Because existing scales measuring internalized homonegativity suffer from various content validity flaws, a more valid instrument is needed. The purpose of this study was to develop and provide preliminary reliability and validity evidence for the Internalized Homonegativity Inventory (IHNI), which measures internalized homonegativity in gay men. Forty-two items were initially generated from a construct definition and were administered to 241 gay men living in the U.S. Exploratory factor analyses suggested that 23 items loaded on 3 subscales, which were labeled Personal Homonegativity, Gay Affirmation, and Morality of Homosexuality. IHNI scores correlated in expected directions and magnitude with measures of extroversion, emotional stability, stage of gay identity development, and another internalized homonegativity instrument. Implications of the three-factor structure of the IHNI for the conceptualization of internalized homonegativity are discussed.

The purpose of this study was to examine the relationship between having access to a medical home and unmet needs for specialty care services for children with autism spectrum disorders (ASD). Parents of children enrolled in a national autism registry were invited to complete an online Access to Care Questionnaire. The resulting sample consisted of 371 parents-child dyads. Bivariate and hierarchical regression analyses were conducted to determine whether having a medical home was associated with the number of unmet needs for specialty care. Less than one in five children with ASD had a medical home (18.9%). Nearly all parents reported that their child had a personal doctor or nurse as well as a usual source of care, but less than one-third received coordinated care (29.9%) and less than one-half received family-centered care (47.1%). Many children had unmet needs (63%), and the highest unmet need was for behavioral therapy. Having a medical home was associated with fewer unmet specialty care needs, even after demographic, child and family characteristics were taken into account. Children with ASD who have a medical home are more likely to have adequate access to needed services. Unfortunately, relatively few children have a medical home that includes family-centered and coordinated care. Enhancements in the delivery of primary care for children with ASD may make a real difference in access to needed specialty care services, potentially improving child and family outcomes.

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These findings indicate a significant disparity in access to HCT services for youth with ASD. Further research is needed to understand this disparity and develop interventions to improve HCT both for youth with ASD and those with other disabling health conditions. Additionally, many caregivers do not recognize the importance of HCT services. Education and training for caregivers, youth, and providers is essential to ensure all parties are working together to address transition issues early and often.