The Influence of Minority Stress on Level of Depression among Thai LGBT Adults

In the US, lesbian, gay, bisexual, and transgender (LGBT) individuals report higher rates of depression compared with heterosexual and cisgender persons. To date, little is known about the mental health of LGBT adults in Thailand. Here, we examined rates and correlates of depression among a volunteer sample of Thai LGBTs. Data were collected as part of a larger cross-sectional survey study. Standardized measures of sexual orientation and gender identity, stress, coping style, and minority stressors were completed. Of the 411 participants, 40.3% met the criteria for depression. In multivariate analyses, the combined influences of sociodemographic factors, general stress, coping strategies, and minority-specific stress variables explained 47.2% of the variance in depression scores (F[16,367]= 20.48, p<.001). Correlates of depression included coping strategies and minority-specific stressors, including experiences of victimization, discrimination, and level of identity concealment. Study findings have implications for psychiatric nursing practice and the development of intervention research. Abstrak Di AS, individu lesbian, gay, biseksual, dan transgender (LGBT) melaporkan tingkat depresi yang lebih tinggi dibandingkan dengan orang heteroseksual dan cisgender. Saat ini, sedikit yang diketahui tentang kesehatan mental pada orang dewasa dengan LGBT di Thailand. Di sini, kami meneliti tingkat dan korelasi depresi di antara sampel sukarelawan LGBT Thailand. Data dikumpulkan sebagai bagian dari studi survei cross-sectional yang lebih besar. Pengukuran terstandar terhadap orientasi seksual dan identitas gender, stres, koping, dan stresor minoritas telah selesai. Dari 411 peserta, 40,3% memenuhi kriteria untuk depresi. Dalam analisis multivariat, pengaruh gabungan faktor sosiodemografi, stres umum, strategi koping, dan variabel stres spesifik-minoritas menjelaskan 47,2% dari varians dalam skor depresi (F [16,367]= 20,48, p< 0,001). Korelasi depresi termasuk strategi koping dan stres spesifik-minoritas, termasuk pengalaman viktimisasi, diskriminasi, dan tingkat penyembunyian identitas. Temuan penelitian memiliki implikasi untuk praktik keperawatan psikiatris dan pengembangan penelitian intervensi. Kata kunci: depresi, LGBT, minoritas seksual dan gender; stres minoritas, Thailan

The Influence of Minority Stress on Level of Depression among Thai LGBT Adults

In the US, lesbian, gay, bisexual, and transgender (LGBT) individuals report higher rates of depression compared with heterosexual and cisgender persons. To date, little is known about the mental health of LGBT adults in Thailand. Here, we examined rates and correlates of depression among a volunteer sample of Thai LGBTs. Data were collected as part of a larger cross-sectional survey study. Standardized measures of sexual orientation and gender identity, stress, coping style, and minority stressors were completed. Of the 411 participants, 40.3% met the criteria for depression. In multivariate analyses, the combined influences of sociodemographic factors, general stress, coping strategies, and minority-specific stress variables explained 47.2% of the variance in depression scores (F[16,367]= 20.48, p&lt;.001). Correlates of depression included coping strategies and minority-specific stressors, including experiences of victimization, discrimination, and level of identity concealment. Study findings have implications for psychiatric nursing practice and the development of intervention research. &nbsp; Abstrak Pengaruh Stres Minoritas terhadap Tingkat Depresi pada LGBT Thailand. Di AS, individu lesbian, gay, biseksual, dan transgender (LGBT) melaporkan tingkat depresi yang lebih tinggi dibandingkan dengan orang heteroseksual dan cisgender. Saat ini, sedikit yang diketahui tentang kesehatan mental pada orang dewasa dengan LGBT di Thailand. Di sini, kami meneliti tingkat dan korelasi depresi di antara sampel sukarelawan LGBT Thailand. Data dikumpulkan sebagai bagian dari studi survei cross-sectional yang lebih besar. Pengukuran terstandar terhadap orientasi seksual dan identitas gender, stres, koping, dan stresor minoritas telah selesai. Dari 411 peserta, 40,3% memenuhi kriteria untuk depresi. Dalam analisis multivariat, pengaruh gabungan faktor sosiodemografi, stres umum, strategi koping, dan variabel stres spesifik-minoritas menjelaskan 47,2% dari varians dalam skor depresi (F [16,367]= 20,48, p&lt; 0,001). Korelasi depresi termasuk strategi koping dan stres spesifik-minoritas, termasuk pengalaman viktimisasi, diskriminasi, dan tingkat penyembunyian identitas. Temuan penelitian memiliki implikasi untuk praktik keperawatan psikiatris dan pengembangan penelitian intervensi. Kata kunci: depresi, LGBT, minoritas seksual dan gender; stres minoritas, Thailan

Predictors of Readiness to Quit Among a Diverse Sample of Sexual Minority Male Smokers

ABSTRACT Introduction: Readiness to quit smoking - a pattern of attitudes, intentions, and behaviors that reflect a likelihood of engaging in cessation activities—is a useful heuristic for understanding smoking disparities based on sexual orientation. This study examined demographic, tobacco-use patterns, psychosocial and cognitive factors associated with readiness to quit among gay and bisexual male smokers. Methods: A cross-sectional survey was conducted as part of a larger Tobacco Elimination and Control Collaboration (Q-TECC) initiative in the lesbian, gay, bisexual, and transgender (LGBT) community. Readiness to quit was measured by a composite score created from four variables (motivation to quit, importance of quitting, plan to quit, and confidence in quitting) (alpha=.87, M=3.42, SD=.96, range 1-5). Results: The sexual minority smokers in the sample (N=208; M=33 years) were racially/ethnically diverse. Latino men had significantly lower levels of readiness to quit compared to African American and White men. Hierarchical linear regression analyses were performed to explore the relative contributions of sociodemographic, tobacco-use patterns, psychosocial and cognitive factors on Readiness to Quit. In the final model, the following variables were associated with readiness to quit scores: Latino ethnicity, fewer quit attempts, positive expectancies for the beneficial effects of smoking, and lower perceived importance of smoking as an important LGBT health issue. None of the psychosocial factors were associated with readiness to quit. Discussion: Readiness to quit scores were largely predicted by modifiable attitudes, behaviors, and expectancies. Study findings have implications for improving outreach and awareness and for the development of effective treatment approaches

Preliminary Evaluation of a Citizen Scientist Educational Curriculum Aimed at Engaging Black Men in Lung Cancer Early Detection Screening

This article describes an educational program to engage African American men as citizen scientists (CSs) and future research partners in a lung cancer screening project. We provide an overview of the curriculum used, the structure and format of the educational sessions, and associated educational outcomes. Furthermore, we describe lessons learned in the engagement of African American men as CS in community-based lung-health equity research. The CS educational program included five group-based sessions delivered through zoom. The educational curriculum was adapted from the University of Florida Citizen Scientist program and tailored to address lung health and the contextual experiences of African American men. Each session lasted 90 minutes. Pre- and post-test measures were collected to examine changes in knowledge, comfort, health literacy, research interests, and medical mistrust. Eight African American men completed the CS educational program. Attendance rates were high for each session (100%). Seven participants completed additional human subject research certification. Improvements were observed from pre- to post-test in participants’ level of knowledge, comfort, and health literacy but not medical mistrust. CS reported the most interest in participating in research aimed to identify important community strengths and problems. Study findings suggest that it was feasible to deliver an online citizen scientist educational program designed to prepare participants to serve as partners in a lung cancer screening intervention for African American men. Results suggest the educational program has the potential to improve key outcomes including completion of regulatory training and increased research-related knowledge, comfort, and health literacy

Racial/ethnic and geographic differences in access to a usual source of care that follows the patient-centered medical home model: Analyses from the Medical Expenditure Panel Survey data

This study examined racial and geographic differences in access to a usual source of care (USC) and it further explored these differences among individuals who had a USC that followed the patient-centered medical home (PCMH) model. Using cross-sectional data from the Household Component of the Medical Expenditure Panel Survey (2008-2013), our sample consisted of non-institutionalized US civilians ages 18-85 (n= 146,233; weighted n = 229,487,016). Our analysis included weighted descriptive statistics and weighted logistic regressions. Although 76% of the respondents had a USC, only 11% of them had a USC that followed the PCMH model. Among respondents who had a USC that followed the PCMH model, 80% were White, 13% Black, 5% Asian, and 12% were of Hispanic ethnicity. Across U.S. regions, 88% percent of those who had a USC that followed the PCMH model resided in metropolitan statistical areas (MSAs), 22% resided in the West, 26% in the Northeast, 25% in the Midwest, and 27% in the South. Results from logistic regression analyses indicated that race and ethnicity were not significant predictors of having a USC that followed the PCMH model. Northeastern U.S. residents (OR: 1.30; 95% CI:1.06-1.61) were more likely to have a USC that followed the PCMH model compared with southern residents. In conclusion, only a small percentage of respondents in our sample had a USC with the PCMH model. Further, race and ethnicity were not predictors of having a USC with the PCMH model

Promotion of tobacco use cessation for lesbian, gay, bisexual, and transgender people: A systematic review

Lesbian, gay, bisexual, and transgender (LGBT) people are at increased risk for the adverse effects of tobacco use given their high prevalence of use, especially smoking. Evidence regarding cessation is limited. To determine if efficacious interventions are available and to aid the development of interventions, a systematic review was conducted of gray and peer-reviewed literature describing clinical, community, and policy interventions as well as knowledge, attitudes, and behaviors regarding tobacco use cessation among LGBT people

Exploring cancer health disparities among formerly incarcerated African Americans

Incarcerated populations have a higher burden of chronic disease and elevated risk factors for cancer (BJS, 2012). In 2013, cancer (31%) and heart disease (26%) accounted for over half of all prisoner deaths. The Genomics Research Program of the National Cancer Institute’s Division of Cancer Control and Population Sciences (2016) identified incarcerated persons as an understudied population about which there is limited data regarding cancer risks and outcomes. A majority of studies on corrections populations focus on health issues associated with reduction of infectious diseases such as HIV, Tuberculosis, and Hepatitis. Scant research has been conducted on issues associated with cancer prevention and control among African Americans with a history of incarceration. This qualitative, participatory, pilot research study explores the domains of cancer health disparities among African American men and women who were formerly incarcerated in Illinois prisons. Four qualitative focus groups will be conducted. The primary purpose of the focus groups is to collect and qualitatively analyze preliminary data on the barriers to access, utilization and treatment of cancer. This presentation seeks to: (1) describe the need for enhanced access to cancer care and treatment, (2) advocate for the inclusion of best practices in cancer care in corrections systems and, (3) identify policy recommendations and initiatives aimed at reducing cancer disparities among incarcerated and formerly incarcerated persons

“You Come Back to the Same Ole Shit:” A Qualitative Study of Smoking Cessation Barriers among Women Living with HIV: Implications for Intervention Development

Although tobacco use among women living with HIV (WLWH) is decreasing, the prevalence is more than double that of women in the general population and remains an important health behavior to target among WLWH. Few smoking cessation interventions specifically focus on the unique social and medical needs of women living with HIV (WLWH). Thus, the investigative team engaged WLWH (N=18) in qualitative focus groups to: 1) understand barriers and facilitators to smoking cessation; and 2) inform intervention structure and content priorities. Participants identified salient reasons for smoking and barriers to smoking cessation, which included coping mechanisms for life stressors, HIV-related stress, HIV-related stigma, and social isolation. Further, WLWH highlighted the importance of long-term smoking cessation support, peer support, mental health content, religion/spirituality, and targeted risk messaging in smoking cessation intervention development. Study findings provide concrete, operational strategies for future use in a theory-based smoking cessation intervention, and underscore the importance of formative research to inform smoking cessation interventions for WLWH