The Qualitative Interview in Psychology and the Study of Social Change: Sexual Identity Development, Minority Stress, and Health in the Generations Study.
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ABSTRACT:
SUBMITTER: Frost DM
PROVIDER: S-EPMC8172075 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Using data from the first national probability sample of Black, White, and Latinx sexual minority people in the United States, we examined whether and how sexual identity development timing and pacing differs across demographic subgroups at the intersections of cohort, sex, sexual identity, and race/ethnicity. Among a sample of 1,491 participants aged 18-60 from 3 distinct birth cohorts, we measured participants' ages of sexual identity development milestones, including first same-sex attraction, first self-realization of a sexual minority identity, first same-sex sexual behavior, first disclosure to a straight friend, and first disclosure to a family member. Participants from more recent cohorts reported earlier and accelerated pacing of milestones relative to those from older cohorts. Subgroups defined by sex and sexual identity varied in milestone timing and pacing, with gay males reporting an earlier onset of some milestones than other subgroups. Those who used newer identity labels (e.g., pansexual, queer) reported younger ages of milestones relative to bisexual participants but similar ages to lesbian and gay participants. Black and Latinx participants reported some milestones at younger ages than White participants. Race-stratified models testing groups at the intersection of cohort, sex, and sexual identity revealed subgroup differences in ages of first disclosure to family, as well as differences in the time between self-realization, same-sex sexual behavior, and disclosure to a straight friend. The results suggest substantial variation in the developmental timing and pacing of milestones across social identities and the need to further examine how milestone timing is related to identity, stress, and health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
| S-EPMC8216084 | biostudies-literature
Project description:ObjectiveThis study examined whether positive changes in social attitudes and policies surrounding sexual minority relationships have translated to diminished deleterious effects of minority stress on relationship quality.BackgroundSexual minority emerging adults now come of age at a time of greater equality and acceptance than previous generations. Research has demonstrated consistent negative effects of stigma-theorized as minority stress-on relationship quality for sexual minority individuals. However, given the improving social climate, questions remain regarding whether minority stress has the same deleterious effects on the romantic relationships of sexual minority emerging adults.MethodFive-hundred forty-nine individuals in relationships drawn from a US national probability sample completed a survey containing validated measures of minority stressors and relationship satisfaction. Responses from emerging adults (aged 18-25) were compared to two cohorts who came of age during the HIV/AIDS crisis (aged 34-41) and post Stonewall (aged 52-59).ResultsEmerging adults were more satisfied with their relationships than older cohorts. Experiences of everyday discrimination were associated with decreased relationship satisfaction for all cohorts; however, felt stigma, stigma concealment, and internalized stigma were associated with lower relationship satisfaction for older but not younger cohorts.ConclusionFindings illustrate the continued but shifting role of minority stress and provide the first evidence that social and policy changes may have translated into more positive relationship experiences for sexual minority emerging adults.
| S-EPMC9302992 | biostudies-literature
Project description:Sexual and gender minority (SGM) people-including members of the lesbian, gay, bisexual, transgender, and queer communities-are understudied and underrepresented in research. Current sexual orientation and gender identity (SOGI) questions do not sufficiently engage SGM people, and there is a critical gap in understanding how SOGI questions reduce inclusion and accurate empirical representation. We conducted a qualitative study to answer the question, "For SGM people, what are the major limitations with current SOGI questions?" Focus groups probed reactions to SOGI questions adapted from prior national surveys and clinical best practice guidelines. Questions were refined and presented in semi-structured cognitive interviews. Template analysis using a priori themes guided analysis. There were 74 participants: 55 in nine focus groups and 19 in cognitive interviews. Participants were diverse: 51.3% identified as gender minorities, 87.8% as sexual minorities, 8.1% as Hispanic/Latinx, 13.5% as Black or African-American, and 43.2% as Non-white. Two major themes emerged: (1) SOGI questions did not allow for identity fluidity and complexity, reducing inclusion and representation, and (2) SOGI question stems and answer choices were often not clear as to which SOGI dimension was being assessed. To our knowledge, this represents the largest body of qualitative data studying SGM perspectives when responding to SOGI questions. We present recommendations for future development and use of SOGI measures. Attention to these topics may improve meaningful participation of SGM people in research and implementation of such research within and for SGM communities.
| S-EPMC7497435 | biostudies-literature
Project description:Although sexual minority women (SMW) are at risk for cervical cancer and sexually transmitted infections (STIs), they may not seek preventative sexual and reproductive health care at the same rates as their heterosexual peers. We conducted a qualitative descriptive study of 22 adult SMW, a subsample of participants enrolled in the Chicago Health and Life Experiences of Women study. The aim was to describe the sexual and reproductive health literacy of this community sample based on qualitative themes, using an integrated model of health literacy. This model considers not only access to information but also understanding, appraisal, and application of information. We found that family of origin, health care providers, and school-based sexual education were the most important sources of sexual and reproductive health information. Participants described their understanding, appraisal, and application of sexual and reproductive health information as interdependent concepts. Pap test literacy and decision making were strongly independent, with SMW seeking various sources of information, or were driven by health care providers, with SMW following instructions and trusting provider advice. STI-related literacy hinged on whether the participant perceived SMW as at risk for STIs. Our findings reinforce that simply having access to information is insufficient to enact health behaviors that reflect full literacy. Findings have implications for health care providers, who should provide evidence-based recommendations for their SMW clients, and for public health practitioners and educators, who could make sexual health education more inclusive of and specific to the needs of SMW.
| S-EPMC7568910 | biostudies-literature
Project description:ObjectiveTo describe a group of young sexual minority women's experiences with and preferences for sexual identity disclosure in the context of contraceptive care.MethodsIn Chicago, Illinois, Salt Lake City, Utah, and Madison, Wisconsin, investigators conducted five focus groups (n=22) and 11 interviews with women aged 20-30 years who identified as something other than heterosexual. Focus groups explored social norms regarding contraceptive care; interviews documented individual experiences with contraceptive care. Using a qualitative descriptive approach and combined deductive and inductive content analysis, investigators coded transcripts for themes related to disclosing sexual orientation to contraceptive providers.ResultsParticipants described the process of sexual identity disclosure in contraceptive care in three stages: 1) listening for whether, when, and how health care providers asked about sexual orientation, 2) deciding whether or not to disclose sexual identity to providers, and 3) evaluating responses from providers after disclosure. Participants wanted providers to: avoid assumptions and ask about both sexual identity and sexual behaviors, signal their openness and competence around the health of sexual minority women during contraceptive encounters, and focus discussions on the individual patient's priorities and needs for contraceptive care.ConclusionDecisions made by sexual minority women about sexual identity disclosure in contraceptive contexts are influenced by previous and current interactions with health care providers. Contraceptive providers should ask all patients about sexual identity and sexual behavior, avoid assumptions about use of and need for contraception, and acknowledge the prevalence of marginalization, discrimination, and stigma experienced by sexual minority women and their communities in health care contexts.
| S-EPMC6483879 | biostudies-literature
Project description:Bisexual individuals experience poorer mental health than other sexual minority individuals. One explanation for this is that biphobia predisposes bisexual individuals to have a more ambiguous sexual identity and fewer opportunities for stress-ameliorating forms of coping and support. This study explores sexual identity and sexual identity dimensions-prominence, valence, integration, and complexity-in bisexual and other sexual minority individuals. We describe differences in sexual identity dimensions between bisexual and other sexual minority individuals and test two explanations for mental health disparities between them: whether sexual identity dimensions directly impact mental health and whether they moderate the impact of stress on mental health. Data came from a longitudinal study of a diverse sample of sexual minority individuals (N = 396, 71 bisexual respondents) sampled from community venues in New York City. Sexual identity was prominent for both bisexual and other sexual minority individuals, but bisexual individuals reported lower valence and integration of sexual identity in their identity structures. The hypothesis that sexual identity dimensions moderate the impact of minority stress on mental health was not supported. After several longitudinal assessments, however, we concluded that identity valence (but not integration or complexity) and depressive symptoms were bidirectionally associated so that differences in valence between bisexual and other sexual minority individuals explained, in part, disparities in depressive symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
| S-EPMC6322952 | biostudies-literature
Project description:BACKGROUND:Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. OBJECTIVE:This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. METHODS:A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. RESULTS:All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. CONCLUSIONS:GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to optimize processes and not hinder other treatments. Looking ahead, education of GPs and recognizing patients' ability and preference to use eHealth with regard to a healthy living are needed.
| S-EPMC5930171 | biostudies-literature
Project description:IntroductionAlthough population studies have documented the poorer health outcomes of sexual minorities, few have taken an intersectionality approach to examine how sexual orientation, gender, and race jointly affect these outcomes. Moreover, little is known about how behavioral risks and healthcare access contribute to health disparities by sexual, gender, and racial identities.MethodsUsing ordered and binary logistic regression models in 2015, data from the 2013 and 2014 National Health Interview Surveys (n=62,302) were analyzed to study disparities in self-rated health and functional limitation. This study examined how gender and race interact with sexual identity to create health disparities, and how these disparities are attributable to differential exposure to behavioral risks and access to care.ResultsConditional on sociodemographic factors, all sexual, gender, and racial minority groups, except straight white women, gay white men, and bisexual non-white men, reported worse self-rated health than straight white men (p<0.05). Some of these gaps were attributable to differences in behaviors and healthcare access. All female groups, as well as gay non-white men, were more likely to report a functional limitation than straight white men (p<0.05), and these gaps largely remained when behavioral risks and access to care were accounted for. The study also discusses health disparities within sexual, gender, and racial minority groups.ConclusionsSexual, gender, and racial identities interact with one another in a complex way to affect health experiences. Efforts to improve sexual minority health should consider heterogeneity in health risks and health outcomes among sexual minorities.
| S-EPMC4875806 | biostudies-literature
Project description:INTRODUCTION:Sexual and gender minority (SGM) young adults have higher smoking prevalence than their non-SGM peers. Less is known about differences in smoking characteristics within the SGM community. METHODS:Participants were SGM young adult smokers age 18-25 (N?=?165, M age?=?21.8) enrolled in a clinical trial of the Put It Out Project, a Facebook smoking cessation intervention for SGM young adults. Analyses tested differences between 1) sexual orientation groups, and 2) gender identity groups, on the following smoking characteristics: cigarettes/day, daily smoker (yes/no), social smoker (yes/no), years of smoking, number of close friends who smoke (out of 5), age of initiation, age began smoking regularly, time to first cigarette (30?min or less/>30?min), lifetime quit attempts, past-year quit attempts, and stage of change for quitting smoking (precontemplation, contemplation, preparation). RESULTS:Participants were 56% bi/pansexual, 18% gay, 18% lesbian, 8% other (e.g., asexual, queer). The gender identity of the sample was 52% cisgender, 18% transgender, 30% gender non-binary. Lesbian women began smoking at an older age (M?=?18.0, SD?=?2.0) than "other" sexual orientation participants (M?=?15.7, SD?=?2.2), p?<?.05. Transgender participants smoked the most cigarettes per day (M?=?11.3, SD?=?6.7), followed by cisgender (M?=?8.1, SD?=?5.6), then non-binary (M?=?5.7, SD?=?3.5) participants (p?<?.001; pairwise comparisons p's?<?0.05). No other constructs differed by sexual orientation or gender. CONCLUSIONS:Smoking characteristics were mostly similar across subgroups of young adult SGM smokers; however, transgender individuals were heavier smokers.
| S-EPMC6545125 | biostudies-literature
Project description:Sexual minority adolescents (SMA) are more likely to suffer from depression, putatively through experiences of social stress and victimization interfering with processing of social reward. Alterations in neural reward networks, which develop during adolescence, confer risk for the development of depression. Employing both social and monetary reward fMRI tasks, this is the first neuroimaging study to examine function in reward circuitry as a potential mechanism of mental health disparities between SMA and heterosexual adolescents. Eight SMA and 38 heterosexual typically developing adolescents completed self-report measures of depression and victimization, and underwent fMRI during monetary and peer social reward tasks in which they received positive monetary or social feedback, respectively. Compared with heterosexual adolescents, SMA had greater interpersonal depressive symptoms and exhibited blunted neural responses to social, but not monetary, reward in socioaffective processing regions that are associated with depressive symptoms. Specifically, compared with heterosexual adolescents, SMA exhibited decreased activation in the right medial prefrontal cortex, left anterior insula (AI), and right temporoparietal junction (TPJ) in response to being liked. Lower response in the right TPJ was associated with greater interpersonal depressive symptoms. These results suggest that interpersonal difficulties and the underlying substrates of response to social reward (perhaps more so than response to monetary reward) may confer risk for development of depressive symptoms in SMA.
| S-EPMC6753189 | biostudies-literature