), and LGBTQ-affirmative CBT skills familiarity (d = 0.91) and use (d = 0.96); effects persisted 8 months postbaseline. Cultural humility showed no significant difference by condition (d = 0.07). In objectively coded assessments of simulated practice, participants in the training condition demonstrated greater uptake of LGBTQ-affirmative practice skills (d = 0.82). CONCLUSIONS Findings preliminarily suggest that mental health providers can be trained to deliver LGBTQ-affirmative CBT using the low-cost, efficient reach of online training. This training can help disseminate evidence-based mental health care to LGBTQ individuals and support its implementation across practice settings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Kalinowski J, Layland EK, Eaton LA, Watson RJ. Strong Ethnic Identity Buffers the Association of Heterosexism with Substance Use Among Black Sexual Minority Men. J Racial Ethn Health Disparities 2022; 10:1270-1279. [PMID: 35556225 PMCID: PMC9936572 DOI: 10.1007/s40615-022-01312-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/08/2022] [Accepted: 04/21/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Heterosexist stigma, including microaggressions experienced in their own racial/ethnic communities, may partially explain disproportionate levels of substance use involvement among Black sexual minority men (BSMM). A strong sense of ethnic identity may provide BSMM with a protective resource. The purpose of this study was to explore associations between ethnic identity and substance use in BSMM. METHODS Data were from Black sexual minority men (n = 390 Mage = 25.28; SD = 2.81) in the PrEP and Substance Use National Survey collected from March 2020 to August 2020 that included self-reported cannabis, cocaine, methamphetamines, inhalants, hallucinogens, prescription drugs misuse, and overall substance use involvement. Using zero-inflated negative binomial regression, we assessed the association between heterosexist microaggressions within BSMM's racial/ethnic communities and substance use involvement, moderated by subjective sense of ethnic identity. RESULTS More than half of participants reported past 3-month substance use. Heterosexist microaggressions were associated with higher relative risk of cannabis use involvement (RR = 1.76; 95% CI 1.13-2.73) and overall substance use involvement (RR = 2.23; 95% CI 1.39-3.56). Stronger ethnic identity buffered the association of heterosexism on substance use involvement (cannabis: RR = 0.82; 95% CI 0.72-0.95; overall: RR = 0.77; 95% CI 0.66-0.89). CONCLUSION Nurturing ethnic identity development and reducing heterosexist stigma in Black communities may be a culturally responsive, two-pronged approach to reducing substance use involvement among BSMM. BSMM with strong ethnic identity demonstrated resilience to heterosexist stigma. Future research should examine the extent to which ethnic identity may be cultivated as a protective resource against substance use involvement.
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Affiliation(s)
- Jolaade Kalinowski
- Human Development and Family Sciences, University of Connecticut, Storrs, CT, 06279-1248, USA.
| | - Eric K Layland
- Center for Interdisciplinary Research On AIDS, Yale School of Public Health, New Haven, CT, USA
| | - Lisa A Eaton
- Human Development and Family Sciences, University of Connecticut, Storrs, CT, 06279-1248, USA
| | - Ryan J Watson
- Human Development and Family Sciences, University of Connecticut, Storrs, CT, 06279-1248, USA
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Soulliard ZA, Layland EK, Smith JC, Kipke MD, Bray BC. Body Image Concerns, Correlates, and Community Connection Among Black and Latinx Sexual Minority Cisgender Men and Transgender/Gender Nonconforming Young Adults. LGBT Health 2022; 9:122-130. [PMID: 34981966 PMCID: PMC8968849 DOI: 10.1089/lgbt.2021.0237] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
AbstractPurpose: We extended the focus on body image research beyond cisgender, White sexual minority men (SMM) by describing body image concerns among Black and Latinx SMM and transgender/gender nonconforming (TGNC) adults and by examining protective effects of community connection. Methods: From 2016 to 2020, 447 Black and Latinx SMM (94%) and TGNC (6%) individuals in Los Angeles provided data semiannually. Participant endorsement of any body image concerns was determined by five body image codes (weight, fitness, appearance, body area dissatisfaction, and general body image) applied to participants' open-ended lists of health and body concerns. Fixed effects multivariable logistic regression was performed to examine the association between gay and racial/ethnic community connection and odds of any body image concerns, accounting for multiple records per person. An interaction term between gay and racial/ethnic community connection approximated the protective effect of connection to multiple, intersecting communities. Results: The majority of participants (51%) reported a body image concern, most commonly weight concerns, at least once across three years. Body image concerns were more common among Latinx participants (χ2 = 17.79, p < 0.001) and participants experiencing food insecurity (χ2 = 4.11, p = 0.04) and unmet basic financial needs (χ2 = 10.56, p = 0.001). Gay community connection was protective against body image concerns, but only for participants who had high racial/ethnic community connection (adjusted odds ratio = 0.87, p = 0.05). Conclusion: Body image concerns were notable, especially among those with low community connection and higher socioeconomic burden. These findings suggest that building connections within SMM/TGNC and racial/ethnic communities may aid in building a support network that buffers against body image concerns.
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Affiliation(s)
- Zachary A. Soulliard
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA.,Address correspondence to: Zachary A. Soulliard, PhD, Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, Suite 316, New Haven, CT 06510, USA
| | - Eric K. Layland
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, Connecticut, USA
| | | | | | - Bethany C. Bray
- Institute for Health Research and Policy, The University of Illinois at Chicago, Chicago, Illinois, USA
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Layland EK, Maggs JL, Kipke MD, Bray BC. Intersecting racism and homonegativism among sexual minority men of color: Latent class analysis of multidimensional stigma with subgroup differences in health and sociostructural burdens. Soc Sci Med 2022; 293:114602. [PMID: 34933242 PMCID: PMC9020748 DOI: 10.1016/j.socscimed.2021.114602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 10/04/2021] [Accepted: 11/22/2021] [Indexed: 01/03/2023]
Abstract
RATIONALE Applying an intersectional framework to quantitative public health research among Black and Latino sexual minority men requires analysis that considers interlocking, multidimensional systems of racist and homonegative oppression that fundamentally subvert health. In this study, person-centered methods reflected the complexity of intersecting stigma and how subgroups experience that intersection differently. METHODS Data were from a cohort of 435 Black and Latino sexual minority young men (mean age = 22.3 years) in the Healthy Young Men's Cohort Study in Los Angeles, United States. Participants provided data semiannually on five occasions spanning 24 months from 2016 to 2019. The marginal approach to longitudinal latent class analysis was used to identify latent classes indicated by multidimensional experiences of racism (e.g., police harassment, workplace discrimination, sexual objectification) and homonegativism (e.g., violence, family rejection, identity concealment) during the transition to adulthood. Associations between sociostructural burdens (e.g., socioeconomic status, food insecurity, unstable housing) and class incidents were investigated. Prevalence of mental health care needs, chronic health conditions, and overall self-reported health were compared among classes. RESULTS Five latent classes were identified: Minimal Stigma (26% of person records), Select Social Stigma (22%), Homonegativism (17%), Multiform Racism (24%), and Compound Stigma (11%). Sociostructural burdens were generally associated with 1.69-3.75 times higher odds of Select Social Stigma, Homonegativism, Multiform Racism, and Compound Stigma class incidents relative to Minimal Stigma. The Compound Stigma class had the greatest sociostructural burden, highest mental health care needs, and highest odds of sleep and gastrointestinal disorders, but classes did not differ in overall self-reported health. CONCLUSION These results exemplify how sociostructural burdens are interconnected with intersectional stigma experiences that together erode the health of Black and Latino sexual minority young men.
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Affiliation(s)
- Eric K Layland
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 220 E. 23rd Street, Suite 405, New York, NY, 10010, USA; Department of Human Development and Family Studies, The Pennsylvania State University, 208 Health and Human Development Building, University Park, PA, 16803, USA.
| | - Jennifer L Maggs
- Department of Human Development and Family Studies, The Pennsylvania State University, 208 Health and Human Development Building, University Park, PA, 16803, USA.
| | - Michele D Kipke
- Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA, 90027, USA; Departments of Pediatrics and Preventive Medicine, Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA, 90027, USA.
| | - Bethany C Bray
- Center for Dissemination and Implementation Science, University of Illinois at Chicago, 818 S Wolcott Ave., Chicago, IL, 60612, USA.
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12
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DiGuiseppi GT, Davis JP, Srivastava A, Layland EK, Pham D, Kipke MD. Multiple Minority Stress and Behavioral Health Among Young Black and Latino Sexual Minority Men. LGBT Health 2021; 9:114-121. [PMID: 34918974 DOI: 10.1089/lgbt.2021.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Young Black and Latino sexual minority men may experience multiple minority stressors, which may negatively impact behavioral health. To investigate this, longitudinal associations between multiple minority stressors and behavioral health outcomes were examined over a 2-year period. Methods: Data were from the Healthy Young Men's Cohort Study. The present study used five waves of data collected every 6 months from 2016 to 2019. Participants were young Black and/or Latino sexual minority men in Los Angeles, California (n = 448; aged 16-24). Participants self-reported their experiences of racial and homonegative discrimination, internalized homonegativity, alcohol use, and depressive symptoms. Latent growth curve models with time-varying covariates examined contemporaneous associations between minority stressors as well as general life stress and behavioral health measures. Results: After accounting for general life stress and demographic characteristics, racial discrimination was persistently associated with unhealthy alcohol use. Internalized homonegativity was associated with unhealthy alcohol use initially, but this association became non-significant over time. In models predicting depressive symptoms, racial discrimination was a significant predictor at early waves, and homonegative discrimination and internalized homonegativity emerged as significant predictors at later waves. Conclusion: These results help clarify which multiple minority stressors are more prominent in their relationship to young Black and Latino sexual minority men's unhealthy alcohol use and depressive symptoms. Interventions targeting multiple minority stressors may be needed at different times during young adulthood.
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Affiliation(s)
- Graham T DiGuiseppi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Center for Artificial Intelligence in Society, University of Southern California, Los Angeles, California, USA.,Center for Mindfulness Science, University of Southern California, Los Angeles, California, USA.,Institute of Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Ankur Srivastava
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | - Eric K Layland
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, Connecticut, USA
| | - Duyen Pham
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Michele D Kipke
- Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
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13
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Cooper DK, Bámaca-Colbert M, Layland EK, Simpson EG, Bayly BL. Puerto Ricans and Mexican immigrants differ in their psychological responses to patterns of lifetime adversity. PLoS One 2021; 16:e0258324. [PMID: 34662358 PMCID: PMC8523059 DOI: 10.1371/journal.pone.0258324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/26/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Puerto Ricans and Mexican immigrants are often exposed to multiple types of adversity across their lifetime (e.g., maltreatment, household dysfunction, discrimination) and this exposure can increase the risk for adult mental health problems. PURPOSE The objective of this study was to (a) identify subgroups of individuals exposed to unique combinations of childhood adversity and lifetime discrimination among Puerto Ricans and Mexican immigrants, and (b) compare the prevalence of mental health problems across different risk profiles. METHOD We used existing data from the HCHS/SOL Sociocultural Ancillary Study. Participants included Puerto Rican (N = 402) and Mexican adults (N = 1351) born outside but living in the continental U.S. FINDINGS Through latent profile analysis, we selected a three-profile solution for Puerto Ricans: (a) Low Exposure (low on all adversity items; 58% of sample), (b) Adverse Childhood Experiences (ACEs) Only (high on ACEs items, average or lower than average on discrimination items; 32%), and (c) Dual Exposure (high on all adversity items; 10%). For Mexicans, we selected a four-profile solution: (a) Low Exposure (52%), (b) ACEs Only (24%), (c) Maltreatment and Discrimination (15%), and (d) Dual Exposure (9%). For Mexicans, we found that the Dual Exposure and the Maltreatment and Discrimination profiles had the highest levels of mental health problems. For Puerto Ricans, the Dual Exposure and ACEs Only profiles had the highest levels of mental health problems, suggesting that Puerto Ricans may be more vulnerable to the effects of childhood adversities as compared to Mexican immigrants. Results from our study indicate that different patterns of adversity exposure are linked to different levels of mental health outcomes, and therefore, may require different intervention dosage. Understanding which groups of individuals are at highest and lowest risk for mental health problems is critical for developing effective, tailored interventions to prevent the negative effects of childhood adversity and discrimination for Latinxs.
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Affiliation(s)
- Daniel K. Cooper
- Department of Psychology, University of South Carolina, Columbia, South Carolina, United States of America
| | - Mayra Bámaca-Colbert
- Department of Psychological Sciences (Developmental Area), University of California, Merced, California, United States of America
| | - Eric K. Layland
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Emily G. Simpson
- Department of Psychology, East Central University, Ada, Oklahoma, United States of America
| | - Benjamin L. Bayly
- Agricultural Economics, Sociology, and Education, The Pennsylvania State University, University Park, Pennsylvania, United States of America
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14
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Layland EK, Ram N, Caldwell LL, Smith EA, Wegner L. Leisure Boredom, Timing of Sexual Debut, and Co-Occurring Behaviors among South African Adolescents. Arch Sex Behav 2021; 50:2383-2394. [PMID: 34401994 PMCID: PMC8911384 DOI: 10.1007/s10508-021-02014-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/01/2020] [Accepted: 04/16/2021] [Indexed: 06/13/2023]
Abstract
Sex during adolescence is normative; however, there are substantial individual differences in the timing and context of sexual debut. Leisure boredom is an underexplored correlate of sexual behavior that is associated with many adolescent health outcomes. We investigated if and how individual differences in leisure boredom may be associated with timing of sexual debut, and whether individuals engage in safe or risky behaviors at debut. Survival analysis, logistic regression, and Poisson regression were applied to eight-wave longitudinal data obtained from 3,088 South African adolescents (baseline Mage = 13.9 years) to examine associations between leisure boredom and cumulative hazard of sexual debut across adolescence, odds of co-occurring sexual behaviors, and incidence rate of co-occurring sexual risk behaviors at debut. Higher levels of leisure boredom were associated with elevated hazard cumulatively across adolescence. Higher levels of leisure boredom were also associated with lower odds of safe sex and higher odds of substance use during sex and transactional sex at sexual debut, but not casual sex or condom non-use at sexual debut. Although odds of singular risk behaviors were lower for girls than for boys, the association between leisure boredom and the number of risk behaviors at sexual debut was stronger for girls than boys. Higher trait leisure boredom was associated with elevated hazard of sexual debut, greater likelihood that risky behaviors accompanied sexual debut, and greater number of co-occurring risky behaviors at sexual debut. Results support leisure boredom as a potential target for preventing sexual risk behavior among South African adolescents.
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Affiliation(s)
- Eric K Layland
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Nilam Ram
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA
| | - Linda L Caldwell
- Department of Recreation, Park and Tourism Management, The Pennsylvania State University, University Park, PA, USA
- Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
| | - Edward A Smith
- Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
- Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Lisa Wegner
- Department of Occupational Therapy, University of Western Cape, Cape Town, South Africa
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15
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Hsueh L, Layland EK, Kipke MD, Bray BC. Linking racism and homonegativity to healthcare system distrust among young men of color who have sex with men: Evidence from the Healthy Young Men's (HYM) study. Soc Sci Med 2021; 284:114219. [PMID: 34271403 DOI: 10.1016/j.socscimed.2021.114219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 07/01/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Experiences with racism predict healthcare system distrust among people of color, but Black and Latino young men who have sex with men (YMSM) also experience overlapping forms of stigma associated with their sexual identities and behaviors (i.e., homonegativity and internalized homonegativity). These forms of minority stress may drive healthcare system distrust among Black and Latino YMSM but have received far less attention. OBJECTIVES To examine the associations of racism, homonegativity, and internalized homonegativity with healthcare system distrust among a community sample of Black and Latino YMSM. METHODS Data came from waves 2-4 (years 2017-2018) of the Healthy Young Men's study, a longitudinal cohort study of Black and Latino YMSM living in Los Angeles County. Data across waves (n = 424, nobs = 1272) were combined and analyzed using a fixed effects approach and adjusting for repeated measures across participants. A series of regression models that added sets of covariates (demographics, syndemic indicators, and health-related factors) were tested to examine associations of racism, homonegativity, and internalized homonegativity with healthcare system distrust. RESULTS Adjusting for demographics and syndemic indicators, racism, but not homonegativity or internalized homonegativity, was associated with healthcare system distrust. Adjustment for health-related factors had little impact on results. CONCLUSIONS Among Black and Latino YMSM, greater exposure to racism is associated with greater healthcare system distrust. Efforts to strengthen healthcare system trust should explicitly target the institutional policies that disproportionately harm people of color.
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Affiliation(s)
- Loretta Hsueh
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
| | - Eric K Layland
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, 135 College Street, Suite 200, New Haven, CT, 06510, USA
| | - Michele D Kipke
- Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA, 90027, USA; Departments of Pediatrics and Preventive Medicine, University of Southern California Keck School of Medicine, 1975 Zonal Ave., Los Angeles, CA, 90027, USA
| | - Bethany C Bray
- Center for Dissemination and Implementation Science, University of Illinois at Chicago, 818 South Wolcott Ave., Chicago, IL, 60612, USA
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16
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Layland EK, Peets JO, Hodge CJ, Glaza M. Sibling relationship quality in the context of digital leisure and geographic distance for college-attending emerging adults. J Leis Res 2021; 52:307-329. [PMID: 34937954 PMCID: PMC8691740 DOI: 10.1080/00222216.2021.1899778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
During the transition to adulthood, emerging adults may experience new geographic distance separating them from their siblings. Digital leisure is common among emerging adults and may serve as a tool for maintaining relationship quality across geographic distance. Using qualitative data, we created individual digital leisure diversity scores for four categories of digital leisure identified from a constructed taxonomy. The sample included 185 college-attending emerging adults (M age = 20.1, 64.3% male). Analysis of variance indicated dyadic gender differences in social media and gaming. Digital leisure diversity was associated with greater levels of affective and cognitive sibling relationship quality, regardless of sibling dyad gender. The association between digital leisure diversity and cognitive relationship quality was significant for participants who lived closer to their sibling. During the transition to adulthood when new geographic separation is common, digital leisure shows potential as a compensatory activity that may help siblings maintain relationship quality.
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Affiliation(s)
- Eric K. Layland
- Department of Human Development and Family Studies; The Pennsylvania State University
| | - Jerrica O. Peets
- Department of Recreation, Park, and Tourism Management; The Pennsylvania State University
| | - Camilla J. Hodge
- Department of Health, Kinesiology, and Recreation; University of Utah
| | - Mikala Glaza
- Department of Recreation, Park, and Tourism Management; The Pennsylvania State University
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17
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Layland EK, Exten C, Mallory AB, Williams ND, Fish JN. Suicide Attempt Rates and Associations with Discrimination Are Greatest in Early Adulthood for Sexual Minority Adults Across Diverse Racial and Ethnic Groups. LGBT Health 2020; 7:439-447. [PMID: 33290152 PMCID: PMC7757577 DOI: 10.1089/lgbt.2020.0142] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The study purpose was to investigate differences in past 5-year suicide attempts among racially/ethnically diverse sexual minority (SM) and heterosexual adults across the life course and examine the association of discrimination with past 5-year suicide attempts among SM adults. Methods: Using nationally representative data collected from 2012 to 2013, we assessed differences in age-varying prevalence of past 5-year suicide attempts among Black, Hispanic, and White SM and heterosexual adults (ages 18-60). We tested whether the association between discrimination and suicide attempts differed by race/ethnicity among SM adults. All secondary data analyses were approved by the Institutional Review Boards of The Pennsylvania State University and University of Maryland. Results: Compared with heterosexual adults of any race/ethnicity, SM adults exhibited elevated suicide attempt rates until the late twenties when prevalence for Black and Hispanic SM adults declined. Disparities persisted into the mid-40s for White SM adults. Among SM adults of all races/ethnicities, the relationship between SM discrimination and suicide attempts was strongest between ages 18 and 25. For SM adults reporting SM discrimination, odds of suicide attempts were 3.6 times higher for White SM adults and 4.5 times higher for Black and Hispanic SM adults, relative to same-race/ethnicity SM adults who did not report SM discrimination. The effect of SM discrimination was robust among Black and Hispanic SM young adults even when accounting for racial/ethnic discrimination. Conclusions: SM adults of all racial/ethnic groups demonstrated disparities when contrasted with heterosexual adults of any race/ethnicity, although ages characterized by heightened prevalence rates of suicide attempts differed by race/ethnicity. Early adulthood is a critical period for intervention seeking to disrupt the association between SM discrimination and suicide attempts.
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Affiliation(s)
- Eric K. Layland
- The Methodology Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Cara Exten
- College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Allen B. Mallory
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Natasha D. Williams
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
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18
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Layland EK, Carter JA, Perry NS, Cienfuegos-Szalay J, Nelson KM, Bonner CP, Rendina HJ. A systematic review of stigma in sexual and gender minority health interventions. Transl Behav Med 2020; 10:1200-1210. [PMID: 33044540 PMCID: PMC7549413 DOI: 10.1093/tbm/ibz200] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Stigma against sexual and gender minorities is a major driver of health disparities. Psychological and behavioral interventions that do not address the stigma experienced by sexual and gender minorities may be less efficacious. We conducted a systematic review of existing psychological and behavioral health interventions for sexual and gender minorities to investigate how interventions target sexual and gender minority stigma and consider how stigma could affect intervention efficacy. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Eligible studies were peer reviewed and published in English between January 2003 and July 2019 and reported empirical results of behavioral or psychological interventions implemented among sexual and gender minorities. All interventions addressed stigma. We identified 37 eligible interventions. Most interventions targeted sexual minority men. Interventions were frequently developed or adapted for implementation among sexual and gender minorities and addressed multiple levels and types of stigma. Interventions most frequently targeted proximal stressors, including internalized and anticipated stigma. HIV and mental health were the most commonly targeted health outcomes. A limited number of studies investigated the moderating or mediating effects of stigma on intervention efficacy. The application of an intersectional framework was frequently absent and rarely amounted to addressing sources of stigma beyond sexual and gender minority identities. A growing number of interventions address sexual and gender minority stigma in an effort to prevent deleterious health effects. Future research is needed to assess whether stigma modifies the effectiveness of existing psychological and behavioral interventions among sexual and gender minorities. Further, the application of intersectional frameworks is needed to more comprehensively intervene on multiple, intersecting sources of stigma faced by the diverse sexual and gender minority community.
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Affiliation(s)
- Eric K Layland
- Human Development and Family Studies Department, The Pennsylvania State University, University Park, PA, USA,Correspondence to: E. K. Layland,
| | - Joseph A Carter
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA,Health Psychology and Clinical Science PhD Program, The Graduate Center, City University of New York, New York, NY, USA
| | - Nicholas S Perry
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Jorge Cienfuegos-Szalay
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA,Health Psychology and Clinical Science PhD Program, The Graduate Center, City University of New York, New York, NY, USA
| | | | - Courtney Peasant Bonner
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA,Health Psychology and Clinical Science PhD Program, The Graduate Center, City University of New York, New York, NY, USA
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19
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Layland EK, Calhoun BH, Russell MA, Maggs JL. Is Alcohol and Other Substance Use Reduced When College Students Attend Alcohol-Free Programs? Evidence from a Measurement Burst Design Before and After Legal Drinking Age. Prev Sci 2020. [PMID: 29516357 DOI: 10.1007/s11121-018-0877-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
College drinking and its negative consequences remain a major public health concern. Yet, many prevention efforts targeting college drinkers are expensive, are difficult to implement, use indicated approaches targeting only high-risk drinkers, and/or are only marginally effective. An alternative strategy taken explicitly or implicitly by many colleges is campus-led alcohol-free programming which provides students with attractive leisure alternatives to drinking on weekend nights. This study aimed to extend work by Patrick et al. (Prevention Science, 11, 155-162, 2010), who found that students drank less on weekend nights they attended LateNight Penn State (LNPS) activities during their first semester of college. Here, daily diary and longitudinal data on college students' daily lives and risk behaviors were collected from 730 students on 19,506 person-days across seven semesters at a large university in the Northeastern United States. Generalized linear mixed models were used to estimate alcohol and illegal substance use on weekend days as a function of LNPS attendance, gender, legal drinking status (≥ 21 years), and day of the weekend. Across college, students who attended LNPS used alcohol and illegal substances less in general and less on days they participated compared to themselves on days they did not participate. Legal drinking status moderated the association between LNPS attendance and alcohol and illegal substance use such that levels of use were lowest for students under 21 years old on weekend days they attended LNPS. Our findings provide support for campus-led alcohol-free programming as a potential harm reduction strategy on college campuses.
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20
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Layland EK, Hodge CJ, Glaza M, Peets JO. Rethinking Leisure Time Use Metrics: Greater Diversity in Shared Sibling Leisure is Associated with Higher Relationship Quality during Emerging Adulthood. J Soc Pers Relat 2020; 37:516-537. [PMID: 33840878 PMCID: PMC8034487 DOI: 10.1177/0265407519867771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Leisure diversity-the total number of unique leisure categories shared within a sibling dyad-may vary according to sibling characteristics (e.g. sibling gender, age difference) and predict sibling relationship quality. Using triangulated lists, brief narratives, and focus groups, we constructed a taxonomy of shared sibling leisure in emerging adulthood and then calculated individual leisure diversity scores. The sample (N=185) included college-attending emerging adults with an average age of 20.1 years old (35.7% female). Taxonomic analysis suggested 19 categories of shared sibling leisure. ANOVAs indicated differences by dyadic gender composition in endorsement rates of select leisure categories and average levels of leisure diversity (lowest for mixed gender dyads). Greater shared leisure diversity was associated with higher levels of affective (sister-sister dyads) and cognitive relationship quality (sister-sister and mixed gender dyads). The association of leisure diversity with sibling relationship quality was strongest for sister-sister dyads and not significant for brother-brother dyads. Sibling dyads that include a sister are more likely to be impacted by level of shared leisure diversity. The results of this study introduce leisure diversity as a metric for quantifying sibling leisure and support its potential as a means for understanding and impacting sibling relationship quality in emerging adulthood.
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21
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Matsick JL, Kruk M, Layland EK, Palmer LE, Salomaa AC. THE EFFECTS OF HOMOSEXUALITY LANGUAGE ON LESBIAN AND GAY PEOPLE’S WELL-BEING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J L Matsick
- The Pennsylvania State University, Departments of Psychology and Women’s Studies, University Park, Pennsylvania, United States
| | - M Kruk
- The Pennsylvania State University Departments of Psychology and Women’s Studies, University Park, PA, USA
| | - E K Layland
- The Pennsylvania State University Prevention and Methodology Center, University Park, PA, USA
| | - L E Palmer
- The Pennsylvania State University Departments of Psychology and Women’s Studies, University Park, PA, USA
| | - A C Salomaa
- The Pennsylvania State University Department of Psychology, University Park, PA, USA
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Abstract
In augmented reality, video games and the physical world converge as individuals participate in digital leisure overlaid on physical spaces. In Pokémon Go, game play in the physical world is impacted by constraints that limit access and play of marginalized groups. Global popularity of Pokémon Go created an opportunity to explore experiences of marginalized groups participating in augmented reality game play. Grey literature surrounding Pokémon Go is rich with accounts of constraints experienced by marginalized groups, particularly individuals self-identifying as White women, Black women, or Black men. Their experiences with Pokémon Go illustrate the need for social justice in digital leisure. Because the lifespan of mobile applications is limited, the gradual process from research to social change may be insufficient in addressing ever evolving digital platforms. Researchers need to strategically work with industry partners to identify needs for social justice during the planning and designing stages.
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Affiliation(s)
- Eric K. Layland
- Recreation, Park, & Tourism Management Department, The Pennsylvania State University
- Human Development and Family Studies Department, The Pennsylvania State University
| | - Garrett A. Stone
- Department of Parks, Recreation, & Tourism Management, Clemson University
| | - J. Tom Mueller
- Recreation, Park, & Tourism Management Department, The Pennsylvania State University
| | - Camilla J. Hodge
- Department of Health, Kinesiology, and Recreation, University of Utah
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23
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Abstract
During a period of newly attained freedom preceding commitments expected in adulthood, emerging adults are faced with the major task of identity development. Leisure provides a context with relative freedom wherein emerging adults explore new experiences and access opportunities not always available in more constrained environments like work and school. In this case study of 40 emerging adults from 18 countries (Mage =23.14 years), qualitative interviews were used to investigate the role of leisure as a context for identity development. Results indicate five major themes for leisure-based identity development in emerging adulthood: discovering identity, forming identity, defining identity, positioning identity, and forgoing opportunities. These themes support leisure as an additional context wherein emerging adults may flourish on the pathway toward adulthood. Access to both novel and familiar leisure provide a context for emerging adults to actively direct their identity development through decisions made in leisure time.
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Affiliation(s)
- Eric K Layland
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA.,Department of Recreation, Park & Tourism Management, Pennsylvania State University, University Park, PA
| | - Brian J Hill
- Department of Recreation Management, Brigham Young University, Provo, UT
| | - Larry J Nelson
- School of Family Life, Brigham Young University, Provo, UT
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