Sexual harassment, sexual assault, violence, self-esteem, and the role of LGBTQ-specific parental support in a sample of Latinx sexual and gender minority youth.

INTRODUCTION: Oftentimes as result of racism, cissexism, and heterosexism, many Latinx and sexual and gender minority (SGM) youth are victims of sexual harassment, sexual assault, and violence. These experiences of victimization are in part related to increased negative mental health outcomes such as decreased self-esteem. Some research links LGBTQ-specific parental support to mental health outcomes among Latinx SGM youth, yet, no research has explored the role of LGBTQ-specific parental support with self-esteem among Latinx SGM youth. METHODS: In a sample of 1,012 Latinx SGM youth (ages 13-17), we assessed: (a) associations between sexual harassment, sexual assault, and violence and self-esteem, (b) association between LGBTQ-specific parental support and self-esteem, and (c) whether LGBTQ-specific parental support moderated the relation between sexual harassment, sexual assault, and violence and self-esteem. Main effect and moderation analyses examined interactions between LGBTQ-specific parental support with sexual harassment, sexual assault, and violence on self-esteem. RESULTS: Latinx SGM youth experienced low levels of LGBTQ-specific parental support and various degrees of sexual harassment, sexual assault, and violence. Also, transgender and nonbinary/genderqueer Latinx youth experienced lower self-esteem than their Latinx cisgender counterparts. Increased LGBTQ-specific parental support was related to increased self-esteem. We also identified a significant interaction between sexual harassment, sexual assault, and violence and LGBTQ-specific parental support, such that parental support was more protective at low levels rather than high levels of sexual harassment, sexual assault, and violence among Latinx SGM youth. CONCLUSIONS: Findings add to a growing body of research about the importance of LGBTQ-specific parental support for Latinx SGM youth, and the need to examine culturally appropriate approaches to understand parent-child relationship among these communities.

Impact of Racist Microaggressions and LGBTQ-Related Minority Stressors: Effects on Psychological Distress Among LGBTQ+ Young People of Color.

BACKGROUND: College students situated at the nexus of racial and sexual and gender minority (SGM) identities may experience multiple identity-related oppressions. We assessed whether racist microaggressions and lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ)-related minority stressors (ie, family rejection, identity concealment, racialized heterosexism and/or cisgenderism, internalized LGBTQ-phobia, and victimization) are associated with greater psychological distress among SGM college students of color (SOC) (students who identified as Hispanic/Latinx and/or any nonwhite race). METHODS: Participants were a subset of SOC (n = 200) from a larger nonprobability cross-sectional study of SGM college students. Participants were recruited by using online social media platforms and university email listserves from May through August 2020. Participants completed an online Qualtrics survey using previously validated measures of minority stress, racist microaggressions, and psychological distress. Simple and covariate-adjusted multiple linear regression models were used to examine the associations between racist microaggressions and LGBTQ-related minority stressors with psychological distress. RESULTS: In simple linear regression models, racist microaggressions and all LGBTQ-related stressors (ie, family rejection, identity concealment, racialized heterosexism and/or cisgenderism, internalized LGBTQ-phobia, and victimization) were significantly and positively associated with greater psychological distress. In covariate-adjusted multiple linear regression, racist microaggressions, internalized LGBTQ-phobia, and LGBTQ-related family rejection (but not identity concealment, racialized heterosexism and/or cisgenderism, and victimization) were independently and significantly associated with greater psychological distress. CONCLUSION: Study findings reveal that racist microaggressions, along with LGBTQ-related family rejection and internalized LGBTQ-phobia, have a significant impact on psychological distress among SGM SOC. Public health leaders have an important opportunity for policy and program development and reform to address the identity-related mental health needs of SGM SOC.

The revised Humpty Dumpty Fall Scale: An update to improve tool performance and predictive validity.

PURPOSE: The purpose of this study was to identify potential modifications to the Humpty Dumpty Fall Scale (HDFS) in order to enhance the accuracy of fall prediction in the pediatric population, thus contributing to the safest possible environment for the hospitalized child. DESIGN AND METHODS: A secondary analysis of data collected by Gonzalez et al. (2020), including a total of 2428 patients, was conducted for this study. Multiple logistic regression was used to examine the relationship between each parameter of the HDFS (e.g., age, gender, diagnosis, cognitive impairments, environmental factors, response to surgery/sedation/anesthesia, and medication usage) and the outcome of fall status. RESULTS: After reviewing associations between HDFS parameters and fall risk, neither gender nor medication use were found to be associated with fall risk. These two parameters were removed from the scoring algorithms, and the HDFS was modified to a minimum score of 5 and maximum score of 20, with a score of 12 or above indicative of high risk of fall. The modified scale demonstrated a sensitivity of 84% and specificity of 57%. CONCLUSIONS: These revisions are anticipated to help support clinical practice and improve fall prevention, thus supporting a safer pediatric environment for the hospitalized child.

Latinx Health Disparities Research During COVID-19: Challenges and Innovations.

BACKGROUND: The Center for Latino Health Research Opportunities (CLaRO) supports and facilitates research addressing substance abuse, violence/trauma, and HIV/AIDS among diverse and underserved Latinx populations. CLaRO runs a pilot awards program for early-stage investigators conducting Latinx health disparities research. This pilot awards program was impacted by the COVID-19 pandemic, necessitating innovative responses for research continuity. PURPOSE: The purpose of this commentary is to describe the challenges and innovative research methods developed in response to COVID-19 to continue Latinx health disparities research in the context of COVID-19. METHODS/RESULTS: This commentary provides a brief description of each CLaRO pilot project, the challenges introduced by COVID-19, and innovative research methods to continue Latinx health disparities research during and beyond COVID-19. CONCLUSIONS: Despite the challenges COVID-19 presents to the continuity of health disparities research, it also presents unprecedented opportunities to innovate. Such innovation is essential for solving persistent scientific, public health, and clinical challenges underlying current and emerging health disparities.

Evaluating horizontal violence and bullying in the nursing workforce of an oncology academic medical center.

AIM: To evaluate horizontal violence and bullying in the nursing workforce of an oncology inpatient and outpatient academic centre and to test the Horizontal Violence Scale in an outpatient setting. BACKGROUND: Horizontal violence (HV) and bullying in the workplace are dysfunctional behaviours that can affect nursing staff and patient care. The impact of bullying and HV is multilevel, affecting patient safety and satisfaction, nursing retention and employee satisfaction, while creating poor patient outcomes. METHODS: A quantitative cross-sectional descriptive design was used to examine prevalence of HV and bullying and the relationship between HV and bullying of nursing department personnel in an oncology setting. RESULTS: The study findings revealed significant positive relationships between bullying and HV in both inpatient and outpatient settings. CONCLUSION: Nurses experience diverse workplace violence, which could decrease their professional quality of life and affect their turnover intention no matter the work setting. IMPLICATIONS FOR NURSING MANAGEMENT: The findings of this study clearly link the presence of bullying and HV, which includes, emotional, physical, verbal and defiant behaviours to both inpatient and outpatient workplace settings. A positive organisational culture, which can be shaped by nursing leaders, can create a work environment that can thwart workplace violence.

The Relationship of Hispanic Cultural Factors and Sexual Behaviors of Hispanic Men who have Sex with Men.

Background/Significance: Hispanics are the largest ethnic minority group in the U.S., and account for 21% of new cases of HIV infection. Previous researchers have examined the relationship of Hispanic cultural factors and the sexual behaviors of Hispanic men who have sex with men (HMSM). However, the exact influence of Hispanic culture factors on the sexual behaviors of these men is currently unclear. Objective: The purpose of this study was to investigate the relationship of selected Hispanic cultural factors and the sexual behaviors of a sample of HMSM. Method: A descriptive, cross-sectional design was used to collect data from 125 Hispanic men in Miami-Dade County, FL. Participants completed standardized measures of Hispanic cultural factors, sexual behaviors, and a demographic questionnaire. Results: Statistically significant positive correlations were noted between age and total cultural constructs, familism, personalism, and machismo. Statistically significant negative correlations were noted between education and total cultural constructs, and education and fatalism. No statistically significant correlation coefficients were noted between total cultural constructs and total sexual behaviors. However, statistically significant positive correlations were noted between condom use and personalism, and assertiveness and personalism. A statistically significant negative correlation was noted between familism and anal sex. Implications: Nurses and other clinicians providing care for HMSM need awareness of certain Hispanic cultural factors (personalism and familism) that may be related to sexual behaviors among HMSM. More research is needed to understand how personalism and familism may be used as protective factors to decrease sexual risk of HMSM.

Psychiatric Symptoms, Parental Attachment, and Reasons for Use as Correlates of Heavy Substance Use Among Treatment-Seeking Hispanic Adolescents.

In early adolescence, Hispanics self-report higher drug use rates compared to White and African American peers. Among adolescent users, heavy users have more negative behavioral and health consequences. The purpose of this cross-sectional study is to examine whether psychiatric symptoms, parental attachment, and reasons for use predict heavy alcohol and illicit drug use (more than 10 times in the past three months) among Hispanic adolescents. METHODS: This study examines baseline data from a study evaluating a family based substance abuse treatment program for Hispanic adolescents. Participants were 14-17 years old (N = 156, 44% female). Adolescent reports on the Diagnostic Interview Schedule for Children Predictive Scales measured psychiatric symptoms of major depressive disorder, attention deficit hyperactivity disorder, conduct disorder, and anxiety. The Personal Experiences Inventory measured type and amount of drug use, as well as perceived social and psychological benefits of drug use. The Inventory of Parent and Peer Attachment measured trust, communication, and alienation between adolescents and their mothers. Logistic regression identified correlates of heavy alcohol use and heavy illicit drug use among Hispanic adolescents. RESULTS: Higher social benefits were associated with increased likelihood of heavy alcohol use. Conduct disorder, higher levels of maternal attachment, lower levels of acculturation, and higher levels of psychological benefits of use were associated with an increased likelihood of heavy illicit drug use. CONCLUSION: These findings support the assumption that substance use treatment among Hispanic adolescents must be capable of addressing co-occurring psychiatric disorders, familial relationships, and the individual reasons/motivators to use.

The Comorbidity of Psychiatric and Substance Use Disorders Among Hispanic Adolescents.

OBJECTIVE: The comorbidity of psychiatric disorders and substance abuse disorders among adolescents and adults is well-documented in the literature. The current study investigates the relationship between psychiatric and substance use disorders in a sample of treatment-seeking Hispanic adolescents. METHODS: The study uses baseline data (N = 190) from a randomized control trial testing the effectiveness of a family-based treatment for Hispanic adolescents with substance abuse disorder to examine the relationship between psychiatric disorders and substance use patterns at baseline, including types of substances used (both lifetime use and past-month use) and age at onset of substance use, controlling for age and gender. RESULTS: Linear regression models were used to examine predictors of age at onset, while logistic regression models examined predictors of lifetime substance use. Significant findings predicting age at onset for marijuana and alcohol are discussed. In addition, psychiatric profiles were differentially associated with lifetime use of sedatives, stimulants, and hallucinogens, but not alcohol or marijuana. CONCLUSIONS: Findings from this study can be used to help inform the treatment of adolescents seeking mental health and substance use services.

The Impact of Parental Reaction to Sexual Orientation on Depressive Symptoms and Sexual Risk Behavior Among Hispanic Men Who Have Sex with Men.

PURPOSE: This study examined the relationship of parent reaction to sexual orientation with depressive symptoms and safer sex among Hispanic adult men who have sex with men (MSM). We also examined men's acculturation to the U.S. (Americanism) in relation with these variables. METHOD: Cross-sectional data collected from July 2011 to December 2012, from 125 MSM with a mean age of 43.02years. Instruments included the Perceived Parent Reaction Scale, the Centers for Epidemiological Studies Depression Scale, the Safer Sex Behavior Questionnaire and the Bidimensional Acculturation Scale. Data was analyzed using Hierarchical generalized linear models (GZLM). RESULTS: Among men whose parents knew of their sexual orientation, rejection of son's sexual orientation from mother (p=0.032) and from father (p=0.004) was related to higher number of depressive symptoms. Parent reactions were not directly related to safer sex behaviors. Americanism was associated with lower depressive symptoms (p=0.001) but was not related to safer sex behaviors. CONCLUSIONS: Current parent attitudes about their sons' sexual orientation had an effect on the sons' emotional wellbeing and acculturation may play a protective role. Mental health and primary care clinicians working with Hispanic MSM should assess for level of family support and provide resources to assist with disclosure and family acceptance of sexual orientation as indicated, particularly among recently immigrated men who may be at higher risk.

A Latent Profile Analysis Investigating Factors Impacting Latino Adolescents' Attendance in Treatment.

In this study, we examined data from 200 families to investigate whether family functioning and adolescent psychiatric symptomatology were associated with differential attendance in a family-based or individually focused intervention for Latino adolescents. Latent profile analysis was used to identify families, and regression models were used to examine whether profiles exhibited differential attendance. Overall, three latent profiles were observed. The first described families where parents and adolescents reported discrepancies on psychiatric symptoms and family conflict. The second profile described families with elevated adolescent psychiatric symptoms but no family conflict. The third profile described families with low family cohesion and high levels of adolescent psychiatric symptoms. For this third profile, attendance in family-based treatment was significantly higher than in individual treatment. Results indicate that a family-based intervention may be better able to address issues of poor family cohesion.

Impact of Living Arrangements of LGBTQ College Students During COVID-19.

This study examines the relationships between living arrangements and educational outcomes, access to LGBTQ affirming care, sexual and gender minority (SGM) stressors, and mental health. Bivariate analyses were implemented to examine relationships between living arrangements and academic outcomes, SGM stressors, access to care, and alcohol and substance use. Differences between undergraduate and graduate students are also reported. Students who continued living on campus were less likely to report increased family rejection, transphobia, and identity concealment.

Asthma Academy for Family Caregivers: A Quality Improvement Project.

Background: Asthma affects one in every 12 children in United States with significant prevalence in underserved groups. Family caregiver education is essential to improve childhood asthma control. The literature suggests that family caregivers' lack of knowledge about asthma management affects their children's health outcomes. An evidence-based education program that improves caregivers' asthma knowledge may improve the family's well-being. Objectives: The goal of the Asthma Academy project is to improve the disease management of children with asthma by providing an in-person family caregiver education program. The main objectives are to (a) improve family caregivers' asthma knowledge, (b) enhance their confidence in asthma management, and (c) evaluate caregivers' satisfaction with the education program. Method: This quality improvement project used an in-person educational program with an asthma education video resource for caregivers of children with asthma. Results: The family caregivers' asthma knowledge improved significantly after the education. The confidence levels in caring for children with asthma increased. Caregivers' satisfaction with the Asthma Academy education session was favorable. Conclusions: The Asthma Academy was an acceptable and effective delivery method of education for family caregivers of children with asthma in the in-patient setting. Empowering family caregivers of vulnerable children through asthma education may improve child health outcomes and mitigate complications from asthma. Implications for Nursing Nurses and clinicians are steward of providing patient education. Individualized, patient-tailored education is recommended.

Radical hope in parents of transgender and gender diverse youth in the United States.

Parental support is crucial in the well-being of transgender and gender diverse (TGD) youth. Research shows that parents of TGD youth often experience stigma and negative mental health outcomes as a result of being exposed to cissexist settings as they advocate and seek services for their child. Yet, there is a lack of research on the experiences of parents of TGD youth in the United States. This study explores the reported hopes of 990 parents (Mage = 48.6 years; SD = 6.7; 88.1% White; 67.3% heterosexual; 89.4% cisgender women) of TGD youth for their children (youth ages 3-18 years) in the United States. Radical hope framework is applied to unpack narratives of hopes by parents of TGD youth as a critical component of resistance and motivation toward healing from oppression. For this study, the following open-ended question was analyzed using thematic analysis: What is your greatest hope for your child? Four main themes and 11 subthemes of parental hopes emerged: (1) living authentically (freely expressing themselves, developing self-love, living a happy and normal life), (2) interpersonal connections (finding community, building social networks and friendships, developing romantic relationships, building their own family, and loved by others), (3) meeting life milestones (career and employment, achieving goals and dreams, and becoming an advocate), and (4) acceptance by society. We provide clinical recommendations grounded on the tenets of radical hope such as collective ways in which parents of TGD youth can engage in both resisting systemic oppression and building strong loving relationships with their child. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of family rejection and racism on sexual and gender minority stress among LGBTQ young people of color during COVID-19.

OBJECTIVE: Given the inequitable impact of COVID-19 on sexual and gender minority (SGM) youth and current sociopolitical racial justice concerns in the United States, this study examines the impact of SGM-related family rejection and racism since the start of COVID-19 on SGM-related internalized homophobia and identity concealment among SGM college students of color (SOC). METHOD: Participants were a subset of SOC (n = 200) from a larger nonprobability cross-sectional study about minority stress and COVID-19 pandemic experiences among SGM college students. Participants completed survey items specifically related to changes in minority stress and racism experiences since the start of COVID-19. Logistic regression models were used to examine the independent and interactive effects of racism and family rejection on identity concealment and internalized homophobia since the start of COVID-19 (adjusting for covariates). RESULTS: Main effects models revealed that increased racism and family rejection were significantly associated with greater odds of experiencing identity concealment since the start of COVID-19. The interaction of increased racism and family rejection was also significantly associated with greater odds of experiencing identity concealment since the start of COVID-19. CONCLUSIONS: Study findings suggest that the intersection of racism and family rejection since the start of COVID-19 consequently translates to increased experiences of identity concealment. Such experiences are known to negatively impact mental health across the life course among SGM young people. Public health, medical, mental health, and higher education stakeholders must implement SGM-affirmative and antiracist practices and interventions to support SGM SOC during COVID-19 and beyond its containment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

LGBTQ Caregiver Acceptance Scale (LCAS): Development and validation with a Latinx sample.

Caregiver acceptance and rejection is crucial to the well-being of lesbian, gay, bisexual, transgender, and queer (LGBTQ) people. Research shows that caregivers are affected by having an LGBTQ child/family member, yet studies have neglected to capture the experiences of Latinx caregivers. We present the development and initial validation of the LGBTQ Caregiver Acceptance Scale (LCAS) with a Latinx sample. We developed items based on a review of the literature, expert feedback (N = 9), and community member feedback (N = 9; Study 1). We then assessed the factor structure through exploratory factor analysis (EFA) in a sample of 215 Latinx caregivers of LGBTQ people (Study 2). The final LCAS consists of 40 items and six dimensions of Latinx caregivers' acceptance and rejection of their LGBTQ child/family member: Outness, Caregiver Acceptance, Concealment, Respeto, Attitudes Toward Queer Parenting, and Supportive Actions. Convergent and divergent validity was performed to compare the LCAS to other constructs of caregiver acceptance and rejection, family conflict and cohesion, and attitudes toward the LGBTQ community. As hypothesized, all subscale scores and total score were found to be significantly correlated with the constructs used for comparison. This validated measure of LGBTQ-specific acceptance and rejection among caregivers provides a rich opportunity to understand family processes and help inform evidence-based interventions. We provide implications for clinicians working with Latinx caregivers of LGBTQ youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Predictors of eating attitudes and behaviors among gay Hispanic men.

Gay men are a vulnerable population at risk for a number of health disparities, but little is known about eating disorders among gay Hispanic men. The purpose of this study was to examine the relationship of eating attitudes and behaviors with alcohol abuse, body image, depression, self-esteem, and sexual behaviors to determine predictors of eating attitudes and behaviors in a community sample of gay Hispanic men. Significant numbers of the participants were at risk for eating disorders (13%), alcohol abuse (18%), body image disturbance (29%), depression (25%), low self-esteem (12%), and high-risk sexual behaviors (34%). Alcohol abuse, body image, depression, self-esteem, and sexual behaviors were significant predictors of eating attitudes and behaviors and accounted for 38% of the variance in eating attitudes and behaviors. Nurses providing care to this population of gay men must be aware of this cluster of related mental health conditions that are experienced by these men. Addressing and treating these health conditions as a group of related mental health conditions are necessary. More research is needed to further explore this cluster of health issues among gay Hispanic men.

The Relationship Between Colorectal Cancer Survivors' Positive Psychology, Symptom Characteristics, and Prior Trauma During Acute Cancer Survivorship.

OBJECTIVES: To examine colorectal cancer survivors' positive psychology and symptom characteristics, and to assess for potential impact of prior trauma on these relationships during acute cancer survivorship. SAMPLE & SETTING: A cross-sectional study of 117 colorectal cancer survivors was conducted at a National Cancer Institute-designated cancer center. METHODS & VARIABLES: Participants completed a demographic questionnaire, and the Carver Benefit Finding Scale and Posttraumatic Growth Inventory assessed positive psychology. Descriptive statistics and multiple linear regression analyses were performed. RESULTS: 49 symptoms were reported and varied based on prior trauma. Significance was found between positive psychology and symptom frequency (p < 0.001); symptoms reported almost daily and daily were inversely related to positive psychology. IMPLICATIONS FOR NURSING: Nurses should prioritize symptoms; less frequent symptoms improve positive psychology. Early identification of positive changes may promote survivors' self-awareness and management skills to mitigate adverse symptoms.

Symptom Occurrence, Frequency, and Severity During Acute Colorectal Cancer Survivorship.

OBJECTIVES: To examine colorectal cancer (CRC) survivors' symptom characteristics (occurrence, frequency, and severity) during acute cancer survivorship. PARTICIPANTS & SETTING: A cross-sectional study of 117 CRC survivors was conducted at a National Cancer Institute-designated cancer center in South Florida. METHODS & VARIABLES: Symptom characteristics were assessed by the Therapy-Related Symptom Checklist. Participants completed a 25-item demographic questionnaire. Mann-Whitney U and Kruskal-Wallis H tests assessed between-group differences based on sex, age, education, and months since diagnosis. Exploratory factor analysis was performed to identify preliminary symptom clusters. RESULTS: 117 CRC survivors completed the study (age range = 21-88 years, 56% male, and 79% stage IV). Common symptoms included peripheral neuropathy, fatigue/feeling sluggish, and skin changes. Significance was found between months since diagnosis and number of symptoms (p = 0.03), suggesting that symptoms accumulate with time. Chemotherapy (85%) was the most common treatment type, and exploratory factor analysis identified two chemotherapy-related symptom clusters. IMPLICATIONS FOR NURSING: Nurses are poised to identify, prevent, and promote self-management skills to reduce symptoms.

Asthma academy: A student nurse-led telehealth education program for low-income family caregivers of children with asthma.

AIMS: The aims of the Asthma Academy study were to (1) evaluate the telehealth performance of DNP students, (2) evaluate the perceived learning experience of DNP students and (3) investigate whether an association exists related to student performance and family caregiver outcomes. DESIGN: A descriptive study was conducted with doctor of nursing practice students. METHODS: Students conducted telehealth visits to help family caregivers of children with asthma and were rated on their performance by two faculty members using a rubric. Student perception data were gathered via survey. RESULTS: Out of a total possible score of 15 points, the mean telehealth performance score of students was 13.38 points. Students indicated the telehealth experience was valuable and that they were satisfied with their learning. This model of leveraging telehealth to bridge nursing students to the community may be adapted to help family caregivers of children with various disease foci.

Mental Health among LGBTQ Cannabis Users During the COVID-19 Pandemic: Analysis of the COVID-19 Cannabis Health Study.

The purpose of this study is to compare the responses of LGBTQ cannabis consumers and their non-LGBTQ counterparts on anxiety, depression, substance use, and COVID-19 coping and stress during the pandemic. Data from an internet-survey of cannabis users during the COVID-19 pandemic were analyzed (N = 2,319). Approximately 18% of the sample identified as LGBTQ. Bivariate analyses were used to examine the relationship between LGBTQ identity and symptoms of anxiety and depression, substance use, and pandemic-related coping strategies and stressors. Logistic regression models were used to evaluate the association between pandemic stressors and coping strategies with LGBTQ identity, while adjusting for sex, age, and race and ethnicity. Differences in the proportion of medicinal cannabis use among LGBTQ respondents (74.6%) and non-LGBTQ respondents (75.3%) were insignificant. LGBTQ cannabis users were more likely to report COVID-19 related stressors and coping behaviors, including increased alcohol use. After adjustment for covariates, LGBTQ cannabis users were more likely to report symptoms of depression and anxiety than non-LGBTQ cannabis users. These results show that compared to their cisgender heterosexual counterparts, LGBTQ cannabis users are experiencing more problematic mental health outcomes during the COVID-19 pandemic.