LGBTQ+ faculty, queering health sciences classrooms: student perspectives.

Lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) students in undergraduate science, technology, engineering, and math (STEM) majors are more likely to drop out than their cisgender, heterosexual peers despite having equivalent grades and research exposure. It has been demonstrated that a sense of belonging, a very strong predictor of student retention, is low in LGBTQ+-identified STEM undergraduates. It has further been posited that faculty openness and authenticity can enhance a sense of belonging for LGBTQ+ students through the creation of an inclusive classroom culture. The authors of this article, three LGBTQ+-identified faculty in the health sciences department at Boston University, surveyed students enrolled in their courses to elicit student thoughts, feelings, and behaviors regarding the effect of faculty 1) sharing their identity openly in the classroom, and 2) actively working to create open, inclusive dialogue and space in their classrooms. Of 86 student participants across multiple classes, the large majority of students, both LGBTQ+-identified and non-LGBTQ+-identified, described feeling safe, included, and welcomed in the classroom. They described engaging more in peer-to-peer education and felt that instructor authenticity created a safe and inclusive classroom. A minority of LGBTQ+-identified students and non-LGBTQ+-identified students reported feeling unsure of voicing their opinions, for the former related to insecurity about being LGBTQ+ and the latter feeling a liberal bias existed in the classroom. Altogether, these results suggest a positive effect on student sense of belonging when faculty authenticity and intentionality create inclusive classroom environments in the health sciences.NEW & NOTEWORTHY Openness and authenticity of lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+)-identified faculty in the health sciences positively affect students by helping them feel seen, welcomed, and included for both students who identify as LGBTQ+ and those who do not. Moreover, faculty openness fostered student action by encouraging them to have peer-to-peer discussions about inclusive language and engage more openly in classroom discussions. Creating academic job security for LGBTQ+-identified faculty to be open can enhance classroom culture, student engagement, and learning.

Feasibility and Acceptability of Dietary Intake Assessment Via 24-Hour Recall and Food Frequency Questionnaire among Women with Low Socioeconomic Status.

BACKGROUND: Comprehensive evaluation of dietary interventions depends on effective and efficient measurement to quantify behavior change. To date, little is known regarding which self-reported measure of dietary intake is most feasible and acceptable for use in evaluation of the effectiveness of diet intervention studies among underserved populations. OBJECTIVE: This research focused on evaluating feasibility and acceptability of two self-report measures of diet. DESIGN: Cross-sectional. PARTICIPANTS/SETTING: Two interviewer-administered 24-hour recalls and a 110-item food frequency questionnaire (FFQ) were administered to both English- and Spanish-speaking participants (n=36) by native English- and Spanish-speaking research assistants. On completion of both dietary assessments, participants were interviewed regarding their preference of measure. MAIN OUTCOME MEASURES: Feasibility for completion of the dietary assessment measures was determined for contacts and retention. Acceptability of the measures was determined through responses to open- and closed-ended questions. RESULTS: During the 5-month trial, 36 participants were enrolled; 29 completed both intake measures, and 26 completed both measures and the interview. Participants were mainly Hispanic/Latina (72%), with a mean age of 37.0 (±7.6) years. Feasibility targets were met for contacts (1.9, 1.6, 1.8 contact attempts to complete each diet assessment measure with a target of ≤2) and for retention with 89% and 91% completing two 24-hour recalls and the FFQ, respectively. Participants indicated both diet assessment methods were generally acceptable; both positive and negative comments were received for use of the FFQ. CONCLUSION: Dietary assessment with the use of 24-hour recalls or an FFQ can be feasible and acceptable among women with low socioeconomic status, although care should be taken to address cultural appropriateness in the selection of the measurement method.

Enhancing physical and social environments to reduce obesity among public housing residents: rationale, trial design, and baseline data for the Healthy Families study.

Intervention programs that change environments have the potential for greater population impact on obesity compared to individual-level programs. We began a cluster randomized, multi-component multi-level intervention to improve weight, diet, and physical activity among low-socioeconomic status public housing residents. Here we describe the rationale, intervention design, and baseline survey data. After approaching 12 developments, ten were randomized to intervention (n=5) or assessment-only control (n=5). All residents in intervention developments are welcome to attend any intervention component: health screenings, mobile food bus, walking groups, cooking demonstrations, and a social media campaign; all of which are facilitated by community health workers who are residents trained in health outreach. To evaluate weight and behavioral outcomes, a subgroup of female residents and their daughters age 8-15 were recruited into an evaluation cohort. In total, 211 households completed the survey (RR=46.44%). Respondents were Latino (63%), Black (24%), and had ≤ high school education (64%). Respondents reported ≤2 servings of fruits & vegetables/day (62%), visiting fast food restaurants 1+ times/week (32%), and drinking soft drinks daily or more (27%). The only difference between randomized groups was race/ethnicity, with more Black residents in the intervention vs. control group (28% vs. 19%, p=0.0146). Among low-socioeconomic status urban public housing residents, we successfully recruited and randomized families into a multi-level intervention targeting obesity. If successful, this intervention model could be adopted in other public housing developments or entities that also employ community health workers, such as food assistance programs or hospitals.

Severity of depressive symptoms and accuracy of dietary reporting among obese women with major depressive disorder seeking weight loss treatment.

An elevation in symptoms of depression has previously been associated with greater accuracy of reported dietary intake, however this association has not been investigated among individuals with a diagnosis of major depressive disorder. The purpose of this study was to investigate reporting accuracy of dietary intake among a group of women with major depressive disorder in order to determine if reporting accuracy is similarly associated with depressive symptoms among depressed women. Reporting accuracy of dietary intake was calculated based on three 24-hour phone-delivered dietary recalls from the baseline phase of a randomized trial of weight loss treatment for 161 obese women with major depressive disorder. Regression models indicated that higher severity of depressive symptoms was associated with greater reporting accuracy, even when controlling for other factors traditionally associated with reporting accuracy (coefficient  =  0.01 95% CI = 0.01 - 0.02). Seventeen percent of the sample was classified as low energy reporters. Reporting accuracy of dietary intake increases along with depressive symptoms, even among individuals with major depressive disorder. These results suggest that any study investigating associations between diet quality and depression should also include an index of reporting accuracy of dietary intake as accuracy varies with the severity of depressive symptoms.

Reliable change in depression during behavioral weight loss treatment among women with major depression.

OBJECTIVE: Although behavioral weight loss interventions generally have been shown to improve depressive symptoms, little is known as to whether some people with major depressive disorder experience worsening of depression during a weight loss intervention. DESIGN AND METHODS: Rates and predictors of change in depression symptoms among 148 obese women with major depressive disorder who participated in a trial comparing depression treatment plus behavioral weight loss treatment (Behavioral Activation; BA) to behavioral weight loss treatment alone (Lifestyle Intervention; LI) were examined. a statistically reliable change in depression was calculated as ≥9 points on the beck depression inventory in this sample. RESULTS: At 6 months, 73% of participants in BA and 54% of participants in LI showed reliable improvement in depression symptoms and 1.5% of participants in BA and 1.3% of participants in LI showed reliable worsening in depression symptoms. Rates of reliable change were similar at 12 months. Participants who experienced reliable improvement in depression lost significantly more weight than those who did not in both conditions. In the LI condition, baseline psychiatric variables and change in physical activity during treatment were also related to reliable improvement in depression. CONCLUSION: No evidence for an iatrogenic effect of behavioral weight loss treatment on depressive symptoms among obese women with major depressive disorder was detected; rather, behavioral weight loss treatment appears to be associated with significant concurrent improvement in depression. Even greater rates of reliable improvement were observed when depression treatment was added to weight loss treatment.