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Shrader CH, Salerno JP, Lee JY, Johnson AL, Algarin AB. Mental health impact of multiple sexually minoritized and gender expansive stressors among LGBTQ+ young adults: a latent class analysis. Epidemiol Psychiatr Sci 2024; 33:e22. [PMID: 38602075 PMCID: PMC11022265 DOI: 10.1017/s2045796024000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/18/2023] [Accepted: 02/03/2024] [Indexed: 04/12/2024] Open
Abstract
AIMS In the United States, lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexually minoritized and gender expansive (LGBTQ+) young adults are at increased risk for experiencing mental health inequities, including anxiety, depression and psychological distress-related challenges associated with their sexual and gender identities. LGBTQ+ young adults may have unique experiences of sexual and gender minority-related vulnerability because of LGBTQ+-related minority stress and stressors, such as heterosexism, family rejection, identity concealment and internalized homophobia. Identifying and understanding specific LGBTQ+-related minority stress experiences and their complex roles in contributing to mental health burden among LGBTQ+ young adults could inform public health efforts to eliminate mental health inequities experienced by LGBTQ+ young adults. Therefore, this study sought to form empirically based risk profiles (i.e., latent classes) of LGBTQ+ young adults based on their experiences with familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment, and then identify associations of derived classes with psychological distress. METHODS We recruited and enrolled participants using nonprobability, cross-sectional online survey data collected between May and August 2020 (N = 482). We used a three-step latent class analysis (LCA) approach to identify unique classes of response patterns to LGBTQ+-related minority stressor subscale items (i.e., familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment), and multinomial logistic regression to characterize the associations between the derived classes and psychological distress. RESULTS Five distinct latent classes emerged from the LCA: (1) low minority stress, (2) LGBTQ+ identity concealment, (3) family rejection, (4) moderate minority stress and (5) high minority stress. Participants who were classified in the high and moderate minority stress classes were more likely to suffer from moderate and severe psychological distress compared to those classified in the low minority stress class. Additionally, relative to those in the low minority stress class, participants who were classified in the LGBTQ+ identity concealment group were more likely to suffer from severe psychological distress. CONCLUSION Familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment are four constructs that have been extensively examined as predictors for mental health outcomes among LGBTQ+ persons, and our study is among the first to reveal nuanced gradients of these stressors. Additionally, we found that more severe endorsement of minority stress was associated with greater psychological distress. Given our study results and the previously established negative mental health impacts of minority stressors among LGBTQ+ young adults, findings from our study can inform research, practice, and policy reform and development that could prevent and reduce mental health inequities among LGBTQ+ young adults.
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Affiliation(s)
- C.-H. Shrader
- Department of Epidemiology, Columbia University, New York City, NY, USA
- ICAP at Columbia University, New York City, NY, USA
| | - J. P. Salerno
- School of Social Work, Columbia University, New York City, NY, USA
| | - J.-Y. Lee
- Department of Mental Health Law & Policy, University of South Florida, Tampa, FL, USA
| | - A. L. Johnson
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, USA
| | - A. B. Algarin
- Department of Nursing and Health Innovations, Arizona State University, Phoenix, AZ, USA
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Wang PW, Chang YP, Tsai CS, Yen CF. Predictors of depressive and anxiety symptoms among lesbian, gay and bisexual young adult individuals experiencing the COVID-19 pandemic: A four-year follow-up study. J Formos Med Assoc 2024:S0929-6646(24)00138-4. [PMID: 38423925 DOI: 10.1016/j.jfma.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/17/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND/PURPOSE Depressive and anxiety symptoms were common among lesbian, gay, and bisexual (LGB) individuals during the COVID-19 pandemic. This 4-year follow-up study was conducted to investigate the predictors of depressive and anxiety symptoms in Taiwan's young adult LGB population. METHODS Baseline data, including depressive and anxiety symptoms, demographic characteristics, sexual stigma, self-identity confusion, and family support were collected from 1000 LGB individuals. The participants' depressive and anxiety symptoms were reassessed 4 years after the baseline measurements. The predictive effects of the baseline factors on depressive and anxiety symptoms at follow-up were examined through linear regression analysis. RESULTS Greater lack of identity, unconsolidated identity, sexual orientation microaggression, and lower perceived family function at baseline were significantly associated with more severe depressive and anxiety symptoms at follow-up. After adjustment for baseline depressive symptoms, being men, greater lack of identity, lower perceived family function, and more severe anxiety symptoms at baseline were significantly associated with more severe depressive symptoms at follow-up. After adjustment for baseline anxiety symptoms, greater unconsolidated identity and more severe depressive symptoms at baseline were significantly associated with more severe anxiety symptoms at follow-up. CONCLUSIONS Intervention aimed at reducing depressive and anxiety symptoms in LGB individuals should be developed considering the predictors identified in this study.
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Affiliation(s)
- Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY, USA
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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Turpin RE, Mandell CJ, Camp AD, Mhonde RRD, Dyer TV, Mayer KH, Liu H, Coates T, Boekeloo B. COVID-19, Vaccine Hesitancy, and HIV Pre-exposure Prophylaxis Among Black Sexual Minority Men. J Acquir Immune Defic Syndr 2023; 94:387-394. [PMID: 37732879 PMCID: PMC10841093 DOI: 10.1097/qai.0000000000003305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The COVID-19 pandemic has created substantial and profound barriers to several forms of health care engagement. For Black sexual minority men, this may include engagement with pre-exposure prophylaxis (PrEP) to prevent HIV infection, with significant implications for HIV disparities. Our study explored how the COVID-19 pandemic affected Black sexual minority men, with a focus on relationships between COVID-19 and PrEP engagement. SETTING We sampled 24 Black sexual minority men attending HIV prevention-related events in the greater D.C. Metropolitan area (D.C., Maryland, Virginia). METHODS We conducted qualitative phone interviews among our sample. Questions were primarily focused on the COVID-19 pandemic and how it affected engagement and considerations of PrEP use. Interviews were transcribed and qualitatively analyzed using the 6 stages of thematic analysis. RESULTS We identified 3 major themes from our thematic analysis: Changes in the health care system, changes in sexual and relationship contexts, and COVID-19 vaccine hesitancy and misinformation. Relationships between COVID-19 vaccine hesitancy and PrEP hesitancy were especially prevalent, with participants describing that COVID-19 hesitancy can directly deter PrEP use through eroding medical trust further. CONCLUSIONS We identified changes in the health care system, sexual and relationship contexts, and COVID-19 vaccine hesitancy as important issues driven by COVID-19 with significant implications for PrEP use. The COVID-19 pandemic has changed the health care and social landscape in profound ways that affect PrEP access, sexual networks, and associated HIV vulnerability. Future research further exploring relationships between specific pandemic stressors and HIV prevention among Black sexual minority men is recommended .
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Affiliation(s)
- Rodman E. Turpin
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA
| | - CJ Mandell
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA
| | - Aaron D. Camp
- Brandeis University, Heller School for Social Policy and Management, Waltham, MA
- INOVA Health System, Fairfax, VA
| | | | - Typhanye V. Dyer
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center
- Harvard Medical School, Boston, MS
| | - Hongjie Liu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD
| | - Thomas Coates
- David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Bradley Boekeloo
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD
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Wu J, Qiu L, Xiong W, Shen Y, Li J, Wu J, Zhou Q. COVID-19 anxiety and related factors amid adjusted epidemic prevention policies: a cross-sectional study on patients with late-life depression in China. BMJ Open 2023; 13:e072725. [PMID: 38000824 PMCID: PMC10680000 DOI: 10.1136/bmjopen-2023-072725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES To explore the prevalence and associated factors of COVID-19 anxiety in patients with late-life depression (LLD) during the adjustment of epidemic prevention policies in China. DESIGN Cross-sectional study. SETTING The data analysed in this study were collected from seven regions in China between November 2022 and January 2023. PARTICIPANTS A total of 1205 patients with LLD (aged 60-78 years) participated in the survey. They completed a social demographic assessment and the Chinese version of the five-point Coronavirus Anxiety Scale (CAS). PRIMARY OUTCOME MEASURES The primary outcome was the anxiety level of the participants. Patients were categorised into two groups based on their anxiety levels, one with anxiety and one without, according to CAS scores. RESULTS The prevalence of COVID-19 anxiety in depressed older adults was 47.3%. Regression analysis revealed that the average COVID-19 anxiety score was significantly higher among females (AOR: 2.177, 95% CI 1.201 to 3.947), widowed individuals (AOR: 3.015, 95% CI 1.379 to 6.591), patients residing at a distance from healthcare facilities (AOR: 3.765, 95% CI 1.906 to 7.438), and those who frequently experienced worry (AOR: 1.984, 95% CI 1.111 to 3.543). Conversely, the anxiety score was significantly lower among divorced individuals (AOR: 0.491, 95% CI 0.245 to 0.988), those aged 70 years and above (AOR: 0.117, 95% CI 0.064 to 0.213), patients without difficulty obtaining medication (AOR: 0.027, 95% CI 0.007 to 0.097), those living with family members (AOR: 0.080, 95% CI 0.022 to 0.282) or in nursing homes compared with those living alone (AOR: 0.019, 95% CI 0.004 to 0.087). CONCLUSION Women with LLD who are widowed, live far from healthcare facilities, and are prone to excessive worry are more likely to experience anxiety. It is advisable to implement appropriate preventive measures and provide psychosocial support programmes for this vulnerable group during the COVID-19 pandemic.
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Affiliation(s)
- Jianhong Wu
- Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
| | - Linghe Qiu
- Department of General Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
| | - Wendian Xiong
- School of Life Sciences and Health Engineering, Jiangnan University, Wuxi, Jiangsu, China
| | - Yuan Shen
- Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
| | - Jun Li
- Department of Pharmacy, Nanjing First Hospital, Nangjing, Jiangsu, China
| | - Ju Wu
- Department of Pharmacy, Jiangsu Provincial Rongjun Hospital, Wuxi, Jiangsu, China
| | - Qin Zhou
- Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
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Everest L, Henderson J, Dixon M, Relihan J, Hawke LD. Experiences of gender-diverse youth during the COVID-19 pandemic in Canada: A longitudinal qualitative study. PLoS One 2023; 18:e0294337. [PMID: 37971999 PMCID: PMC10653488 DOI: 10.1371/journal.pone.0294337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Recent studies have suggested that the COVID-19 pandemic has increased existing health challenges experienced by transgender (trans) and non-binary people. Additionally, COVID-19 has also negatively impacted youth mental health. However, the impact of the COVID-19 pandemic with respect to the intersection of youth and trans and non-binary populations is currently not well established. The present longitudinal qualitative study aimed to examine the evolving challenges experienced by trans and non-binary youth during the COVID-19 pandemic. METHODS Gender-diverse youth, defined as participants who did not identify as cisgender in April 2020, were invited to participate from among the participant pool of a COVID-19 cohort study in Canada. Qualitative interviews were conducted in August 2020, January 2021, and August 2021, during the first year and a half of the COVID-19 pandemic. Qualitative themes were identified based on reflexive thematic analysis and plot-line narrative inquiry. RESULTS Ten participants aged 18 to 28 were included in the present analysis, yielding 29 transcripts. We identified themes of (1) losses of connection to gender-diverse communities, (2) changes in gender identity, affirmation, and self-reflection, (3) a dual burden of trans and non-binary specific health and service access challenges as well as COVID-19 pandemic related health challenges, and (4) virtually rebuilding gender-diverse communities during the COVID-19 pandemic. CONCLUSIONS Gender-diverse youth may experience unique challenges during the COVID-19 pandemic. The losses with gender-diverse communities may further isolate queer people from access to healthcare, housing, and employment. Public health policy targeted at gender-diverse youth may consider addressing "upstream" disparities in healthcare and housing in order to support the rebuilding of queer and gender-diverse communities by gender-diverse people.
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Affiliation(s)
| | - Jo Henderson
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Mahalia Dixon
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Lisa D. Hawke
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Firk C, Großheinrich N, Scherbaum N, Deimel D. The impact of social connectedness on mental health in LGBTQ + identifying individuals during the COVID-19 pandemic in Germany. BMC Psychol 2023; 11:252. [PMID: 37644578 PMCID: PMC10466739 DOI: 10.1186/s40359-023-01265-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/26/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Recent studies report that LGBTQ + people have experienced high levels of mental health problems during COVID-19-related social distancing. Given the well-established association between social isolation and mental health, the main aim of the current study was to investigate differences in mental health and (perceived) social isolation and social support in LGBTQ + individuals compared to heterosexual, cisgender people and to explore whether the hypothesized higher mental health burden in LGBTQ + individuals is (partly) mediated by (perceived) social isolation or social support. METHODS N = 531 participants indicating belonging to the LGBTQ + community and N = 1826 not identifying as LGBTQ + participated in a cross-sectional online survey during the initial COVID-19-related lockdown in Germany. Standardized questionnaires were used to assess depression, anxiety, suicidality, loneliness and social support. Further, perceived social isolation and face-to-face communication during the lockdown were assessed. RESULTS LGBTQ + people had higher levels of depression, anxiety and suicidal thought, were lonelier and experienced less social support than non-LGBTQ + identifying individuals. Mediation analysis showed that the higher levels of mental health burden in LGBTQ + people were (partly) mediated by reduced social connectedness. Further face-to-face contact positively affected mental health by reducing feelings of loneliness. CONCLUSION Given the high impact of loneliness on mental health, governmental actions should be taken to promote social connectedness particularly among LGBTQ + identifying individuals to ensure that the COVID-19 pandemic does not exacerbate the health inequalities that already exist between LGBTQ+-identifying and heterosexual, cisgender people.
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Affiliation(s)
- Christine Firk
- Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman- Str. 25, 52066, Aachen, Germany.
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman-Str. 25, 52066, Aachen, Germany.
| | - Nicola Großheinrich
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman-Str. 25, 52066, Aachen, Germany
- Catholic University of Applied Sciences of North Rhine-Westphalia, Wörthstraße 10, 50668, Cologne, Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Daniel Deimel
- Catholic University of Applied Sciences North Rhine-Westphalia, Robert-Schuman- Str. 25, 52066, Aachen, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences North Rhine-Westphalia, Konrad-Adenauer-Ufer 79-81, 50668, Cologne, Germany
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Gjebrea E, Toçi D, Mali J, Hoxha L. Young Queer Community Members Faced Higher Discrimination in Albania During the COVID-19 Pandemic. Cureus 2023; 15:e43674. [PMID: 37724218 PMCID: PMC10505487 DOI: 10.7759/cureus.43674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has hit vulnerable populations harder. In this context, the aim of this study was to assess the negative personal impacts and discrimination experienced by the LGBTQ+ community in Albania during the COVID-19 pandemic. METHODS This cross-sectional study was carried out in Albania in 2021, as a part of a larger multicenter study conducted by the International Planned Parenthood Federation European Network (IPPF EN). Binary logistic regression was used to assess the likelihood of feeling discriminated, ashamed, or afraid due to sexual orientation, adjusting for main confounding factors. RESULTS In total, 279 youngsters aged 14-30 years were included in this study. Of these, 55 participants or 19.7% self-declared as LGBTQ+. Significantly higher proportions of LGBTQ+ were older and of Albanian ethnicity, whereas lower proportions were not married/cohabiting compared to non-LGBTQ+ participants. Significantly higher proportions of LGBTQ+ members have felt discriminated (32.7%), ashamed to discuss about sexual and reproductive health (SRH) issues of concern (32.7%), afraid to express their sexual orientation (45.5%), and lacked privacy to discuss SRH issues with people of trust (36.4%) compared to non-LGBTQ+ participants (5.4%, 15.2%, 4%, and 17.4%, respectively). LGBTQ+ participants were 19.57 times more likely to feel discriminated because of their sexual orientation and 25.05 times more likely to be afraid to express their sexual orientation compared to non-LGBTQ+ participants. CONCLUSION The LGBTQ+ community in Albania was more negatively impacted by the COVID-19 pandemic compared to non-LGBTQ+ participants. The findings should guide future interventions for addressing the needs of the LGBTQ+ community in emergency situations.
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Affiliation(s)
- Elona Gjebrea
- Sexual and Reproductive Health and Rights, Albanian Center for Population and Development, Tirana, ALB
| | - Dorina Toçi
- Department of Public Health Performance and Chronic Diseases, Institute of Public Health, Tirana, ALB
| | - Juna Mali
- Epidemiology and Public Health, Albanian Center for Population and Development, Tirana, ALB
| | - Livia Hoxha
- Economic Development and Professional Training, Ministry of Finance and Economy, Tirana, ALB
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Dharma C, Fu R, Chaiton M. Table 2 Fallacy in Descriptive Epidemiology: Bringing Machine Learning to the Table. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6194. [PMID: 37444042 PMCID: PMC10340623 DOI: 10.3390/ijerph20136194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
There is a lack of rigorous methodological development for descriptive epidemiology, where the goal is to describe and identify the most important associations with an outcome given a large set of potential predictors. This has often led to the Table 2 fallacy, where one presents the coefficient estimates for all covariates from a single multivariable regression model, which are often uninterpretable in a descriptive analysis. We argue that machine learning (ML) is a potential solution to this problem. We illustrate the power of ML with an example analysis identifying the most important predictors of alcohol abuse among sexual minority youth. The framework we propose for this analysis is as follows: (1) Identify a few ML methods for the analysis, (2) optimize the parameters using the whole data with a nested cross-validation approach, (3) rank the variables using variable importance scores, (4) present partial dependence plots (PDP) to illustrate the association between the important variables and the outcome, (5) and identify the strength of the interaction terms using the PDPs. We discuss the potential strengths and weaknesses of using ML methods for descriptive analysis and future directions for research. R codes to reproduce these analyses are provided, which we invite other researchers to use.
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Affiliation(s)
- Christoffer Dharma
- Dalla Lana School of Public Health, University of Toronto, Toronton, ON M5T 3M7, Canada; (C.D.); (R.F.)
- Center for Addictions and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Rui Fu
- Dalla Lana School of Public Health, University of Toronto, Toronton, ON M5T 3M7, Canada; (C.D.); (R.F.)
- Department of Otolaryngology—Head and Neck Surgery, Temerty Faculty of Medicine, Sunnybrook Hospital, Toronto, ON M4N 3M5, Canada
| | - Michael Chaiton
- Dalla Lana School of Public Health, University of Toronto, Toronton, ON M5T 3M7, Canada; (C.D.); (R.F.)
- Center for Addictions and Mental Health, Toronto, ON M6J 1H4, Canada
- Ontario Tobacco Research Unit, Toronto, ON M5S 2S1, Canada
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Gonzales G, de Mola EL, Robertson L, Gavulic KA, McKay T. LGBTQ College student health and wellbeing at the onset of the pandemic: additional evidence and lessons learned from COVID-19. BMC Public Health 2023; 23:967. [PMID: 37237277 DOI: 10.1186/s12889-023-15909-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The coronavirus (COVID-19) pandemic has killed more than six million people and disrupted health care systems globally. In the United States alone, more than one million people have died from COVID-19 infections. At the start of the pandemic, nearly all aspects of our lives paused to prevent the spread of the novel coronavirus. Many institutions of higher education transitioned to remote learning and enacted social distancing measures. This study examined the health needs and vulnerabilities of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) college students at the start of the COVID-19 pandemic in the United States. METHODS We fielded a rapid-response online survey between April and June of 2020. We recruited 578 LGBTQ-identifying college students aged 18 years and older by reaching out to LGBTQ-serving organizations on 254 college campuses and via targeted social media advertising. RESULTS Approximately 40% of LGBTQ college students surveyed were dissatisfied with life at the start of the COVID-19 pandemic, and almost all (90%) were concerned that COVID-19 would threaten their mental health. Moreover, about 40% of LGBTQ college students reported unmet mental health needs, and 28% were worried about seeking care during the pandemic because of their LGBTQ identity. One out of four LGBTQ college students had to go back in the closet because of the pandemic, and approximately 40% were concerned about their finances or personal safety during the COVID-19 pandemic. Some of these adverse outcomes were prominent among younger students, Hispanic/Latinx students, and students with unsupportive families or colleges. CONCLUSIONS Our study adds novel findings to the large body of research demonstrating that LGBTQ college students experienced distress and elevated mental health needs early in the pandemic. Future research should examine the long-term consequences of the pandemic among LGBTQ and other minoritized college students. Public health policymakers, health care providers, and college and university officials should provide LGBTQ students affirming emotional supports and services to ensure their success as the COVID-19 pandemic transitions to endemic.
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Affiliation(s)
- Gilbert Gonzales
- Department of Medicine, Health & Society, Department of Health Policy, Program for Public Policy Studies, Vanderbilt University, 2301 Vanderbilt Place PMB #351665, Nashville, TN, USA.
| | - Emilio Loret de Mola
- Department of Community Health Sciences, School of Public Health, Boston University, Boston, MA, USA
| | - Lee Robertson
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | | | - Tara McKay
- Department of Medicine, Health & Society, Vanderbilt University, Nashville, TN, USA
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Gill EK, McQuillan MT. LGBTQ+ Students' Peer Victimization and Mental Health before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11537. [PMID: 36141809 PMCID: PMC9517503 DOI: 10.3390/ijerph191811537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Given the well-established health disparities between lesbian, gay, bisexual, transgender, queer, and gender-expansive (LGBTQ+) and cisgender, straight youth, scholars predicted the COVID-19 pandemic would disproportionately impact LGBTQ+ students. Yet, few studies have described changes in LGBTQ+ students' school experiences and well-being during the pandemic. Using survey data from 40,904 middle and high school students, we examined changes from before (2018) to during (2021) the pandemic in peer victimization, anxiety, and suicide attempts. We conducted bivariate and multivariate regression analyses to assess changes between the two time points among LGBTQ+ and cisgender, straight students. We found LGBTQ+ students experienced more peer victimization, anxiety, and suicide attempts at both points, before and during the pandemic, than cisgender, straight youth. However, LGBTQ+ students reported increased anxiety, decreased peer victimization, and decreased suicide attempts in 2021, during the pandemic, compared to pre-pandemic 2018 reports. These findings suggest pandemic-related school disruptions may have provided LGBTQ+ students some relief from the harmful effects of poor, in-person school climates.
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Algarin AB, Salerno JP, Shrader CH, Lee JY, Fish JN. Associations between living arrangement and sexual and gender minority stressors among university students since the start of the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 35658096 PMCID: PMC9718887 DOI: 10.1080/07448481.2022.2076560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/06/2022] [Accepted: 05/08/2022] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To examine the associations between COVID-19-related living arrangements and sexual and gender minority (SGM)-related stressors (ie, identity concealment and familial rejection). PARTICIPANTS N = 478 SGM university students (Mage = 22 years, SD = 4.00). METHODS SGM university students were surveyed cross-sectionally between May and August 2020 regarding SGM-related stressors and living arrangements since the start of COVID-19. RESULTS Approximately half (48.7%) of the sample reported a living rearrangement to their parents' home due to COVID-19. Living rearrangement to parents' homes was associated with an increased degree of identity concealment (β [95% C.I.] = 0.62 [0.10, 1.15]; p = .020) and familial rejection (β [95% C.I.] = 1.56 [0.72, 2.41]; p < .001) since the start of COVID-19 compared to stably living without parents (34.3%). Stably living with parents (17.0%) was not associated with increased degree of SGM-related stressors compared to experiencing a living rearrangement. CONCLUSIONS Stakeholders must consider the unique identity-related vulnerabilities of SGM students living with parents and who experience living rearrangements due to COVID-19.
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Affiliation(s)
- Angel B Algarin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - John P Salerno
- Department of Behavioral & Community Health, University of Maryland, College Park, MD, USA
| | - Cho-Hee Shrader
- ICAP at Columbia University, Mailman School of Public Health
| | - Ji-Young Lee
- Center for Sexuality and Health Disparities, University of Michigan USA
| | - Jessica N Fish
- Department of Family Science, University of Maryland, College Park, MD, USA
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Gattamorta K, Salerno JP, Laporte RR. Family Rejection During COVID-19: Effects on Sexual and Gender Minority Stress and Mental Health Among LGBTQ University Students. LGBTQ+ FAMILY : AN INTERDISCIPLINARY JOURNAL 2022; 18:305-318. [PMID: 37151804 PMCID: PMC10162589 DOI: 10.1080/27703371.2022.2083041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study examines the relationship between family rejection and moderate to severe psychological distress during COVID-19 among LGBTQ university students. Data were obtained from a national cross-sectional electronic survey of LGBTQ university students (N = 565) collected in the summer of 2020. Hierarchical logistic regression models were used to examine the predictive association between increased family rejection and moderate to severe psychological distress. Respondents who reported increased rejection were more than twice as likely to report moderate to severe psychological distress, with social isolation and LGBTQ identity concealment being significant covariate predictors in the model. These results demonstrate the importance of public health, medical, mental health, and higher education stakeholders understanding the significance of LGBTQ-identity related family rejection when addressing the mental health and well-being of LGBTQ young people.
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Affiliation(s)
- Karina Gattamorta
- University of Miami, School of Nursing and Health Studies, Coral Gables, 33124 United States
| | - John P Salerno
- University of Maryland at College Park, School of Public Health, College Park, 20742-5031 United States
| | - Roberto Roman Laporte
- University of Miami, School of Nursing and Health Studies, Coral Gables, 33124 United States
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