Design Thinking for Health Disparities and Interdisciplinary Knowledge Translation: An LGBTQ+ Youth Health Literacy Project.

This article discusses the use of codesign, design thinking (DT), and design jams in collaboration with interdisciplinary scholars, service providers, and community-based stakeholders as an approach to social work intervention development-specifically, to tackle health inequities and timely knowledge translation (KT). An application of these methods to the problem of sexual health disparities and lack of access to inclusive sexual health education in school-based settings for LGBTQ+ youth is discussed. LGBTQ+ Youth HeLP (Health Literacy Project) is a holistic online sexual health resource providing evidence-based information to LGBTQ+ youth in an accessible and age-appropriate format. This article considers potential opportunities and obstacles for utilizing DT to develop responsive solutions to health inequities and health-related KT learned from the project. Codesign offers effective options for generating collaborations that may increase cross-stakeholder perspective taking in group settings and produce high-quality outputs with increased likelihood of uptake.

Stigma, the Media, and Pre-exposure Prophylaxis for HIV Prevention: Observations for Enhancing Knowledge Translation and Resisting Stigma in the Canadian Context.

Pre-Exposure Prophylaxis (PrEP) is an effective, though sometimes stigmatized, strategy for HIV prevention. With the goal of examining how PrEP stigma can be addressed, this study examined the media's handling of stigma related to PrEP by searching the Canadian Newsstream and Daily Xtra news databases for key terms related to PrEP. Overall, 101 media articles were thematically coded in triplicate; 36.3% of which included mentions of PrEP stigma. LGBT media sources were more likely than mainstream sources to have included content coded as relating to PrEP stigma (p = 0.02). In these articles, uncertainty regarding PrEP, and neo-liberal attitudes towards sexual responsibility were major factors associated with media discussion of PrEP stigma. We discuss the role that heuristics play in shaping lay readers perceptions and interpretation of PrEP media coverage and discuss methods for overcoming stigma using evidence-based communication strategies.

Using Geosocial Networking Apps to Understand the Spatial Distribution of Gay and Bisexual Men: Pilot Study.

BACKGROUND: While services tailored for gay, bisexual, and other men who have sex with men (gbMSM) may provide support for this vulnerable population, planning access to these services can be difficult due to the unknown spatial distribution of gbMSM outside of gay-centered neighborhoods. This is particularly true since the emergence of geosocial networking apps, which have become a widely used venue for meeting sexual partners. OBJECTIVE: The goal of our research was to estimate the spatial density of app users across Metro Vancouver and identify the independent and adjusted neighborhood-level factors that predict app user density. METHODS: This pilot study used a popular geosocial networking app to estimate the spatial density of app users across rural and urban Metro Vancouver. Multiple Poisson regression models were then constructed to model the relationship between app user density and areal population-weighted neighbourhood-level factors from the 2016 Canadian Census and National Household Survey. RESULTS: A total of 2021 app user profiles were counted within 1 mile of 263 sampling locations. In a multivariate model controlling for time of day, app user density was associated with several dissemination area-level characteristics, including population density (per 100; incidence rate ratio [IRR] 1.03, 95% CI 1.02-1.04), average household size (IRR 0.26, 95% CI 0.11-0.62), average age of males (IRR 0.93, 95% CI 0.88-0.98), median income of males (IRR 0.96, 95% CI 0.92-0.99), proportion of males who were not married (IRR 1.08, 95% CI 1.02-1.13), proportion of males with a postsecondary education (IRR 1.06, 95% CI 1.03-1.10), proportion of males who are immigrants (IRR 1.04, 95% CI 1.004-1.07), and proportion of males living below the low-income cutoff level (IRR 0.93, 95% CI 0.89-0.98). CONCLUSIONS: This pilot study demonstrates how the combination of geosocial networking apps and administrative datasets might help care providers, planners, and community leaders target online and offline interventions for gbMSM who use apps.

Predictors of Facebook User Engagement With Health-Related Content for Gay, Bisexual, and Other Men Who Have Sex With Men: Content Analysis.

BACKGROUND: Social media is used by community-based organizations (CBOs) to promote the well-being of gay and bisexual men (GBM). However, few studies have quantified which factors facilitate the diffusion of health content tailored for sexual minorities. OBJECTIVE: The aim of this study was to identify post characteristics that can be leveraged to optimize the health promotion efforts of CBOs on Facebook. METHODS: The Facebook application programming interface was used to collect 5 years' of posts shared across 10 Facebook pages administered by Vancouver-based CBOs promoting GBM health. Network analysis assessed basic indicators of network structure. Content analyses were conducted using informatics-based approaches. Hierarchical negative binomial regression of post engagement data was used to identify meaningful covariates of engagement. RESULTS: In total, 14,071 posts were shared and 21,537 users engaged with these posts. Most users (n=13,315) engaged only once. There was moderate correlation between the number of posts and the number of CBOs users engaged with (r=.53, P<.001). Higher user engagement was positively associated with positive sentiment, sharing multimedia, and posting about pre-exposure prophylaxis, stigma, and mental health. Engagement was negatively associated with asking questions, posting about dating, and sharing posts during or after work (versus before). CONCLUSIONS: Results highlight the existence of a core group of Facebook users who facilitate diffusion. Factors associated with greater user engagement present CBOs with a number of strategies for improving the diffusion of health content.

Prevalence of Depression and Anxiety Among Bisexual People Compared to Gay, Lesbian, and Heterosexual Individuals:A Systematic Review and Meta-Analysis.

Over the past decade, evidence has accumulated to suggest that bisexual people experience higher rates of poor mental health outcomes compared to both heterosexual and gay/lesbian individuals. However, no previous meta-analyses have been conducted to establish the magnitude of these disparities. To address this research gap, we conducted a systematic review and meta-analysis of studies that reported bisexual-specific data on standardized measures of depression or anxiety. Of the 1,074 full-text articles reviewed, 1,023 were ineligible, predominantly because they did not report separate data for bisexual people (n = 562 studies). Ultimately, 52 eligible studies could be pooled in the analysis. Results indicate that across both outcomes, there is a consistent pattern of lowest rates of depression and anxiety among heterosexual people, while bisexual people exhibit higher or equivalent rates in comparison to lesbian/gay people. On the basis of empirical and theoretical literature, we propose three interrelated contributors to these disparities: experiences of sexual orientation-based discrimination, bisexual invisibility/erasure, and lack of bisexual-affirmative support. Implications for interventions to improve the health and well-being of bisexual people are proposed.

Advancing the conversation: next steps for lesbian, gay, bisexual, trans, and queer (LGBTQ) health sciences librarianship.

In recent years, librarians in various sectors have been moving forward a conversation on the distinct information needs and information-seeking behavior of our lesbian, gay, bisexual, trans, and queer (LGBTQ) patrons and how well the profession recognizes and meets those needs. Health sciences librarianship has been slower than other areas of the profession in creating an evidence base covering the needs of its LGBTQ patrons, with, until recently, only very limited literature on this subject. LGBTQ health sciences librarianship is now starting to attract new interest, with librarians working together to bring this emerging specialization to the attention of the broader professional community. In this paper, the authors report on a dedicated panel discussion that took place at the 2016 joint annual meeting of the Medical Library Association and Canadian Health Libraries Association/Association des bibliothèques de la santé du Canada in Toronto, Ontario, Canada; discuss subsequent reflections; and highlight the emerging role for health sciences librarians in providing culturally competent services to the LGBTQ population. Recommendations are also provided for establishing a tool kit for LGBTQ health sciences librarianship from which librarians can draw. We conclude by highlighting the importance of critically reflective practice in health sciences librarianship in the context of LGBTQ health information.