Perceptions of Sexual and Gender Minority Content in Graduate Nursing Curricula.

AIM: The aim of the study was to evaluate how faculty and nursing students perceive the importance of including sexual and gender minority (SGM) content in graduate curricula. BACKGROUND: Nurses in education and practice must be culturally sensitive to the unique populations we serve and to the diversity represented in all health care environments. METHOD: Online secure web-based surveys were distributed to graduate nursing faculty and students in 2015 and 2017 employing a triangulated methodology. RESULTS: Faculty and students responded that basic content and knowledge of clinical care for SGM populations are important. Thematic analysis of open-ended questions provided suggestions for improvement in curricula and within the learning environment. CONCLUSION: Continued development of faculty knowledge and application of SGM content in nursing curricula must meet student expectations and health needs of SGM populations.

Program Design for Healthy Weight in Lesbian and Bisexual Women: A Ten-City Prevention Initiative.

PURPOSE: Adult lesbian and bisexual (LB) women are more likely to be obese than adult heterosexual women. To address weight- and fitness-related health disparities among older LB women using culturally appropriate interventions, the Office on Women's Health (OWH) provided funding for the program, Healthy Weight in Lesbian and Bisexual Women (HWLB): Striving for a Healthy Community. This paper provides a description of the interventions that were implemented. METHODS: Five research organizations partnered with lesbian, gay, bisexual, and transgender community organizations to implement healthy weight interventions addressing the needs of LB women 40 years and older. The interventions incorporated evidence-based recommendations related to physical activity and nutrition. Each group intervention developed site-specific primary objectives related to the overall goal of improving the health of LB women and included weight and waist circumference reduction as secondary objectives. A 57-item core health survey was administered across the five sites. At a minimum, each program obtained pre- and post-program assessments. RESULTS: Each program included the OWH-required common elements of exercise, social support, and education on nutrition and physical activity, but adopted a unique approach to deliver intervention content. CONCLUSION: This is the first time a multisite intervention has been conducted to promote healthy weight in older LB women. Core measurements across the HWLB programs will allow for pooled analyses, and differences in study design will permit analysis of site-specific elements. The documentation and analysis of the effectiveness of these five projects will provide guidance for model programs and future research on LB populations.

An ecological framework for sexual minority women's health: factors associated with greater body mass.

In recent years, many studies have focused on the body of sexual minority women, particularly emphasizing their larger size. These studies rarely offer theoretically based explanations for the increased weight, nor study the potential consequences (or lack thereof) of being heavier. This article provides a brief overview of the multitude of factors that might cause or contribute to larger size of sexual minority women, using an ecological framework that elucidates upstream social determinants of health as well as individual risk factors. This model is infused with a minority stress model, which hypothesizes excess strain resulting from the stigma associated with oppressed minority identities such as woman, lesbian, bisexual, woman of color, and others. We argue that lack of attention to the upstream social determinants of health may result in individual-level victim blaming and interventions that do not address the root causes of minority stress or increased weight.

Aging, Weight, and Health Among Adult Lesbian and Bisexual Women: A Metasynthesis of the Multisite "Healthy Weight Initiative" Focus Groups.

PURPOSE: Adult lesbian and bisexual (LB) women are more likely to be obese than adult heterosexual women. Achieving a healthy weight reduces health risks and improves quality of life, but the evidence based on successful weight interventions is limited. To inform a national initiative, a metasynthesis (a form of qualitative meta-analysis) of focus group data was conducted to gather lesbian and bisexual womens' perspectives. METHODS: Analysis used de-identified transcripts and narrative reports from 11 focus groups guided by different semi-structured discussion guides with 65 participants from five locations. A literature search was conducted to identify existing themes in published literature and unpublished reports. RESULTS: Six key themes were identified: aging; physical and mental health status; community norms; subgroup differences; family and partner support; and awareness and tracking of diet and physical activity. Participants expressed feeling unprepared for age-related changes to their health and voiced interest in interventions addressing these issues. Their perspectives on community acceptance of body size shifted as they aged. Participants cited age, class, race, ethnicity, sexual identity, and gender expression as potential characteristics that may influence participation in interventions. Families were both a barrier to and a facilitator of health behaviors. Awareness and tracking of dietary habits, stressors, and physical activity levels emerged as a theme in more than half of the groups. CONCLUSION: An unsolicited, overarching theme was aging and its influence on the participants' perspectives on health and weight. Interventions should be tailored to the needs, goals, and community norms of LB women.

A systematic review of the literature on weight in sexual minority women.

BACKGROUND: Over the past 20 years, a growing literature has demonstrated that sexual minority women have greater weight than heterosexual women, prompting concern that they may be at high risk for disparities in physical disorders. In 2008, Bowen et al. published a review of the existing research on sexual minority women and obesity, finding no methodologically strong studies with representative sampling procedures. METHOD: We conducted a systematic review of the literature covering the period of July 2006 to February 2014 on the relationship between sexual orientation and weight. The review includes 20 population-based and 17 nonprobability sample studies. CONCLUSIONS: The majority of these studies found that lesbian and bisexual women had significantly greater body mass index (BMI) or a higher percentage with a BMI over 30 than heterosexual women. The difference in BMI was fairly consistent across the lifespan, with the weight differences beginning in adolescence. The studies, however, did not show a higher prevalence of physical disorders thought to be associated with weight. This potentially paradoxical finding warrants further research to compare prevalence of chronic disease by BMI category and sexual orientation.

Lesbians' and bisexual women's definition of health.

Health is an abstract term used to describe the state of the human body, a mental state or the likelihood of longevity. Throughout history, many definitions have been provided by agencies and healthcare professionals. Although the meaning of health has a long and well-examined history, there remains a gap in the literature surrounding the meaning of health to specific populations of people. The purpose of this article is to present an analysis of the meaning of health from the perspective of lesbians and bisexual women. A content analysis was performed on the definition of health as reported by 189 sexual minority women. The conclusions from this study strongly suggest that health interventions for lesbian and bisexual women focus on what women want to achieve, rather than on what individual behavior should be.