Digital Commons Network^™

Effectiveness Of Online Instructional Videos: Intervening Medical Students' Learning Of Shared Decision-Making, Truth-Telling, Patient Emotional Disturbance Evaluations, And Emotional Processing Training, Shu-Chung Lii, Ji-Tseng Fang

Journal of Medical Education

Communication is a fundamental part of healthcare. Poor communication is a common cause of medical complaints; the common and difficult communication often involves truth-telling and shared decision-making (SDM). Medical treatment can be emotionally distressing for patients; thus, understanding how to communicate with patients and treat patient emotional problems is paramount for providing quality healthcare. This study evaluates the effectiveness of learning SDM, truth-telling, patient emotional disturbance evaluation methods, and emotional processing of staff and patients. Fifth- and sixth-year medical students from Chang Gung University were recruited and administered a research questionnaire based on the COMRADE (Combined Outcome Measure for Risk …

Perceptions On Entrustable Professional Activities (Epas) In Psychiatry Among Specialty Trainees, Mei-Feng Huang, Yi-Chun Yeh, Tai-Ling Liu, Wei-Po Chou, Peng-Wei Wang, Cheng-Sheng Chen

Journal of Medical Education

Background: Competence-based medical education (CBME) has been proposed and will lead the paradigm shift in medical education. Entrustable professional activities (EPAs) is one of the operational systems to achieve the goals of CBME. The development of scopes of professional clinical tasks is the first step for EPAs medical education. In this study, we aimed to develop a framework of EPAs specially for psychiatry specialty training and to investigate the perceptions of these EPAs among trainees. Methods: This study combined the methods of expert focus group and questionnaire survey. Experts in the focus group were attending psychiatrists at Kaohsiung Medical University …

Virtual Patients Vs Standardized Patients In Medical Education - From The Perspectives Of Clinical Teachers, Chia-Hung Chen, Feng-Cheng Liu, Zi-Xiang Xu, Fu-Hsiung Su, Tsuen-Chiuan Tsai

Journal of Medical Education

Patient encounters have been highlighted important for learning clinical skills. Virtual patients and standardized patients have been widely used as supplement models in medical education. Purpose: This study aims to first compare the effectiveness of using SPs and VPs from the perspectives of clinical teachers and secondly to suggest the smart choice based on the educational objectives. Methods: A questionnaire-assisted interview was conducted to gather feedback from teachers based on their experience with VPs and SPs in clinical teaching. The items for VP/SP comparison include: clinical reasoning, history taking, physical examination, procedural skills, communication, conceptualization, range of case varieties, authentic …

Use Of The Nursing Practice Grade As A Predictor Of Registered Nurse Examination First Attempt Pass Rate Of Baccalaureate Nursing Graduates, Shu-Ying Fu, Jen-Hung Wang, Jiin-Ling Jiang

Journal of Medical Education

Purpose: This study aimed to examine whether the nursing practice grade can serve as a predictor of pass rate for the first attempt of the Registered Nurse (RN) Examination of baccalaureate nursing graduates. Methods: A retrospective study was conducted to collect data from the Nursing Practice Management System in one university. Data covered the grades of various nursing practice courses of students who graduated from 2015 to 2019. All the students had completed the required nine nursing practice courses. The outcome was pass/ fail in the first attempt of the RN examination. Results: Among a total of 260 students, most …

Establishing Core Competencies Of Taiwanese Pharmacists Using The Nominal Group Technique, Ya-Hui Chang, Shao-Chin Chiang, Chih-Wei Yang

Journal of Medical Education

Purpose: The implementation of competency-based medical education (CBME) is increasing worldwide and has been emphasized by key reports in health professional education. The objective of this study is to describe the consensus process and results that led to the Taiwanese pharmacists' core competencies framework. Methods: The initial draft of the core competencies and profession-specific sub-competencies were formulated by CBME task force members of the Taiwan Society of Health-System Pharmacists (TSHP). Expert pharmacist educators from representative teaching medical facilities across Taiwan were invited to go through a standard process of the nominal group technique (NGT) to come up with the final …

Evolution Of Journal Of Medical Education To Open Access, Ming-Been Lee

Journal of Medical Education

Modern medical education in Taiwan began in 1897. The National Taiwan University College of Medicine (NTUCM) led medical education reform by introducing a new curriculum and small class teaching in August 1992. To celebrate the 100th anniversary of Taiwan medical education, the NTUCM published the Journal of Medical Education (JME) in Mandarin in 1997, hoping to share the education reform and further improve the quality of medical education in Taiwan. For more than 26 years, the JME has grown and served as the platform that supports the work of medical education researchers, medical professionals, administrators, and policymakers. Along with our …

Perspectives Of A Foreigner Teaching At A Taiwanese Medical School, Russell Oliver Kosik

Journal of Medical Education

Dr. Kosik has had multiple years of experience teaching medicine in Asia. He has found the medical education system in Taiwan to be quite impressive and is inspired by the dedication of the faculty and students. Still, there is room for improvement, especially in more abstract areas such as critical thinking.

Looks And Status Are Still Essential: Testing The Mate Preference Priority Model With The Profile-Based Experimental Paradigm, Jose C. Yong, Yi Wen Tan, Norman P. Li, Andrea L. Meltzer

Research Collection School of Social Sciences

Objective: Although the mate preference priority model (MPPM; Li et al., 2002) has advanced our understanding of mate preferences, tests of the MPPM have relied on methods using text labels and thus lack ecological validity. We address this gap by testing the MPPM using Townsend and colleagues’ (1990a; 1990b; 1993) profile-based experimental paradigm, which utilizes profiles comprising photos of pre-rated models to manipulate physical attractiveness as well as costumes and descriptions to manipulate social status.Method: Using Singaporean samples, we conducted two studies (Study 1 n = 431, Study 2 n = 964) where participants judged the short-term and long-term mating …

Developing A Lifestyle Intervention Program For Overweight Or Obese Preconception, Pregnant And Postpartum Women Using Qualitative Methods, Chee Wai Ku, Shu Hui Leow, Lay See Ong, Christina Erwin, Isabella Ong, Xiang Wen Ng, Jacinth Jia Xin Tan, Fabian Yap, Jerry K. Y. Chan, See Ling Loy

Research Collection School of Social Sciences

The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors to improve the metabolic health of mothers and their offspring. However, the success of a lifestyle intervention is dependent on uptake and continued compliance. To identify enablers and barriers towards engagement with a lifestyle intervention, thematic analysis of 15 in-depth interviews with overweight or obese women in the preconception, pregnancy or postpartum periods was undertaken, using the integrated-Promoting Action on Research Implementation in Health Services framework as a guide to systematically chart factors influencing adoption of a novel lifestyle intervention. …

Ten Year Real World Experience With Ultrafiltration For The Management Of Acute Decompensated Heart Failure, Donald C. Haas, Maureen Hummel, Patricia Barrella, Waqas Ullah, Misung Yi, Robert Watson

Abington Jefferson Health Papers

Background: Randomized controlled trials (RCT) of ultrafiltration (UF) have demonstrated conflicting results regarding its efficacy and safety.

Objective: We reviewed 10 years of data for adjustable UF during heart failure hospitalizations in a real world cohort.

Methods: We performed a retrospective, single center analysis of 335 consecutive patients treated with adjustable rate UF using the CHF Solutions Aquadex Flex Flo System from 2009 to 2019.

Results: Compared to previous RCTs investigating UF, our cohort was older, with worse renal impairment and more antecedent HF hospitalizations in the year preceding therapy. Mean fluid removal with UF was 14.6 l. Mean weight …

Secure Human Action Recognition By Encrypted Neural Network Inference, Miran Kim, Xiaoqian Jiang, Kristin Lauter, Elkhan Ismayilzada, Shayan Shams

Faculty Research, Scholarly, and Creative Activity

Advanced computer vision technology can provide near real-time home monitoring to support “aging in place” by detecting falls and symptoms related to seizures and stroke. Affordable webcams, together with cloud computing services (to run machine learning algorithms), can potentially bring significant social benefits. However, it has not been deployed in practice because of privacy concerns. In this paper, we propose a strategy that uses homomorphic encryption to resolve this dilemma, which guarantees information confidentiality while retaining action detection. Our protocol for secure inference can distinguish falls from activities of daily living with 86.21% sensitivity and 99.14% specificity, with an average …

A Multitask Deep Learning Approach For Pulmonary Embolism Detection And Identification, Xiaotian Ma, Emma C. Ferguson, Xiaoqian Jiang, Sean I. Savitz, Shayan Shams

Faculty Research, Scholarly, and Creative Activity

Pulmonary embolism (PE) is a blood clot traveling to the lungs and is associated with substantial morbidity and mortality. Therefore, rapid diagnoses and treatments are essential. Chest computed tomographic pulmonary angiogram (CTPA) is the gold standard for PE diagnoses. Deep learning can enhance the radiologists’workflow by identifying PE using CTPA, which helps to prioritize important cases and hasten the diagnoses for at-risk patients. In this study, we propose a two-phase multitask learning method that can recognize the presence of PE and its properties such as the position, whether acute or chronic, and the corresponding right-to-left ventricle diameter (RV/LV) ratio, thereby …

Towards The Ionizing Radiation Induced Bond Dissociation Mechanism In Oxygen, Water, Guanine And Dna Fragmentation: A Density Functional Theory Simulation, Santosh Kc, Ramin Abolfath

Faculty Research, Scholarly, and Creative Activity

The radiation-induced damages in bio-molecules are ubiquitous processes in radiotherapy and radio-biology, and critical to space projects. In this study, we present a precise quantification of the fragmentation mechanisms of deoxyribonucleic acid (DNA) and the molecules surrounding DNA such as oxygen and water under non-equilibrium conditions using the first-principle calculations based on density functional theory (DFT). Our results reveal the structural stability of DNA bases and backbone that withstand up to a combined threshold of charge and hydrogen abstraction owing to simultaneously direct and indirect ionization processes. We show the hydrogen contents of the molecules significantly control the stability in …

Meeting The 24-H Movement Guidelines And Health-Related Outcomes Among Youth With Autism Spectrum Disorder: A Seven-Country Observational Study, Chunxiao Li, Justin A. Haegele, Fenghua Sun, Maria Luiza Tanure Alves, Stefanie Hwee Chee Ang, Jihyun Lee, Kwok Ng, Isabella Dos Santos Alves, Sean Healy, Wendy Yajun Huang, Pauli Rintala, Jernice Sing Yee Tan, Yandan Wu, Hannah Yang, Eija Kärnä, Hyokju Maeng, André Lisandro Schliemann, Ding Ding

Faculty Research, Scholarly, and Creative Activity

Background: Meeting daily guidelines for physical activity, screen time, and sleep duration is associated with a host of health indicators for youth. In this cross-sectional observational study, we investigated the associations between adherence to the movement guidelines and health-related outcomes among youth with autism spectrum disorder (ASD). Methods: Parents of youth with ASD (10–17 years) from seven countries and regions were invited to provide online proxy-reports for child’s movement behaviors (i.e., physical activity, sleep and screen time), and health-related outcomes (i.e., body mass index [BMI], general health, and quality of life). A series of multiple linear regression analyses were used …

Addressing Forced Labor In Supply Chains In California, Kezban Yagci Sokat

Faculty Research, Scholarly, and Creative Activity

Transportation plays a key role in combating human trafficking and California is monumental in understanding this role. This paper presents one element of research undertaken for United States Department of Transportation for understanding the role of transportation in combating human trafficking in California through a survey of multi-disciplinary anti-trafficking practitioners followed by a semi-structured interview. This paper focuses on forced labor and supply chain management. It presents general knowledge on forced labor issues in California and globally, the intersection with transportation, efforts to combat forced labor in the supply chains, and experts’ suggestions on how to address forced labor. The …

The Evolution Of Extraordinary Self-Sacrifice, D. B. Krupp, Wes Maciejewski

Faculty Research, Scholarly, and Creative Activity

From a theoretical perspective, individuals are expected to sacrifice their welfare only when the benefits outweigh the costs. In nature, however, the costs of altruism and spite can be extreme, as in cases of irreversible sterility and self-destructive weaponry. Here we show that “extraordinary” self-sacrifice—in which actors pay costs that exceed the benefits they give or the costs they impose on recipients—can evolve in structured populations, where social actions bring secondary benefits to neighboring kin. When given information about dispersal, sedentary actors evolve extraordinary altruism towards dispersing kin. Likewise, when given information about dispersal and kinship, sedentary actors evolve extraordinary …

Machine Learned Daily Life History Classification Using Low Frequency Tracking Data And Automated Modelling Pipelines: Application To North American Waterfowl, Cory Overton, Michael Casazza, Joseph Bretz, Fiona Mcduie, Elliott Matchett, Desmond Mackell, Austen Lorenz, Andrea Mott, Mark Herzog, Josh Ackerman

Faculty Research, Scholarly, and Creative Activity

Background: Identifying animal behaviors, life history states, and movement patterns is a prerequisite for many animal behavior analyses and effective management of wildlife and habitats. Most approaches classify short-term movement patterns with high frequency location or accelerometry data. However, patterns reflecting life history across longer time scales can have greater relevance to species biology or management needs, especially when available in near real-time. Given limitations in collecting and using such data to accurately classify complex behaviors in the long-term, we used hourly GPS data from 5 waterfowl species to produce daily activity classifications with machine-learned models using “automated modelling pipelines”. …

Deep Immunophenotyping Reveals Endometriosis Is Marked By Dysregulation Of The Mononuclear Phagocytic System In Endometrium And Peripheral Blood, Júlia Vallvé-Juanico, Ashley F. George, Sushmita Sen, Reuben Thomas, Min Gyoung Shin, Divyashree Kushnoor, Joshua J. Vásquez, Kim Chi Vo, Juan C. Irwin, Nadia R. Roan, Alexis J. Combes, Linda C. Giudice

Faculty Research, Scholarly, and Creative Activity

Background: Endometriosis is a chronic, estrogen-dependent disorder where inflammation contributes to disease-associated symptoms of pelvic pain and infertility. Immune dysfunction includes insufficient immune lesion clearance, a pro-inflammatory endometrial environment, and systemic inflammation. Comprehensive understanding of endometriosis immune pathophysiology in different hormonal milieu and disease severity has been hampered by limited direct characterization of immune populations in endometrium, blood, and lesions. Simultaneous deep phenotyping at single-cell resolution of complex tissues has transformed our understanding of the immune system and its role in many diseases. Herein, we report mass cytometry and high dimensional analyses to study immune cell phenotypes, abundance, activation states, …

The Role Of State Breastfeeding Laws And Programs On Exclusive Breastfeeding Practice Among Mothers In The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic), Paschal A. Apanga, Elizabeth J. Christiansen, Ann M. Weber, Lyndsey A. Darrow, Mark S. Riddle, Wei Chen Tung, Yan Liu, Taya Kohnen, Joshua V. Garn

Faculty Research, Scholarly, and Creative Activity

Background: It is unclear if state laws supporting breastfeeding are associated with exclusive breastfeeding (EBF) practice among low-income mothers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The main objectives of our study were to assess the relationship between such laws and EBF among WIC-participating mothers and to assess whether this association varied by employment status. We also assessed how mother’s exposure to WIC breastfeeding consultation was associated with EBF. Methods: A cross-sectional study was conducted across seven WIC program locations (i.e., Georgia, Massachusetts, Nevada, Pennsylvania, Wisconsin, Wyoming, Chickasaw Nation) between July–August 2020. Data were …

Developing A Feedback-Rich Culture In Academic Medicine: The Effect Of Coaching And 360-Feedback On Physician Leadership, Rachel Schwartz, Barbette Weimer-Elder, Elizabeth Wilkins, Dan Deka, Stephanie Wong, Bryan K. Dang, Ryan Brown, Merisa Kline, Lawrence Kwan

Faculty Research, Scholarly, and Creative Activity

Background: This is a time of unprecedented change in healthcare. More physicians are being tasked with stepping into a variety of leadership roles without having received the training needed to be an effective leader. Previous data have demonstrated the effectiveness of both leadership coaching and 360-feedback tools to foster physician well-being and leadership growth. In this proof of concept study, we explore the combined effect of these two tools. The objective of this study was to examine the effect of a brief physician 360 leadership coaching intervention on perception of professional dynamics and acquired leadership skills. Methods: Participants completed a …

A Multi-Site, International Audit Of Malnutrition Risk And Energy And Protein Intakes In Patients Undergoing Treatment For Head Neck And Esophageal Cancer: Results From Inform, Lisa Martin, Merran Findlay, Judith D. Bauer, Rupinder Dhaliwal, Marian De Van Der Schueren, Alessandro Laviano, Adrianne Widaman, Vickie E. Baracos, Andrew G. Day, Leah M. Gramlich

Faculty Research, Scholarly, and Creative Activity

Patients with foregut tumors are at high risk of malnutrition. Nutrition care focuses on identifying individuals at risk of malnutrition and optimizing nutrient intake to promote the maintenance of body weight and lean body mass. This multi-center prospective, longitudinal study audited nutrition care practices related to screening for risk of malnutrition (Patient-Generated Subjective Global Assessment Short Form; PG-SGA SF), and nutrition interventions prescribed (route; adequacy of energy and protein intakes). Audits occurred at four time periods: baseline (before treatment) and at 2, 4, and 6 months after starting cancer treatment; 170 patients (esophageal (ESO; n = 51); head and neck …

The Flavor Profiles Of Highland Barley Fermented With Different Mushroom Mycelium, Kai Wang, Cuicui Yang, Ziyan Dai, Zhenxiang Wen, Yin Liu, Xi Feng, Ying Liu, Wen Huang

Faculty Research, Scholarly, and Creative Activity

Highland barley was fermented with Cordyceps militaris, Stropharia rugoso-annulata, Morchella esculenta, Schizophyllum commune and Tremella sanguinea. The flavor profiles were investigated by electronic nose (E-nose), headspace solid-phase microextraction gas chromatography-mass spectrometry (HS-SPME-GC-MS) and sensory evaluation by train panel. Fermentation with mushroom mycelium was able to change the aroma profile of highland barley. The original strong grassy taste was reduced due to a decrease in hexanal, decanal and 2-pentylfuran, and new aromatic flavors (floral, sweet and mushroom fragrance) were acquired after fermentation. The overall flavor of the fermented highland barley varied with mushroom strains. Schizophyllum commune gave a heavier sour taste …

Supplemental Nutrition Assistance Program (Snap)-Authorized Retailers Received A Low Score Using The Business Impact Assessment For Obesity And Population-Level Nutrition (Bia-Obesity) Tool, Bailey Houghtaling, Tessa Englund, Susan Chen, Nila Pradhananga, Vivica I. Kraak, Elena Serrano, Samantha M. Harden, George C. Davis, Sarah Misyak

Faculty Research, Scholarly, and Creative Activity

Background: The Supplemental Nutrition Assistance Program (SNAP) supports Americans with lower income to purchase dietary products at authorized retailers. This research aimed to evaluate SNAP-authorized retailers’ public commitments in support of nutrition security and to examine differences between traditional grocers and nontraditional (e.g., convenience, drug, dollar) SNAP-authorized retailers’ public commitments. Methods: Prominent United States (U.S.) SNAP-authorized retailers nationally and in two U.S. states (California and Virginia) were identified based on number of store locations (n = 61). Public information available in grey literature were reviewed and scored using the Business Impact Assessment for Obesity and population-level nutrition (BIA-Obesity) tool. SNAP-authorized …

Analysis Of Volatile Compounds In Jinhua Ham Using Three Extraction Methods Combined With Gas Chromatography–Time-Of-Flight Mass Spectrometry, Dengyong Liu, Cong Yang, Lu Bai, Xi Feng, Yanping Chen, Yin Zhang, Yuan Liu

Faculty Research, Scholarly, and Creative Activity

The volatile compounds in Jinhua ham samples after different aging times were characterized using solvent-assisted flavor evaporation (SAFE), solid-phase microextraction (SPME), and needle trap (NT) extraction methods combined with gas chromatography–time-of-flight mass spectrometry (GC–TOF/MS). Hundreds of aroma compounds were identified, including aldehydes, alcohols, ketones, furans, esters, acids, pyrazines, and sulfides. The results showed that NT extracted the greatest number of volatile compounds, whereas the extraction efficiency of SPME headspace adsorption was highest among the three sample preparation methods. Principal component analysis of SPME effectively distinguished the variation in the aroma of the Jinhua hams specific to aging time. Butyrolactone, 2,6-dimethylpyrazine, …

Experimental Realization Of An Extended Fermi-Hubbard Model Using A 2d Lattice Of Dopant-Based Quantum Dots, Xiqiao Wang, Ehsan Khatami, Fan Fei, Jonathan Wyrick, Pradeep Namboodiri, Ranjit Kashid, Albert F. Rigosi, Garnett Bryant, Richard Silver

Faculty Research, Scholarly, and Creative Activity

The Hubbard model is an essential tool for understanding many-body physics in condensed matter systems. Artificial lattices of dopants in silicon are a promising method for the analog quantum simulation of extended Fermi-Hubbard Hamiltonians in the strong interaction regime. However, complex atom-based device fabrication requirements have meant emulating a tunable two-dimensional Fermi-Hubbard Hamiltonian in silicon has not been achieved. Here, we fabricate 3 × 3 arrays of single/few-dopant quantum dots with finite disorder and demonstrate tuning of the electron ensemble using gates and probe the many-body states using quantum transport measurements. By controlling the lattice constants, we tune the hopping …

Development And Evaluation Of A Novel Dietary Bisphenol A (Bpa) Exposure Risk Tool, Jennifer C. Hartle, Roy S. Zawadzki, Joseph Rigdon, Juleen Lam, Christopher D. Gardner

Faculty Research, Scholarly, and Creative Activity

Background: Exposure to endocrine disrupting chemicals such as bisphenol A (BPA) is primarily from the diet through canned foods. Characterizing dietary exposures can be conducted through biomonitoring and dietary surveys; however, these methods can be time-consuming and challenging to implement. Methods: We developed a novel dietary exposure risk questionnaire to evaluate BPA exposure and compared these results to 24-hr dietary recall data from participants (n = 404) of the Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) study, a dietary clinical trial, to validate questionnaire responses. High BPA exposure foods were identified from the dietary recalls and used …

Objective Evaluation Of The Somatogravic Illusion From Flight Data Of An Airplane Accident, Eric L. Groen, Torin K. Clark, Mark M.J. Houben, Jelte E. Bos, Randall J. Mumaw

Faculty Research, Scholarly, and Creative Activity

(1) Background: It is difficult for accident investigators to objectively determine whether spatial disorientation may have contributed to a fatal airplane accident. In this paper, we evaluate three methods to reconstruct the possible occurrence of the somatogravic illusion based on flight data recordings from an airplane accident. (2) Methods: The outputs of two vestibular models were compared with the “standard” method, which uses the unprocessed gravito-inertial acceleration (GIA). (3) Results: All three methods predicted that the changing orientation of the GIA would lead to a somatogravic illusion when no visual references were available. However, the methods were not able to …

Promoting Permanency In Families With Parental Substance Misuse: Lessons From A Process Evaluation Of A Multi-System Program, Karla Shockley Mccarthy, Jennifer Price Wolf, Elinam Dellor

Faculty Research, Scholarly, and Creative Activity

Background: Families affected by substance misuse are at increased risk for child maltreatment and child welfare system involvement. The Enhancing Permanency in Children and Families (EPIC) program uses four evidence-based and informed multi-system practices to promote safety and permanency outcomes for children involved with the child welfare system due to parental substance misuse: 1) Peer Recovery Support (PRS), 2) Family Treatment Drug Court (FTDC), 3) Medications for Opioid Use Disorder (MOUD) and 4) Nurturing Parent Program (NPP) relational skill-building. The purpose of the current study was to identify barriers, facilitators, and lessons learned in the implementation of and client engagement …

Examining The Differential Protective Effects Of Women's Spirituality And Religiosity On Alcohol And Marijuana Use By Sexual Identity, Laurie A. Drabble, Amy A. Mericle, Cat Munroe, Alison Cerezo, Katherine J. Karriker-Jaffe, Tonda L. Hughes, Karen F. Trocki

Faculty Research, Scholarly, and Creative Activity

The current study explored how religiosity and spirituality may differentially influence substance use by sexual identity based on a sample of adult sexual minority women (SMW; n = 437 lesbian; n = 323 bisexual) relative to a heterosexual comparison sample (n = 636). We examined three questions: (1) whether spirituality was differentially associated with alcohol and marijuana use by sexual identity; (2) whether religiosity was differentially associated with alcohol and marijuana use by sexual identity; (3) whether observed differences between spirituality or religiosity and substance use by sexual identity persisted after adjusting for religious environment. Measures included spirituality (importance of …

Healthcare Mistreatment, State-Level Policy Protections, And Healthcare Avoidance Among Gender Minority People, Kristen D. Clark, Sean Luong, Mitchell R. Lunn, Elena Flowers, Esmaeil Bahalkeh, Micah E. Lubensky, Matthew R. Capriotti, Juno Obedin-Maliver, Annesa Flentje

Faculty Research, Scholarly, and Creative Activity

Introduction: This study examined whether past experiences of mistreatment in healthcare were associated with greater healthcare avoidance due to anticipated mistreatment among gender minority (GM) people. We evaluated whether state-level healthcare policy protections moderated this relationship. Methods: Data from the 2018 Annual Questionnaire of The PRIDE Study, a national longitudinal study on sexual and gender minority people’s health, were used in these analyses. Logistic regression modeling tested relationships between lifetime healthcare mistreatment due to gender identity or expression and past-year healthcare avoidance due to anticipated mistreatment among GM participants. Interactions between lifetime healthcare mistreatment and state-level healthcare policy protections and …