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Introduction: Increased rates of mental health issues among LGBTQ+ people have been reported during the COVID-19 pandemic, particularly among young people. Method: Semi-structured interviews were conducted in 2021 with 61 young adult LGBTQ+ people residing in France, Italy, Portugal, Sweden, and the UK. Each interview was summarized on a template covering the participants' experiences of pandemic restrictions, mental health, and minority stress during this period. A thematic analysis was conducted on the templates. Results: The pandemic restrictions had a large impact on the participants' lives, leaving them stuck at home. Not having access to the LGBTQ+ community was an additional stress, as this is a venue for support. Half of the participants had suffered from mental health issues during the pandemic. Those who were living in non-affirmative households had a particularly difficult time and experienced overwhelming stress. Increased feelings of gender dysphoria were seen among trans participants due to the lack of access to gender-affirming healthcare. Most participants experienced less distal minority stress than usual due to social isolation restrictions. Conclusion: The COVID-19 pandemic and the associated social restrictions had a large impact on the lives of LGBTQ+ young adults. Many experience worse mental health, although relief from distal minority stress was common. Policy Implications: Policy makers must consider the needs of LGBTQ+ young adults as they seek to explore and establish their gender and/or sexual identity. During a pandemic, it is particularly important to help young LGBTQ+ people to engage with the LGBTQ+ community. [ABSTRACT FROM AUTHOR]

This study examined the indirect effect of relationship and parental status on mental health through internalized homonegativity among lesbian, gay, and bisexual (LGB) individuals. Prior research suggested that being in a relationship and becoming a parent may improve the mental health of LGB individuals, acting as protective factors against stigma and discrimination. However, the role of internalized homonegativity in mental health disparities between LGB individuals in relationships/parents and those who are not remains unclear. Therefore, we surveyed 491 LGB cisgender Israelis aged 18–64 years (M = 33.51, SD = 9.09) assessing relationship status, parental status, internalized homonegativity, depressive symptomatology, and life satisfaction. Indirect effects were explored using the PROCESS macro. Results showed that LGB individuals in romantic relationships reported lower depressive symptomatology and higher life satisfaction compared to those not in relationships. Similarly, LGB individuals who were parents reported lower depressive symptomatology and higher life satisfaction compared to non-parents. Significant indirect effect was found for couplehood/parenthood on depressive symptomatology/life satisfaction through internalized homonegativity. This study deepens the understanding of the interplay between couplehood, parenthood, and internalized homonegativity and their contribution to mental health of LGB individuals. It provides valuable insights for researchers and practitioners, highlighting the potential role of couplehood and parenthood in the mental health of sexual minority groups facing legal restrictions on marriage and parenting. [ABSTRACT FROM AUTHOR]

Background: Zhiguo ethnic groups, commonly known as "the directly-entering-socialism ethnic groups", represent Chinese ethnic minorities who have undergone a unique social development trajectory by transforming directly from primitive societies to the socialist stage. In recent decades, significant lifestyle transformations have occurred among Zhiguo ethnic groups. Understanding their health lifestyles can play a strategic role in China's pursuit of universal health coverage. This study aims to examine patterns of health-related lifestyle among Zhiguo ethnic groups and explore whether sociodemographic features and specific indicators related to health status are associated with particular classes. Methods: A cross-sectional study was conducted in Yunnan Province, China, from July to December 2022. Stratified random sampling method was employed to recruit residents belonging to six Zhiguo ethnic groups aged between 15 and 64. Latent class analysis was performed to identify clusters of health-related behaviors within each ethnic group. Logistic regression was utilized to determine the predictors of health lifestyles. Results: A total of 1,588 individuals from the Zhiguo ethnic groups participated in this study. Three latent classes representing prevalent health lifestyles among the Zhiguo ethnic groups were identified: "unhealthy lifestyle" (31.80%), "mixed lifestyle" (57.37%), and "healthy lifestyle" (10.83%). In the overall population, individuals belonging to the "healthy lifestyle" group exhibited a higher likelihood of being non-farmers (OR: 2.300, 95% CI: 1.347–3.927), women (OR: 21.459, 95% CI: 13.678–33.667), married individuals (OR: 1.897, 95% CI: 1.146–3.138), and those residing within a walking distance of less than 15 min from the nearest health facility (OR: 2.133, 95% CI: 1.415–3.215). Conversely, individuals in the age cohorts of 30–39 years (OR: 0.277, 95% CI: 0.137–0.558) and 40–49 years (OR: 0.471, 95% CI: 0.232–0.958) showed a decreased likelihood of adopting a healthy lifestyle. Conclusions: A considerable proportion of the Zhiguo ethnic groups have not adopted healthy lifestyles. Targeted interventions aimed at improving health outcomes within these communities should prioritize addressing the clustering of unfavorable health behaviors, with particular emphasis on single male farmers aged 30–49, and expanding healthcare coverage for individuals residing more than 15 min away from accessible facilities. [ABSTRACT FROM AUTHOR]

Policy Points Artificial intelligence (AI) is disruptively innovating health care and surpassing our ability to define its boundaries and roles in health care and regulate its application in legal and ethical ways. Significant progress has been made in governance in the United States and the European Union. It is incumbent on developers, end users, the public, providers, health care systems, and policymakers to collaboratively ensure that we adopt a national AI health strategy that realizes the Quintuple Aim; minimizes race‐based medicine; prioritizes transparency, equity, and algorithmic vigilance; and integrates the patient and community voices throughout all aspects of AI development and deployment. Artificial intelligence (AI) is disruptively innovating health care and surpassing our ability to define its boundaries and roles in health care and regulate its application in legal and ethical ways. Significant progress has been made in governance in the United States and the European Union. It is incumbent on developers, end users, the public, providers, health care systems, and policymakers to collaboratively ensure that we adopt a national AI health strategy that realizes the Quintuple Aim; minimizes race‐based medicine; prioritizes transparency, equity, and algorithmic vigilance; and integrates the patient and community voices throughout all aspects of AI development and deployment. [ABSTRACT FROM AUTHOR]

Lesbian and gay (LG) people experience minority stressors, resulting in adverse mental health outcomes. To cope, many LG people engage in individualistic or collectivistic strategies, that is, self-distancing or connecting with their in-group, the LGBTQ+ community. Even though research suggests what may help LG people cope with minority stress, it is less clear how and under which conditions they do so. In this study, we examine how LG people employ individualistic and collectivistic strategies and what that entails for the negative relationship between minority stress and mental health. A total of 199 responses from British LG people were collected via the online crowdsourcing platform Clickworker. A custom mediation model indicated that, for collectivistic strategies, higher levels of minority stress were associated with increased LGBTQ+ community identification, and LGBTQ+ identification was positively related to high LGBTQ+ social support; in turn, LGBTQ+ social support was associated with positive mental health outcomes. For individualistic strategies, results show higher minority stress was related to an increased likelihood of individual mobility, but individual mobility was not associated with mental health outcomes. These findings highlight how collectivistic responses to minority stress might prove more reliable than individualistic ones in enhancing the mental health of LG people. [ABSTRACT FROM AUTHOR]

Background Perceived discrimination in health care settings can have adverse consequences on mental health in minority groups. However, the association between perceived discrimination and mental health is prone to unmeasured confounding. The study aims to quantitatively evaluate the influence of unmeasured confounding in this association, using g-estimation. Methods In a predominantly African American cohort, we applied g-estimation to estimate the association between perceived discrimination and mental health, adjusted and unadjusted for measured confounders. Mental health was measured using clinical diagnoses of anxiety, depression and bipolar disorder. Perceived discrimination was measured as the number of patient-reported discrimination events in health care settings. Measured confounders included demographic, socioeconomic, residential and health characteristics. The influence of confounding was denoted as α 1 from g-estimation. We compared α 1 for measured and unmeasured confounding. Results Strong associations between perceived discrimination in health care settings and mental health outcomes were observed. For anxiety, the odds ratio (95% confidence interval) unadjusted and adjusted for measured confounders were 1.30 (1.21, 1.39) and 1.26 (1.17, 1.36), respectively. The α 1 for measured confounding was –0.066. Unmeasured confounding with α 1 = 0.200 ⁠ , which was over three times that of measured confounding, corresponds to an odds ratio of 1.12 (1.01, 1.24). Similar results were observed for other mental health outcomes. Conclusion Compared with measured confounding, unmeasured that was three times measured confounding was not enough to explain away the association between perceived discrimination and mental health, suggesting that this association is robust to unmeasured confounding. This study provides a novel framework to quantitatively evaluate unmeasured confounding. [ABSTRACT FROM AUTHOR]

Objective: Sexual minority disparities in behavioral health (e.g., mental health and substance use) are well-established. However, sexual identity is dynamic, and changes are common across the life course (e.g., identifying with a monosexual [lesbian or gay] label and later with a plurisexual [queer, pansexual, etc.] label). This study assessed whether behavioral health risks coincide with sexual identity change among sexual minority people. Methods: Associations in a 3-year U.S. national probability sample of sexual minority adults were assessed between sexual minority identity change (consistently monosexual [N=400; 44.3% weighted], consistently plurisexual [N=239; 46.7% weighted], monosexual to plurisexual [N=19; 4.2% weighted], and plurisexual to monosexual [N=25; 4.8% weighted]) and five behavioral health indicators (psychological distress, social well-being, number of poor mental health days in the past month, problematic alcohol use, and problematic use of other drugs), controlling for demographic characteristics and baseline behavioral health. Results: Among female participants, monosexual-to-plurisexual identity change (vs. consistently monosexual identity) was associated with greater psychological distress (B=3.41, SE=1.13), lower social well-being (B=−0.61, SE=0.25), and more days of poor mental health in the past month (B=0.69 [Bexp=1.99], SE=0.23). Among male participants, plurisexual-to-monosexual identity change (vs. consistently plurisexual identity) was associated with lower social well-being (B=−0.56, SE=0.25), and identity change (regardless of type) was generally associated with increased problematic use of alcohol and other drugs. Conclusions: Sexual identity change is an important consideration for sexual minority behavioral health research, with changes (vs. consistency) in identity being an important risk factor for compromised behavioral health. Prevention and treatment interventions may need to tailor messaging to sexual minority men and women differently. [ABSTRACT FROM AUTHOR]

Asian, Pacific Islander, African, and Caribbean communities in the U.S. are heavily impacted by chronic hepatitis B (HBV) and hepatocellular carcinoma (HCC). Educating these groups about the link between the two diseases is imperative to improve screening rates and health outcomes. This study aims to identify and incorporate preferred mediated communication methods into community-specific educational campaigns which emphasize the connection between the conditions, to promote uptake of prevention and management behaviors for HBV and HCC. Fifteen focus groups and two key informant interviews were conducted with Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Data were analyzed using thematic coding and analysis. Findings demonstrate that all communities preferred materials be offered in both English and native languages and requested that materials highlight the connection between HBV and HCC. Delivery channel preferences and messaging themes varied by group. This study provides insight into community-specific preferences for learning about HBV and HCC. The findings can be used to design culturally and linguistically tailored, multi-platform, health education campaigns to facilitate improved HBV screening and vaccination rates and increase knowledge about HCC risk among highly impacted communities in the U.S. [ABSTRACT FROM AUTHOR]

The current study examines the impact of COVID-19 for a sample of lesbian, gay, bisexual, transgender, queer and questioning, and other emerging sexual (and gender) identities (LGBTQ+) adults. We hypothesized that financial strain, mental health, job loss, and physical COVID-19 symptoms would be positively related to intimate partner violence (IPV). Data were collected through recruitment using Amazon Mechanical Turk (MTurk) from May to September 2020. Respondents were 18+ years old, identified as a member of the LGBTQ + community, and resided in the United States. Participant ages ranged from 18-90 years old, and most of the sample identified as White (53.9%), bisexual (47.6%), and transgender (32.6%). The final sample consisted of 1,249 participants. All types of perpetration violence were significantly associated with COVID-19 symptoms. Both physical perpetration and psychological victimization were significantly associated with financial strain. All types of perpetration violence were significantly associated with COVID-19 symptoms. Both physical perpetration and psychological victimization were significantly associated with financial strain. Results highlight the increased need for access to IPV prevention resources for LGBTQ + adults, especially during national public health crises such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression – subtle/ambiguous slights against one's marginalized identity – is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups. Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure. Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (OR Micro = 1.42, OR Discrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (OR Depress = 1.24, OR Sleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents. Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences. The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits. • One in five college students experienced microaggression/discrimination the past year. • Exposure rates were higher in racially marginalized students than in Whites. • Microaggression and discrimination each predicted increased odds of all symptoms. • Pathways from the exposures to anxiety, depression, and sleep varied for microaggression versus discrimination. • Clinicians must proactively address identity-based exposures to advance mental health equity. [ABSTRACT FROM AUTHOR]

The rise in the study of sexualised drug use among gay, bisexual and other men who have sex with men (MSM), known as chemsex, has generated a multiplicity of data that contribute to its problematisation as a public health issue through the link with HIV and addictions. The study of these practices, from a biomedical paradigm, has focused on risk and has contributed to its reduction as a unique and quantifiable phenomenon. This study aims to explore the experience of risk in the course of the practices, to find out what management strategies they employ in the face of risk and how they are generated. Semi-structured interviews were conducted with five chemsex practitioners in the Metropolitan Area of Barcelona and, subsequently, a thematic analysis was applied. The findings show how these men detect, assume and confront the risks present in these practices, where the type of relationships that take place and the social circle available to them are relevant. This study also highlights the creation of strategies based on experience and how the transmission of this knowledge among participants facilitates decision-making and risk management. [ABSTRACT FROM AUTHOR]

Physical inactivity is a growing societal concern with significant impact on public health. Identifying barriers to engaging in physical activity (PA) is a critical step to recognize populations who disproportionately experience these barriers. Understanding barriers to PA holds significant importance within patient-facing healthcare professions like nursing. While determinants of PA have been widely studied, connecting individual and social factors to barriers to PA remains an understudied area among nurses. The objectives of this study are to categorize and model factors related to barriers to PA using the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework. The study population includes nursing students at the study institution (N = 163). Methods include a scoring system to quantify the barriers to PA, and regularized regression models that predict this score. Key findings identify intrinsic motivation, social and emotional support, education, and the use of health technologies for tracking and decision-making purposes as significant predictors. Results can help identify future nursing workforce populations at risk of experiencing barriers to PA. Encouraging the development and employment of health-informatics solutions for monitoring, data sharing, and communication is critical to prevent barriers to PA before they become a powerful hindrance to engaging in PA. [ABSTRACT FROM AUTHOR]

Purpose: To examine factors of influence in diabetes management and their association with self-reported health outcomes in patients with type 2 diabetes treated at Federally Qualified Health Centers (FQHCs). Methods: This cross-sectional study examined data from the 2014 Health Center Patient Survey (HCPS). Predictor variables were categorized across three levels of the National Institute on Minority Health and Health Disparities research framework. Outcome variables retrieved from HCPS included self-reports of blood glucose levels, and diabetes-related emergency department (ED)/hospital visits during past year. Results: A total of 936 patients with diabetes were included. Most (65%) participants received a diabetes self-management plan. During the previous year, 72% received > = 2 A1C checks, 52% reported high blood glucose levels, and 12% visited an ED/hospital. Multivariable results showed that insulin use and receiving a self-management plan were associated with high blood glucose levels and ED/hospital visits. Community factors of being unable to get medications and receiving a specialist foot exam were respectively associated with high blood glucose levels and ED/hospital visits. Conclusion: Different factors were associated with health outcomes in patients with diabetes treated at FQHCs. Identifying these factors can help with targeted screening and follow-up and assessing potential interventions to improve health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Sexual and gender minorities (SGM) make up 4% of the Canadian population. Due to existing barriers to care in the community, SGM patients may seek more help and be sicker at presentation to hospital. Paramedics occupy a unique role and can remove or decrease these barriers. There are no existing evaluations of training programs in SGM health for prehospital providers. A training program to develop better allyship in paramedics toward SGM populations was developed and assessed. Methods: A 70‐ to 90‐min mandatory, asynchronous, online training module in SGM health in the prehospital environment was developed and delivered via the emergency medical service (EMS) system's learning management system. A before‐and‐after study of cisgender, heterosexual, frontline paramedics was performed to measure the impact of the training module on the care of SGM patients. The validated Ally Identity Measure (AIM) tool was used to identify success of training and includes subscales of knowledge and skills, openness and support, and oppression awareness. Demographics and satisfaction scores were collected in the posttraining survey. Matched and unmatched pairs of surveys and demographic associations were analyzed using nonparametric statistics. Results: Of 609 paramedics, 571 completed the training, and 239 surveys were completed before and 105 (n = 344) surveys after the training; 60 surveys were paired. Overall AIM scores of matched pairs (n = 60) improved by 12% (p < 0.001), with knowledge and skills accounting for most of the increase (21%, p < 0.001). Unmatched pairs (n = 344) were similar in demographics and scores. Rural paramedics also had significantly lower pretraining oppression awareness scores and had lower posttraining AIM scores compared to suburban paramedics (6% difference). Satisfaction scores rated the training as relevant and applicable (87% and 82%, respectively). Conclusions: A novel prehospital training program in the care of SGM patients resulted in a statistically significant increase in allyship in cisgender, heterosexual‐identified frontline paramedics. [ABSTRACT FROM AUTHOR]

Sexual minority (SM) youth experience a greater mental health burden compared with their heterosexual peers. This study aimed to characterize mental health disparities among SM compared with non-SM youth, test main and interactive associations of SM identity and stressors targeting SM youth at the individual level (interpersonal SM discrimination) and structural level (state-level structural SM stigma) with youth mental health, and explore the contribution of interpersonal SM discrimination to the mental health burden of SM youth. Participants included 11,622 youth (ages 9-13; 47.6% assigned female at birth) from the Adolescent Brain Cognitive Development (ABCD) Study. Linear mixed-effects models tested main and interactive associations of SM identity, interpersonal SM discrimination, and structural SM stigma with mental health measures (self-reported overall psychopathology, suicidal ideation, and suicide attempts), adjusting for demographics and other interpersonal stressors not specific to SM (other discrimination types, peer victimization, and cyberbullying). Longitudinal mediation models tested whether interpersonal SM discrimination mediated the associations between SM identity and mental health measures. SM youth (n = 1,051) experienced more interpersonal SM discrimination and overall psychopathology compared with their non-SM peers (n = 10,571). Adjusting for demographics, there were significant associations (main effects) of interpersonal SM discrimination and structural SM stigma with overall psychopathology. When further adjusting for other non-SM–related stressors, the main effect of structural SM stigma was no longer significant. Interpersonal SM discrimination was also significantly associated with suicidal ideation and attempt, accounting for demographics, while structural SM stigma was not. Accounting for both demographics and other non-SM stressors, there was a significant interaction between SM identity and structural SM stigma in association with psychopathology (p =.02), such that, compared with their peers, SM youth showed a greater association between structural SM stigma and psychopathology. Longitudinal mediation revealed that interpersonal SM discrimination was a significant mediator explaining approximately 10% to 15% of the variance of the pathways between SM identity and all mental health outcomes. Results delineate contributions of interpersonal discrimination and structural stigma targeting SM youth to their heightened mental health burden in early adolescence. These findings underscore the need to address microlevel and macrolevel SM discrimination and structural stigma when caring for this population. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. [ABSTRACT FROM AUTHOR]

Without comprehensive examination of available literature on health disparities and minority health (HDMH), the field is left vulnerable to disproportionately focus on specific populations or conditions, curtailing our ability to fully advance health equity. Using scalable open-source methods, we conducted a computational scoping review of more than 200,000 articles to investigate major populations, conditions, and themes as well as notable gaps. We also compared trends in studied conditions to their relative prevalence using insurance claims (42 million Americans). HDMH publications represent 1% of articles in Medical Literature Analysis and Retrieval System Online (MEDLINE). Most studies are observational in nature, although randomized trial reporting has increased fivefold in the past 20 years. Half of HDMH articles concentrate on only three disease groups (cancer, mental health, and endocrine/metabolic disorders), while hearing, vision, and skin-related conditions are among the least well represented despite substantial prevalence. To support further investigation, we present HDMH Monitor, an interactive dashboard and repository generated from the HDMH bibliome. [ABSTRACT FROM AUTHOR]

In the present scoping review, we explore whether existing evidence supports the premise that social determinants of health (SDoH) affect immigrant health outcomes through their effects on the microbiome. We adapt the National Institute on Minority Health and Health Disparities' research framework to propose a conceptual model that considers the intersection of SDoH, the microbiome, and health outcomes in immigrants. We use this conceptual model as a lens through which to explore recent research about SDoH, biological factors associated with changes to immigrants' microbiomes, and long‐term health outcomes. In the 17 articles reviewed, dietary acculturation, physical activity, ethnicity, birthplace, age at migration and length of time in the host country, socioeconomic status, and social/linguistic acculturation were important determinants of postmigration microbiome‐related transformations. These factors are associated with progressive shifts in microbiome profile with time in host country, increasing the risks for cardiometabolic, mental, immune, and inflammatory disorders and antibiotic resistance. The evidence thus supports the premise that SDoH influence immigrants' health postmigration, at least in part, through their effects on the microbiome. Omission of important postmigration social‐ecological variables (e.g., stress, racism, social/family relationships, and environment), limited research among minoritized subgroups of immigrants, complexity and inter‐ and intra‐individual differences in the microbiome, and limited interdisciplinary and biosocial collaboration restrict our understanding of this area of study. To identify potential microbiome‐based interventions and promote immigrants' well‐being, more research is necessary to understand the intersections of immigrant health with factors from the biological, behavioral/psychosocial, physical/built environment, and sociocultural environment domains at all social‐ecological levels. [ABSTRACT FROM AUTHOR]

Introduction: Throughout the COVID-19 pandemic, underserved populations, such as racial and ethnic minorities, were disproportionately impacted by illness, hospitalization, and death. Equity in clinical trials means that the participants in clinical trials represent the people who are most likely to have the health condition and need the treatment that the trial is testing. Infodemiology approaches examining user conversations on social media platforms have the potential to elucidate specific barriers and challenges related to clinical trial participation, including among racial and ethnic minority populations. Materials and methods: The study retrospectively collected and analyzed user question and answer posts from Quora in October 2021 using an inductive content coding approach. We also examined user's publicly available profile metadata to identify racial and ethnic minority users to capture their experiences, attitudes, topics, and discussions of barriers to COVID-19 vaccine trials. Results: A total of 1073 questions and 7479 answers were collected. A total of 763 questions and 2548 answers were identified as related to COVID-19 vaccine clinical trials. The majority of these online interactions focused on asking questions and sharing knowledge and opinions about COVID-19 vaccine trials, including major topics related to: (a) interpreting whether clinical trial results could be trusted; (b) questions about vaccine efficacy and safety; (c) understanding trial design, regulatory considerations, and vaccine platforms; and (d) questions about trial enrollment, length, and adequate representation. Additionally, four major barriers discussed included: (i) disagreement from users regarding whether clinical trials require representation from different racial and ethnic minorities; (ii) concerns regarding the safety of trials when participating; (iii) lack of knowledge on how to participate in a trial; and (iv) questions of whether participants could withdraw from a trial to access an approved COVID-19 vaccine. Conclusions: Our study found active user discussions related to COVID-19 vaccine clinical trials on Quora, including those specific to minority health topics and those posted by a smaller group of self-identified racial and ethnic minority online users. Results from this study can help identify barriers to participation among the general public and underrepresented groups while also supporting the design of future outreach strategies to help with recruitment and inclusive trial participation. [ABSTRACT FROM AUTHOR]

Background In 2011, the Veterans Health Administration (VHA) established a policy for the delivery of transition-related services, including gender-affirming hormone therapy (GAHT), for transgender and gender diverse (TGD) patients. In the decade since this policy's implementation, limited research has investigated barriers and facilitators of VHA's provision of this evidence-based therapy that can improve life satisfaction among TGD patients. Purpose This study provides a qualitative summary of barriers and facilitators to GAHT at the individual (e.g. knowledge, coping mechanisms), interpersonal (e.g. interactions with other individuals or groups), and structural (e.g. gender norms, policies) levels. Methods Transgender and gender diverse patients (n = 30) and VHA healthcare providers (n = 22) completed semi-structured, in-depth interviews in 2019 regarding barriers and facilitators to GAHT access and recommendations for overcoming perceived barriers. Two analysts used content analysis to code and analyze transcribed interview data and employed the Sexual and Gender Minority Health Disparities Research Framework to organize themes into multiple levels. Results Facilitators included having GAHT offered through primary care or TGD specialty clinics and knowledgeable providers, with patients adding supportive social networks and self-advocacy. Several barriers were identified, including a lack of providers trained or willing to prescribe GAHT, patient dissatisfaction with prescribing practices, and anticipated or enacted stigma. To overcome barriers, participants recommended increasing provider capacity, providing opportunities for continual education, and enhancing communication around VHA policy and training. Conclusions Multi-level system improvements within and outside the VHA are needed to ensure equitable and efficient access to GAHT. [ABSTRACT FROM AUTHOR]

Background: In the USA, access to quality healthcare varies greatly across racial and ethnic groups, resulting in significant health disparities. A new term, "racial health equity" (RHE), is increasingly reported in the medical literature, but there is currently no consensus definition of the term. Additionally, related terms such as "health disparities," "health inequities," and "equality" have been inconsistently used when defining RHE. Methods: The primary purpose of this scoping review is to investigate the current use and underlying concepts used to define racial health equity. The study will address two key questions: (1) "What terminology and definitions have been used to characterize RHE?" and (2) "What knowledge gaps and challenges are present in the current state of RHE research and theory?" The review will collect and analyze data from three sources: (1) websites from key national and international health organizations, (2) theoretical and narrative published articles, and (3) evidence synthesis studies addressing interventions targeting racial health equity and minority stakeholder engagement. Discussion: Defining "racial health equity" and related terminology is the first step to advancing racial health equity within the USA. This review aims to offer an improved understanding of RHE constructs and definitions, bringing greater unity to national racial health equity research efforts across disciplines. Systematic review registration: This protocol is registered with the Open Science Framework at https://osf.io/7pvzq. [ABSTRACT FROM AUTHOR]

Aims: Sexual minority youth experience health disparities across mental, physical and sexual domains. However, little is known about the extent to which mental health overlaps with sexual and physical health to compound health problems among sexual minority youth. This study examined risky health behaviours, adverse health outcomes, and their overlap across mental, physical and sexual domains, in lesbian, gay, bisexual, questioning (LGBQ) and heterosexual third‐level students in Ireland. Method: Cross‐sectional data from the My World Survey 2‐Post Second Level (MWS2‐PSL) were used. Analyses were conducted on data from N = 7950 18–25‐year‐old students, of which 6204 (78%) identified as heterosexual, 910 (11.4%) bisexual, 412 (5.2%) lesbian/gay and 424 (5.3%) questioning. Risky health behaviours (e.g., self‐harm), adverse outcomes (e.g., mental health difficulties, physical health conditions) and their overlap across mental, physical and sexual domains were compared across heterosexual and LGBQ students using Chi‐square tests. Clustering of health behaviours/outcomes within and between domains were examined. Results: LGBQ students were more likely to exhibit a greater number of risky mental and sexual health behaviours and outcomes. Sexual, physical and mental health behaviours and outcomes overlapped to a greater extent in LGBQ versus heterosexual students. Distinct health outcomes were observed across sexual minority subgroups (e.g., bisexual women reported greater mental health difficulties). Conclusion: Findings demonstrate health inequalities experienced by LGBQ students, particularly across mental and sexual domains. Holistic integrated approaches that consider multiple health domains simultaneously and the distinct health needs of sexual minority subgroups are needed to promote greater health equity. [ABSTRACT FROM AUTHOR]

Social determinants are structures and conditions in the biological, physical, built, and social environments that affect health, social and physical functioning, health risk, quality of life, and health outcomes. The adoption of recommended, standard measurement protocols for social determinants of health will advance the science of minority health and health disparities research and provide standard social determinants of health protocols for inclusion in all studies with human participants. A PhenX (consensus measures for Phenotypes and eXposures) Working Group of social determinants of health experts was convened from October 2018 to May 2020 and followed a well-established consensus process to identify and recommend social determinants of health measurement protocols. The PhenX Toolkit contains data collection protocols suitable for inclusion in a wide range of research studies. The recommended social determinants of health protocols were shared with the broader scientific community to invite review and feedback before being added to the Toolkit. Nineteen social determinants of health protocols were released in the PhenX Toolkit (https://www.phenxtoolkit.org) in May 2020 to provide measures at the individual and structural levels for built and natural environments, structural racism, economic resources, employment status, occupational health and safety, education, environmental exposures, food environment, health and health care, and sociocultural community context. Promoting the adoption of well-established social determinants of health protocols can enable consistent data collection and facilitate comparing and combining studies, with the potential to increase their scientific impact. [ABSTRACT FROM AUTHOR]

Individual-level behavior can be influenced by injunctive and descriptive social network norms surrounding that behavior. There is a need to understand how the influence of social norms within an individual's social networks may influence individual-level sexual behavior. We aimed to typologize the network-level norms of sexual behaviors within the social networks of Black sexual and gender minoritized groups (SGM) assigned male at birth. Survey data were collected in Chicago, Illinois, USA, between 2018 and 2019 from Black SGM. A total of 371 participants provided individual-level information about sociodemographic characteristics and HIV vulnerability from sex (i.e., condomless sex, group sex, use of alcohol/drugs to enhance sex) and completed an egocentric network inventory assessing perceptions of their social network members' (alters') injunctive and descriptive norms surrounding sexual behaviors with increased HIV vulnerability. We used Latent Profile Analysis (LPA) to identify network-level norms based on the proportion of alters' approval of the participant engaging in condomless sex, group sex, and use of drugs to enhance sex (i.e., injunctive norms) and alters' engagement in these behaviors (i.e., descriptive norms). We then used binomial regression analyses to examine associations between network-level norm profiles and individual-level HIV vulnerability from sex. The results of our LPA indicated that our sample experienced five distinct latent profiles of network-level norms: (1) low HIV vulnerability network norm, (2) moderately high HIV vulnerability network norm, (3) high HIV vulnerability network norm, (4) condomless sex dominant network norm, and (5) approval of drug use during sex dominant network norm. Condomless anal sex, group sex, and using drugs to enhance sex were positively and significantly associated with higher HIV vulnerability social network norm profiles, relative to low HIV vulnerability norm profiles. To mitigate Black SGM's HIV vulnerability, future HIV risk reduction strategies can consider using network-level intervention approaches such as opinion leaders, segmentation, induction, or alteration, through an intersectionality framework. [ABSTRACT FROM AUTHOR]

Drowning is a public health concern that disproportionally affects children and minorities in Washington State. Community health educators from Seattle Children's Hospital designed a Water Safety Education and Lifejacket Giveaway Program for low-income parents of preschool-aged children from culturally and linguistically diverse backgrounds. The program was interpreted into multiple languages and parents and children in attendance received free lifejackets. The mixed-methods pilot evaluation of this program found statistically significant relationships between language and self-reported parent swim skill level (Englishspeaker OR 4.6; 95%CI: 1.84 - 11.54); and confidence of keeping one's child safe (English-speaker OR 3.34; 95%CI: 1.10 - 10.4). Additionally, parents who selfreported that they could swim had four times the odds of feeling confident in keeping their children safe around the water (95% CI: 1.21 - 13.28). Qualitative data from follow-up interviews identified that the program boosted parent knowledge and confidence in safe water practices. Multi-lingual delivery and the role of partner preschools was critical to this program's success. Specific programmatic focus on adult parent/caregiver skills and knowledge that reduce risk around the water should be a priority for future efforts to reduce drowning. [ABSTRACT FROM AUTHOR]

Dr. Cuilin Zhang, an expert on nutrition, is leading a pilot study to develop fusion meals that incorporate culture-specific food and flavor profiles while maintaining nutrient composition. The study aims to test the effects of these meals on the metabolic health profiles of Asian populations. Dr. Zhang's research has shown that a consistent Mediterranean diet can effectively prevent metabolic complications during pregnancy, such as gestational diabetes. She is currently focused on identifying modifiable risk factors and underlying molecular mechanisms to predict and prevent postpartum disease in women who had gestational diabetes. Asian women are particularly at risk for gestational diabetes, and more research is needed to understand the reasons behind this. [Extracted from the article]

This article discusses the importance of advancing equity research in the quality of and access to healthcare, particularly in the context of racial and ethnic disparities. It highlights the historical neglect of voices from marginalized communities and the recognition of disparities as a problem in the 1985 Report of the Secretary's Task Force on Black and Minority Health. The article also explores the priority research themes and action steps proposed by the Agency for Healthcare Research and Quality (AHRQ) to promote health equity and improve access to care. It emphasizes the need for AHRQ to leverage partnerships and develop a health equity research agenda that addresses systemic barriers and inequities. The article concludes by emphasizing the critical role of high-quality research in informing equitable healthcare delivery and the importance of community engagement in achieving health equity. [Extracted from the article]

This article discusses the disparities and challenges faced by LGBTQ+ individuals in accessing healthcare and achieving health equity. It highlights the discrimination and inequity experienced by sexual and gender minority populations, as well as the impact of anti-LGBT+ legislation. The article presents three studies that examine the health disparities faced by sexual minority adults, transgender and gender diverse individuals within the Veterans Health Administration, and intersex populations. The findings of these studies provide recommendations for future research and policy, emphasizing the need for longitudinal studies, the inclusion of measures of sexual orientation and gender identity in research, and the implementation of trauma-informed care practices. The article also emphasizes the importance of privacy and data security policies, comprehensive training of healthcare staff, and systematic reviews to consolidate knowledge on LGBTQ+ health. Finally, it calls for policy evaluation research and the effectiveness of training and educational programs for healthcare providers to ensure culturally competent and inclusive care for LGBTQ+ individuals. [Extracted from the article]

Background: Understanding the diversity and multiplicity of identities experienced by youth in Aotearoa (Te reo Māori name of the country) New Zealand (NZ) is vital to promoting their wellbeing. Ethnic minority youth (EMY) in NZ (defined as those identifying with Asian, Middle Eastern, Latin American and African ethnic origins) have been historically under-studied and under-counted, despite reporting high levels of discrimination, a major determinant of mental health and wellbeing and potentially a proxy for other inequities. In this paper, we describe the protocol for a multi-year study that examines, using an intersectional approach, how multiple marginalised identities impact mental and emotional wellbeing of EMY. Methods: This is a multiphase, multi-method study designed to capture the diversity of lived realities of EMY who self-identify with one or more additional marginalised intersecting identity (the population referred here as EMYi). Phase 1 (Descriptive study) will involve secondary analyses of national surveys to examine the prevalence and relationships between discrimination and wellbeing of EMYi. Phase 2 (Study on public discourse) will analyse data from media narratives, complemented by interviews with stakeholders to explore discourses around EMYi. Phase 3 (Study on lived experience) will examine lived experiences of EMYi to discuss challenges and sources of resilience, and how these are influenced by public discourse. Phase 4 (Co-design phase) will use a creative approach that is youth-centered and participatory, and will involve EMYi, creative mentors and health service, policy and community stakeholders as research partners and advisors. It will employ participatory generative creative methods to explore strengths-based solutions to discriminatory experiences. Discussion: This study will explore the implications of public discourse, racism and multiple forms of marginalisation on the wellbeing of EMYi. It is expected to provide evidence on the impacts of marginalisation on their mental and emotional wellbeing and inform responsive health practice and policy. Using established research tools and innovative creative means, it will enable EMYi to propose their own strength-based solutions. Further, population-based empirical research on intersectionality and health is still nascent, and even more scarce in relation to youth. This study will present the possibility of expanding its applicability in public health research focused on under-served communities. [ABSTRACT FROM AUTHOR]

The study aimed at the determination of risk factors, their relationship with the development of stenosing lesions of the coronary arteries in different ethnic groups in Kazakhstan. Primary coronary angiographies of n=640 patients diagnosed with coronary heart disease (CHD) (2017-2019) have been analysed (Almaty, Kazakhstan). The patients were subdivided into: Kazakhs (n=338) and Russians (n=302). In the Russian group, the chance of arterial hypertension incidence was higher (44% and 33%, p<0.05). In the Russian group, the percentage of obstructive CHD was higher than in the Kazakhs (66% and 57%, p<0.05). There was association between obstructive CHD and risk factors such as male sex, diabetes, smoking, and diastolic blood pressure (DBP) in the Kazakhs (p<0.05). In the Russian group, the relationship between development of CHD and age, level of total cholesterol and high-density lipoprotein (HDL) was higher (p<0.05). There is an association between smoking, diabetes, sex, DBP and the development of CHD in Kazakhs. In the Russian group, CHD was associated with risk factors such as older age, dyslipidaemia and arterial hypertension. There were significant ethnic differences in the risk factors and CHD, in the Russian group the probability of development of obstructive CHD was higher. There was an association between smoking, diabetes, sex, DBP and the development of CHD in Kazakhs. In the Russian group, CHD was associated with risk factors such as older age, dyslipidaemia and arterial hypertension. These finding indicate the need to develop differentiated programmes for the screening, preventive measures for different ethnic groups. [ABSTRACT FROM AUTHOR]

Objective: As numbers of sandwiched caregivers in the United States grow, it is essential to document the literature on the impacts of dual care demands on well-being and health. Method: Guided by Arksey and O'Malley's (2005) framework, this scoping review examined the literature on sandwiched caregivers' psychological well-being and physical health, identified gaps in the literature, and provided future directions to advance the family caregiving literature. Results: Findings showed that there were inconsistencies in the conceptualization of sandwiched caregivers. Additionally, an examination of the studies showed that sandwiched caregivers exhibited lower levels of psychological well-being and poorer health behaviors compared to other types of family caregivers and noncaregivers. Furthermore, the quality of sandwiched caregivers' psychological well-being was shaped by family and work contexts. Conclusions: Future research should direct more attention to the examination of sandwiched caregivers' physical health and those of minority status given that multigenerational care occurs at greater rates in these populations. Additionally, a systems perspective would allow for the examination of the impact of sandwiched caregiving on other family members. Public Significance Statement: Sandwiched caregivers are more vulnerable to lower levels of psychological well-being and physical health as compared to noncaregivers or other types of family caregivers. Aspects of work and family characteristics also contribute to sandwiched caregivers' well-being and health risks. To better identify the risk and resilience factors that shape well-being and health, greater precision in the operationalization of sandwiched caregivers is needed. [ABSTRACT FROM AUTHOR]

Copyright of Sexuality, Gender & Policy Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Accessing household toilets is vital for adolescent health during crucial stages of growth and development; however, some ethnic minority families in China lack toilets. The relationship between household toilet accessibility and the physical health of adolescents in China's ethnic minority areas has been underexamined. Methods: Using two waves of data from the China Education Panel Survey (2013 and 2014), this study explored the effect of household toilet accessibility on Chinese ethnic minority adolescents' physical health. The sample consisted of 576 ethnic minority adolescents with an average age of approximately 13 years. To test the health effect of household toilet accessibility on ethnic minority adolescents, a fixed effects ordinary least squares model and difference-in-differences combined with propensity score matching method were used. Results: The results of the fixed effects model and difference-in-differences combined with propensity score matching showed a significant and positive effect of household toilet accessibility on adolescents' physical health. The heterogeneity analysis indicated that among the toilet types of soil cesspits, cement cesspits, squat toilets, and flush toilets, the flush toilets were proven to be the most efficient in improving adolescents' physical health. Moreover, the family living arrangement was proven to play a moderating role in the effect of household toilet accessibility on the physical health of ethnic minority adolescents. The average marginal effects of household toilet accessibility on the physical health of ethnic minority adolescents who lived without parents were more evident and significant than those who lived with their parents. Conclusion: Promoting household toilet accessibility in China's ethnic minority areas is essential for improving adolescents' health. Moreover, having a household toilet is not sufficient, the quality and dignity of household toilets are also important. [ABSTRACT FROM AUTHOR]

Background: The prevalence of Human Papillomavirus (HPV) infection in the general population is widely known, however, there are still few studies related to this infection in minority groups, Thus, the objective is to analyze the frequency of human papillomavirus and associated factors in quilombola and gypsy women. Methods: Cross-sectional research with 145 quilombola and gypsy women from Caxias, Maranhão. Two Pap smear collections were performed and a questionnaire with 46 questions was applied between January, 2020 and March, 2021. Descriptive analysis and Odds Ratio with 95% confidence interval were performed. The research was approved by the ethics committee. Results: There were 09 cases of atypia. The frequency of human papillomavirus was 41.37%, with a higher risk in quilombolas 55 (91.70%). Multiple infections were prevalent (53%) with high-risk genotypes 21 (35%). Types 16 and 18 together accounted for 42.85% of cases. Conclusions: The frequency of human papillomavirus infection was higher than those recorded in the Northeast and Brazil, and therefore type 16 predominated. Due to limitations, the virus lineages and sublineages were not evaluated. Quilombola women had a higher rate of infection than gypsies. [ABSTRACT FROM AUTHOR]

In 2021, HHS Office of Minority Health and CDC developed a composite measure of social vulnerability called the Minority Health Social Vulnerability Index (MHSVI) to assess the needs of communities most vulnerable to COVID-19. The MHSVI extends the CDC Social Vulnerability Index with two new themes on healthcare access and medical vulnerability. This analysis examines COVID-19 vaccination coverage by social vulnerability using the MHSVI. County-level COVID-19 vaccine administration data among persons aged ≥18 years reported to CDC from 12/14/20 to 01/31/22 were analyzed. U.S. counties from 50 states and DC were categorized into tertiles of vulnerability (low, moderate, and high) for the composite MHSVI measure and each of the 34 indicators. Vaccination coverage (≥1 dose, primary series completion, and receipt of a booster dose) was calculated by tertiles for the composite MHSVI measure and each indicator. Counties with lower per capita income, higher proportion of individuals with no high school diploma, living below poverty, ≥65 years of age, with a disability, and in mobile homes had lower vaccination uptake. However, counties with larger proportions of racial/ethnic minorities and individuals speaking English less than "very well" had higher coverage. Counties with fewer primary care physicians and greater medical vulnerabilities had lower ≥ 1 dose vaccination coverage. Furthermore, counties of high vulnerability had lower primary series completion and receipt of a booster dose. There were no clear patterns in COVID-19 vaccination coverage by tertiles for the composite measure. Results from the new components in the MHSVI identify needs to prioritize persons in counties with greater medical vulnerabilities and limited access to health care, who are at greater risk for adverse COVID-19 outcomes. Findings suggest that using a composite measure to characterize social vulnerability might mask disparities in COVID-19 vaccination uptake that would have otherwise been observed using specific indicators. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent sexually transmitted infections (STIs) and unintended birth are critical public health issues, with a need for continued prevention and an essential focus on health equity. This scoping review systematically examines the existing literature on the impact of state policies in the USA on both teen pregnancy/birth and STIs, including the impact of policy on racial disparities. Methods: A comprehensive scoping review approach was used to systematically identify relevant studies. Articles were assessed by three reviewers for relevance based on predetermined inclusion criteria. Results: Thirty-two peer-reviewed articles met all inclusion criteria. Years of publication ranged from 1986 to 2022. Broadly, policies evaluated can be grouped into seven categories: abortion access/restrictions; sex education; welfare reform and public assistance policies; family planning expenditures; contraception access/restrictions; state public education expenditures; and child support enforcement. Nine articles discussed multiple policies and their association with the selected outcomes. Conclusions: State policies supporting family planning, including contraceptive access, were consistently associated with lower rates of teen pregnancy/birth. Evidence related to abortion, sex education, and public assistance policies was inconclusive. Few studies examined state policy's impact on STIs, or the association with minority health disparities, illustrating critical gaps in the literature. Policy Implications: Evidence on policy effectiveness is a vital tool in health promotion and may be particularly influential in promoting improved health behaviors and outcomes among adolescents. Collectively, this study offers a comprehensive summary of existing evidence on the association between state-level policies and adolescent sexual health outcomes, highlighting essential areas for future research in policy and adolescent sexual health. [ABSTRACT FROM AUTHOR]

Recent studies on emotional geographies of physical activity have furnished valuable insights into the affective and emotional intensities of space in mediating physical activity engagements. Nevertheless, I suggest there is potential in departing from an ahistorical treatment of emotion to critically consider how people's health engagements are mediated by their sticky emotional relations to space stretching over multiple space-times. I bring these ideas to life through an empirical exploration of physical activity engagements in Singapore that involved in-depth interviews with 17 fitness trainers and diaries from 22 fitness participants. Drawing on Sara Ahmed's idea of 'sticky emotions', I argue that people's physical activity engagements are not just mediated by the immediate affective intensities of space such as energies and atmospheres. Equally importantly, their access to physical activity spaces is also profoundly shaped by their sticky emotional histories and memories of racism, misogyny, and sizism, amongst others. However, instead of theorising minority health subjects through a discourse of passivity and victimhood, I also explore how they could actively 'unstick' their bodies from public exercising spaces to create socially fitting environments. This paper emphasises that paying attention to sticky emotions could sharpen a feminist sensitivity to power geometries that are necessarily entwined with people's health engagements. Accordingly, it aims to develop an ethical corrective to understanding issues of health access, particularly amongst minority communities. [ABSTRACT FROM AUTHOR]

The present study, using a moderated mediational model, explored levels of distal/proximal stressors, rumination, resilience, and health in a group of Italian and Taiwanese LGB+ people. The study also examined the role of internalized sexual stigma (ISS) and rumination as mediators between discrimination and health, and resilience as a moderator of the relationship between discrimination and ISS, rumination, and health, respectively. An online survey was administered to 508 LGB+ participants (270 Italian and 238 Taiwanese) whose age ranged from 18 to 70 years (M = 37.93, SD = 13.53). The moderated mediation model was tested through a series of path analyses stratified by group nationality. Italian participants reported higher discrimination and resilience, but lower ISS, rumination, and health problems compared to their Taiwanese counterparts. The only common path between groups was the direct effect of discrimination on health problems. The mediating role of ISS and rumination in the relationship between discrimination and health, as well as the moderating role of resilience, were partly significant only for the Italian group. Conclusions: The findings suggest that mediators and moderators used to evaluate the effects of minority stress on health may differ between groups; further culturally sensitive research in the field of LGB+ health is needed. [ABSTRACT FROM AUTHOR]

Incidentally diagnosed small renal masses (SRM) may or may not represent kidney malignancy. Therefore, risk factors for likelihood of malignancy are needed. We reviewed 331 patients who underwent partial nephrectomy for SRM. We found that non-Hispanic Black (NHB) patients had an increased odds of having malignant SRM compared to non-Hispanic White patients. Therefore, Urologists should exercise increased caution in managing SRM among NHB patients. Introduction: Small renal masses (SRMs) are often incidentally diagnosed, and a large proportion are malignant. However, there is a paucity of data describing predictors of malignancy in minority patients with SRMs. Thus, our goal was to examine clinical risk factors associated with SRM malignant histology in patients undergoing partial nephrectomy (PN) a diverse, urban academic center. Materials and Methods: Patients with a SRM undergoing PN at a single institution between 2010 to 2018 were reviewed. Demographic, clinical, and imaging characteristics were compared to pathology results. Logistic regression was used to examine associations between demographic/clinical variables for malignant and high-grade histology. Results: In total, 331 patients who underwent PN for SRM were included. Of those, 264 (79.8%) had malignant histology while 67 (20.2%) had benign histology. The proportions of men and of current smokers were significantly higher among patients with malignant histology. In multivariate models, non-Hispanic Black (NHB) patients had increased odds of having malignant histology (OR 2.46, 95% CI: 1.01-5.99, P = .048) and current smokers (OR = 4.02; 95% CI 1.14-14.18, P = .031). Hispanic patients had a 3-fold increased risk of high-grade RCC (OR 3.06, 95% CI: 1.19-7.87, P = 0.02) compared to Non-Hispanic White patients. Conclusion: In our population, male sex, smoking, and NHB race/ethnicity was associated with an increased risk of malignancy in patients undergoing partial nephrectomy for SRM. Older age and Hispanic race/ethnicity were associated with high grade RCC. Our results suggest that urologists should exercise a higher level of vigilance in managing and treating SRM among NHB and Hispanic patients. [ABSTRACT FROM AUTHOR]

Background: Scholars have found that as a multi-facet phenomenon, religion has a complicated relationship with people's health well-being. However, current research on health and religion has left a vacuum in understanding why we observe widespread health disparities between the majority and minority religious groups. Purpose: The present study is aimed at two purposes. First, we conduct a cross-national comprehensive examination of the relationship between religious minority/majority status and self-rated health. Second, we investigate the moderating potential of political contexts on the relationship in question. Methods: Drawing from the 2010–2014 wave of World Values Survey, we construct an analytic sample containing about 70,000 individual cases nested within 51 countries, and apply multilevel modeling to account for the hierarchical data structure. Results: We first find that religious minorities are less likely to report good/very good health status relative to members of majority group. However, we note that the religious minority health disadvantage is driven by a few country outliers. After exclusion of any of these country outliers from the analysis, there is no significant health difference between majority and minority groups. Moreover, we find that political contexts moderate the health effect of being a religious minority. In countries with low levels of democracy or heavy religious restriction on minority groups, people of minority groups are less likely to report good/very good health compared with those belonging to majority group. By contrast, in societies with high levels of democracy or low levels of religious restriction, the health dispartities between religious majority and minority groups become non-significant. A series of sensitivity analysis, including using multiple-imputation sample and different ways of coding key variables, provides credibility to the results. Conclusions and Implications: This study's findings suggest that religious minorities experience health disadvantage, only when minority groups are denied of political and religious freedom. Compared with past works that mostly focused on a single or a few societies, this study provides large-scale, cross-national evidence for the issue of religious minority health. This study also adds to our understanding of how political context shapes the health impacts of religion. [ABSTRACT FROM AUTHOR]

Objectives: Sexual minorities experience higher rates of psychological distress than heterosexual people, likely due to minority stress. While rates of help‐seeking by sexual minorities are high, sexual minorities report greater dissatisfaction with mental health service providers. This dissatisfaction may result from poor cultural competence practices. Our study sought to determine the importance of service provider cultural competence practices to a community sample of sexual minority people. Methods: Participants (n = 274) were sexual minority Australians recruited from affirming Facebook groups, organizations, and research‐based organizations. To measure the importance of cultural competence practices, participants completed a modified online version of the Gay Affirming Practices Scale (GAP) and responded to open‐ended questions. Results: Between 80% and 99% of participants endorsed each item on the GAP, indicating the importance of service providers demonstrating an array of culturally affirming practices. No significant associations were found between overall GAP score and age or sexual orientation, though further analyses revealed individual items on the GAP showed associations with age. A structured tabular thematic analysis, of open‐ended participant responses, found positive attitudes, knowledge, and affirming practices were the three most important characteristics for service providers seeking to demonstrate culturally competent practices, mirroring the tripartite model (attitudes, knowledge, and skills) of cultural competence. Conclusion: Recommendations for service providers to demonstrate cultural competence include: utilizing affirming practices such as inclusive language, increasing knowledge about sexual minorities, and utilizing education resources such as cultural competence workshops, lived experience stories, and seeking mentorship from service providers with expertise in working with sexual minorities. [ABSTRACT FROM AUTHOR]

Copyright of Psychiatria Hungarica is the property of Hungarian Psychiatric Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Refugees experience poorer health outcomes especially which can be exacerbated by or can be a result of low health literacy of refugee populations. To address poor health outcomes, health literacy, and health usage in refugee populations, it is essential to develop health educational interventions for refugees’ healthcare integration. To do so, learning objectives must be identified based on refugees’ health knowledge gaps. Therefore, the overall aim of this study is to identify these knowledge gaps. A modified Delphi method was employed for this study with three rounds of survey: the first to identify learning objectives, the second to prioritise learning objectives, and the third to categorise the learning objectives as not recommended, partially recommended, or highly recommended. An overarching theme of utilising the healthcare system and its various services effectively and efficiently was recognised to be an important learning objective for educational interventions to address refugees’ health integration. Overall, learning objectives within the theme self-care and preventative health were ranked as most important. [ABSTRACT FROM AUTHOR]

Inflammation is implicated in the pathophysiology of depression and type 2 diabetes (T2D) and is linked to social determinants of health (SDoH) associated with socioeconomic disadvantage. The objective of this review is to identify and map the range of SDoHs associated with inflammation in depression, T2D, or their co-occurrence among women. PubMed, CINAHL, PsychINFO, and Web of Science were searched March–July 2023 to identify studies where 1) an SDoH was a predictor or independent variable, 2) depression or T2D was a clinical focus, 3) inflammatory markers were collected, and 4) analysis was specific to women. We used the National Institute on Minority Health and Health Disparities research framework to guide searching SDoHs, organize findings, and identify gaps. Of the 1135 studies retrieved, 46 met criteria. Within the reviewed studies, the most used inflammatory measures were C-reactive protein, interleukin-6, and tumor necrosis factor-α, and the most studied SDoHs were early life stress and socioeconomic status. Individual and interpersonal-level variables comprised the bulk of SDoHs in the included studies, while few to no studies examined built environment (n = 6) or health system level (n = 0) factors. Disadvantageous SDoHs were associated with higher levels of inflammation across the included studies. The scope and intersection of depression and T2D represent a syndemic that contributes to and results from socioeconomic inequities and disproportionately affects women. Simultaneous inclusion of social and inflammatory measures, particularly understudied SDoHs, is needed to clarify potent targets aimed at advancing health and equity. • Social factors link to inflammation in depression and diabetes suggest a shared path. • Early life stress and socioeconomic status showed consistent inflammatory links in reviewed studies. • Violence and discrimination were less studied, but links to inflammation were noted. • The effect of the built environment, material needs, and health systems is unknown. [ABSTRACT FROM AUTHOR]

Backgrounds: In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies.Waves 2–12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations.Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with “other” orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures.The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations.Methods: In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies.Waves 2–12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations.Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with “other” orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures.The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations.Results: In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies.Waves 2–12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations.Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with “other” orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures.The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations.Conclusions: In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies.Waves 2–12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations.Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with “other” orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures.The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations. [ABSTRACT FROM AUTHOR]

Tens of thousands of trucks cross the U.S.–Mexico border every day. Cross-border truckers’ high mobility puts them at risk of acquiring and transmitting infectious diseases and creates challenges reaching them with emergency public health messaging due to their everchanging locations and limited English proficiency. Despite this community-level transmission risk and documented health disparities related to various infectious and noninfectious diseases experienced by truckers themselves, little has been published to provide practical recommendations on better reaching this audience through innovative outreach methods. This article describes a COVID-19 health promotion campaign that aimed to (1) identify, pilot test, and evaluate effective messages, channels, sources, and settings for reaching truckers on both sides of the U.S.–Mexico border and (2) build capacity and sustainability for messaging around future health emergencies. The pilot program ran for 6 weeks, June to August 2023, in three key commercial border crossings and delivered approximately 50,000,000 impressions, nearly 45% more impressions than expected. Considerations for practitioners include the areas of design, implementation, and evaluation. The results provide insight into how to design health promotion messages that resonate with cross-border truckers and how to place these messages where they will be seen, heard, and understood. This includes working effectively with community health workers (CHW), known locally as promotores; identifying local partners that allow CHW to set up onsite; and, working with partner organizations including employers. Practical insights for building evaluation metrics into traditional and grassroots outreach strategies to facilitate real-time optimization as well as continued learning across efforts are also described. [ABSTRACT FROM AUTHOR]

Despite initiatives aimed at improving study participation and inclusion among ethnic and racially minoritized and marginalized populations, participation remains low. While necessary to ensure ethical practice in human participant research, certain Institutional Review Board (IRB) guidelines may introduce additional barriers in research involving these populations. This work outlines guidelines pertaining to consent translation for non-English speaking populations and offers discussion on a greater emphasis for more inclusive methods for marginalized communities. The University of Wisconsin’s IRB approved alternative oral consent processes after the community partner determined that standard translation processes would be inefficient. Researchers used translated consent materials for four different ethnic groups (Hmong, Karen, Karenni, and Burmese). We provided recorded consents in each respective language to participants before study participation and obtained verbal consent prior to study participation at the study location. We experienced time and resource constraints in both access to translators and the consent-translation process itself. Furthermore, many participants were unable to read in their native language making standard written consent processes both difficult and impractical. Oral discussion and verbal consent processes were efficient. Adjustments to consent-related guidelines may prevent and eliminate time and resource-related barriers in consent processes. In eliminating such barriers, subsequent improved efficiency in both study design and study promotion areas can work to better promote diversity in research among populations that emphasize oral language and in instances where literacy rates in written non-English language may be lower. [ABSTRACT FROM AUTHOR]

Over the past two decades, there has been increasing recognition of the importance and merits of increasing representation of historically underrepresented minorities in the health professions. However, people with disabilities are less discussed in these efforts. More than one in four of U.S. adults have a disability; yet it seems that these individuals are less represented in the field of health education. This commentary discusses the merits of increasing representation of people with disabilities in the health education/promotion profession and calls for preparation programs and professional organizations to reduce systemic barriers and facilitate increased representation. [ABSTRACT FROM AUTHOR]