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1.
Int J Eat Disord ; 2020 Jan 14.
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.

2.
LGBT Health ; 2020 Jan 27.
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.

3.
J Acad Nutr Diet ; 2020 Jan 08.
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.

4.
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.

5.
West J Nurs Res ; 42(2): 81-89, 2020 Feb.
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.

6.
J Adolesc Health ; 66(2): 181-188, 2020 Feb.
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.

7.
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.

8.
Fam Community Health ; 43(1): 17-25, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31764303

RESUMO

This study explored weight-based victimization by family members, accepting lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) attitudes, and family connectedness, and how these experiences are associated with health, self-esteem, and depressive symptoms among LGBTQ adolescents. Data came from the LGBTQ National Teen Survey (N = 9261, mean age = 15.6 years). The 3 key variables were significantly associated with poorer self-rated health, self-esteem, and depressive symptoms. For example, weight-based victimization was associated with approximately 2 more points on the depressive symptoms scale (ß = 1.81, P < .001), adjusting for covariates. Findings highlight the negative impact of weight-based victimization among LGBTQ youth, even in the context of other types of family support.

9.
J Forensic Nurs ; 15(4): 222-230, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31764526

RESUMO

PURPOSE: The current study tests associations between reporting sexual victimization to a healthcare provider, campus authority, police, or social contact, and emotional well-being among college women. METHODS: Data from 2,162 women who participated in the 2015 College Student Health Survey at 17 colleges in Minnesota was used. Analyses tested associations between reporting sexual assault to formal or informal resources and diagnosis with anxiety, depression, panic attacks, and posttraumatic stress disorder, as well as self-rated health. RESULTS: Significantly higher rates of all four diagnoses were observed among those who reported to formal resources (e.g., healthcare provider, police) compared with those who reported to informal resources (i.e., friends, family). However, no differences were seen in self-rated physical or mental health. CONCLUSIONS: Expansion of trauma-informed healthcare services and advocacy efforts is recommended to optimally support students who report sexual assault experiences.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Estudantes , Adolescente , Adulto , Ansiedade/epidemiologia , Vítimas de Crime/psicologia , Depressão/epidemiologia , Feminino , Nível de Saúde , Humanos , Minnesota/epidemiologia , Transtorno de Pânico/epidemiologia , Delitos Sexuais/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários , Universidades , Adulto Jovem
10.
Prev Sci ; 2019 Oct 28.
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.

11.
Prev Med Rep ; 16: 100986, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31660286

RESUMO

This paper examines the prevalence of homelessness among transgender/gender diverse (TGD) youth in a population-based sample of adolescents. We used data from a statewide sample of 9th and 11th grade adolescents in Minnesota who responded to a school-based survey during 2016 (N = 80,929). Survey questions assessed adolescents' gender identity and experiences of homelessness (either with adult family members or unaccompanied) in the past 12 months. We used chi-square analyses to compare the prevalence of homelessness between gender identity groups. Overall, 2.7% of the sample reported identifying as TGD. Significantly more TGD (vs. cisgender) youth reported experiencing homelessness either with adult family members (6.7% vs. 3.5%) or unaccompanied (3.6% vs. 1.1%; p < .0001). Findings from this population-based survey suggest that TGD youth are more likely to experience homelessness, either with a family member or unaccompanied, than cisgender peers. Ensuring housing stability among this population is critical, given health risks associated with homelessness during adolescence. Data on homelessness experiences of TGD youth are needed to inform practice and policies for this distinct population.

12.
J Adolesc Health ; 65(5): 690-697, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31500945

RESUMO

PURPOSE: The aim of the study was to identify whether parent encouragement to diet as an adolescent predicts subsequent encouragement to diet from significant others/romantic partners as an adult and examine longitudinal associations between cumulative encouragement to diet from close relationships (i.e., parent and significant other) and later weight, weight-related, and psychosocial well-being outcomes in adulthood. METHODS: Data from Project EAT I-IV, a 15-year longitudinal population-based study of socioeconomically and racially/ethnically diverse adolescents followed into adulthood (n = 1,116; mean age = 31.1 years; 61% female), were used for this study. Surveys and anthropometric measures were completed at school by adolescents in 1998-1999, and follow-up mailed and online surveys were completed at approximately 5-year intervals between 2003 and 2016. RESULTS: Adolescents who experienced encouragement to diet from their parents were more likely to have a significant other as an adult who also encouraged them to diet. In addition, there was a significant (p < .05) cumulative effect of encouragement to diet, such that experiencing more encouragement to diet from both a parent(s) and significant other was associated with higher weight status, more unhealthy weight-control behaviors (e.g., dieting, binge eating, and unhealthy weight control behaviors), and lower psychosocial well-being (e.g., lower body satisfaction and self-esteem and higher depressive symptoms) as a young adult. CONCLUSIONS: Encouragement to diet tracked from one close relationship to another and had a cumulative effect on adult weight, weight-related, and psychosocial well-being outcomes. Future interventions, clinical work, and research should be aware of these patterns and cumulative effects of encouragement to diet to target key relationships to reduce these harmful interpersonal patterns.

13.
Subst Use Misuse ; 54(14): 2368-2379, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31407958

RESUMO

Objectives: Despite college students reporting high rates of substance use and adverse childhood experiences (ACE), few studies have examined ACE-related substance use patterns with diverse student samples. We estimated the prevalence of ACE and substance use and investigated ethnic differences in the relationship between ACE and substance use among college students from two states. Design: Data are responses (N = 7,148) on the National College Health Assessment (in California) and the College Student Health Survey (in Minnesota). Multivariable regression models assessed the associations between individual and accumulated ACE and alcohol, tobacco, marijuana, and illicit substance use and binge drinking (adjusting for age, gender, depression, and state) among non-Hispanic White, Hispanic, African American/Black, Asian Pacific Islanders, multiracial, and other students. Interaction terms were calculated to test for ethnic differences. Results: In the month preceding the survey, 22% of students used marijuana, 28% used tobacco, 75% drank alcohol; 6% used an illicit drug in the past year and 30% acknowledged past 2-week binge drinking. Although ACE were associated with all substance use behaviors (AORs ranged from 1.19 to 1.54, p < .001), there was significant ethnic variation in ACE exposure (40-52%) and the dose-response relationship between ACE and marijuana and tobacco use and binge drinking. Conclusions: The variability in ACE-related substance use patterns across ethnic groups highlights the need for research that advances our understanding of sociocultural influences in trauma response and the role that campus communities could have in the development of culturally sensitive services that address this issue.

14.
J Youth Adolesc ; 2019 Aug 24.
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.

15.
J Sch Nurs ; : 1059840519863094, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337243

RESUMO

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.

16.
J Gay Lesbian Soc Serv ; 31(3): 314-331, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31327914

RESUMO

The social environment in which lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth live influences health and wellbeing. We describe the development of the LGBTQ Supportive Environments Inventory (LGBTQ SEI), designed to quantify the LGBTQ-inclusiveness of social environments in the US and Canada. We quantify aspects of the social environment: 1) Presence/quality of LGBTQ youth-serving organizations; 2) LGBTQ-inclusive Community Resources; 3) Socioeconomic and Political environment. Using GIS tools, we aggregated data to buffers around 397 schools in 3 regions. The LGBTQ SEI can be used to assess the role of the social environment in reducing health disparities for LGBTQ youth.

17.
J LGBT Youth ; 16(3): 235-254, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156739

RESUMO

This study examines the intersection of sexual and gender identities among adolescents, including the prevalence of these groups and rates of emotional distress and bullying victimization. Data come from a large population-based sample; two measures of sexual orientation and gender identity create eight identity groups. Youth who report identifying both as lesbian, gay, bisexual, or queer/questioning (LGBQ) and as transgender/gender diverse (TGD) had significantly higher levels of two measures of emotional distress and four measures of bullying victimization than those who report only identifying as LGBQ non-TGD or straight TGD. Implications for research and practice are discussed.

18.
Soc Sci Med ; 233: 64-70, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31181470

RESUMO

RATIONALE: Unhealthy weight control behaviors (UWCBs) often predict future substance use, resulting in a comorbidity that predicts later health consequences. OBJECTIVE: The current study aimed to examine whether weight stigma and its associated harms magnify or attenuate the effect of UWCBs at baseline on substance use at 10-year follow-up among girls and to elucidate factors related to the perceived harms of weight stigma. METHODS: Data from 1147 adolescent girls from Project EAT (Eating and Activity in Teens and Young Adults) were analyzed at baseline and 10-year follow-up. Participants were split into three groups at baseline: no weight stigma; weight stigma only (being teased by peers or parents); and weight stigma with perceived harms (e.g., being bothered by teasing). Moderation and stratified regression analyses examined the role of weight stigma and its perceived harms on the relationship between UWCBs and substance use. ANOVA models aimed to elucidate factors related to the perceived harms of weight stigma. RESULTS: Moderation analyses revealed marginally significant effects of group membership on the effect of UWCB on substance use (p = .08). Stratified regression results indicated that UWCBs at baseline predicted substance use at 10-year follow-up among girls in the weight stigma with perceived harms group (p = .005), but not in the no weight stigma or weight stigma only groups. Girls in the weight stigma with perceived harms group reported higher weight concern, depressive symptoms and BMIs than girls who report no weight stigma or weight stigma only. CONCLUSIONS: Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution. CONCLUSIONS: Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution.

19.
J Pediatr ; 211: 172-178, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31079853

RESUMO

OBJECTIVE: To compare social connectedness factors that facilitate use of primary, dental, and mental healthcare services among transgender and gender nonconforming (TGNC) and cisgender adolescents. METHODS: Data from the cross-sectional 2016 Minnesota Student Survey were used to examine protective social connectedness factors associated with use of different healthcare services among matched samples of 1916 TGNC and 1916 cisgender youth. Stratified, logistic regression analyses were used to examine background characteristics and social connectedness factors (parent connectedness, connections to other nonparental adults, teacher-student relationships, and friend connections) associated with use of each healthcare service within the last year. RESULTS: For TGNC youth, but not for cisgender youth, higher levels of parent connectedness were associated with receipt of primary (OR, 2.26; 95% CI, 1.40-3.66) and dental (OR, 3.01; 95% CI, 1.78-5.08) care services, and lower levels of connectedness to nonparental adults was associated with receipt of mental healthcare (OR, 0.55; 95% CI, 0.33-0.93). Among cisgender youth, no protective factors were significantly associated with receipt of primary care services, higher levels of friend connections were associated with receipt of dental services (OR, 1.85; 95% CI, 1.10-3.09), and lower levels of parent connectedness were associated with receipt of mental healthcare (OR, 0.20; 95% CI, 0.10-0.40). CONCLUSIONS: To promote the health of TGNC youth, clinicians should understand the distinct factors associated with obtaining healthcare among this population such as the need for tailored efforts focused on strengthening connectedness between TGNC youth and their parents to facilitate receipt of needed care.

20.
J Psychosom Res ; 122: 88-93, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31029452

RESUMO

OBJECTIVE: This study examines the prevalence of weight-based teasing by family members and associations with unhealthy weight control behaviors, body satisfaction, self-esteem, and depressive symptoms among adolescents from three immigrant communities (Latinx, Hmong, and Somali). METHODS: Data come from EAT 2010, a population-based study of weight and related behaviors (N = 1577, mean age = 14.5 years). Adjusted models tested associations between weight-based teasing and well-being, controlling for BMI and ethnic group; effect modification by ethnic group and acculturation were also explored. RESULTS: Family weight-based teasing was common (12.1%-42.9% reporting this experience across gender and ethnic groups) and was associated with all four measures of well-being in the expected direction. Associations were statistically equivalent in all ethnic groups and were not modified by acculturation. CONCLUSION: Youth from immigrant communities experience family weight-based teasing and associated threats to well-being. Additional research is needed to further understand the cultural context of weight-based teasing and develop relevant prevention messages.

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