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1.
Artigo em Inglês | MEDLINE | ID: mdl-33410250

RESUMO

CONTEXT: Transgender and gender-diverse youth experience significant health disparities across numerous domains of health, including sexual health. Among general populations, parent connectedness has been strongly associated with youth sexual health. METHODS: The relationships between parent connectedness and sexual health indicators were investigated among 2,168 transgender and gender-diverse youth who participated in the 2016 Minnesota Student Survey, a statewide population-based survey of ninth- and 11th-grade students. Multivariate logistic regression models, stratified by sex assigned at birth, tested associations between parent connectedness-youth's perceptions of parent caring and parent-youth communication-and eight sexual health indicators: ever having had sex, having multiple sexual partners in the past year, pregnancy involvement, substance use at last sex, partner communication about STI prevention, partner communication about pregnancy prevention, condom use at last sex and pregnancy prevention methods at last sex. RESULTS: The level of parent connectedness was inversely associated with ever having had sex, regardless of sex assigned at birth (odds ratios, 0.6-0.8). Although level of connectedness was inversely associated with having multiple sexual partners in the past year and pregnancy involvement among transgender and gender-diverse youth assigned male at birth (0.6-0.7), these relationships were nonsignificant among transgender and gender-diverse youth assigned female at birth. Further differences in associations between parent connectedness and four sexual risk-reduction behaviors were found between youth assigned male at birth and those assigned female. CONCLUSIONS: As with other populations, parent connectedness promotes sexual health among transgender and gender-diverse youth and may provide a point of intervention.

2.
Am J Orthopsychiatry ; 91(1): 109-119, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33151733

RESUMO

Research addressing the linkages between acculturation and markers of adolescent well-being across multiple ethnic minority groups is limited in scope and breadth, even though children of immigrant origin are the fastest growing population. We examined cross-sectional relationships between acculturation and substance use, socioemotional well-being, and academic achievement. Somali, Latino, and Hmong adolescents in Minnesota provided data as part of the EAT 2010 (Eating and Activity in Teens) cohort study (N = 1,066). Acculturation was based on nativity, language usually spoken at home, and length of residence in the United States. Chi-square, ANOVA, and regression models were used to test for differences in adolescent well-being by acculturation and ethnic group, and interaction terms were added to models to test effect modification by ethnicity. Hmong adolescents had the highest mean acculturation scores (4.4 ± 1.5), whereas Somali adolescents (2.2 ± 1.8) were the least acculturated. Independent of ethnicity, acculturation was positively associated with marijuana (OR: 1.38; CI [1.25, 1.53]) and alcohol use (OR: 1.12; CI [1.02, 1.22]), and was negatively associated with academic achievement, based on grade point average (ß = -0.07; CI [-0.12, -0.03]). Interaction effects indicated significant differences by ethnicity only for academic achievement; significant associations between acculturation and academic achievement were evident only for Somali and Latino youth. Prevention programming should include supports for multilingual and multicultural learners and account for cultural assets within immigrant origin families that maintain and nurture protective factors as adolescents acculturate and transition into young adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

3.
Int J Eat Disord ; 2020 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-33277727

RESUMO

BACKGROUND: This study explores cross-sectional associations between yoga and body image, mindful eating, disordered eating, and muscle-enhancing behaviors among a population-based sample of ethnically/racially diverse emerging adults. METHOD: An ethnically/racially diverse population-based sample of 1,568 emerging adults (18-26 years) completed surveys as part of EAT 2010-2018 (Eating and Activity over Time). Models were adjusted for sociodemographic characteristics and body mass index (BMI). RESULTS: Practicing yoga at least 30 min/week was reported by 12.7% (n = 210) of the sample. Yoga practitioners had higher levels of mindful eating than those not practicing yoga. Although effect sizes were small, yoga practitioners were more likely than non-yoga practitioners to use steroids (3.8 vs. 0.7%, p < .001, h = 0.22) or protein powder/shakes (35.1 vs. 25.3%, p < .010, h = 0.21) to increase their muscle size/tone. Body satisfaction, unhealthy weight control behaviors, and binge eating tended to be similar among yoga practitioners and non-yoga practitioners. There was a significant interaction between BMI and yoga in predicting body satisfaction with a trend toward a positive impact among yoga practitioners at higher BMI values. Interactions between yoga practice and all body image attitudes and behaviors across gender and ethnicity/race were not statistically significant. DISCUSSION: Young people from diverse ethnic/racial backgrounds who practice yoga are more likely to engage in mindful eating but have equal or elevated levels of unhealthy body image attitudes and behaviors as compared to non-yoga practitioners. Further research should explore how yoga is best taught and practiced to ensure that it is beneficial for body image and related behaviors.

4.
LGBT Health ; 7(8): 407-419, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33170062

RESUMO

Transgender and gender-diverse (TGD) youth experience significant health and well-being disparities compared to their cisgender peers. However, disparities experienced at a population level might be mitigated by individual-level factors such as strong family relationships. Discrete aspects of strong family relationships may impact the health and well-being of TGD youth differently. To date, no systematic review known to us has explored the state of the science regarding the association between family relationships and the health and well-being of TGD adolescents and young adults. As such, our review aimed to (1) compile and present the scientific literature addressing the connection between family relationships and the health and well-being of TGD youth in those families; (2) sort results utilizing the Family Strengths Model; and (3) assess the strength of the literature with evidence-based appraisal tools. Sixteen articles met eligibility criteria (10 quantitative and 6 qualitative). These articles discussed family relationship qualities influencing health and well-being outcomes, including mental health, homelessness, sexual health, and substance use. Three of six qualities of strong families-coping ability, appreciation and affection, and positive communication-were represented in the literature. The risk for bias and study strength appraisals suggest that the available literature is moderately strong overall. Certain characteristics of strong families (commitment, enjoyable time spent together, and spiritual well-being) were underrepresented in the literature. Future research should explore these gaps to ensure that health care and community service providers can deliver the most effective support and care for TGD youth and their families.

5.
J Adolesc Health ; 2020 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-33183922

RESUMO

PURPOSE: Weight teasing from family members is common during adolescence. However, little is known about parental factors that increase adolescents' risk for family weight teasing and its adverse health sequelae. Using multi-informant data from adolescents, mothers and fathers, the current longitudinal study examined how parental concerns about their child's weight and their own weight contribute to family weight teasing in adolescence and its long-term health consequences. METHODS: Data were collected in the population-based Project EAT 2010-2018 (Eating and Activity over Time) study, following a longitudinal cohort of young people (N = 2,793). Parental weight concerns for their adolescent and themselves were reported by mothers (N = 2,298) and fathers (N = 1,409) at baseline and examined as a predictor of family weight teasing in adolescence as well as a moderator of family weight teasing effects on health eight years later. RESULTS: Mothers' and fathers' concerns about their child's weight, as well as mothers' dieting frequency, increased the likelihood of adolescents experiencing family weight teasing. Longitudinal analyses revealed that adolescents teased about their weight by family had higher levels of stress (ß = .21, 95% confidence interval [CI] = .09-.33) and substance use (ß = .16, 95% CI = .04-.28), and lower self-esteem (ß = -.16, 95% CI = -.28 to -.05) in young adulthood. CONCLUSIONS: Findings highlight parent weight concern, particularly concern for their child's weight, as a risk factor for family weight teasing. These findings underscore the importance of encouraging parental attention to health, rather than weight, in family-based treatment and public health initiatives.

6.
Ann Behav Med ; 54(10): 738-746, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32909031

RESUMO

BACKGROUND: Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID-19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. PURPOSE: We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults. METHODS: Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010-2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020. RESULTS: Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (ß = 0.15, p < .001), stress (ß = 0.15, p = .001), eating as a coping strategy (ß = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables. CONCLUSIONS: Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.


Assuntos
Peso Corporal , Infecções por Coronavirus/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Pneumonia Viral/psicologia , Angústia Psicológica , Estigma Social , Betacoronavirus , Exercício Físico/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade/psicologia , Pandemias , Adulto Jovem
7.
Int J Behav Med ; 27(6): 660-667, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32643038

RESUMO

BACKGROUND: The original Adverse Childhood Experiences (ACE) study demonstrated strong, graded relationships between child maltreatment and household dysfunction and adult health status. The present study re-examined these relationships in a sample of young adult, college students to better characterize the developmental timing of health problems related to ACE exposure and differences by biological sex. METHOD: A cross-sectional general health questionnaire that included items on ACE was administered to young adults (ages 18-29) at universities in California (n = 3880), Minnesota (n = 7708), and Texas (n = 451) between 2017 and 2018. Seven ACE were assessed: psychological, physical, or sexual abuse; violence between parents; or living with household members who were substance misusers, mentally ill, or ever imprisoned. Binary health indicators were regressed on number of ACE as 0 (referent), 1, 2, 3, and 4 or more using logistic regression controlling for age, biological sex, race/ethnicity, and site. RESULTS: Approximately 51.7% of the sample reported at least one ACE with a significantly higher rate among Texas participants (p < 0.001). We observed graded relationships between levels of ACE exposure and physical, mental, and behavioral health indicators including cigarette use, e-cigarette use, drinking and driving, obesity, lifetime depression, suicide ideation and attempt, non-suicidal self-injury, and lack of restful sleep. ACE-exposed females reported worse mental health status than ACE-exposed males while males reported more substance use than females. Most outcomes did not vary significantly by sex. CONCLUSION: The strong, graded relationships observed between ACE exposure and health status among young adults reinforce the need for trauma-informed intervention programs on college campuses.


Assuntos
Maus-Tratos Infantis , Sistemas Eletrônicos de Liberação de Nicotina , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , Estudantes , Adulto Jovem
8.
Prev Med ; 139: 106191, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32653353

RESUMO

Despite supportive structural changes to reduce stigma towards lesbian, gay, and bisexual, transgender, queer, and questioning (LGBTQ) Canadian residents, sexual minority youth still face disparities compared to heterosexual peers. We aimed to characterize LGBTQ-supportive environments and political climates, and examine their links to suicidal behavior among sexual minority adolescents in western Canada. Data were from the 2013 British Columbia Adolescent Health Survey, a cluster-stratified random cross-sectional survey of public school students in BC, Canada; We sampled 2678 self-identified LGB and mostly heterosexual students (69% girls) from 274 schools, representing an estimated provincial population of 24,624 sexual minority students in weighted models. Student reports of past-year suicidal ideation, suicidal attempts, and self-harm behaviors were merged with community-level data assessing diverse aspects of LGBTQ-supportive resources and progressive political climates in communities surrounding the schools. Adjusted multilevel models showed that for sexual minority adolescent girls, higher community LGBTQ-supportiveness predicted marginally significant lower suicidal ideation (aOR = 0.94, 95% CI [0.88, 1.01]) and suicidal attempts (aOR = 0.91, 95% CI [0.83, 1.00]) and significantly lower self-harm behaviors (aOR = 0.91, 95% CI [0.85, 0.98]). Further, progressive political climates predicted marginally significant lower suicidal ideation (aOR = 0.89, 95% CI [0.78, 1.02]) and significantly lower self-harm behaviors (aOR = 0.87, 95% CI [0.77, 0.99]). For sexual minority adolescent boys, no community-level variables were associated with suicidal behavior in adjusted models. Thus, LGBTQ-supportive communities and progressive political climates appear to be protective against suicidal behavior among sexual minority adolescent girls, but not sexual minority adolescent boys.

9.
J Psychosom Res ; 134: 110134, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32413612

RESUMO

OBJECTIVE: This study examines weight stigma experiences in a population-based sample of young adults from diverse ethnic/racial and socio-economic backgrounds, and explores cross-sectional associations between weight stigma and self-compassion, including gender differences in this relationship. METHODS: Data come from EAT 2018, a population-based study of weight and related behaviors in young adults (N = 1523, mean age = 22 years, 53.5% females). Adjusted models tested associations between different experiences of weight stigma and the Self-Kindness Subscale of the Self-Compassion Scale, controlling for age, body mass index (BMI), ethnicity/race, and SES. RESULTS: Over a third (32.3-52.2%) of participants reported experiences of weight teasing, and almost half (39.2-54.8%) indicated that people in their work or school settings are treated differently based on weight. There were few differences across ethnic/racial groups in reports of weight stigma. The prevalence of weight stigma experiences reported by participants in their current school or work environment was similar across gender, and those who had experienced weight stigma had lower levels of self-kindness. Among both females and males, lower self-kindness scores were associated with the experience of weight teasing (females: χ2 = 22.6, df = 1, p < .001, d = 0.32; males χ2 = 7.6, df = 1, p < .001, d = 0.22). For females only, lower self-kindness scores were associated with being treated unfairly due to weight (χ2 = 11.1, df = 1, p < .001, d = 0.23), and having others make comments about your weight (χ2 = 14.6, df = 1, p < .001, d = 0.28). Findings remained after adjusting for race/ethnicity, BMI, and SES. CONCLUSION: Associations between self-compassion and experiences of weight stigma found in our diverse sample of young adults offers insights on this understudied relationship.


Assuntos
Peso Corporal , Empatia , Grupos Étnicos/psicologia , Estigma Social , Fatores Socioeconômicos , Adolescente , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Adulto Jovem
10.
J Interpers Violence ; : 886260520915549, 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32370591

RESUMO

The authors examined whether team athletic involvement is related to sexual violence victimization and perpetration among male and female high school students. A secondary data analysis was conducted with Minnesota Student Survey data gathered from 122,501 Minnesota eighth-grade, ninth-grade, and 11th grade students. Multivariable logistic regression indicates that sport-involved youth are more likely to be involved in sexual violence than peers not involved in sports. For example, highly sport-involved males are significantly more likely to coerce a partner into sex (odds ratio [OR] = 1.35, 95% confidence interval [CI] = [1.01, 1.67]) and be coerced (OR = 1.19, 95% CI = [1.02, 1.38]) than nonsport peers. The results suggest high school sport programs could be an important site to implement comprehensive sexual violence prevention programs targeted at individual actions as well as harmful cultural norms and systematic inequities.

11.
Artigo em Inglês | MEDLINE | ID: mdl-32333287

RESUMO

Anti-smoking norms and educational aspirations are established tobacco prevention targets for general United States (U.S.) adolescent populations but protective factors remain poorly characterized for Somali-American youth. Here we describe patterns of past 30-day tobacco use and associated protective factors among eighth, ninth, and eleventh grade Somali adolescent respondents (n = 2009) to the 2016 Minnesota Student Survey using multivariate logistic regressions. E-cigarette (5.7%) and hookah (5.0%) use were most prevalent. Male youth reported higher levels of tobacco use across products. Adjusted odds ratios showed that internal developmental assets (e.g., e-cigarettes aOR 0.37, 95% CI 0.37, 0.79) and parental anti-smoking norms (e.g., e-cigarettes aOR 0.19, 95% CI 0.09, 0.38) protected against use of all tobacco products. E-cigarettes and hookah are prevalent among U.S. Somali youth, highlighting the need for prevention efforts that address emerging tobacco products and leverage protective factors such as internal assets and parental anti-smoking norms.

12.
LGBT Health ; 7(2): 82-89, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31985327

RESUMO

Purpose: Using representative school-based data and community-level primary data, we investigated how environmental factors (e.g., school and community climate) might be protective against substance use behaviors among a vulnerable population of adolescents. Methods: We analyzed a sample of 2678 sexual minority adolescents using a combination of student-level data (British Columbia Adolescent Health Survey) and primary community-level data (assessing lesbian, gay, bisexual, transgender, and queer [LGBTQ]-specific community and school environments). Using multilevel logistic regression models, we examined associations between lifetime substance use (alcohol, illegal drugs, marijuana, nonmedical use of prescription drugs, and smoking) and community-level predictors (community and school LGBTQ supportiveness). Results: Above and beyond student characteristics (e.g., age and years living in Canada), sexual minority adolescents residing in communities with more LGBTQ supports (i.e., more supportive climates) had lower odds of lifetime illegal drug use (for boys and girls), marijuana use (for girls), and smoking (for girls). Specifically, in communities with more frequent LGBTQ events (such as Pride events), the odds of substance use among sexual minority adolescents living in those communities was lower compared with their counterparts living in communities with fewer LGBTQ supports. Conclusions: The availability of LGBTQ community-level organizations, events, and programs may serve as protective factors for substance use among sexual minority adolescents. In particular, LGBTQ-supportive community factors were negatively associated with substance use, which has important implications for our investment in community programs, laws, and organizations that advance the visibility and rights of LGBTQ people.

13.
Int J Eat Disord ; 53(4): 513-524, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31943285

RESUMO

OBJECTIVE: The purpose of the current study was threefold: (a) compare rates of self-reported anorexia nervosa (AN), self-reported bulimia nervosa (BN), and eating pathology-specific academic impairment (EAI) by gender identity (cisgender men, cisgender women, transgender or genderqueer) and sexual orientation (gay or lesbian, bisexual, unsure, other), (b) examine associations between gender identity, sexual orientation, and eating outcomes, and (c) identify for whom rates of eating disorder diagnosis and impairment is greatest. METHOD: The study includes a sample of Minnesota students (n = 13,906) who participated in the College Student Health Survey from 2015 to 2018. Chi-square tests with bootstrapping examined differences in eating pathology rates between groups. Adjusted logistic regressions tested the association between gender identity, sexual orientation, and self-reported eating outcomes. RESULTS: Chi-square results revealed heightened rates of self-reported AN, self-reported BN, and EAI in cisgender women, transgender or genderqueer, and sexual minority (e.g., lesbian or bisexual) students. Logistic regression analyses in cisgender men and cisgender women revealed higher odds of self-reported AN, self-reported BN, and EAI in sexual minority students relative their heterosexual peers. Chi-square analyses indicated that bisexual cisgender women reported heightened rates of all three eating pathology measures relative to other sexual and/or gender (e.g., transgender) minority students. DISCUSSION: Individuals with marginalized gender and/or sexual orientation identities report heightened rates of eating pathology, with cisgender bisexual women reporting the poorest outcomes relative to individuals from other marginalized identities. Preventive efforts and more research are needed to understand the mechanisms driving this disparity and to reduce prevalence among marginalized groups.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Disparidades em Assistência à Saúde/normas , Heterossexualidade/psicologia , Minorias Sexuais e de Gênero/psicologia , Pessoas Transgênero/psicologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudantes , Adulto Jovem
14.
J Acad Nutr Diet ; 120(3): 414-423, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31926771

RESUMO

BACKGROUND: Research has related child participation in organized activities to health and academic benefits; however, participation may interfere with family meals. OBJECTIVE: Examine whether parents perceive child participation in organized activities to interfere with family meals and how perceptions are related to the household eating environment. DESIGN: A cross-sectional analysis was completed using survey data collected in 2015-2016 as part of the Project EAT (Eating and Activity in Teens and Young Adults) cohort study. PARTICIPANTS: Survey participants were originally recruited in Minneapolis-St Paul schools in 1998-1999. The analytic subsample of parents (one per household, n=389, 69% female, 31% nonwhite race, mean age=31) had one or more children involved in an organized activity. Approximately 33% of households included a child aged 2 to 5 and no older child; two thirds of households included school-aged children (6 to 18 years). MAIN OUTCOME MEASURES: Parents reported family meal frequency, family meal scheduling difficulties, frequency of at-home meal preparation, and their own intake of fast food, fruit, and vegetables. STATISTICAL ANALYSES PERFORMED: Analyses compared household environment characteristics reported by parents who perceived low interference between organized activities and family meals to characteristics reported by parents who perceived moderate to high interference from at least one form of activity. Regression models included a dichotomous indicator of interference as the independent variable and were adjusted for parental and household characteristics. RESULTS: Among parents with children at any age, moderate to high interference was associated with lower family meal frequency, greater difficulty scheduling family meals, and more fast-food intake (all P≤0.01). The perception of moderate to high interference was more common among parents who reported involvement in both sport and nonsport activities (P<0.001) and those with a school-aged child (P<0.001) vs those with only preschool-aged children. CONCLUSIONS: Follow-up research, including qualitative studies, is needed to identify the specific aspects of child participation in organized activities (eg, scheduled time of day) that may interfere with family meals.


Assuntos
Comportamento Alimentar/psicologia , Refeições/psicologia , Pais/psicologia , Recreação/psicologia , Meio Social , Adolescente , Comportamento do Adolescente , Adulto , Criança , Estudos de Coortes , Estudos Transversais , Dieta/psicologia , Dieta/estatística & dados numéricos , Ingestão de Alimentos/psicologia , Características da Família , Feminino , Humanos , Masculino , Relações Pais-Filho , Percepção
15.
Health Soc Care Community ; 28(3): 1082-1089, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31917883

RESUMO

Research has identified discrimination and a lack of knowledgeable providers as major barriers for transgender and gender diverse (TGD) individuals seeking care, which contributes to greater stress and significant health disparities affecting this population. However, research involving TGD youth is limited. The aim of this study, therefore, was to describe TGD adolescents' experiences, concerns and needs in healthcare settings, including their feedback on themes previously identified by healthcare providers (i.e. discomfort with gender-related topics, reasons for not asking patients about gender and previous training regarding gender diversity). The authors conducted semi-structured interviews with 12 TGD-identified adolescents aged 14-17, living in Minnesota, USA in 2017-2018. Inductive thematic analysis was used to summarise participant comments into themes and subthemes. Two main themes were directly relevant to concerns and needs of TGD youth in healthcare settings and their views on healthcare providers' concerns: (a) asking about gender and pronouns and (b) training for healthcare providers. Findings suggest the need for revisions to clinic materials, infrastructure and protocols. Adding training to all general medical and nursing education to increase knowledge, comfort and competence around gender identity would further improve care and ultimately reduce healthcare disparities affecting TGD youth.

16.
J Adolesc Health ; 66(2): 181-188, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31630924

RESUMO

PURPOSE: Disordered eating behaviors are prevalent among adolescents. Understanding how these behaviors link to body mass index (BMI) across different stages of development and over an extended period may provide insight for designing interventions around eating and weight. This study had two objectives: (1) to assess the distribution of disordered eating behaviors and develop a global score of disordered eating behaviors among adolescents and (2) to examine the association between the number of disordered eating behaviors in adolescence and BMI trajectory over 15 years. METHODS: Project Eating and Activity in Teens and Young Adults (EAT), a longitudinal study of weight-related health and behavior comprising four waves (EAT-I to EAT-IV), measured seven disordered eating behaviors (importance of weight and shape, frequent dieting, extreme unhealthy weight control behaviors, overeating, distress about overeating, loss of control while overeating, and frequency of overeating and loss of control) at baseline (N = 1,230, ages 11 to 18 years, 1998-1999). These behaviors were summed to create a disordered eating behavior score. BMI was self-reported at all four waves (up to age 27-33 years at EAT-IV). Repeated measures with random slope and intercept examined the association between disordered eating behaviors and BMI trajectories over 15 years. RESULTS: At baseline, 50.7% and 33.7% of females and males endorsed disordered eating behaviors. Throughout 15 years of follow-up, sociodemographic-adjusted BMI was higher among adolescents who engaged in disordered eating behaviors. The association remained significant after further adjustment for baseline BMI (p < .05). CONCLUSIONS: Among adolescents, regardless of the type of disordered eating behaviors, engagement in disordered eating behavior predicted higher BMI in a dose-response fashion.

17.
West J Nurs Res ; 42(2): 81-89, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30943875

RESUMO

Young peoples' acceptance and use of nontraditional, descriptive identity labels (e.g., pansexual, genderqueer) require nurses to consider moving beyond use of traditional terms (e.g., gay, transgender). This mixed methods study explores (a) labels used by sexual orientation and gender identity (SOGI) minority youth, (b) their expressed importance and meaning of these labels, and (c) differences in label usage. Sixty-six SOGI minority adolescents in British Columbia, Minnesota, and Massachusetts (mean age = 16.6) participated in "go-along" interviews; during interviews, 42 (63.6%) commented on labels. Chi-square and t tests were used to compare traditional versus nontraditional labels across participant demographic categories. Inductive thematic analysis was used to identify representative themes. Approximately, 1/3 of participants used nontraditional sexual orientation identity labels; this finding was associated with a trans identity and nontraditional gender labels. Using terminology that is meaningful and representative to the youth themselves has potential to facilitate representative research and welcoming environments in practice.

18.
J Am Assoc Nurse Pract ; 32(1): 70-80, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31232865

RESUMO

BACKGROUND AND PURPOSE: The World Health Organization has developed standards for youth-friendly health services to support adolescents and encourage health care utilization among youth. Necessary building blocks for youth-friendly care include strong interpersonal relationships between youth and health care providers. Nurse practitioners (NPs) may be particularly well positioned to form these relationships. This study explored a core aspect for building youth-provider relationships. The study examined how lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents discussed use of personal pronouns (e.g., he, she, they, ze) in relation to transgender and gender diverse (TGD) people. METHODS: A secondary qualitative analysis of 66 in-depth interviews with LGBTQ youth from across Minnesota, Massachusetts, and British Columbia, Canada was conducted. Results were sorted into four main themes describing different aspects of personal pronoun use as related to TGD individuals. CONCLUSIONS: Stories and experiences shared by participants illustrate how to assess which pronouns to use for a given person, how to use pronouns in different contexts, why respecting pronouns is important to TGD people, and flexibility as an integral component of the learning process when it comes to appropriate pronoun use. IMPLICATIONS FOR PRACTICE: Understanding how youth discuss personal pronouns could improve practice with TGD youth. Each of the four themes can be applied to clinical encounters to ensure culturally sensitive care. Practice recommendations include asking adolescents what pronouns they prefer clinic staff to use on intake forms and having NPs and clinic staff provide their own pronouns to patients in introductions.


Assuntos
Comportamento do Adolescente/psicologia , Identidade de Gênero , Relações Interpessoais , Minorias Sexuais e de Gênero/psicologia , Adolescente , Feminino , Humanos , Masculino , Minorias Sexuais e de Gênero/estatística & dados numéricos , Inquéritos e Questionários
19.
Prev Sci ; 21(3): 422-433, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31659611

RESUMO

Previous research has identified significant sexual orientation disparities in obesity. Contextual factors, like lack of anti-discrimination policies and gay-straight alliances, have been shown to be associated with health outcomes like poor mental health and substance use for lesbian, gay, and bisexual (LGB) individuals moreso than their heterosexual counterparts; however, little work to date has explored the role of contextual factors on sexual orientation disparities in obesity. Individual-level, serial cross-sectional data from the 2009-2013 College Student Health Survey, which includes 2- and 4-year college students (n = 29,118) attending 46 Minnesota colleges, were used. College-level data on LGB context were primarily collected through college websites. Multinomial logistic regression models were fit to examine associations between LGB college climate scores (including non-discrimination policies, presence of LGB or diversity-related student groups, LGB courses offered, LGB housing accommodations, and prevalence of LGB students) and students' weight status (underweight, healthy weight, overweight, and obese), based on self-reported height and weight. Higher LGB climate scores (i.e., more supportive environments) were associated with lower risk of overweight and obesity among all students. Sexual orientation-stratified findings among female students suggested that the association between LGB climate scores and weight status was similar to the overall female sample. Sexual orientation-stratified findings among male students showed a more complex relationship between LGB climate scores and weight status. More work is needed to disentangle the observed associations, and to investigate other contextual factors, like state- and city-level policies, social networks and norms, and individual resiliency within these contexts to better understand the contextual influences on sexual orientation disparities in obesity.

20.
J Youth Adolesc ; 49(4): 836-848, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31446582

RESUMO

Research has indicated that lesbian, gay, bisexual, and queer/questioning (LGBQ) adolescents have disproportionately high rates of substance use compared to heterosexual peers; yet certain features of schools and communities have been associated with lower substance use rates in this population. To advance this field, research examining multiple levels of influence using measures developed with youth input is needed. With community, school, and student data, this study tested hypotheses that LGBQ students attending high schools and living in communities with more LGBQ-supportive environments (assessed with a novel inventory tool) have lower odds of substance use behaviors (cigarette smoking, alcohol use, marijuana use, prescription drug misuse, and other drug use) than their peers in less supportive LGBQ environments. Multilevel models using data from 2454 LGBQ students (54.0% female, 63.9% non-Hispanic white) in 81 communities and adjusting for student and school covariates found that LGBQ adolescents who lived in areas with more community support had lower odds of frequent substance use, particularly among females. Expanding and strengthening community resources (e.g., LGBQ youth-serving organizations, LGBQ events such as a Pride parade, and LGBQ-friendly services) is recommended to further support LGBQ adolescents and reduce substance use disparities.


Assuntos
Serviços de Saúde do Adolescente/organização & administração , Serviços Comunitários de Saúde Mental/organização & administração , Serviços de Saúde Escolar/organização & administração , Minorias Sexuais e de Gênero/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Redes Comunitárias/organização & administração , Feminino , Humanos , Masculino , Minnesota , Fatores de Risco , Minorias Sexuais e de Gênero/psicologia , Estudantes/estatística & dados numéricos
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