How SES May Figure in Perceptions of Zika Risks and in Preventive Action

abstract

The present study intended to determine how the socioeconomic status (SES) of citizens and public health communications help explain citizens’ risk perception and actions taken during Zika virus outbreaks in 2016. We used data from a nationally representative study conducted in March 2016 by the Associated Press–National Opinion Research Center to analyze 831 American adult responses regarding Zika. We found that respondent risk perception and actions taken diminished as SES level rose. Risk perception was also found to mediate preventive actions’ associations. To quell the global spread of emerging infectious diseases (EIDs) like Zika, health organizations worldwide must understand how SES contributes to Zika (and other future EIDs) risk perception and preventive action. A more compelling form of public health communications must be developed that takes into account the impact made on future outbreaks and infections by these higher-SES “risk assessments.”     

Beyond alphabet soup: helping college health professionals understand sexual fluidity

ABSTRACT

Many college students today are no longer using the terms straight, gay, lesbian, bisexual, or transgender to self-identify their sexual orientation or gender identity. This commentary explores research related to fluidity of sexual identities, emerging sexual identities used by college students, and how these identities interact with the health and well-being of the student. Additionally, the authors discuss strategies to help college health professionals provide a sensitive environment and clinical experience for students whose sexual identity is fluid.     

A Population-Wide Screening and Tailored Intervention Platform for Eating Disorders on College Campuses: The Healthy Body Image Program

Abstract

Objectives: This article presents a new approach to intervention for eating disorders and body image concerns on college campuses, using a model of integrated eating disorder screening and intervention. Formative data on implementation feasibility are presented. Participants: College students enrolled at 2 universities between 2011 and 2012. Methods: The Healthy Body Image program is an evidence-based screening and intervention platform, enacted via community and online resources. An online screen was used to identify students at varying levels of risk or eating disorder symptom status; responses were used to direct students to universal or targeted online interventions or further evaluation. Universal prevention programs to improve healthy weight regulation and body image culture were offered to all students. Results: Formative data from 1,551 students illustrates the application of this model. Conclusions: The Healthy Body Image program is feasible to deliver and provides a comprehensive system of screening, evidence-based intervention, and community culture change.     

Does Home- and Community-Based Care Affect Nursing Home Use?

A study was conducted to assess change in numbers, expenditures, and case mix of nursing home residents as Medicaid investment in home- and community-based services (HCBS) 1915(c) waivers increased in seven states. The seven states provided Medicaid expenditure and utilization data from 2001 to 2005, including waiver and state plan utilization. The Minimum Data Set was used for nursing home residents. For three states, community assessment data were also used. In six states, the number of nursing home clients decreased as the numbers of HCBS clients grew. However, in most states, the number of additional waiver clients often greatly exceeded reductions in nursing home residents. Nursing home payments decreased moderately, but this decrease was offset by increases in HCBS waiver and state plan expenditures, leading to a net increase in long-term support services (LTSS) expenditures from 2001 to 2005. Increases in waiver expenditures outpaced increases in waiver clients, indicating expansion of services on top of expansion in clients. States that showed substantial increases in HCBS showed only modest increases in nursing home case mix. The case mix for nursing home residents was more acute than that for HCBS users. The expectation that greater HCBS use would siphon off less severe LTSS users and hence lead to a higher case mix in nursing homes was partially met. The more acute case mix in nursing homes suggests that HCBS serves some individuals who were previously cared for in nursing homes but many who were not. Efforts to promote substitution of HCBS for institutional care will require more proactive strategies such as diversion.     

When Injustice Gets Old: A Systematic Review of Trans Aging

A lack of knowledge regarding the needs and experiences of trans and gender-nonconforming older adults contributes to and perpetuates the experiences of marginalization associated with being trans. Mitigating the conditions of marginalization—including those that are compounded by age—requires the production of trans aging knowledge. It was with the intent to produce such knowledge that this systematic review was undertaken. In so doing, five medical databases, eight social science databases, and two gray literature databases were searched. These included the following: CINAHL (1942–), Medline (1942–), Health Services/Technology Assessment Texts, Web of Science, EMBASE (1947–), Sociological Abstracts (1952), Social Services Abstracts (1806–), Gender Studies Database (1972–), LGBT Life with Full Text, Ageline (1978–), PsycINFO (1806–), Scopus, ERIC, The New York Academy of Medicine Grey Literature Report, and Dissertations & Theses: Full Text. A total of 436 titles and abstracts were independently reviewed. Of these, 106 full-text articles were retrieved; 34 met the inclusion criteria and were reviewed. The following themes were identified: 1. the methodological challenges associated with conducting research with trans and gender nonconforming older adults;

2. violence and abuse among trans and gender nonconforming older adults;

3. discriminatory policies and practices in health and mental health care;

4. the lack of appropriate HIV/AIDS education, prevention, and treatment strategies for trans and gender nonconforming older adults;

5. obstacles in education, employment, government systems, and housing; and

6. the lack of adequate social support networks.

Gaps in the literature, recommendations for future research, and implications for policy and practice were also identified.     

Traversing the Margins: Intersectionalities in the Bullying of Lesbian,Gay, Bisexual and Transgender Youth

SUMMARY

This study explores the perspectives of service providers and youth advocates on bullying of lesbian, gay, bisexual and transgender (LGBT) youth and intersectionalities in LGBT peer victimization. In depth, semi-structured interviews were conducted with nine key informants (4 male, 4 female, 1 transgender male; 4 gay, 3 lesbian, 2 non-identified; 6 white, 1 South Asian, 2 Middle Eastern) recruited using purposive sampling from diverse education and social service settings. Narrative thematic analysis and a constant comparative method were used to identify themes. Five themes emerged from the data: (1) “transgressing gender norm boundaries”; (2) homophobic sexism vs. sexist homophobia; (3) “you choose sexuality or you choose race”; (4) newcomer youth and citizenship; and (5) “multiple wires together … create the cage.” Findings suggest the importance of an intersectional approach to conceptualizing and addressing LGBT bullying and to uncovering the differential experiences of bullying among LGBT youth. Bullying related to sexual orientation should not be assumed to be the only or primary form of violence shaping the lives of LGBT youth.     

Women Reentering the Community: Understanding Addiction and Trauma-Related Characteristics of Recidivism

Women represent 26% of those arrested for serious crimes; many have posttraumatic stress and co-occurring substance use disorders, which may influence recidivism. This study examined 57 women residing in a community re-entry program after exiting prison. Participants completed the Trauma Symptom Inventory and Substance Abuse Subtle Screening Inventory. A discriminant function analysis accounted for 34% of between-group variability and provided a profile of women who recidivated. Women who recidivated had greater alcohol dependence and lower rates of sexual dysfunction and sexual concerns. Practitioners should consider potential links between substance abuse, trauma, and sexual behavior in treatment settings.     

Comparing the Ethnic Identity and Well-Being of Adopted Korean Americans With Immigrant/U.S.-Born Korean Americans and Korean International Students

This study compared the ethnic identity and well-being of Korean Americans who were adopted internationally with immigrant/U.S.-born Korean Americans and Korean international students, as well as the relationship between ethnic identity and well-being for each group. One-hundred seven college students completed measures of ethnic identity and subjective well-being. Immigrant/U.S.-born Korean Americans had higher ethnic identity scores than the other two groups. Immigrant/U.S.-born Korean Americans also had higher positive affect scores than international students. Ethnic identity was positively correlated with positive affect for all three groups (r = .27 to .34) but was negatively correlated with negative affect for international students (r = –.44). Overall, the results suggest that ethnic identity, although slightly lower than in non-adopted peers, is relevant to the well-being of adopted Korean American college students.     

Gendered Divisions of Fertility Work: Socioeconomic Predictors of Female Versus Male Sterilization

Domestic labor researchers have examined a multitude of duties disproportionately performed by women, yet the responsibility associated with navigating a couple's fertility—fertility work—has been overlooked. Using data from the 2006–2010 National Survey of Family Growth (N = 1,415), the author examined how racial and socioeconomic factors affect the division of contraceptive fertility work among married and cohabiting women who rely on either their partners' vasectomies or their own sterilizations. Drawing theoretical connections between fertility work and housework, resource‐ and gender‐based perspectives were used to assess whether women's or their partners' characteristics are stronger predictors of sterilization type, and whether women's absolute or relative education level has a greater impact. Findings suggest that White and socioeconomically privileged women are more likely to have vasectomized partners than disadvantaged women. Male partners' characteristics were more closely associated with sterilization type than women's characteristics, lending greater support for the gender‐based hypotheses.