Disclosure Matters: Enhancing Patient-Provider Communication is Necessary to Improve the Health of Sexual Minority Adolescents

Hubach, Randolph D.

doi:10.1016/j.jadohealth.2017.08.021

Cited by 8 publications

(5 citation statements)

References 17 publications

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“…Greater sensitivity to confidentiality and privacy concerns related to sexual minority status, as well as an openness to discuss minority stressors, can foster a supportive environment for sexual minority adolescents. 67,68 Study limitations include the classification of sexual minority status on the basis of a single item assessing sexual attraction at one time point. This item only categorized youth who experienced some same-sex attraction as sexual minority youth and did not capture asexual youth or the full spectrum of gender identity.…”

Section: Figurementioning

confidence: 99%

Sexual Minority Status and Age of Onset of Adolescent Suicide Ideation and Behavior

Luk

Haynie

et al. 2021

Pediatrics

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OBJECTIVES: To determine if sexual minority adolescents have earlier onset of suicidality and faster progressions from ideation to plan and attempt than heterosexual adolescents. METHODS: A population-based longitudinal cohort of 1771 adolescents participated in the NEXT Generation Health Study. Participants reported sexual minority status (defined by sexual attraction) in 2010-2011 and retrospectively reported age at onset of suicidality in 2015-2016.RESULTS: Sexual minority adolescents (5.8% of weighted sample) had higher lifetime risk of suicide ideation (26.1% vs 13.0%), plan (16.6% vs 5.4%), and attempt (12.0% vs 5.4%) than heterosexual adolescents. Survival analyses adjusted for demographic characteristics and depressive symptoms revealed positive associations of sexual minority status with time to first onset of suicide ideation (hazard ratio [HR] = 1.77; 95% confidence interval [CI] 1.03-3.06) and plan (HR = 2.69; 95% CI 1.30-5.56). The association between sexual minority status and age at onset of suicide attempt was stronger at age <15 (HR = 3.26; 95% CI 1.25-8.47) than age $15 (HR = 0.59; 95% CI 0.21-1.66). The association between sexual minority status and progression from ideation to plan was stronger in the same year of first ideation (HR = 2.01; 95% CI 1.07-3.77) than $1 year after first ideation (HR = 1.33; 95% CI 0.26-6.77).CONCLUSIONS: Sexual minority adolescents had earlier onset of suicidality and faster progression from suicide ideation to plan than heterosexual adolescents. The assessment of sexual minority status in routine pediatric care has the potential to inform suicide risk screening, management, and intervention efforts among early sexual minority adolescents.

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Section: Figurementioning

confidence: 99%

Sexual Minority Status and Age of Onset of Adolescent Suicide Ideation and Behavior

Luk

Haynie

et al. 2021

Pediatrics

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“…Beyond sex and race/ethnicity, no other moderators were tested in the studies reviewed. A recent commentary noted that sexual minority adolescents living in rural areas may have inequitable access to healthcare relative to their non-rural counterparts (Hubach, 2017), highlighting the importance of considering geographical location as a possible moderator. Additionally, family connectedness, social support and self-esteem may moderate sexual orientation health disparities during the transition from adolescence to young adulthood (Darwich, Hymel, & Waterhouse, 2012;Pakula, Carpiano, Ratner, & Shoveller, 2016), and should be examined as potential moderators in future studies.…”

Section: Moderators Of Sexual Orientation Disparitiesmentioning

confidence: 99%

A Systematic Review of Sexual Orientation Disparities in Disordered Eating and Weight-Related Behaviors Among Adolescents and Young Adults: Toward a Developmental Model

Miller

Luk

2018

Adolescent Res Rev

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Adolescence is a sensitive period for the development of disordered eating and weight-related behaviors, and sexual minorities may be particularly at risk due to heightened minority stress and challenges related to sexual identity development. This review synthesized findings from 32 articles that examined sexual orientation disparities (each with a heterosexual referent group) in four disordered eating behaviors (binging, purging, restrictive dieting, diet pill use) and four weight-related behaviors (eating behaviors, physical activity, body image, and Body Mass Index [BMI]). Potential variations by outcome, sex, race/ethnicity, and developmental stage were systematically reviewed. Evidence supporting sexual orientation disparities in disordered eating and weight-related behaviors was more consistent among males than females. Among females, sexual orientation disparities in disordered eating behaviors appeared to be more pronounced during adolescence than in young adulthood. Sexual minority females generally reported more positive body image than heterosexual females but experienced disparities in BMI. Sexual orientation differences in eating behaviors and physical activity were especially understudied. Incorporating objectification and minority stress theory, a developmental model was devised where body image was conceptualized as a key mechanism leading to disordered eating behaviors. To advance understanding of sexual orientation disparities and tailor intervention efforts, research in this field should utilize longitudinal study designs to examine developmental variations and incorporate multi-dimensional measurements of sexual orientation and body image.

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“…19 While about half of the sample reported discussing puberty, less than one-third reported discussing any of the other seven sexual health topics; older adolescents were more likely to report having discussed all eight topics than younger adolescents. There is consistent evidence demonstrating variation in the delivery of sexual health discussions during preventative care visits based on patient demographic characteristics including, but not limited to, age, race/ethnicity, and sexual and gender identity, 17,19,21 which may contribute to persistent sexual health disparities among adolescents and young adults. For example, research shows that health care providers are often more likely to engage in sexual health discussions with older adolescents as compared with their younger counterparts.…”

Section: Routine Provider-patient Sexual Health Discussionmentioning

confidence: 99%

Application of the unified theory of behavior to strengthen sexual health discussions between providers and young patients in the United States

Lanier,

Rivera‐Cash,

Lavarin

et al. 2024

Perspect Sexual Reproductive

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ContextSexual health discussions between healthcare providers and adolescent and young adult patients are an important strategy for addressing and improving sexual health. However, healthcare providers often do not engage in comprehensive sexual health discussions with young patients during routine clinical visits.MethodsWe propose the use of a conceptual model, the Unified Theory of Behavior (UTB), as a tool that can aid healthcare providers in facilitating more comprehensive sexual health conversations with young patients.ResultsWe present clinical scenarios on how healthcare providers can use the UTB with existing sexual health assessments during routine, clinical visits with their patients.ConclusionsUsing the UTB may be one effective tool to aid healthcare providers in initiating sexual health discussions and facilitating more comprehensive sexual health conversations with adolescent and young adult patients during routine clinical visits and sexual and reproductive health‐focused visits.

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Disclosure Matters: Enhancing Patient-Provider Communication is Necessary to Improve the Health of Sexual Minority Adolescents

Cited by 8 publications

References 17 publications

Sexual Minority Status and Age of Onset of Adolescent Suicide Ideation and Behavior

Sexual Minority Status and Age of Onset of Adolescent Suicide Ideation and Behavior

A Systematic Review of Sexual Orientation Disparities in Disordered Eating and Weight-Related Behaviors Among Adolescents and Young Adults: Toward a Developmental Model

Application of the unified theory of behavior to strengthen sexual health discussions between providers and young patients in the United States

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