Dataset Information

Improving Shared Decision Making For Asian American Pacific Islander Sexual and Gender Minorities.

ABSTRACT: 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.

SUBMITTER: Bi S

PROVIDER: S-EPMC7135924 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Improving Shared Decision Making For Asian American Pacific Islander Sexual and Gender Minorities.

Bi Stephanie S Gunter Kathryn E KE López Fanny Y FY Anam Seeba S Tan Judy Y JY Polin Danielle J DJ Jia Justin L JL Xu Lucy J LJ Laiteerapong Neda N Pho Mai T MT Kim Karen E KE Chin Marshall H MH

Medical care 20191201 12

<h4>Background</h4>Asian American Pacific Islander (AAPI) sexual and gender minorities (SGM) face unique challenges in mental health and accessing high-quality health care.<h4>Objective</h4>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.<h4>Research design</h4>Interviews, focus groups, and surveys.<h4>Subjects</h4>AAPI SGM interviewees in Chicago (n=20) and San Francisco ( ...[more]

PMID: 31567862

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Project description:Objective: The aim of this study was to describe current measurement of health disparities for Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations and subgroups across U.S. states. Methods: State department of health websites were searched for publicly available online reports and interactive databases denoted as state health or minority health assessments. Sources were examined to determine whether health metrics stratified by any racial/ethnic groups included the AANHPI aggregate population or subgroups. The number and frequency of AANHPI population designations were tabulated, as were the proportion of states that included AANHPIs in stratified metrics in four domains across the life span and the median number of metrics (1) stratified by any racial/ethnic group and (2) including AANHPI populations. A Pearson correlation coefficient assessed the association between the proportion of AANHPIs in state populations and the proportion of state metrics that included AANHPIs in the stratification. Results: States used 17 AANHPI population descriptors. Of 49 states stratifying health metrics by race/ethnicity, 34 included AANHPI populations and 2 included disaggregated AANHPI subgroups in ≥1 metric. The proportion of states that included AANHPI populations in stratification ranged from 57% for maternal–infant health to 69% for adult health, and by metric groups within domains, the proportion ranged from 14% for maternal mortality to 100% for marital or head of household status. The median number of metrics reported for AANHPI populations was lower than the median number reported for other racial/ethnic groups in adult, maternal–infant, and child and adolescent health domains. The proportion of state metrics that included AANHPIs in racial/ethnic stratification was not correlated with the proportion of AANHPIs in state populations (r=0.30). Conclusions and Implications for Health Equity: AANHPIs were substantially underrepresented in state health equity data, with rare subgroup disaggregation. Reducing disparities and inequities affecting AANHPI health in the United States requires improved and equitable data.

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Dataset Information

Improving Shared Decision Making For Asian American Pacific Islander Sexual and Gender Minorities.

Publications

Improving Shared Decision Making For Asian American Pacific Islander Sexual and Gender Minorities.

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