Advancing health equity in prelicensure nursing curricula: Findings from a critical review.

Nurses play a crucial role in reducing health disparities and advancing health equity for individuals and communities. The future nursing workforce relies on their nursing education to prepare them to promote health equity. Nursing educators prepare students through a variety of andragogical learning strategies in the classroom and in clinical experiences and by intentionally updating and revising curricular content to address knowledge and competency gaps. This critical review aimed to determine the extent to which health equity concepts are explicitly present in prelicensure undergraduate nursing curricula globally. Of 434 articles screened, 22 articles describing 20 studies met inclusion criteria. Frequency and quantity of health equity content, concepts and topics, teaching strategies, evaluation strategies, and the overall extent of integration varied widely. Notably, only two articles described overall well-integrated explicit health equity content, and there was little attention to whether students transfer this learning into practice. A focus on individualism rather than population and community was noted, highlighting the presence of whiteness in nursing. Results from this review confirm that nursing education has room to improve with respect to health equity in the curricula.

A meta-analysis of person-centered care interventions for improving health outcomes in persons living with dementia.

BACKGROUND: Person-centered care emphasizes the importance of valuing and supporting the humanness of a person living with dementia as compared to focusing heavily on disease symptom management and treatment. The state of the evidence and outcomes from person-centered care is unclear and is an important knowledge gap to address informed evidence-based care for persons living with dementia. AIMS: To synthesize the evidence on the efficacy of person-centered care in improving health outcomes in people living with dementia. METHODS: Our search using the following databases: Academic Search Complete, CINAHL, COCHRANE library, EMBASE, MEDLINE, PubMed, and Google Scholar. The methodology quality of the included studies was assessed using a revised Cochrane risk-of-bias tool for randomized trials. Meta-analyses were performed using the DerSimonian and Laird random effects model to investigate the effectiveness of person-centered care on improving health outcomes in persons living with dementia. RESULTS: Seventeen trials were included in this systematic review and meta-analysis. Person-centered care implementation was found to improve cognitive function (pooled SMD: 0.22; 9CRD420223808975% CI [0.04, 0.41], p = .02) in persons living with dementia, although outcomes including the impact of the care model on activities of daily living, agitation, depression, and quality of life remain inconclusive. LINKING EVIDENCE TO ACTION: Person-centered care improves the cognitive function of persons living with dementia, which is clinically meaningful and should not be ignored or overlooked in delivering evidence-based care to this population. The findings of this study emphasize the importance of person-centered care implementation among people living with dementia as an approach in improving health outcomes particularly on cognitive function improvement. Person-centered care emphasizes the personhood of individuals living with dementia while respecting their needs, values, and beliefs and is identified as a preferred model of delivering dementia care in all settings as a non-pharmacological approach.

Effects of telehealth-assisted interventions for secondary prevention of cardiovascular disease: A systematic review and meta-analysis.

BACKGROUND: Telehealth-assisted interventions have been used as secondary prevention measures in cardiac rehabilitation, especially for the delivery of information between healthcare service providers and patients. However, as the application of this intervention modality broadens, investigation of its effects in secondary prevention of cardiovascular disease (CVD) is necessary. AIMS: To identify the effectiveness of telehealth-assisted interventions for secondary prevention of CVD. DESIGN: Systematic review and meta-analysis. METHODS: The PRISMA protocol was used to conduct a systematic review and meta-analysis of randomised controlled trials. The full text of articles was obtained from six databases for the period from database establishment to 25 November 2021. To assess the methodological quality of the studies reviewed, the updated Cochrane risk-of-bias checklist for randomised trials was employed. A meta-analysis was performed using a random-effects model to calculate the pooled effects of telehealth-assisted interventions for secondary CVD prevention. RESULTS: The final analysis included 4012 individuals from 18 different trials. Telehealth-assisted interventions were shown to improve medication adherence (standardised mean difference [SMD]: 0.31; 95% confidence interval [CI]: 0.33-0.59) and reduce depression (SMD: -0.28; 95% CI: -0.46 to -0.10). CONCLUSIONS: Telehealth-assisted interventions appear to improve adherence to medication and reduce depression of individuals with CVD. These intervention strategies could be offered to both healthcare providers and individuals with CVD as an option in delivering and facilitating the use of health services to improve health behaviours and overall outcomes. Furthermore, this study may be used as guidance for future research to provide an appropriate plan of care for this population. RELEVANCE TO CLINICAL PRACTICE: The findings imply that the delivery of care remotely via telehealth-assisted interventions for secondary prevention of CVD is beneficial in improving CVD survivors' health and access to healthcare services. TRIAL REGISTRATION: The International Prospective Register of Systematic Review: (PROSPERO): CRD 42021290111.

Acceptability, Feasibility, and Efficacy of Telehealth Interventions for HIV Testing and Treatment in Adult Populations.

Introduction: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the rapid adoption of telehealth to provide HIV care and treatment. However, limited information exists about the feasibility, acceptability, and efficacy of telehealth interventions at different points of the HIV care continuum. Methods: A systematic search was conducted of Ovid MEDLINE, PsycINFO, and CINAHL databases to synthesize evidence regarding the feasibility, acceptability, and efficacy of videoconferencing and video-based interventions for HIV testing and treatment in adult populations. Seventeen articles published through July 2021 were included in the review. We used descriptive methods to analyze data, and findings were reported using frequencies and percentages. Results: Findings show that videoconferencing and video-based interventions are generally feasible and acceptable. Videoconferencing is effective in improving adherence to HIV treatment and in promoting HIV testing. In addition, video-based interventions were effective in promoting HIV testing, treatment initiation, and adherence to medication. Both modalities enhanced linkage and retention in treatment for HIV-positive patients. Conclusions: Video-based and videoconferencing interventions are beneficial in HIV testing and treatment. However, the scarcity of primary studies employing these telehealth modalities means that there is a need for more research in these areas. Also, reviewed studies suffered from several limitations, including reliance on subjective measures, lack of standardized ways of evaluating acceptability and feasibility, use of small sample sizes, and short follow-up durations. In addition, there was less representation of studies from resource-limited settings disproportionately affected by HIV and AIDS. Thus, future research should focus on addressing these challenges.

Barriers to HIV care in Uganda and implications for universal test-and-treat: a qualitative study.

Achieving universal HIV test-and-treat will require targeted interventions for those with worse outcomes, including advanced HIV. We conducted qualitative, semi-structured interviews with healthcare workers (HCWs) and people living with HIV (PLWH) at 5 HIV clinics in Kampala, Uganda, to understand barriers to care. PLWH enrolled started/restarted on HIV treatment ≤3 months prior. PLWH were grouped as 1) "ART-experienced" or those restarted therapy after ≥12 months off, 2) ART naïve CD4 count <100 cells/uL "late presenters" or 3) ART naïve CD4 count >350 cells/uL "early presenters". In-depth interviews were conducted in Luganda, translated, and transcribed verbatim. Between May and August 2017, 58 PLWH and 20 HCWs were interviewed. High stigma and low social support emerged as themes among all as barriers to care. Alcohol abuse was a barrier for men. Fear of domestic violence and abandonment were barriers for women, limiting disclosure of their HIV status to their male partners. Clinic factors such as rapport with staff, distance, efficiency, and privacy impacted care. Future interventions to decrease delayed ART initiation should target stigma and social support. Assisted disclosure, contact tracing, and alcohol abuse treatment should be implemented. Strengthening client support, reducing wait times, and increasing privacy assurances would improve care-seeking behaviors.

Sex in the Context of Substance Use: A Study of Perceived Benefits and Risks, Boundaries, and Behaviors among Adolescents Participating in an Internet-Based Intervention.

Little research has examined adolescents' perspectives of sex with substance use. This study examined (1) adolescents' perceived benefits and risks of sex with substance use, as well as boundaries; (2) the potential for positive and negative social influences among adolescents when they discuss these topics; and (3) whether exposure to health-promoting content is associated with trajectories of sex with substance use over a 6-month period. To address the first two objectives, 176 comments were analyzed from 71 adolescents (90% female) aged 14-18 years who participated in an Internet-based sexual health promotion intervention and posted to at least one message board addressing sex with substance use. Adolescents' perceived benefits and risks of sex with substance use primarily reflected concern for the experience of sex in the moment; perceived risks and boundaries primarily reflected concern for the ability to develop and maintain meaningful relationships. Comments of 63% and 22% of adolescents, respectively, were evaluated to have potential for health-promoting and risk-promoting social influence. To address the third objective, trajectories of self-reported sex with substance use were compared between 89 intervention and 54 control participants. No significant differences were observed. However, a dose-response effect was observed; intervention participants who completed less than one third of assigned tasks reported increases in sex with alcohol or marijuana use over time, while no marked changes or much smaller changes in sex with substance use were observed among intervention participants who completed one third or more tasks. Implications for prevention and intervention programs are discussed.

Effects of telehealth intervention for people with dementia and their carers: A systematic review and meta-analysis of randomized controlled studies.

PURPOSE: Interventions delivered using telehealth modalities are becoming standard practice with patient populations around the world, partly because of innovation necessitated by the COVID-19 pandemic and partly due to improved infrastructure and comfort of providers, patients, and families, through technology. Though increasingly utilized, the effectiveness of telehealth interventions with families with dementia remains unclear. This gives rise to the need for investigation to develop telehealth interventions that are evidence based and not merely convenient tools. This current study is designed to systematically examine the impact and effectiveness of telehealth-delivered psychoeducational and behavioral interventions among persons with dementia and their caregivers. DESIGN: The design combines systematic review and meta-analysis. METHODS: A total of eight databases were electronically accessed and searched as of November 16, 2021. Experimental studies identifying the results of telehealth interventions for persons with dementia and associated caregivers published in English have been reviewed in this study. Standardized mean differences (SMD) offering 95% confidence intervals (CI) were developed to pool the effect size using a random effects model (in this case, Stata 16.0). The Revised Cochrane Risk-of-Bias Tool for Randomized Trials (RoB-2) was used to analyze the study's methodological soundness. FINDINGS: Nineteen cases met the eligibility criteria (including 1379 persons with dementia and 1339 caregivers). Overall, telehealth interventions demonstrated effects in the expected directions on depression (SMD -0.63; 95% degree of confidence intervals (CI) -0.88 to -0.38, p < 0.001); and caregivers' perceived competency (SMD 0.27; 95% CI -0.05 to 0.50, p = 0.02). There were, however, no statistically significant effects observed on cognitive function or multiple aspects of quality of life for subjects. CONCLUSIONS: Telehealth interventions appear to effect a reduction in depression among persons diagnosed with dementia while improving the perceived competency of caregivers. CLINICAL RELEVANCE: The study's results could be used as evidence of the effectiveness of using telehealth for persons with dementia and their caregivers, including contextualizing where they are used (i.e., long-term care facilities, private homes, etc.), understanding the mechanisms in play (including intervention delivery and systems), and isolating and identifying mediating influences.

First- and Second-Hand Experiences of Enacted Stigma Among LGBTQ Youth.

Research on enacted stigma, or stigma- and bias-based victimization, including bullying and harassment, among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth often focuses on one context (e.g., school) or one form (e.g., bullying or microaggressions), which limits our understanding of these experiences. We conducted qualitative go-along interviews with 66 LGBTQ adolescents (14-19 years) in urban, suburban, town, and rural locations in the United States and Canada identified through purposive and snowball sampling. Forty-six participants (70%) described at least one instance of enacted stigma. Three primary themes emerged: (1) enacted stigma occurred in many contexts; (2) enacted stigma restricted movement; and (3) second-hand accounts of enacted stigma shaped perceptions of safety. Efforts to improve well-being among LGBTQ youth must address the diverse forms and contexts of enacted stigma that youth experience, which limit freedom of movement and potential access to opportunities that encourage positive youth development. School nurses can play a critical role in reducing enacted stigma in schools and in collaboration with community partners.

Evaluating the Feasibility and Acceptability of a Community-Based Parenting Support Intervention for Refugee Parents From Burma.

Refugee families negotiate stressors as they adjust to communities of resettlement, which can result in shifting family dynamics. The purpose of this community-engaged, explanatory, mixed-methods pilot study was to evaluate the feasibility and acceptability of a culturally oriented, community-based parenting curriculum. Through a partnership with a prominent refugee-serving organization, the curriculum was delivered to 50 Karen refugee mothers and fathers of adolescent youth resettled in the United States. Results demonstrated the potential for impact on key constructs of family adaptability and cohesion, as well as parent self-efficacy. Participants were highly engaged with the program and attrition was low.

Nursing and Sustainable Development Goals (SDGs) in a COVID-19 world: The state of the science and a call for nursing to lead.

The World Health Organization declared 2020 the Year of the Nurse and the Midwife well before the world was plunged into a pandemic response to SARS-CoV-2 (COVID-19). Worldwide, nurses are advancing critical research and policy efforts to achieve all 17 of the United Nations Sustainable Development Goals (SDGs). Nursing is best positioned to ask and answer how to achieve the SDGs over the next decade, and in this COVID-19 era. In this article, we summarize the state of the nursing and midwifery literature about the SDGs. Twenty-four publications met criteria for inclusion, with nearly half published in 2019. Findings emphasize a need for: (a) nursing curricula and training revisions to include SDG content and strengthen development of a future nursing workforce comprised of global citizens; (b) innovative and disruptive nursing research documenting advances toward achieving the SDG 2030 agenda; (c) nursing practice that operates within a SDG framework; and (d) responsive and proactive nursing policy development that foresees what is needed to achieve the SDGs. When the urgency of COVID-19 response subsides, the world will adjust to a new normal and nursing must be positioned to lead and contribute to micro- and macro-level efforts toward achieving the SDGs.

Nursing Disruption for Achieving Sustainable Development Goals by 2030.

Sixteen million nurses, the largest global health care workforce, contribute to achievement of 17 United Nations Sustainable Development Goals through strategic and disruptive research, education, practice, and policy. Responsible for advancing the well-being of individuals, families, communities, and society, nurses are positioned to influence and impact health across the life span. They do this from promoting prenatal health and early childhood success to encouraging healthy aging and end-of-life transitions. They utilize both predictive analytics that prevent rehospitalization and evidence-based practices, such as rocking and kangaroo care, that encourage survival and thriving of preterm newborns. Nurses have a scope of practice that necessitates their presence essentially everywhere. Direct nursing care is delivered in homes, schools, correctional settings, districts, hospitals, helicopters, combat zones, refugee camps, and postnatural disaster or homeless shelters. Nurses advancing system-level health are positioned in health care administration, higher education, international nongovernmental organizations, and governmental offices. Nurse educators and researchers shape tomorrow's practitioners and practice. In general, nurses innovate and generate solutions to improve global health. Shared in this article are strategies for nurses to employ to disrupt the status quo and aggressively contribute to achieving the 2030 Sustainable Development Goals.

Complex Decision-Making in Heart Failure: A Systematic Review and Thematic Analysis.

BACKGROUND: Heart failure follows a highly variable and difficult course. Patients face complex decisions, including treatment with implantable cardiac defibrillators, mechanical circulatory support, and heart transplantation. The course of decision-making across multiple treatments is unclear yet integral to providing informed and shared decision-making. Recognizing commonalities across treatment decisions could help nurses and physicians to identify opportunities to introduce discussions and support shared decision-making. OBJECTIVE: The specific aims of this review are to examine complex treatment decision-making, specifically implantable cardiac defibrillators, ventricular assist device, and cardiac transplantation, and to recognize commonalities and key points in the decisional process. METHODS: MEDLINE, CINAHL, PsycINFO, and Web of Science were searched for English-language studies that included qualitative findings reflecting the complexity of heart failure decision-making. Using a 3-step process, findings were synthesized into themes and subthemes. RESULTS: Twelve articles met criteria for inclusion. Participants included patients, caregivers, and clinicians and included decisions to undergo and decline treatment. Emergent themes were "processing the decision," "timing and prognostication," and "considering the future." Subthemes described how participants received and understood information about the therapy, making and changing a treatment decision, timing their decision and gauging health status outcomes in the context of their decision, the influence of a life or death decision, and the future as a factor in their decisional process. CONCLUSIONS: Commonalities were present across therapies, which involved the timing of discussions, the delivery of information, and considerations of the future. Exploring this further could help support patient-centered care and optimize shared decision-making interventions.

Substance Use among Sexual Minorities: Has it Actually Gotten Better?

BACKGROUND: Despite efforts to decrease substance use, rates among sexual minority youth (SMY) remain higher than among heterosexuals. Substance use is a leading contributor to morbidity and mortality in adulthood, and SMY's use of substances is related to poorer mental and emotional health. OBJECTIVES: We sought to document the trends in substance use for a large sample of youth over 14 years with special attention to SMY. In addition, we tested whether there were disparities in substance use behaviors between SMY and heterosexual youth. Last, we examined changes in disparities over time in substance use among SMY. METHODS: We analyzed data from 8 waves of the Massachusetts YRBS (N = 26,002, Mage = 16), from 1999 to 2013, to investigate trends and disparities in current tobacco, alcohol, and cannabis use for heterosexual youth and SMY. We used logistic regression interaction models to test whether these disparities have widened or narrowed for SMY, as compared to heterosexuals, over the span of 14 years. RESULTS: In absolute terms, substance use rates decreased for nearly all youth between 1999 and 2013. There were striking disparities in substance use between heterosexual youth and all sexual minority subgroups. These disparities in substance use narrowed among males but remained unchanged or worsened among females. Conclusions/Importance: Trends in substance use are changing over time, but not in the same ways for all sexual minority subgroups. Patterns are worsening for females. These findings suggest that we need to address the needs of LGB populations in novel ways.

Bi-national cross-validation of an evidence-based conduct problem prevention model.

OBJECTIVES: To (a) explore the preferences of Mexican parents and Spanish-speaking professionals working with migrant Latino families in Minnesota regarding the Mexican-adapted brief model versus the original conduct problems intervention and (b) identifying the potential challenges, and preferred solutions, to implementation of a conduct problems preventive intervention. METHOD: The core practice elements of a conduct problems prevention program originating in the United States were adapted for prevention efforts in Mexico. Three focus groups were conducted in the United States, with Latino parents (n = 24; 2 focus groups) and professionals serving Latino families (n = 9; 1 focus group), to compare and discuss the Mexican-adapted model and the original conduct problems prevention program. Thematic analysis was conducted on the verbatim focus group transcripts in the original language spoken. RESULTS: Participants preferred the Mexican-adapted model. The following key areas were identified for cultural adaptation when delivering a conduct problems prevention program with Latino families: recruitment/enrollment strategies, program delivery format, and program content (i.e., child skills training, parent skills training, child-parent activities, and child-parent support). For both models, strengths, concerns, barriers, and strategies for overcoming concerns and barriers were identified. CONCLUSIONS: We summarize recommendations offered by participants to strengthen the effective implementation of a conduct problems prevention model with Latino families in the United States. This project demonstrates the strength in binational collaboration to critically examine cultural adaptations of evidence-based prevention programs that could be useful to diverse communities, families, and youth in other settings. (PsycINFO Database Record

Unhealthy weight control behaviors among youth: Sex of sexual partner is linked to important differences.

Unhealthy weight control behaviors (UWCBs) have been decreasing for most youth over time, yet little is known whether these behaviors have changed for sexual minority (e.g., non-heterosexual) youth. This is important because many studies have found that sexual minorities report some of the highest rates of UWCBs. To determine whether or not these behaviors have changed over time, given the extreme changes in social contexts over the past two decades, we utilised three waves of the Minnesota Student Survey (N = 55,597, Mage = 17). In doing so, we report trends, disparities, and changes in disparities of UWCBs. Overall, the prevalence of UWCBs has declined from 1999 to 2010 for all youth, but there are alarming disparities by sex of sexual partner. We found that both- and same-sex partnered male youth were more likely to fast, use diet pills, and vomit on purpose to lose weight compared to their opposite-sex partnered counterparts in all three survey years; specifically, both-sex partnered boys were up to 5.5× as likely to vomit on purpose compared to their opposite-sex partnered counterparts. Likewise, both-sex partnered girls were more likely to use diet pills and vomit on purpose to lose weight compared to opposite-sex partnered girls in all three survey years. Additionally, the disparity in fasting to lose weight widened for the same-sex partnered females compared to the opposite-sex partnered females from 1998 to 2004. This has implications for UWCB interventions and preventions targeted specifically towards sexual minorities.

Chasing the rainbow: lesbian, gay, bisexual, transgender and queer youth and pride semiotics.

While the pride rainbow has been part of political and social intervention for decades, few have researched how lesbian, gay, bisexual, transgender and queer young people perceive and use the symbol. How do lesbian, gay, bisexual, transgender and queer youth who experience greater feelings of isolation and discrimination than heterosexual youth recognise and deploy the symbol? As part of a larger study on supportive lesbian, gay, bisexual, transgender and queer youth environments, we conducted 66 go-along interviews with lesbian, gay, bisexual, transgender and queer youth people from Massachusetts, Minnesota and British Columbia. During interviews, young people identified visible symbols of support, including recognition and the use of the pride rainbow. A semiotic analysis reveals that young people use the rainbow to construct meanings related to affiliation and positive feelings about themselves, different communities and their futures. Constructed and shared meanings help make the symbol a useful tool for navigating social and physical surroundings. As part of this process, however, young people also recognize that there are limits to the symbolism; it is useful for navigation but its display does not always guarantee supportive places and people. Thus, the pride rainbow connotes safety and support, but using it as a tool for navigation is a learned activity that requires caution.

"Kicked out": LGBTQ youths' bathroom experiences and preferences.

Attention toward who can use which gender binary, multi-stall bathroom has brought to the forefront, once again, the ways in which youth are supported or marginalized. No study has documented sexual and gender minority youths' experiences with and perspectives about bathrooms. We collected qualitative data in 2014-2015. Participants were 25 lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth, aged 14-19, in the United States and Canada. Their comments describe first- and second-hand bathroom experiences, identify advocacy efforts, and highlight the roles of peers and adults in making bathrooms safe (or not). Youth emphasized the importance of gender-neutral bathrooms in fostering a sense of safety and inclusivity. Adult support and gay-straight alliances (GSAs) were important contributors to a welcoming environment and fostered advocacy efforts for gender-neutral bathrooms. We encourage purposeful inclusivity of youths' voices when enacting bathroom-specific policies and legislation that directly influence their health and well-being.

Encuentro: Feasibility, Acceptability, and Outcomes of a Culturally Tailored Teen-Parent Health Promotion Program.

The growth of the Latino youth population, combined with the reality that many Latino adolescents live in environments characterized by social disparities, reveals a compelling need to address health inequalities affecting Latinos through effective health promotion programs designed by and for this population. This article presents findings from a pilot study of Encuentro, a health promotion program for young Latino teens and their parents. Developed by a community-university partnership, Encuentro aims to bolster internal assets, familial and cultural supports for young teens' positive development, and healthy sexual decision making and behaviors. Encuentro was pilot tested with 49 Latino families at 3 community sites in Minneapolis/St. Paul. Families were assigned to a program group or a control group. Pilot study findings confirm program feasibility and acceptability. Compared to the control group, program group youth reported substantially more involvement in activities celebrating Latino culture, and greater communication with their parents about sexual health topics. Parents in the program group reported greater ethnic pride, engaging in more activities to share Latino values and traditions with their teens, greater communication with their teens about sexual health topics, and increased parental monitoring than did parents in the control group. Findings demonstrate the potential of the Encuentro program.

Living as an LGBTQ Adolescent and a Parent's Child: Overlapping or Separate Experiences.

It is well known that parental and community-based support are each related to healthy development in lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth, but little research has explored the ways these contexts interact and overlap. Through go-along interviews (a method in which participants guide the interviewer around the community) with 66 youth in British Columbia, Massachusetts, and Minnesota, adolescents (aged 14-19 years) reported varying extent of overlap between their LGBTQ experiences and their parent-youth experiences; parents and youth each contributed to the extent of overlap. Youth who reported high overlap reported little need for resources outside their families but found resources easy to access if wanted. Youth who reported little overlap found it difficult to access resources. Findings suggest that in both research and practice, considering the extent to which youth feel they can express their authentic identity in multiple contexts may be more useful than simply evaluating parental acceptance or access to resources.

Lesbian, gay and bisexual college student perspectives on disparities in weight-related behaviours and body image: a qualitative analysis.

AIMS AND OBJECTIVES: To (1) explore college students' perceived sexual orientation-related barriers to engaging in physical activity, eating healthfully and maintaining healthy body images and (2) identify types of campus resources on physical activity, healthy eating and body image available to lesbian, gay and bisexual college students. BACKGROUND: Previous research has highlighted sexual orientation disparities in weight status, physical activity, healthy eating and body image. Despite this, little is known about the context surrounding these disparities. DESIGN: Cross-sectional study using individual interviews. METHODS: Thirty (15 males, 15 females) lesbian, gay, bisexual, queer and pansexual-identified college students, aged 18-30 years participated in the study. Quasi-inductive coding was used to analyse transcribed interview data and an iterative coding process was used to organise data into themes. RESULTS: Many felt their sexual orientation helped them be physically active, engage in healthful eating habits and have a positive body image. However, sexual orientation was also identified as a stressor that adversely impacted physical activity and eating habits. CONCLUSIONS: Lesbian, gay and bisexual students may have to negotiate their sexuality in ways that could adversely influence their physical activity, eating habits and body image. Both clinical and institutional interventions should be inclusive of all people, including lesbian, gay and bisexual, queer, and pansexual students. Further, tailored interventions to meet the specific health needs of sexual minority populations are needed. RELEVANCE TO CLINICAL PRACTICE: Clinicians need to understand the context in which sexual minority young adults experience health promotion messaging and programming. Clinic-based tailored interventions are critical as part of a multi-faceted approach in promoting physical activity and healthier eating habits for all young people, including lesbian, gay, bisexual, queer and pansexual, to more effectively address the prevention of chronic diseases.