Sexual and Gender Diverse Healthcare Navigation Model: A Community-Participatory Delphi Adaptation of the Transitional Care Model for Sexual and Gender Diverse Individuals.

Health care transitions, movements between providers or settings, can lead to poor outcomes, higher resource utilization, and even higher costs. Health care transitions can be complex experiences for sexual and gender diverse (SGD) individuals, especially when there is a need for ongoing health care (e.g.

"I felt like a freak when I would go to the doctor": Investigating healthcare experiences across the lifespan among older LGBT and transgender/gender diverse adults.

In the past several decades, the United States has enacted civil rights legislation protecting lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations from discrimination, including enacting proactive healthcare laws such as the Affordable Care Act. However, given today's divisive politics, LGBTQ people's access to appropriate and respectful health care is precarious. This study explored the disconnections from and connections to health care and the respective health effects among two self-identified groups: i) older LGBT adults and ii) transgender and gender-diverse (TG/GD) adults.

Mapping the Dynamic Complexity of Sexual and Gender Minority Healthcare Disparities: A Systems Thinking Approach.

Sexual and gender minority (SGM) populations experience extensive health disparities compared to their straight and cisgender counterparts. The importance of addressing these disparities is paramount, as SGM groups often encounter significant barriers to accessing comprehensive healthcare, including societal stigma, provider bias, and financial constraints. This study utilizes a community-based system dynamics approach to understand and visualize the barriers to and facilitators of healthcare engagement for SGM groups across their life course.

Disparities in Social and Economic Determinants of Health by Sexual Identity, Gender, and Age: Results from the 2015-2018 National Survey on Drug Use and Health.

We characterize disparities between lesbian, gay, and bisexual (LGB) adults and heterosexual adults across multiple health determinants in a nationally representative sample. Data on 153,939 adults (including 11,133 LGB adults) were from the 2015-2018 National Survey on Drug Use and Health. Separate Poisson regression models were used to estimate the relative risk (RR) that gay/lesbian and bisexual adults, respectively, experienced each health determinant, relative to heterosexual adults of the same gender and age group (ages 18-25, 26-34, 35-49, and 50-64).

Disproportionate Impact of the COVID-19 Pandemic on Perceived Social Support, Mental Health and Somatic Symptoms in Sexual and Gender Minority Populations.

Deaths from COVID-19 continue to rise, and this virus has asymmetric impacts on marginalized communities though specific impacts on sexual and gender minority communities are not well understood. From March 23 to June 20, 2020, in an online cross-sectional survey among 1380 US adults, we assessed physical symptoms, psychological symptoms, rumination, and perceived social support in order to describe differences between sexual and gender minority (n = 290) and cisgender heterosexual (n = 1090) respondents. Sexual and gender minority respondents had more frequent COVID-19-associated physical symptoms and depression and anxiety symptoms.

Substance Use Disparities at the Intersection of Sexual Identity and Race/Ethnicity: Results from the 2015-2018 National Survey on Drug Use and Health.

Lesbian, gay, and bisexual (LGB) racial/ethnic minority individuals experience minority stress due to both their sexual identity and race/ethnicity and may be at elevated substance use risk (relative to heterosexuals) compared with their White LGB peers. We examined differences in the presence and magnitude of substance use disparities among LGB adults across race/ethnicity. Using data on 168,560 adults (including 11,389 LGB adults) from the 2015-2018 National Survey on Drug Use and Health, we examined disparities in cigarette smoking, heavy episodic drinking (HED), and marijuana use by race/ethnicity (White, Black, Hispanic, and other race/multiracial).

Multiple Disadvantage and Discrimination: Implications for Adolescent Health and Education.

Multiply disadvantaged youths exhibit worse health and academic success than their less disadvantaged peers, possibly due to greater exposure to social status-based discrimination. Models that capture the additive burden of disadvantage in tandem with multiple forms of discrimination are needed to explicate the unique and combined impact of these factors on adolescent health and academic outcomes. In addition, protective factors like positive family and peer relationships may attenuate these relationships.

Effects of individual risk and state housing factors on adverse outcomes in a national sample of youth transitioning out of foster care.

Introduction: Compared to their peers, youth who leave the foster care system without permanency experience greater risks for adverse young adult outcomes, including homelessness, incarceration, substance abuse, and early child birth. Extant literature focuses on individual-level factors related to adversity. In this study, we estimated the impact of state and individual-level risk and protective factors on adverse 19-year-old outcomes among a cohort of U.

Multisystem-Involved Youth: A Developmental Framework and Implications for Research, Policy, and Practice.

Multisystem-involved youth are children and adolescents concurrently served in the child welfare, behavioral health, and/or juvenile justice systems. These youth are a high risk and vulnerable population, often due to their experience of multiple adversities and trauma, yet little is known about their multiple needs and pathways into multisystem involvement. Multisystem-involved youth present unique challenges to researchers, practitioners, and policymakers.

Collective Efficacy as a Key Context in Neighborhood Support for Urban Youth.

Neighborhood context, including the physical and social environment, has been implicated as important contributors to positive youth development. A transactional approach to neighborhood asserts that place and people are mutually constitutive; negative perceptions of place are intrinsically bound with negative portrayals of stigmatized groups, including youth. Adult perceptions of neighborhood youth may contribute to an increased sense of alienation and youth antisocial behavior.

Neighborhood sexual violence moderates women's perceived safety in urban neighborhoods.

Perceptions of neighborhood safety are positively associated with perceptions of neighborhood violence. However, research has yet to examine whether this relationship is moderated by specific types of violence, such as sexual violence, that are more salient for women. Using street-intercept interviews with 343 adults in 9 neighborhoods of a U.

Socio-psychological mediators of the relationship between behavioral health stigma and psychiatric symptoms.

The stigma associated with mental illness or addiction is significantly and positively related to psychiatric symptoms. According to Modified Labeling Theory, several processes should mediate this relationship, including rejection experiences, stigma management (secrecy coping), and social support. In the first comprehensive test of this theory, we examined a serial mediation model on three waves of data from 138 adults receiving outpatient behavioral health treatment.

Reciprocal Effects of Positive Future Expectations, Threats to Safety, and Risk Behavior Across Adolescence.

We examined the reciprocal relationships among positive future expectations, expected threats to future safety, depression, and individual substance use and delinquency using 4 waves of data (N = 248-338) from African American and Latino adolescent male participants in the Chicago Youth Development Study. Individual positive future expectations and expected threats to safety were assessed at each wave and modeled as latent constructs. Individual substance use and delinquency were assessed at each wave and represented as ordinal variables ranging from low to high.

Assessing future expectations of low-income minority young men: Survival-threats and positive expectations.

Future expectations, a subset of overall orientation, represent youths' most realistic appraisals of future outcomes, and has been demonstrated to be associated with a range of health risk behaviors and wellbeing. The current study extends previous measurement efforts to operationalize and measure future expectations by estimating a multidimensional model of future expectations encompassing both positive and survival-based expectations, and using longitudinal data to test the consistency of these constructs over time. The current work uses data from six waves of the Chicago Youth Development Study (n=338), a sample of African American and Latino young men from low income neighborhoods in an urban center, to test a hypothesized multidimensional structure of future expectations across adolescence.

Cumulative Disadvantage and Youth Well-Being: A Multi-Domain Examination with Life Course Implications.

Purpose: The accumulation of disadvantage has been shown to increase psychosocial stressors that impact life course well-being. This study tests for significant differences, based on disadvantage exposure, on youths' emotional and physical health, as well as family supports, peer assets, and academic success, which hold potential for resilience and amelioration of negative health outcomes.

Methods: A 12 item cumulative disadvantage summed index derived from surveys of a racially and socioeconomically diverse sample of urban high school seniors (n=9,658) was used to distinguish youth at low, moderate, and high levels.