Objectives: Two randomized-controlled studies explored the feasibility, acceptability, and efficacy of the EVERYbody Project, a gender-inclusive, diversity-focused, dissonance-based body image intervention for college students. Method: Trial 1 (N = 98; 80% female, 14% male, and 6% gender-expansive) piloted the two-session intervention delivered by an expert (faculty or staff) and peer cofacilitators compared to a waitlist control. Trial 2 (N = 141; 79% female, 15% male, and 6% gender-expansive) utilized peer leaders, comparing the EVERYbody Project to a video and expressive writing intervention. Around half of the participants in both trials self-identified in one or more specific marginalized identity category. Changes in eating disorder symptoms and risk factors were assessed through 1-month follow-up. Trial 1 also assessed the intervention's impact on students with marginalized identities through qualitative interviews. Results: In Trial 1, the EVERYbody Project produced greater reductions in eating disorder symptoms, internalized appearance norms, body dissatisfaction, and negative affect compared to the waitlist control through 1-month follow-up, with medium effect sizes. The impact was similar in students with marginalized and majority identities, and qualitative interviews suggested specific positives of the intervention. In Trial 2, there were significant changes in two of four outcomes for participants in the EVERYbody Project compared to the video and expressive writing intervention, but overall, the intervention impact was modest. Conclusions: The EVERYbody Project is a feasible and acceptable inclusive dissonance-based body image program. It appears to be beneficial when delivered via experts, but research is needed to establish whether the program can be delivered using peer leaders with greater impact. Public Health SignificanceA dissonance-based body image program that is inclusive of all college students appears to be beneficial when diversity in cultural body image pressures is directly discussed and groups are led by at least one expert. Additional research is needed to assess whether college peer facilitators can successfully deliver inclusive body image programs.

The amount of time adolescents spend communicating via digital technologies such as smartphones has led to concerns that computer-mediated communication (CMC) is displacing face-to-face (FtF) interactions and disrupting social development. Although many studies have examined CMC in adolescents' relationships with friends, few studies have examined the role of CMC in adolescents' renegotiation of closeness and autonomy with parents. To examine this issue, we administered an online daily diary with 169 U.S. adolescents to estimate the time they spend in CMC and FtF interactions and the number of texts they exchange with friends and parents. On the last day of the survey we asked adolescents about their emotional closeness to friends and parents, and their balance of closeness and volition with parents. Overall, we found more evidence for social stimulation than displacement effects of CMC. Texts and CMC time with friends predicted friend closeness after accounting for FtF time with friends; texts with parents predicted parent closeness after accounting for FtF time with parents. We also found support for our hypothesis that CMC would be associated with greater adolescent volition. CMC time with parents predicted greater volitional dependence (volition plus closeness) whereas texts with friends predicted greater independent decision-making (volition plus distance). We discuss how communication technologies are integrated into U.S. adolescents' relationships with friends and parents and how CMC can facilitate, rather than stifle, adolescents' adjustment of autonomy-relatedness with parents and their construction of emotional closeness with friends.

Most prior research on culture and the dynamics of social support has focused on the emotional outcomes for social support recipients. Though an existing body of research has identified cross-cultural differences in the emotional correlates of receiving different types of social support, researchers have seldom examined possible cultural differences in the experience of social support providers . This study used the Day Reconstruction Method to examine cultural differences in the emotional correlates of the provision of solicited and unsolicited and emotional and informational social support in the daily lives of Singaporean (n = 79) and American (n = 88) participants. Singaporean participants reported providing more social support overall. Regardless of culture, participants reported more positive emotion (affection, happiness) and less negative emotion (anger, anxiety) when they provided emotional social support. Also, multilevel modeling analyses revealed a 3-way interaction between culture, social support provision, and social support solicitation, indicating cultural differences in negative emotional responses to providing solicited social support. Specifically, results suggest that attempts to provide more solicited social support were associated with more negative emotions in the U.S. In contrast, provider negative emotions were highest in Singapore when the provider did not meet the recipient’s request for support. Patterns of cultural differences in social support provision are dissimilar to—rather than simply mirroring—those found in published research on social support receipt, highlighting the importance of studying social support provision as a distinct phenomenon.

Culturally appropriate social support predicts better psychological outcomes. Motivation for providing social support may vary cross-culturally, with more independent cultures valuing self-esteem and more interdependent cultures valuing closeness. Participants in the U.S. (N = 85) and Singapore (N = 78) reported on emotions and social support receipt using the Day Reconstruction Method. We examined cultural differences in stress and affection, and tested country as a moderator of the associations between both social support receipt and social support motivation, and next-episode emotions. Multilevel modeling analyses showed that not only did the emotional correlates of social support receipt vary by country, but that recipient perceptions of esteem-building and closeness-fostering SS also differentially correlated with subsequent emotion. For example, esteem-building SS predicted greater next-episode stress for Singaporean participants, but less stress in the U.S. Esteem-building SS predicted more next-episode affection only in the U.S. Culturally appropriate social support predicts positive psychological outcomes. This research highlights the importance of considering culture when examining the dynamic emotional correlates of social support receipt.

Background: Little is known about how health insurance payer types differ between transgender and gender diverse (TGD) people and cisgender people. Much of what is known about insurance coverage among TGD adults has been based on research from claims and electronic health record data, which excludes individuals who have not accessed gender-affirming care. Research designed to understand how TGD populations pay for health care to best inform care interventions and public insurance policies is lacking.Objective: The objective of this study was to examine differences in the prevalence of public and private health insurance between transgender and cisgender adults.Methods: Using data from the Behavioral Risk Factor Surveillance System, this study estimated prevalence of health insurance coverage among TGD and cisgender adults residing in 22 states that administered the Sexual Orientation and Gender Identity module and the Healthcare Access module from 2014 to 2019. This study estimated the odds of health insurance coverage (no insurance, private insurance, public insurance) among cisgender adults compared with TGD adults.Results: TGD people had greater odds of being uninsured compared with cisgender women. Among nondisabled, nonelderly respondents, TGD adults had lower odds of having private insurance and higher odds of public insurance compared with cisgender men. Among respondents who were likely Medicaid-eligible, TGD respondents had lower odds of having public insurance and higher odds of being uninsured compared with cisgender women. Conclusion:These findings provide foundational information about the payer mix among TGD people and provide insight into barriers to health insurance that TGD adults may face.