Bladder Health Experiences, Perceptions and Knowledge of Sexual and Gender Minorities.
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ABSTRACT:
SUBMITTER: Hardacker CT
PROVIDER: S-EPMC6747507 | biostudies-literature | 2019 Aug
REPOSITORIES: biostudies-literature
Publications
Bladder Health Experiences, Perceptions and Knowledge of Sexual and Gender Minorities.
Hardacker Cecilia T CT Baccellieri Anna A Mueller Elizabeth R ER Brubaker Linda L Hutchins Georgia G Zhang Jory Luc Yimei JLY Hebert-Beirne Jeni J
International journal of environmental research and public health 20190830 17
While recent efforts have been made to understand the bladder health experiences, perceptions, and knowledge of cisgender adolescent females and women, virtually nothing is known about the bladder health experiences of people who identify as sexual and gender minorities (SGMs). A community-based participatory research approach using a focus group methodology to engage 36 adult participants who identify as SGM, including individuals who identify as gender non-conforming, queer, transgender (trans ...[more]
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Project description:Sexual and gender minorities face extreme challenges that breed stigma with alarming consequences damaging their mental health. Nevertheless, sexual and gender minority people and their mental health needs remain little understood. Because of stigma, sexual and gender minorities are often unwilling to self-identify themselves as sexual and gender minorities when asked. However, social media have become popular platforms for health-related researches. We first explored methods to find sexual and gender minorities through their self-identifying tweets, and further classified them into 11 sexual and gender minority subgroups. We then analyzed mental health signals extracted from these sexual and gender minorities' Twitter timelines using a lexicon-based analysis method. We found that (1) sexual and gender minorities expressed more negative feelings, (2) the difference between sexual and gender minority and non-sexual and gender minority people is shrinking after 2015, (3) there are differences among sexual and gender minorities lived in different geographic regions, (4) sexual and gender minorities lived in states with sexual and gender minority-related protection laws and policies expressed more positive emotions, and (5) sexual and gender minorities expressed different levels of mental health signals across different sexual and gender minority subgroups.
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Project description:BackgroundThe health and healthcare of sexual minorities have recently been identified as priorities for health research and policy.ObjectiveTo compare the health and healthcare experiences of sexual minorities with heterosexual people of the same gender, adjusting for age, race/ethnicity, and socioeconomic status.DesignMultivariate analyses of observational data from the 2009/2010 English General Practice Patient Survey.ParticipantsThe survey was mailed to 5.56 million randomly sampled adults registered with a National Health Service general practice (representing 99 % of England's adult population). In all, 2,169,718 people responded (39 % response rate), including 27,497 people who described themselves as gay, lesbian, or bisexual.Main measuresTwo measures of health status (fair/poor overall self-rated health and self-reported presence of a longstanding psychological condition) and four measures of poor patient experiences (no trust or confidence in the doctor, poor/very poor doctor communication, poor/very poor nurse communication, fairly/very dissatisfied with care overall).Key resultsSexual minorities were two to three times more likely to report having a longstanding psychological or emotional problem than heterosexual counterparts (age-adjusted for 5.2 % heterosexual, 10.9 % gay, 15.0 % bisexual for men; 6.0 % heterosexual, 12.3 % lesbian and 18.8 % bisexual for women; p < 0.001 for each). Sexual minorities were also more likely to report fair/poor health (adjusted 19.6 % heterosexual, 21.8 % gay, 26.4 % bisexual for men; 20.5 % heterosexual, 24.9 % lesbian and 31.6 % bisexual for women; p < 0.001 for each). Adjusted for sociodemographic characteristics and health status, sexual minorities were about one and one-half times more likely than heterosexual people to report unfavorable experiences with each of four aspects of primary care. Little of the overall disparity reflected concentration of sexual minorities in low-performing practices.ConclusionsSexual minorities suffer both poorer health and worse healthcare experiences. Efforts should be made to recognize the needs and improve the experiences of sexual minorities. Examining patient experience disparities by sexual orientation can inform such efforts.
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Project description:Aims and objectivesTo evaluate the knowledge and attitudes towards sexual and gender minority (SGM) oncology patients' needs among advanced practice providers (APPs).BackgroundSGM individuals experience health disparities, in part due to lack of access to knowledgeable providers. Despite the important role of APPs in cancer care, less is known about their attitudes and knowledge towards SGM cancer patients.DesignCross-sectional study.MethodsA survey of APPs at a National Cancer Institute-Designated Comprehensive Cancer Center assessed self-reported demographics, attitudes, knowledge and postsurvey confidence in knowledge of SGM oncology patient needs. Reporting of this study adheres to STROBE guidelines.ResultsKnowledge of health needs was low with an average of 2.56 (SD = 1.27) items answered correctly out of 6. The majority of APPs self-reported being comfortable treating SGM patients (93.6% and 87.2%, respectively), but less confident in knowledge of their health needs (68.0% and 53.8%, respectively). Although less than half of APPs believed education should be mandatory (44.9%), 79.5% were interested in education about SGMs' unique health needs. Political affiliation, medical specialty, licensure, and having SGM friends or family were associated with various attitude items, but not knowledge. Moderation analyses indicated that APPs who had greater overall knowledge scores were more likely to agree, on average, that knowing sexual orientation, gender identity and sex assigned at birth are important to providing quality oncology care.ConclusionAPPs report being comfortable providing care for SGMs with cancer, but knowledge gaps remain that may inhibit the quality of care provided. Given the interest in education, results would support the development of SGM-related healthcare training for oncology APPs.Relevance to clinical practiceTargeted education for providers during training and continuing education is likely to improve the provision of quality care for SGMs with cancer.
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Project description:The purpose of this study was to examine and compare depression and suicide literacy among Canadian sexual and gender minorities (SGM). Online surveys comprised of the 22-item depression literacy scale (D-LIT) and the 12-item literacy of suicide scale (LOSS) were completed by 2,778 individuals identifying as SGM. Relationships between depression and suicide literacy and demographic characteristics were evaluated using multivariable linear regression. Overall, SGM correctly answered 71.3% of the questions from the D-LIT and 76.5% of the LOSS. D-LIT scores were significantly lower among cisgender men and D-LIT and LOSS scores were lower among transgender women when compared to cisgender women. LOSS and D-LIT scores were significantly lower among SGM without a university degree (compared to those with a university degree) and among SGM from ethnic minority groups (compared to White SGM). D-LIT scores, but not LOSS scores, were significantly lower among Indigenous SGM compared to White SGM. The findings provide evidence of differences in suicide and depression literacy between SGM subgroups along multiple social axes. Interventions to increase depression and suicide literacy should be prioritized as part of a mental health promotion strategy for SGM, targeting subgroups with lower literacy levels, including cisgender men, transgender women, Indigenous people, racialized minorities, and those without a university degree.
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Project description:Introduction: There is substantial evidence that severe mental illness (SMI) can have significant impacts on general development, knowledge acquisition, and quality of life including sexual function. However, whilst the sexual development, sexual health, sexual experiences and sexual knowledge of the broader Australian community and the Australian prisoner population have been well-described, these concepts have been less explored in people with a SMI. In particular, there is an absence of research around these topics involving people who are subject to a treatment order (aka a Forensic Order) under the relevant jurisdictional Mental Health Act. Methods and Analysis: People currently under the treatment requirements of a Queensland Forensic Order will be invited to participate in this descriptive, mixed-method study. The study will be conducted in three phases. The first two phases will involve 50 participants (100 face-to-face quantitative interviews) with the aim of mapping sexual development, sexual health, sexual experiences, and sexual knowledge. The third phase will involve qualitative semi-structured interviews with a purposely enrolled, informant-rich cohort identified through the quantitative surveys until saturation is reached. Quantitative data will be analyzed using descriptive and comparative statistics. Qualitative data will be analyzed by content analysis of the major themes. Ethics and dissemination: The project has ethics approval from a Queensland Health Human Research Ethics Committee. Results will be reported to participants and other stakeholders at seminars and conferences and through peer-reviewed publications. Strengths and Limitations of this Study: This is a mixed-method study which engages with participants by using face-to-face interviews. The study is conducted in three phases which sub-divide the research into the following areas: (1) demographics, general health, and sexual health, (2) sexual knowledge and experiences, and (3) sexual knowledge gaps. This study uses electronic data capture to efficiently record and analyse participant responses. This study captures self-reported data and uses non-probability sampling from a population who have been pre-selected through an arms-length approach-both these processes elevate the risk of bias.
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Project description:INTRODUCTION:The tobacco industry has previously targeted sexual/gender and racial/ethnic minorities with focused campaigns in traditional, offline marketing. We assess whether these populations report more engagement with online tobacco marketing compared with heterosexual and non-Hispanic white youth. METHODS:Data were from 8015 adolescents sampled between 2014 and 2015 in the nationally-representative Population Assessment for Tobacco and Health (PATH) Study. Engagement with online tobacco marketing within the past year was assessed through eight forms of engagement. A weighted logistic regression model was fit with engagement as outcome and socio-demographic and psychosocial characteristics, internet-related and substance use behavior, tobacco-related risk factors, tobacco use status, and prior engagement with online tobacco marketing as covariates. RESULTS:Accounting for other covariates including tobacco use status and prior engagement with online tobacco marketing, the odds of past-year engagement were higher for sexual minority males (aOR?=?1.57; 95% CI: 1.05-2.35) compared to straight males and higher for sexual minority females (aOR?=?1.45; 95% CI: 1.13-1.87) compared to straight females. The odds of past-year engagement were also higher for Hispanics (aOR?=?1.31; 95% CI: 1.11-1.56) and non-Hispanic Blacks (aOR?=?1.42; 95% CI: 1.14-1.77) compared to non-Hispanic Whites. CONCLUSIONS:Sexual/gender and and racial/ethnic minority youth reported higher engagement with online tobacco marketing than their heterosexual and non-Hispanic white peers, respectively.
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Project description:IntroductionHistorical and current stigmatizing and discriminatory experiences drive sexual and gender minority (SGM) people away from health care and clinical research. Being medically underserved, they face numerous disparities that make them vulnerable to poor health outcomes. Effective methods to engage and recruit SGM people into clinical research studies are needed.ObjectivesTo promote health equity and understand SGM health needs, we sought to design an online, national, longitudinal cohort study entitled The PRIDE (Population Research in Identity and Disparities for Equality) Study that enabled SGM people to safely participate, provide demographic and health data, and generate SGM health-related research ideas.MethodsWe developed an iPhone mobile application ("app") to engage and recruit SGM people to The PRIDE Study-Phase 1. Participants completed demographic and health surveys and joined in asynchronous discussions about SGM health-related topics important to them for future study.ResultsThe PRIDE Study-Phase 1 consented 18,099 participants. Of them, 16,394 provided data. More than 98% identified as a sexual minority, and more than 15% identified as a gender minority. The sample was diverse in terms of sexual orientation, gender identity, age, race, ethnicity, geographic location, education, and individual income. Participants completed 24,022 surveys, provided 3,544 health topics important to them, and cast 60,522 votes indicating their opinion of a particular health topic.ConclusionsWe developed an iPhone app that recruited SGM adults and collected demographic and health data for a new national online cohort study. Digital engagement features empowered participants to become committed stakeholders in the research development process. We believe this is the first time that a mobile app has been used to specifically engage and recruit large numbers of an underrepresented population for clinical research. Similar approaches may be successful, convenient, and cost-effective at engaging and recruiting other vulnerable populations into clinical research studies.
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Project description:BACKGROUND:Asian American Pacific Islander (AAPI) sexual and gender minorities (SGM) face unique challenges in mental health and accessing high-quality health care. OBJECTIVE:The objective of this study was to identify barriers and facilitators for shared decision making (SDM) between AAPI SGM and providers, especially surrounding mental health. RESEARCH DESIGN:Interviews, focus groups, and surveys. SUBJECTS:AAPI SGM interviewees in Chicago (n=20) and San Francisco (n=20). Two focus groups (n=10) in San Francisco. MEASURES:Participants were asked open-ended questions about their health care experiences and how their identities impacted these encounters. Follow-up probes explored SDM and mental health. Participants were also surveyed about attitudes towards SGM disclosure and preferences about providers. Transcripts were analyzed for themes and a conceptual model was developed. RESULTS:Our conceptual model elucidates the patient, provider, and encounter-centered factors that feed into SDM for AAPI SGM. Some participants shared the stigma of SGM identities and mental health in their AAPI families. Their AAPI and SGM identities were intertwined in affecting mental health. Some providers inappropriately controlled the visibility of the patient's identities, ignoring or overemphasizing them. Participants varied on whether they preferred a provider of the same race, and how prominently their AAPI and/or SGM identities affected SDM. CONCLUSIONS:Providers should understand identity-specific challenges for AAPI SGM to engage in SDM. Providers should self-educate about AAPI and SGM history and intracommunity heterogeneity before the encounter, create a safe environment conducive to patient disclosure of SGM identity, and ask questions about patient priorities for the visit, pronouns, and mental health.
| S-EPMC7135924 | biostudies-literature
Project description:BackgroundSexual and gender minority (SGM) persons face a number of physical and mental health disparities closely linked to discrimination, social stigma, and victimization. Despite the acceptability and increasing number of digital health interventions focused on improving health outcomes among SGM people, there is a lack of reviews summarizing whether and how researchers assess engagement with social media-delivered health interventions for this group.ObjectiveThe objective of this systematic review was to synthesize and critique the evidence on evaluation of engagement with social media-delivered interventions for improving health outcomes among SGM persons.MethodsWe conducted a literature search for studies published between January 2003 and June 2020 using 4 electronic databases. Articles were included if they were peer-reviewed, in English language, assessed engagement with a social media-delivered health intervention for improving health outcomes among sexual and gender minorities. A minimum of two authors independently extracted data from each study using an a priori developed abstraction form. We assessed quality of data reporting using the CONSORT extension for pilot and feasibility studies and CONSORT statement parallel group randomized trials.ResultsWe included 18 articles in the review; 15 were feasibility studies and 3 were efficacy or effectiveness randomized trials. The quality of data reporting varied considerably. The vast majority of articles focused on improving HIV-related outcomes among men who have sex with men. Only three studies recruited cisgender women and/or transgender persons. We found heterogeneity in how engagement was defined and assessed. Intervention usage from social media data was the most frequently used engagement measure.ConclusionIn addition to the heterogeneity in defining and assessing engagement, we found that the focus of assessment was often on measures of intervention usage only. More purposeful recruitment is needed to learn about whether, how, and why different SGM groups engage with social media-interventions. This leaves significant room for future research to expand evaluation criteria for cognitive and emotional aspects of intervention engagement in order to develop effective and tailored social media-delivered interventions for SGM people. Our findings also support the need for developing and testing social media-delivered interventions that focus on improving mental health and outcomes related to chronic health conditions among SGM persons.
| S-EPMC8350614 | biostudies-literature