Sexual minority youth are more likely to experience homelessness, and homeless sexual minority youth report greater risk for mental health and substance abuse symptoms than homeless heterosexual youth, yet few studies have assessed determinants that help explain the disparities. Minority stress theory proposes that physical and mental health disparities among sexual minority populations may be explained by the stress produced by living in heterosexist social environments characterized by stigma and discrimination directed toward sexual minority persons. We used data from a sample of 200 young men who have sex with men (YMSM) (38 % African American, 26.5 % Latino/Hispanic, 23.5 % White, 12 % multiracial/other) to develop an exploratory path model measuring the effects of experience and internalization of sexual orientation stigma on depression and substance use via being kicked out of home due to sexual orientation and current homelessness. Direct significant paths were found from experience of sexual orientation-related stigma to internalization of sexual orientation-related stigma, having been kicked out of one's home, experiencing homelessness during the past year, and major depressive symptoms during the past week. Having been kicked out of one's home had a direct significant effect on experiencing homelessness during the past 12 months and on daily marijuana use. Internalization of sexual orientation-related stigma and experiencing homelessness during the past 12 months partially mediated the direct effect of experience of sexual orientation-related stigma on major depressive symptoms. Our empirical testing of the effects of minority stress on health of YMSM advances minority stress theory as a framework for investigating health disparities among this population.

Objective We tested the feasibility and efficacy of an electronic health record (EHR) strategy that automated the delivery of print medication information at the time of prescribing. Methods Patients (N = 141) receiving a new prescription at one internal medicine clinic were recruited into a 2-arm physician-randomized study. We leveraged an EHR platform to automatically deliver 1-page educational ‘MedSheets’ to patients after medical encounters. We also assessed if physicians counseled patients via patient self-report immediately following visits. Patients’ understanding was objectively measured via phone interview. Results 122 patients completed the trial. Most intervention patients (70%) reported receiving MedSheets. Patients reported physicians frequently counseled on indication and directions for use, but less often for risks. In multivariable analysis, written information (OR 2.78, 95% CI 1.10–7.04) and physician counseling (OR 2.95, 95% CI 1.26–6.91) were independently associated with patient understanding of risk information. Receiving both was most beneficial; 87% of those receiving counseling and MedSheets correctly recalled medication risks compared to 40% receiving neither. Conclusion An EHR can be a reliable means to deliver tangible, print medication education to patients, but cannot replace the salience of physician-patient communication. Practice implications Offering both written and spoken modalities produced a synergistic effect for informing patients.

Please note that in the first paragraph on p. 575 on this article, p values are reported incorrectly. The following is the correct text for this paragraph: Direct significant paths were found from experience of sexual orientation-related stigma to internalization of sexual orientation-related stigma (β=0.31, pG.001), having been kicked out of one's home (β=1.59, O.R.=4.90, pG.001), experiencing homelessness during the past year (β=0.65, O.R.= 1.91, p G.01), and major depressive symptoms during the past week (β=1.21, O.R.=3.36, pG.001). Both internalization of sexual orientation-related stigma and experiencing homelessness during the past 12 months partially mediated the direct effect of experience of sexual orientation-related stigma on major depressive symptoms. Having been kicked out of one's home had a direct significant effect on experiencing homelessness during the past 12 months (β=1.59, O.R.=4.90, p,G.001) and daily marijuana use (β=1.59, O.R.=4.90, pG.001).Bruce and Fata are with the

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