Background Given extant health disparities among women who belong to the sexual minority, we must understand the ways in which access to and satisfaction with health care contribute to such disparities. The purpose of this study was to explore how sexual minority women’s (SMW) health care experiences compared with those of their heterosexually identified counterparts. We also sought to investigate whether there were differences within SMW in this regard. Finally, we explored whether participant satisfaction and comfort with health care providers (HCPs) differed depending upon HCP knowledge of participants’ sexual orientation. Methods We administered surveys to 420 women including lesbian, gay, bisexual, or other “queer” identified women (n = 354) and heterosexually identified women (n = 66). Findings Contrary to our expectations, we found that SMW were as likely to have had a recent health care appointment, to have been recommended and to have received similar diagnostic and preventive care, and to feel comfortable discussing their sexual health with their HCPs. They were, however, less likely to report being satisfied with their HCPs. We found no differences between lesbian SMW and non-lesbian SMW with respect to these indicators. We found important differences with respect to sexual orientation disclosure and health care satisfaction, however. Those participants whose HCPs purportedly knew of their minority sexual orientation reported greater satisfaction with their HCPs and greater comfort discussing their sexual health than those whose providers were presumably unaware. Conclusion We discuss important clinical and research implications of these findings.
Purpose – This paper aims to test whether overall and specific healthy eating behaviors and intentions could be better predicted by expanding the theory of planned behavior (TPB) to include a healthy eater identity. Major health organizations suggest increasing consumption of fruits, vegetables and whole grains to address the growing number of overweight and obese individuals, yet researchers have questioned the degree to which existing behavioral intervention programs sufficiently explain healthy eating behaviors. Design/methodology/approach – Adult women (N = 79) completed questionnaires related to TPB components and healthy eater identity. Participants then recorded food consumption for four days using food diaries and food frequency questionnaires. Findings – Using hierarchical multiple regressions, the authors demonstrated that identity as a healthy eater was a significant predictor of healthy eating intentions beyond the TPB components and a significant predictor of fruit and low-fat dairy consumption and overall healthy eating behaviors. Research limitations/implications – Despite the limitation of correlational data from a homogenous population, results support previous research and add to existing literature by demonstrating the unique contribution identity has in predicting specific healthy diet behaviors of fruit and low-fat dairy consumption. Originality/value – Findings advance our understanding of how young women think about nutrition and underscore which healthy eating behaviors might need to be directly targeted in interventions if such behaviors fall outside of the scope of common conceptions of what it means to be a “healthy eater”.
Volunteer peer leaders (PLs) benefit from their involvement in health interventions but we know little about how they compare with other non-PL volunteers or with the intervention recipients themselves. We randomized 58 veterans' service organizations' posts (e.g. VFW) to peer- versus professionally led self-management support interventions. Our primary research questions were whether hypertensive PLs changed over the course of the project, whether they changed more than hypertensive volunteers who were not randomized to such a role [i.e. post representatives (PRs)] and whether they changed more than the intervention recipients with respect to health knowledge, health beliefs and health outcomes from baseline to 12 months. After the intervention, PLs provided open-ended feedback and participated in focus groups designed to explore intervention impact. Hypertensive PLs improved their systolic blood pressure and hypertension knowledge and increased their fruit/vegetable intake and pedometer use. We found no differences between PLs and PRs. PLs improved knowledge and increased fruit/vegetable intake more than intervention recipients did; they provided specific examples of personal health behavior change and knowledge acquisition. Individuals who volunteer to be peer health leaders are likely to receive important benefits even if they do not actually take on such a role.
Background: Self-identity predicts healthy eating behaviors and intentions above and beyond Theory of Planned Behavior components (TPB; i.e., attitudes, perceived behavioral control, and subjective norms), but interventions exploring the relationship between self-identity and motivation are limited. Self-as-doer identity may be an important point of intervention for healthy eating behaviors (Houser-Marko & Sheldon, 2006). Therefore, I investigated whether the experimental manipulation of a self-as-doer identity predicted improved healthy food consumption, intentions, and increased selfidentity as a healthy eater compared to women who received nutritional education or no intervention directly following the intervention and one month post-intervention. Method: Participants were 79 women ages 18-53 years old (M=22.92, SD=6.92) who were randomly assigned to one of three conditions (i.e., control, education only, or education and self-as-doer activity) and asked to record their diet for four days using a food diary and an online food frequency questionnaire. Intentions to eat a healthy diet, nutrition knowledge, identity as a healthy eater, and healthy eating behaviors were recorded over a six week period: before, after, and one month post-intervention. Repeated iii measures ANOVAs and hierarchal linear regressions were performed to determine if the self-as-doer intervention created change and predicted increases in intentions, selfidentity, and healthy food consumption. Results: Healthy eater identity predicted intentions to eat a healthy diet and overall healthy eating behavior above and beyond TPB components, but did not predict specific food group eating behaviors. Self-as-doer participants strengthened self-identity and intentions over the course of the study, but no group differences were found. Self-as-doer participants increased overall healthy eating behaviors while education and control participants decreased overall healthy eating behaviors. Self-as-doer participants ate significantly more healthy foods at time three than did education and control participants. Discussion: Findings support the role of self-identity in predicting intentions and overall healthy eating behaviors and demonstrate a causal relationship between self-as-doer identity and change in healthy eating identity, intentions, and some behaviors. The selfas-doer intervention may provide individuals with the unique motivational tools needed for diet change. Further research refining the self-as-doer intervention, targeting other health behaviors, and employing the intervention in a clinical population is needed.
We make suggestions for future research studies, particularly as related to understanding how peer leader identities and cultural norms within VSOs might contribute to peer-led health intervention success.
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