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Lamontagne E, Leroy V, Yakusik A, Parker W, Howell S, Ventelou B. Assessment and determinants of depression and anxiety on a global sample of sexual and gender diverse people at high risk of HIV: a public health approach. BMC Public Health 2024; 24:215. [PMID: 38238673 PMCID: PMC10795213 DOI: 10.1186/s12889-023-17493-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/14/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Sexual and gender diverse people face intersecting factors affecting their well-being and livelihood. These include homophobic reactions, stigma or discrimination at the workplace and in healthcare facilities, economic vulnerability, lack of social support, and HIV. This study aimed to examine the association between such factors and symptoms of anxiety and depression among sexual and gender diverse people. METHODS This study is based on a sample of 108,389 gay, bisexual, queer and questioning men, and transfeminine people from 161 countries collected through a cross-sectional internet survey. We developed a multinomial logistic regression for each group to study the associations of the above factors at different severity scores for anxiety and depression symptoms. RESULTS Almost a third (30.3%) of the participants reported experiencing moderate to severe symptoms of anxiety and depression. Higher severity scores were found for transfeminine people (39%), and queer or questioning people (34.8%). Severe symptoms of anxiety and depression were strongly correlated with economic hardship for all groups. Compared to those who are HIV-negative, those living with HIV were more likely to report severe symptoms of anxiety and depression, and the highest score was among those who do not know their HIV status. Transfeminine people were the most exposed group, with more than 80% higher risk for those living with HIV suffering from anxiety and depression. Finally, homophobic reactions were strongly associated with anxiety and depression. The relative risk of severe anxiety and depression was 3.47 times higher for transfeminine people facing transphobic reactions than those with no symptoms. Moreover, anxiety and depression correlate with stigma or discrimination in the workplace and healthcare facilities. CONCLUSIONS The strong association between the severity of anxiety and depression, and socioeconomic inequality and HIV status highlights the need for concrete actions to meet the United Nations' pledge to end inequalities faced by communities and people affected by HIV. Moreover, the association between stigma or discrimination and anxiety and depression among sexual and gender diverse people is alarming. There is a need for bold structural public health interventions, particularly for transfeminine, queer and questioning people who represent three communities under the radar of national HIV programmes.
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Affiliation(s)
- Erik Lamontagne
- UNAIDS, 20 Ave Appia, 1211, Geneva, Switzerland.
- Aix-Marseille University, CNRS, EHESS, Centrale Marseille, Aix-Marseille School of Economics, 5-9 Boulevard Maurice Bourdet 13205, Marseille, France.
| | - Vincent Leroy
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de L'Information Médicale, ISSPAM, Marseille, France
| | - Anna Yakusik
- UNAIDS, 20 Ave Appia, 1211, Geneva, Switzerland
- Imperial College London, Faculty of Medicine, School of Public Health, London, SW7 2AZ, England
| | | | | | - Bruno Ventelou
- Aix-Marseille University, CNRS, EHESS, Centrale Marseille, Aix-Marseille School of Economics, 5-9 Boulevard Maurice Bourdet 13205, Marseille, France
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Swilley-Martinez ME, Coles SA, Miller VE, Alam IZ, Fitch KV, Cruz TH, Hohl B, Murray R, Ranapurwala SI. "We adjusted for race": now what? A systematic review of utilization and reporting of race in American Journal of Epidemiology and Epidemiology, 2020-2021. Epidemiol Rev 2023; 45:15-31. [PMID: 37789703 DOI: 10.1093/epirev/mxad010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/31/2023] [Accepted: 09/28/2023] [Indexed: 10/05/2023] Open
Abstract
Race is a social construct, commonly used in epidemiologic research to adjust for confounding. However, adjustment of race may mask racial disparities, thereby perpetuating structural racism. We conducted a systematic review of articles published in Epidemiology and American Journal of Epidemiology between 2020 and 2021 to (1) understand how race, ethnicity, and similar social constructs were operationalized, used, and reported; and (2) characterize good and poor practices of utilization and reporting of race data on the basis of the extent to which they reveal or mask systemic racism. Original research articles were considered for full review and data extraction if race data were used in the study analysis. We extracted how race was categorized, used-as a descriptor, confounder, or for effect measure modification (EMM)-and reported if the authors discussed racial disparities and systemic bias-related mechanisms responsible for perpetuating the disparities. Of the 561 articles, 299 had race data available and 192 (34.2%) used race data in analyses. Among the 160 US-based studies, 81 different racial categorizations were used. Race was most often used as a confounder (52%), followed by effect measure modifier (33%), and descriptive variable (12%). Fewer than 1 in 4 articles (22.9%) exhibited good practices (EMM along with discussing disparities and mechanisms), 63.5% of the articles exhibited poor practices (confounding only or not discussing mechanisms), and 13.5% were considered neither poor nor good practices. We discuss implications and provide 13 recommendations for operationalization, utilization, and reporting of race in epidemiologic and public health research.
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Affiliation(s)
- Monica E Swilley-Martinez
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Serita A Coles
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7440, United States
| | - Vanessa E Miller
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Ishrat Z Alam
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Kate Vinita Fitch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Theresa H Cruz
- Prevention Research Center, Department of Pediatrics, Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, United States
| | - Bernadette Hohl
- Penn Injury Science Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6021, United States
| | - Regan Murray
- Center for Public Health and Technology, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, United States
| | - Shabbar I Ranapurwala
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
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Moayad L, Zajner C, Popovic MM, Mercer G, Kertes PJ, Muni RH, Hall E, Goel N, Rana M, Kohly RP. Association Between Sociodemographic Factors and Vision Difficulty in the National Health Interview Survey: A Population-Based Analysis. Am J Ophthalmol 2023; 255:30-42. [PMID: 37343742 DOI: 10.1016/j.ajo.2023.06.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/05/2023] [Accepted: 06/16/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE To investigate the relationship between social determinants of health with self-reported vision difficulty. DESIGN Cross-sectional, population-based analysis. METHODS The National Health Interview Survey (NHIS) is an annual survey based on the U.S. population ≥18 years of age. It provides self-reported data on demographic characteristics, socioeconomic factors, health status, and health care access. The 2021 NHIS database was used in this study. Adult participants of the NHIS who responded to the vision difficulty question "Do you have difficulty seeing, even when wearing glasses or contact lenses?" were included in this analysis. The outcome of interest was self-reported vision difficulty by participants. Analysis was done through univariable and multivariable logistic regression. RESULTS Overall, there were 29,464 participants included in the analysis. Univariable logistic regression showed an increased odds of self-reported vision difficulty among female (odds ratio [OR] 1.28 [95% confidence interval {CI} 1.20-1.38]; P < .001), gay, lesbian, or bisexual participants (OR 1.24 [95% CI 1.04-1.49]; P = .02), those who possessed public compared with private insurance (OR 1.83 [95% CI 1.69-1.99]; P < .001), those with less than a high school education (OR 1.88 [95% CI 1.67-2.13]; P < .001), and those with an income below the poverty threshold (OR 2.22 [95% CI 1.96-2.51]; P < .001). Multivariable analysis revealed an increased risk of vision difficulty reported amongst non-Hispanic Black participants (OR 1.65 [95% CI 1.21-2.25]; P = .002). CONCLUSIONS A multitude of sociodemographic factors are associated with self-reported vision difficulty in the U.S. POPULATION Our findings emphasize the importance of considering factors of social determinants of health in clinical practice and policymaking for patients with vision loss.
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Affiliation(s)
- Lana Moayad
- The Michael G. DeGroote School of Medicine (L.M.), McMaster University, Hamilton, Ontario, Canada
| | - Chris Zajner
- Schulich School of Medicine and Dentistry (C.Z.), Western University, London, Ontario, Canada
| | - Marko M Popovic
- Department of Ophthalmology and Vision Sciences (M.M.P., G.M., P.J.K., R.H.M., R.P.K.), University of Toronto, Toronto, Ontario, Canada
| | - Gareth Mercer
- Department of Ophthalmology and Vision Sciences (M.M.P., G.M., P.J.K., R.H.M., R.P.K.), University of Toronto, Toronto, Ontario, Canada
| | - Peter J Kertes
- Department of Ophthalmology and Vision Sciences (M.M.P., G.M., P.J.K., R.H.M., R.P.K.), University of Toronto, Toronto, Ontario, Canada; John and Liz Tory Eye Centre (P.J.K., R.P.K.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences (M.M.P., G.M., P.J.K., R.H.M., R.P.K.), University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology (R.H.M.), St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | | | - Neha Goel
- Department of Surgery (N.G.), Division of Surgical Oncology, University of Miami, Miami, Florida, USA
| | - Mariam Rana
- The University of Saskatchewan (M.R.), Saskatoon, Saskatchewan, Canada
| | - Radha P Kohly
- Department of Ophthalmology and Vision Sciences (M.M.P., G.M., P.J.K., R.H.M., R.P.K.), University of Toronto, Toronto, Ontario, Canada; John and Liz Tory Eye Centre (P.J.K., R.P.K.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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Conte WL, Cascione M, Sullivan AB. Podcast on the Challenges and Recommendations to Address Unmet Needs in MS for LGBTQ+ Populations in the United States. Neurol Ther 2023; 12:1399-1407. [PMID: 37353720 PMCID: PMC10444714 DOI: 10.1007/s40120-023-00506-4] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/19/2023] [Indexed: 06/25/2023] Open
Abstract
In general, individuals who are lesbian, gay, bisexual, transgender, queer or questioning, plus other identities (LGBTQ+) living with multiple sclerosis (MS) have less favorable healthcare experiences and poorer overall health than cisgendered heterosexual individuals. They may experience further challenges in addition to managing their MS, including psychological or emotional problems, and an increased risk of comorbid diseases and substance abuse. Transgender individuals specifically face additional unique challenges, including high rates of mental health distress and effects from long-term exogenous hormone use and gender affirmation surgery. These findings highlight disparities in both quality of care and health outcomes of LGBTQ+ individuals. Unmet needs and drivers of these disparities relate to a lack of inclusivity in healthcare environments, poor communication between healthcare professionals (HCPs) and LGBTQ+ patients, inadequate HCP knowledge of LGBTQ+ health issues, and gaps in research into the impact of sexual orientation and gender identity in MS. Although data are limited, recommendations to improve the experience and care of LGBTQ+ individuals with MS include increasing HCP awareness of the challenges LGBTQ+ individuals face and provision of inclusive care, with the overarching goal for HCPs to be allies to the LGBTQ+ community. Improvements may be achieved through diversity and cultural awareness training of HCPs on sexual orientation and gender identity, and ensuring a friendly, open, and supportive healthcare environment. Use of sensitive and gender-neutral language by HCPs, representation of LGBTQ+ individuals in patient materials, and access to LGBTQ+ MS support groups are also recommended. HCPs should aim to integrate discussion of sexual orientation and gender identity and sexual and mental health into routine assessments and collaborate with other HCPs as needed. By addressing the challenges and unmet needs of LGBTQ+ individuals with MS, this should help resolve disparities in their quality of care and improve their overall health.
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Affiliation(s)
- William L. Conte
- Comprehensive MS Center, Neuroscience Institute, Methodist Hospitals, 200 E 89Th Avenue, Merrillville, IN 46410 USA
| | - Mark Cascione
- First Choice Neurology/South Tampa Multiple Sclerosis Center, 2919 Swann Avenue, Suite 401, Tampa, FL 33609 USA
| | - Amy B. Sullivan
- Mellen Center for MS Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue/U10, Cleveland, OH 44195 USA
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Lipton BJ, Pesko MF. State Medicaid and private telemedicine coverage requirements and telemedicine use, 2013-2019. Health Serv Res 2023; 58:988-998. [PMID: 37202903 PMCID: PMC10480084 DOI: 10.1111/1475-6773.14173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE To examine the association between state Medicaid and private telemedicine coverage requirements and telemedicine use. A secondary objective was to examine whether these policies were associated with health care access. DATA SOURCES AND STUDY SETTING We used nationally representative survey data from the 2013-2019 Association of American Medical Colleges Consumer Survey of Health Care Access. The sample included Medicaid-enrolled (4492) and privately insured (15,581) adults under age 65. STUDY DESIGN The study design was a quasi-experimental two-way-fixed-effects difference-in-differences analysis that took advantage of state-level changes in telemedicine coverage requirements during the study period. Separate analyses were conducted for the Medicaid and private requirements. The primary outcome was the past-year use of live video communication. Secondary outcomes included same-day appointment, always able to get needed care, and having enough options for where to go to receive care. DATA COLLECTION/EXTRACTION METHODS N/A. PRINCIPAL FINDINGS Medicaid telemedicine coverage requirements were associated with a 6.01 percentage-point increase in the use of live video communication (95% CI, 1.62 to 10.41) and an 11.12 percentage-point increase in always being able to access needed care (95% CI, 3.34 to 18.90). While generally robust to various sensitivity analyses, these findings were somewhat sensitive to included study years. Private coverage requirements were not significantly associated with any of the outcomes considered. CONCLUSIONS Medicaid telemedicine coverage during 2013-2019 was associated with significant and meaningful increases in telemedicine use and health care access. We did not detect any significant associations for private telemedicine coverage policies. Many states added or expanded telemedicine coverage policies during the COVID-19 pandemic, but states will face decisions about whether to maintain these enhanced policies now that the public health emergency is ending. Understanding the role of state policies in promoting telemedicine use may help inform policymaking efforts going forward.
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Affiliation(s)
- Brandy J. Lipton
- Department of Health, Society, and Behavior, Program in Public HealthUniversity of California IrvineIrvineCaliforniaUSA
- Center for Health Economics & Policy StudiesSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Michael F. Pesko
- Andrew Young School of Policy StudiesGeorgia State UniversityAtlantaGeorgiaUSA
- Institute of Labor Economics (IZA)BonnGermany
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Moore JX, Andrzejak SE, Casanova T, Langston ME, Estvold S, Adsul P. Investigating the Joint Effect of Allostatic Load among Lesbian, Gay, and Bisexual Adults with Risk of Cancer Mortality. Int J Environ Res Public Health 2023; 20:6120. [PMID: 37372707 DOI: 10.3390/ijerph20126120] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/31/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Sexual minorities (SM) have higher chronic physiologic stress as indicated by allostatic load (AL), which may be explained in part by consistent experiences of discriminatory practices. This is one of the first studies to examine the joint effects of SM status and AL on the association with long-term risk for cancer death. Retrospective analyses were conducted on 12,470 participants using National Health and Nutrition Examination Survey (NHANES) from years 2001 through 2010 linked with the National Death Index through December 31, 2019. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) of cancer deaths between groups of SM (those reporting as gay, lesbian, bisexual, or having same-sex sexual partners) status and AL. SM adults living with high AL (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.55, 95% CI: 1.40-4.65) when compared to straight/heterosexual adults living with low AL (n = 6674). Among those living with high AL, SM (n = 326) had a 2-fold increased risk of cancer death (aHR: 2.26, 95% CI: 1.33-3.84) when compared to straight/heterosexual adults with high AL (n = 4957). SM with high AL have an increased risk of cancer mortality. These findings highlight important implications for promoting a focused agenda on cancer prevention with strategies that reduce chronic stress for SM adults.
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Affiliation(s)
- Justin Xavier Moore
- Cancer Prevention, Control & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
- Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Sydney Elizabeth Andrzejak
- Cancer Prevention, Control & Population Health Program, Department of Medicine, Augusta University, Augusta, GA 30912, USA
| | - Tracy Casanova
- Department of Psychiatry and Health Behavior, Georgia Cancer Center, Augusta University, Augusta, GA 30912, USA
| | - Marvin E Langston
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA 49305, USA
| | - Søren Estvold
- Department of Family Medicine, Augusta University, Augusta, GA 20912, USA
| | - Prajakta Adsul
- Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico, Albuquerque, NM 87131, USA
- Cancer Control and Population Sciences Research Program, Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM 87131, USA
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Scott SB, Gaska KA, Knopp K, Do QA, Yang JP. Sexual Minority Women and Discriminatory Health Care Experiences: An Intersectional Evaluation Across Race and Ethnicity. Womens Health Issues 2023; 33:160-166. [PMID: 36517367 DOI: 10.1016/j.whi.2022.10.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/05/2022] [Accepted: 10/31/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Health care discrimination contributes to medical mistrust among marginalized communities. Sexual minority women of color (SM-WOC) are marginalized because of the intersection of their sexual orientation, gender, and race/ethnicity and regularly report poor health care experiences at the intersection of these identities. However, research has yet to quantify differences in the prevalence of reported health care discrimination across SM women of various racial/ethnic backgrounds. As such, this study compared the rates of discriminatory treatment during the most recent medical appointment between SM-WOC (Black, Hispanic, Asian American, Native American) and White SM women. METHODS We used nationally representative data from the Association of American Medical Colleges survey of health care services. Data were collected from 2010 to 2019 from N = 1,499 SM women (n = 458 SM-WOC). Binary logistic regressions compared frequencies of reported identity-based discrimination between each minoritized racial/ethnic group to White SM women. RESULTS Across the sample, 33% of SM-WOC reported discrimination during their last medical appointment compared with 19% of White SM women. Discriminatory treatment was more common among every minoritized racial/ethnic group of SM women compared with White SM women, with variability in frequency of specific forms of identity-based discrimination across minoritized racial/ethnic groups. CONCLUSIONS Although discriminatory treatment during the last medical appointment was common for all SM women, prevalence was higher for SM-WOC compared with White SM women. Findings have important implications for policy and practice to reduce health disparities, such as targeted interventions for SM-WOC and provider trainings in cultural humility, implicit bias, and common microaggressions.
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Affiliation(s)
- Shelby B Scott
- Department of Psychology, University of Texas at San Antonio, San Antonio, Texas.
| | - Karie A Gaska
- Department of Clinical Foundations, Ross University School of Medicine, Bridgetown, Barbados
| | - Kayla Knopp
- Research Service, VA San Diego Health Care System, San Diego, California
| | - Quyen A Do
- Department of Psychology, University of Texas at San Antonio, San Antonio, Texas
| | - Joyce P Yang
- Department of Psychology, University of San Francisco, San Francisco, California
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Grant W, Adan MA, Samurkas CA, Quigee D, Benitez J, Gray B, Carnevale C, Gordon RJ, Castor D, Zucker J, Sobieszczyk ME. Effect of Participative Web-Based Educational Modules on HIV and Sexually Transmitted Infection Prevention Competency Among Medical Students: Single-Arm Interventional Study. JMIR Med Educ 2023; 9:e42197. [PMID: 36692921 PMCID: PMC9906317 DOI: 10.2196/42197] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/30/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The number of new HIV diagnoses in the United States continues to slowly decline; yet, transgender women and men who have sex with men remain disproportionately affected. Key to improving the quality of prevention services are providers who are comfortable broaching the subjects of sexual health and HIV prevention with people across the spectrum of gender identities and sexual orientations. Preservice training is a critical point to establish HIV prevention and sexual health education practices before providers' practice habits are established. OBJECTIVE The study aimed to develop participative web-based educational modules and test their impact on HIV prevention knowledge and awareness in future providers. METHODS Sexual health providers at an academic hospital, research clinicians, community engagement professionals, and New York City community members were consulted to develop 7 web-based educational modules, which were then piloted among medical students. We assessed knowledge of HIV and sexually transmitted infection prevention and comfort assessing the prevention needs of various patients via web-based questionnaires administered before and after our educational intervention. We conducted exploratory factor analysis of the items in the questionnaire. RESULTS Pre- and postmodule surveys were completed by 125 students and 89 students, respectively, from all 4 years of training. Before the intervention, the majority of students had heard of HIV pre-exposure prophylaxis (122/123, 99.2%) and postexposure prophylaxis (114/123, 92.7%). Before the training, 30.9% (38/123) of the students agreed that they could confidently identify a patient who is a candidate for pre-exposure prophylaxis or postexposure prophylaxis; this increased to 91% (81/89) after the intervention. CONCLUSIONS Our findings highlight a need for increased HIV and sexually transmitted infection prevention training in medical school curricula to enable future providers to identify and care for diverse at-risk populations. Participative web-based modules offer an effective way to teach these concepts.
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Affiliation(s)
- William Grant
- Duke University School of Medicine, Duke University, Durham, NC, United States
| | - Matthew A Adan
- Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, United States
| | - Christina A Samurkas
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Daniela Quigee
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Jorge Benitez
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Brett Gray
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Caroline Carnevale
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Rachel J Gordon
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Delivette Castor
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Jason Zucker
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Magdalena E Sobieszczyk
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY, United States
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Ajayi KV, Panjwani S, Garney W, McCord CE. Sociodemographic factors and perceived patient-provider communication associated with healthcare avoidance among women with psychological distress. PEC Innov 2022; 1:100027. [PMID: 37213787 PMCID: PMC10194386 DOI: 10.1016/j.pecinn.2022.100027] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/28/2022] [Accepted: 03/06/2022] [Indexed: 05/23/2023]
Abstract
Objective To establish the extent to which psychological distress influences health avoidance behavior among women, controlling for patient provider communication and sociodemographic characteristics. Methods Data from the 2019 Health Information National Trends Survey (HINTS 5, Cycle 3) was analyzed to obtain healthcare avoidance behavior among women aged 18 and older (n = 2788). Weighted descriptive, bivariate, and multivariable logistic regression models were conducted. Results Approximately 649 women or 1 in 4 women (26.7% weighted prevalence; 95% Confidence Interval [CI] 0.23%-0.29%) avoided healthcare in the past 12 months. Non-Hispanic white (62.8%) and married (55.4%) women represented a higher proportion of the sample. Bivariate analysis revealed that the odds of reporting healthcare avoidance among women with mild, moderate, and severe psychological distress (Odds Ratio [OR]: 2.26, 95% CI: 1.45-3.53, p = 0.001; OR: 3.88, 95% CI: 2.29-6.56, p < 0.001; OR: 3.08, 95% CI: 1.81-5.23, p < 0.001) was significantly higher compared to those with none-minimal psychological distress. In the adjusted model, women with moderate and severe psychological distress (Adjusted OR [AOR]:3.15, 95% CI: 1.55-6.38, p = 0.002; AOR: 2.24, 95% CI: 1.10-4.92, p = 0.044) were more likely to report healthcare avoidance than those experiencing none-minimal psychological distress. Furthermore, increasing patient-provider communication score (AOR: 0.91, 95% CI: 0.87-0.96, p < 0.001) reduced the likelihood of healthcare avoidance. Among the sociodemographic variables assessed, being younger (18-49 years) and having less than a high school degree significantly increased the chances of avoiding healthcare. Conclusion A high proportion of women with psychological distress avoid necessary healthcare. Patient-provider communication quality, increasing age, and being a high school student contribute to healthcare avoidance in women. Innovation Strategies to improve health service utilization must address healthcare avoidance by developing effective health communication targeted at women with psychological distress.
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Affiliation(s)
- Kobi V. Ajayi
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
- Laboratory of Community Health Evaluation Science and Systems (CHESS), Texas A&M University, College Station, TX, United States
- Educating, Directing, Empowerment & Nurturing (EDEN) Foundation, Abuja, Nigeria
| | - Sonya Panjwani
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
- Laboratory of Community Health Evaluation Science and Systems (CHESS), Texas A&M University, College Station, TX, United States
| | - Whitney Garney
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
- Laboratory of Community Health Evaluation Science and Systems (CHESS), Texas A&M University, College Station, TX, United States
| | - Carly E. McCord
- Department of Psychiatry, College of Medicine, Texas A&M University, Bryan, TX, United States
- Department of Educational Psychology, College of Education, Texas A&M University, College Station, TX, United States
- Corresponding author at: Department of Psychiatry, Department of Educational Psychology, Texas A&M University, 8441 Riverside Parkway, Clinical Building 1, Suite 2580, Bryan, TX 77807, United States.
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Taing M, Le K, Britton M, Chen TA, Parent MC, Tamí-Maury I, Leal IM, Rogova A, Kyburz B, Williams T, Patel M, Reitzel LR. Smoking Intervention Practices in Texas Healthcare Centers with Sexual and Gender Minority Patients. Health Behav Policy Rev 2022; 9:1074-1088. [PMID: 36778530 PMCID: PMC9910434 DOI: 10.14485/hbpr.9.6.1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives This study evaluated the use of evidence-based practices (EBPs) for smoking cessation in centers providing behavioral healthcare for patient populations that included some proportion of sexual and gender minorities (SGMs). Methods Healthcare providers from 75 healthcare centers across Texas serving SGMs with behavioral health needs participated in a survey assessing their center's tobacco control policies and practices. Results Nearly half (N = 36) of participating centers had a comprehensive tobacco-free workplace policy, 30.67% employed ≥1 tobacco treatment specialist, 73.91% employed ≥1 prescriber, 80.82% mandated screening for patient tobacco use at intake, and 57.53% provided a template for tobacco use assessments. Overall, 70.67% of providers asked patients about smoking status, 69.33% advised patients to quit, 64.00% assessed patients' interest in quitting, 58.67% assisted patients with quit attempts, and 36.00% arranged follow-up. Providers' ability to tailor interventions for special populations like SGMs ranged from very low/0 to very high/10 (M = 4.63 ± 2.59). Conclusions There are opportunities to improve policy implementation, standardization and usage of evidence-based interventions, and intervention tailoring within settings providing care to SGM patients in Texas to better address their tobacco use inequities.
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Affiliation(s)
- Matthew Taing
- Dell Medical School, University of Texas at Austin, Austin, Texas, United States
| | - Kathy Le
- Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Maggie Britton
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Tzuan A Chen
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas, United States
| | - Michael C Parent
- Department of Educational Psychology, University of Texas at Austin, Austin, Texas, United States
| | - Irene Tamí-Maury
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston, Texas, United States
| | - Isabel Martinez Leal
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Anastasia Rogova
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | | | - Mayuri Patel
- Department of State Health Services, Tobacco Prevention and Control Branch, Austin, TX, United States
| | - Lorraine R Reitzel
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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11
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Jenkins WD, Walters S, Phillips G, Green K, Fenner E, Bolinski R, Spenner A, Luckey G. Stigma, Mental Health, and Health care Use Among Rural Sexual and Gender Minority Individuals. Health Educ Behav 2022:10901981221120393. [PMID: 36036544 PMCID: PMC10064479 DOI: 10.1177/10901981221120393] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sexual and gender minorities (SGM) frequently experience depression and health care-related stigma. Health care satisfaction is important for seeking care, but little is known about SGM health care satisfaction, and especially as it relates to depression among rural SGM. From May 25 to July 2, 2021, we surveyed rural Illinois (IL) individuals aged ≥18 years on the topics of demographics, depression, health care satisfaction, past health care experiences, internalized stigma, and victimization. Among the 398 respondents, the gender identity distribution included cisgender males and females (171 and 203, respectively) and transgender males and females (8 and 7, respectively), while sexual orientation included heterosexuals (114), gay/lesbians (143), and other orientations (141). Analyses were conducted with respect to both identity and orientation (and their interaction). In univariate analysis, transgender individuals were more likely than cisgender to screen positive for depression and less likely to report feeling accepted by their medical provider. Compared to heterosexual respondents, gay/lesbians and other orientations were more likely to screen positive for depression. In logistic regression, factors associated with increased risk of depression included nonheterosexual orientation and past poor health care experiences. In linear regression, factors most commonly associated with the seven satisfaction subscales include: sexual orientation, past poor experiences, and employment. There were significant differences in depression across both sexual orientation and gender identity, and in health care satisfaction by sexual orientation. Rural SGMs are more vulnerable to depression and less likely to report satisfactory care. As health care engagement is critical for screening and care adherence, engaging rural SGM in a routine and satisfactory fashion is needed.
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Affiliation(s)
- Wiley D. Jenkins
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | | | | | - Kanicia Green
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Emma Fenner
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | | | - Allison Spenner
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Georgia Luckey
- Southern Illinois University School of Medicine, Springfield, IL, USA
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12
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Stranix JT, Bluebond-Langner R. Improving Access to Genital Gender-Affirming Surgery-The Need for Comprehensive Gender Health Centers of Excellence. JAMA Surg 2022; 157:806. [PMID: 35793116 DOI: 10.1001/jamasurg.2022.2644] [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: 11/14/2022]
Affiliation(s)
- John T Stranix
- Department of Plastic and Maxillofacial Surgery, UVA Health, Charlottesville, Virginia.,Department of Urology, UVA Health, Charlottesville, Virginia
| | - Rachel Bluebond-Langner
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, New York.,Department of Urology, NYU Langone Health, New York, New York
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13
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Franco I, Olazagasti C, Osman F, Duma N. Proyecto ELEVAR: Evaluating the Latinx Experience With the Health Care System Through Variables on Access and Resources. JCO Oncol Pract 2022; 18:e814-e826. [PMID: 35544653 DOI: 10.1200/op.22.00043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Hispanic/Latinx communities encounter disparities in access and availability of appropriate timely health care services, negatively affecting cancer outcomes. Limited data exist on the role of these factors in personal experiences of Hispanic/Latinx with health care systems. We aim to better understand Hispanic/Latinx experience with the health care system, focusing on the impact of the Affordable Care Act (ACA) and applications to clinical practice in patients diagnosed with cancer. METHODS Competitively obtained data from 2010 to 2019 Association of American Medical Colleges Consumer Survey of Health Care Access (a US population-based sample of potential health care consumers needing health care at least once in the past year) were retrospectively reviewed. Descriptive statistics and univariate and multivariate comparisons of patterns pre- versus post-ACA were performed for respondents self-identifying as Hispanic/Latinx. RESULTS In a total cohort of 53,523 respondents, Hispanic/Latinx comprised 7.5% (n = 4,094). Post-ACA demographics showed a higher proportion of female and an increase in employment, educational attainment, income, and private insurance coverage, with a decrease in uninsured. Adjusted models showed that post-ACA Hispanic/Latinx patients are less likely to use emergency room if sick or needing medical advice (odds ratio [OR] 0.33; P < .001) and more likely to report chronic conditions involving cancer (OR 2.43; P < .001) or being limited in activities because of mental or emotional problems (OR 1.36; P = .005). CONCLUSION Although ACA implementation was associated with decreased health care access barriers in Hispanic/Latinx, they continue to experience disparities in chronic health conditions, including cancer, with higher limitations because of emotional or mental health. Ongoing efforts that build upon current strides, toward improved patient satisfaction and overall outcomes, are of paramount importance.
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Affiliation(s)
- Idalid Franco
- Harvard Radiation Oncology Program, Brigham and Women's Hospital, Dana Farber Cancer Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Coral Olazagasti
- Division of Medical Oncology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - Fauzia Osman
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
| | - Narjust Duma
- Medical Oncology, Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
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14
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Singleton MC, Enguidanos SM. Exploration of Demographic Differences in Past and Anticipated Future Care Experiences of Older Sexual Minority Adults. J Appl Gerontol 2022; 41:2045-2055. [PMID: 35503678 DOI: 10.1177/07334648221098996] [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: 11/17/2022] Open
Abstract
Care experiences of sexual minority (SM) adults are largely characterized by the need for receiving care and providing care to their chosen family. This is due, in part, to the lack of family and social support and higher rates of health disparities. Using data from the "Maintaining Dignity: Understanding and Responding to the Challenges Facing Older LGBT Americans" AARP survey (N = 1694), we examined factors associated with past and anticipated future care experiences among older SMs. Older SM individuals reported high rates of providing care (70%), anticipating future provision of care (71%), and needing care from a loved one (73%). Being older, identifying as female, and having a disability were highly associated with past care experiences. Being female, being in a relationship, and having better self-rated health were highly associated with future anticipated care experiences. These outcomes indicate the importance of having services that are inclusive in serving the SM community.
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Affiliation(s)
- Mekiayla C Singleton
- Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA
| | - Susan M Enguidanos
- Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA
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15
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Turpin RE, Williams ND, Akré ERL, Boekeloo BO, Fish JN. Trends in Health Care Access/Experiences: Differential Gains across Sexuality and Sex Intersections before and after Marriage Equality. Int J Environ Res Public Health 2022; 19:ijerph19095075. [PMID: 35564470 PMCID: PMC9101359 DOI: 10.3390/ijerph19095075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/17/2022] [Accepted: 04/18/2022] [Indexed: 12/10/2022]
Abstract
Background: Sexual minority adults experience several health care access inequities compared to their heterosexual peers; such inequities may be affected by LGBTQ+ legislation, such as the 2015 national marriage equality ruling. Methods: Using population-based data (n = 28,463) from the Association of American Medical Colleges biannual Consumer Survey of Health Care Access, we calculated trend ratios (TR) for indicators of health care access (e.g., insurance coverage, delaying or forgoing care due to cost) and satisfaction (e.g., general satisfaction, being mistreated due to sexual orientation) from 2013 to 2018 across sexuality and sex. We also tested for changes in trends related to the 2015 marriage equality ruling using interrupted time series trend interactions (TRInt). Results: The largest increases in access were observed in gay men (TR = 2.42, 95% CI 1.28, 4.57). Bisexual men had decreases in access over this period (TR = 0.47, 95% CI 0.22, 0.99). Only gay men had a significant increase in the health care access trend after U.S. national marriage equality (TRInt = 5.59, 95% CI 2.00, 9.18), while other sexual minority groups did not. Conclusions: We found that trends in health care access and satisfaction varied significantly across sexualities and sex. Our findings highlight important disparities in how federal marriage equality has benefited sexual minority groups.
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Affiliation(s)
- Rodman E Turpin
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Natasha D Williams
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Ellesse-Roselee L Akré
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Bradley O Boekeloo
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD 20742, USA
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16
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Scheer JR, Batchelder AW, Bochicchio LA, Kidd JD, Hughes TL. Alcohol use, behavioral and mental health help-seeking, and treatment satisfaction among sexual minority women. Alcohol Clin Exp Res 2022; 46:641-656. [PMID: 35318685 PMCID: PMC9018513 DOI: 10.1111/acer.14789] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sexual minority women (SMW) report higher rates of heavy episodic drinking (HED) and adverse alcohol-related outcomes, including poor mental health, than heterosexual women. These disparities indicate a greater need for behavioral and mental health treatment for SMW. This study examined associations among alcohol outcomes, behavioral and mental health help-seeking, and treatment satisfaction among SMW by age, sexual identity, race/ethnicity, and income. METHODS Participants included a community sample of 695 SMW (Mage = 40.0, SD = 14.1; 74.1% lesbian, 25.9% bisexual; 37.6% White, 35.8% Black, 23.2% Latinx; 26.3% annual income $14,999 or less). We used bivariate analyses to characterize the sample's demographic characteristics and multivariable logistic regression analyses to examine associations among variables. RESULTS SMW subgroups based on age, race/ethnicity, and annual income differed in alcohol outcomes (i.e., HED, DSM-IV alcohol dependence, alcohol-related problem consequences, alcohol problem recognition, and motivation to reduce drinking); help-seeking; and treatment satisfaction. SMW who engaged in help-seeking for alcohol-related concerns were more likely than those who did not to meet criteria for DSM-IV alcohol dependence (adjusted odds ratio [aOR] = 7.13; 95% CI = 2.77; 18.36), endorse alcohol-related problem consequences (aOR = 11.44; 95% CI = 3.88; 33.71), recognize problematic drinking (aOR = 14.56; 95% CI = 3.37; 62.97), and report motivation to reduce drinking (aOR = 5.26; 95% CI = 1.74; 15.88). SMW's alcohol outcomes did not differ based on their satisfaction with treatment or with providers. CONCLUSIONS This study's findings confirm SMW's elevated risk for HED and other alcohol-related outcomes and underscore the importance of identity-affirmative and accessible behavioral and mental health treatment for young, Black, and low-income SMW. Clinicians and intervention scientists should develop or enhance existing brief behavioral and mental health treatments for SMW engaging in HED who may not recognize that their drinking is problematic or who are not motivated to reduce drinking.
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Affiliation(s)
| | - Abigail W. Batchelder
- Harvard Medical School, Harvard University, Boston, MA
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- The Fenway Institute, Fenway Health, Boston, MA
| | - Lauren A. Bochicchio
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY
| | - Jeremy D. Kidd
- Columbia University Irving Medical Center, New York, NY
- New York State Psychiatric Institute, New York, NY
| | - Tonda L. Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY
- Columbia University Irving Medical Center, New York, NY
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17
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Williams ND, Turpin RE, Akré ERL, Boekeloo BO, Fish JN. Disparities in Mental Health Care Access Among Persons Differing in Sexual Identity: Nationally Representative Findings. Psychiatr Serv 2022; 73:456-459. [PMID: 34407630 PMCID: PMC9213076 DOI: 10.1176/appi.ps.202100045] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to describe disparities in three outcomes: self-reported mental health, need for mental health care, and barriers to care at the intersection of sexual identity and sex. METHODS Data from the 2015 Association of American Medical Colleges Consumer Survey of Health Care Access (N=5,932) were analyzed in regression analyses to estimate relationships among sex, sexual identity, and all three outcomes. RESULTS Compared with heterosexual men, bisexual women reported the poorest mental health (adjusted prevalence ratio [APR]=0.42, 95% confidence interval [CI]=0.35-0.51) and the greatest number of barriers to care (APR=2.29, 95% CI=1.77-2.97), whereas gay-lesbian women reported the most frequent need for care (APR=1.67, 95% CI=1.28-2.18). CONCLUSIONS The findings support existing knowledge on health inequities among sexual minority groups and situate these disparities in the context of unequal access to behavioral and mental health care. As such, addressing barriers to care is paramount in efforts to address sexual orientation-related disparities in behavioral and mental health.
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Affiliation(s)
- Natasha D Williams
- Department of Family Science (Williams, Fish), Department of Epidemiology and Biostatistics (Turpin), and Department of Behavioral and Community Health (Boekeloo), University of Maryland, College Park; Geisel School of Medicine at Dartmouth, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (Akré)
| | - Rodman E Turpin
- Department of Family Science (Williams, Fish), Department of Epidemiology and Biostatistics (Turpin), and Department of Behavioral and Community Health (Boekeloo), University of Maryland, College Park; Geisel School of Medicine at Dartmouth, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (Akré)
| | - Ellesse-Roselee L Akré
- Department of Family Science (Williams, Fish), Department of Epidemiology and Biostatistics (Turpin), and Department of Behavioral and Community Health (Boekeloo), University of Maryland, College Park; Geisel School of Medicine at Dartmouth, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (Akré)
| | - Bradley O Boekeloo
- Department of Family Science (Williams, Fish), Department of Epidemiology and Biostatistics (Turpin), and Department of Behavioral and Community Health (Boekeloo), University of Maryland, College Park; Geisel School of Medicine at Dartmouth, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (Akré)
| | - Jessica N Fish
- Department of Family Science (Williams, Fish), Department of Epidemiology and Biostatistics (Turpin), and Department of Behavioral and Community Health (Boekeloo), University of Maryland, College Park; Geisel School of Medicine at Dartmouth, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (Akré)
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18
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Seefeld L, Mojahed A, Thiel F, Schellong J, Garthus-Niegel S. Preferences and Barriers to Counseling for and Treatment of Intimate Partner Violence, Depression, Anxiety, and Posttraumatic Stress Disorder Among Postpartum Women: Study Protocol of the Cross-Sectional Study INVITE. Front Psychiatry 2022; 13:836350. [PMID: 35422719 PMCID: PMC9001846 DOI: 10.3389/fpsyt.2022.836350] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
The cross-sectional study INVITE (INtimate partner VIolence care and Treatment prEferences in postpartum women) aims to examine treatment and counseling preferences and barriers in relation to the experience of intimate partner violence (IPV), depression and anxiety, and (childbirth-related) posttraumatic stress disorder (PTSD) among postpartum women in Dresden, Germany. Currently, the INVITE study consists of an interim sample of N = 1,787 participants with n = 891 completed interviews. Recruitment is ongoing, targeting a community sample of at least N = 4,000 women who complete various quantitative questionnaires via telephone interviews at 3-4 months postpartum. The differences in rates of IPV, postpartum depression and anxiety, and/or (childbirth-related) PTSD as well as treatment and counseling preferences and barriers between affected and non-affected women will be assessed. Further, predisposing variables, past and present stress exposure, enabling resources, as well as past and present health will be examined as predictors of service preferences and barriers. In this study protocol, the theoretical background, methods, as well as preliminary results regarding sociodemographic characteristics and birth-related factors of the interim sample are presented and discussed in terms of their socio-political relevance. Simultaneously assessing IPV, postpartum depression and anxiety, and (childbirth-related) PTSD will facilitate exploring comorbidities and concomitant special needs of affected women. Results of the INVITE study will therefore set the ground for well-aimed development and improvement of treatment and counseling services for the respective target groups by informing health care professionals and policy makers about specific preferences and barriers to treatment. This will yield the possibility to tailor services to the needs of postpartum women.
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Affiliation(s)
- Lara Seefeld
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Amera Mojahed
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Freya Thiel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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19
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Morris H, Tumin D, Kroeger RA, Buckman C. Medical home access among children of parents in same-sex couples. Children's Health Care 2021. [DOI: 10.1080/02739615.2021.2005599] [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: 10/19/2022]
Affiliation(s)
- Hannah Morris
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | | | - Cierra Buckman
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
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