Introduction: Globally, transgender populations are disproportionally impacted by HIV and effective HIV prevention interventions targeting these populations are critically needed. Such interventions require research focused on the specific needs and experiences of transgender people. This methodological review aims to determine the extent to which HIV prevention research has included transgender participants by subsuming them into non-transgender populations, or by centring them either in comparison with other groups or as the sole focus of research. Methods: We searched five electronic databases (e.g. SCOPUS) for empirical studies that focused on HIV prevention and included transgender participants, published through 31 December 2020. For each study, we extracted information on: (a) types of inclusion of transgender participants; (b) total sample size and number/percentage of transgender participants; (c) country(ies) where study was conducted; (d) HIV research topics; (e) methods (i.e. quantitative, qualitative or mixed-methods research) and (f) gender identity of transgender participants. Results and discussion: Of 667 HIV prevention studies included in the review, 38.5% subsumed transgender participants into cisgender populations (most frequently combining transgender women with cisgender men who have sex with men), 20.4% compared transgender and cisgender participants and 41.1% focused exclusively on transgender populations. Our global scoping review also revealed that these three types of transgender inclusion in HIV prevention research vary greatly over time, place and thematic areas. Transgender women are the focus of the majority of reviewed studies, whereas transgender men and gender expansive people are rarely included as participants. Conclusions: Inclusion of transgender persons as participants in HIV prevention research has significantly increased, particularly in the last decade. Further research centred on transgender participants and their experiences are needed to develop effective HIV prevention interventions for transgender populations. We advocate for HIV prevention research to move from subsuming transgender people, to trans-centred research that asks questions that focus on their specific needs and experiences. We provide recommendations to move from trans-subsumed to trans-centred HIV prevention research.
There is a paucity of research on the within-group differences in experiences of health care discrimination among transgender and gender nonconforming people of color. This study employs latent class analysis to identify mutually exclusive subgroups of TGNC POC based on responses to measures of health care discrimination. The association between demographic and health indicators and subgroup membership was also examined. Four subgroups were found: the low discrimination subgroup marked by a low probability of endorsing any indicator; the experienced discrimination subgroup marked by a high probability of being denied treatment and having to teach one's provider about TGNC people to receive appropriate care; the anticipated discrimination subgroup characterized by a high probability of postponing care and having to teach one's provider about TGNC people; and the experienced and anticipated discrimination subgroup marked by a high probability of all discrimination indicators. The experienced discrimination subgroup was more likely to be comprised of participants who reported $40,000-$59,000 income range, had graduate degrees, were "out" as transgender and had undergone hormone treatment and bottom surgery; the anticipated discrimination subgroup was more likely to be comprised of participants who identified as transgender men, reported $40,000-$59,000 income range, and had undergone hormone treatment; and the experienced and anticipated discrimination subgroup was more likely to be comprised of participants who identified as transgender men, multiracial, had graduate degrees, had public insurance, were "out," and had undergone hormone treatment, top surgery, and bottom surgery. Our findings have implications for health care practice, policy, and practitioners' education. Public Significance StatementThis study suggests that there are distinct subgroups of TGNC POC based on their reported experiences of discrimination in health care settings. There is also an association between demographic indicators and subgroup membership, which highlights the need to consider these factors to assess risk of discrimination and inform health care access improvements.
Mass shootings and gun violence are becoming more and more commonplace in the United States. Gun control continues to be a controversial topic in America. This controversy extends to the playroom and play therapy literature, as play therapists grapple with the decision to include or exclude toy guns from the playroom. Within this phenomenological study, play therapists considered and defined their decisions to include/exclude guns within the playroom. Themes identified included the influence of personal and theoretical beliefs on inclusion and exclusion, child development, toys as metaphors, and boundaries and limit setting around toy guns in the playroom. Implications, limitations, and directions for future research are explored.
BackgroundOver the last 40 years advances in the field of rehabilitation counseling continue to play a major role in the professional identity, skills, and competencies of rehabilitation counselors. While advances have developed in several areas (e.g., multiculturalism, ethics) within the scope of rehabilitation counseling research and practice, there are research gaps for vocational evaluation and the psychometric properties of instruments utilized for assessment.ObjectiveThis study sought to investigate what psychometric instruments rehabilitation counselors utilize for assessment. Primarily, our goal was to seek major details in how practicing rehabilitation counselors utilize psychometric assessments in their work environments and any ethical concerns involved with their use. We sought to investigate the presence of what assessment tools are commonly used by rehabilitation counseling practitioners and the frequency with which they are used.MethodsData from 228 participants was analyzed using a mixed-methods research design with a goal of obtaining both quantitative and qualitative data simultaneously. We sought to determine if there were any statistically significant differences on whether demographic variables affected the selection and use of psychometric assessments.FindingsAverage use of psychometric instruments for assessment use for the entire sample was low, at .66 (between “never” and “sometimes”). Average assessment use for the five subgroups ranged from .37 (body system function) to .99 (interests). Average use for individual assessments ranged from .08 to 2.07. There was a significant effect for education, (R2 = .039 F(1) = 8.82, p = .003).ConclusionsResults indicate higher education levels were associated with increased utilization of psychometric instruments. In addition, collaboration between psychometric assessments and clinical judgment have proven to be valuable in overall quality of rehabilitation services provided.
This study investigated how rehabilitation counselors integrated their use of psychometric instruments into clinical practice. The primary aim was to determine how psychometric instruments interact with clinical judgment during assessment as well as what ethical concerns practitioners have. The sample consisted of 228 participants from the International Association for Rehabilitation Professionals (IARP) and the American Board of Vocational Experts (ABVE), whom responded to an electronic survey distributed through listservs. Participants responded to a quantitative section regarding overall assessment use, followed-up by a qualitative section with open response prompts. Results provided a preliminary investigation into the selection of psychometric assessments utilized by rehabilitation counselors and the degree to which this process affects ethical and clinical judgment. These findings, in consideration with previous literature, highlight the need for improved training on the selection and utilization of psychometric assessments.
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