Introduction: As anti-immigrant hostility toward Latino populations grows, more fervent attention is needed to consider strength-based approaches to attenuate the effects of perceived discrimination. This systematic review synthesizes the evidence about the effects of racial/ethnic discrimination on mental, physical, and health behaviors of Latinos and examines the coping mechanisms and cultural factors that attenuate the negative association between discrimination and health among adult Latinos living in the United States. Method: The search criteria included articles that (a) examined ethnic/racial discrimination in relationship to a health outcome, (b) had study samples composed of least 25% Latino adults, and (c) were written in English. Results: A total of 33 studies were included in the review. Our findings demonstrated the negative relationship between perceived discrimination, mental health, and health behaviors. The evidence for the relationship between perceived discrimination and physical health was less robust. For mental health, greater feeling of ethnic pride and belonging attenuated the negative relationship between perceived discrimination and mental health. Conclusions: Our findings highlight the potential for building on ethnic identity for addressing mental health and perceived discrimination. Future research directions are outlined to address identified gaps.
Purpose: Transgender and nonbinary (trans*) people are affected disproportionately by discrimination and violence, contributing to gender minority stress and negative health effects. Transgender community connection (TCC), defined as (i) emotional connectedness (internal sense of belonging) to the trans* community and/or (ii) behavioral participation in the trans* community (observable interaction with other trans* people, in person, online, or through media) may moderate these negative effects on health. This systematic review synthesizes research on links between TCC and health and wellbeing for trans* people. Methods: Twenty research articles (3 quantitative, 3 mixed methods, and 14 qualitative) linking TCC to health and wellbeing were identified from systematic searches of PubMed, CINAHL, and PsycINFO. Data regarding TCC were extracted, synthesized, and grouped by (i) gender transitioning, (ii) mental health, (iii) sexual health, and (iv) access to care to illustrate the findings. Results: TCC was linked to several positive outcomes, including improved mental health, increased connection to care, supported exploration of sexual and gender identities, and informed gender transition. For transgender women, especially, TCC was also linked to increased engagement in sex work (as a worker, not a client) and, in some cases, deterred them from getting sexual health testing and treatment due to fear of being observed at specialized clinics and subsequent loss of confidentiality among peers. Conclusion: These findings highlight the overall protective nature of TCC and a need to consider best practices to ensure confidentiality for community members. The findings can be used to inform the development and adaptation of health care interventions aimed at decreasing the harmful effects of gender minority stress for trans* people.
Background: Compared to cisgender peers, transgender and gender diverse (TGD) people experience significant health disparities associated with discrimination and limited access to appropriate care in healthcare settings. Nurses represent the largest segment of the United States (US) healthcare workforce; however, US nursing programs only dedicate approximately 2.12 h to Lesbian, Gay, Bisexual, and TGD (LGBT)-related content. Objectives/design/setting/participants: To fill the gap in TGD-related nursing education, the Transgender Curriculum Integration Project (TCIP) developed and integrated an evidence-based curriculum specific to TGD health into the pre-licensure accelerated Bachelor’s in Nursing Science (BSN) program at Johns Hopkins School of Nursing. The purpose of this study was to assess the preliminary efficacy and feasibility (i.e., attrition, engagement, acceptability) of the TCIP in improving the TGD-related health knowledge and attitudes among a sample of pre-licensure nursing students. Methods: TCIP utilized a self-administered online survey to assess students’ knowledge and attitudes about TGD health prior to (time point 1) and following (time points 2 and 3) the integration of TGD-specific content into five nursing pre-licensure courses. Rank-based nonparametric testing using Kruskal-Wallis H and Mann-Whitney U were conducted to determine if there were statistically significant differences in responses between the three time points. Thematic content analysis was used to determine themes present among short answers. Results: Findings indicate TGD-specific content improved student’s gender sensitivity overtime, with improvements in self-reported skills in providing care for TGD people and knowledge of additional TGD-specific resources. However, gender sensitivity remains low among student’s and students requested more TGD content suggesting room for further improvement. Conclusions: Findings support the efficacy of TCIP and highlight complexities of curricular change that can guide future curricular integration and evaluation in nursing programs nation-wide.
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