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Ruth Zambrana named Distinguished University Professor
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A leading voice for minority and underrepresented groups
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News
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New York Times Article quotes Kearney in discussion of child care and opening the economy
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Child care key to economy re-opening
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News
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Fish editorial published in AJPH
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So-called “conversion therapy” efforts create serious harm for youth that are LGBTQ
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News
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Sonalde Desai cited in report on India survey differences
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Detailing women's work changes employment perspective
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News
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Kearney edits Future of Children volume
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How Cultural Factors Shape Economic Outcomes
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News
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Thoma wins honorable mention in Global Health Now challenge
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Infertility in low-income countries is an Untold Health Story
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News
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Creating Supportive Environments for LGBT Older Adults: An Efficacy Evaluation of Staff Training in a Senior Living Facility
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Supportive housing later in life tends to be a key concern for lesbian, gay, bisexual, and transgender (LGBT) elders. Most senior care providers are un(der)prepared to meet the needs of older LGBT adults. This study evaluated the efficacy of a 4 h, face-to-face, research-based, LGBT-diversity training designed to improve senior housing facility staff’s cultural competency regarding the needs of LGBT elders. Findings from this study found a significant increase in LGBT content knowledge between pre- and post-intervention assessments and a significant decrease in perceived preparedness when working with LGBT elders. These effects remained significant after controlling for staff designation, religion, educational attainment, and training session. Findings suggest that staff’s cultural competence affected their perceived readiness to address LGBT elders’ needs. Implications are related to the concept of cultural humility or the lifelong process of understanding others’ experiences based on the recognition of lack of un(der)preparedness to create a culturally supportive residential environment.
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MPRC People
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Jessica N Fish, Ph.D.
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Jessica N Fish Publications
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Reconsidering Approaches to Estimating Health Disparities Across Multiple Measures of Sexual Orientation
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Purpose: We propose a new theoretically grounded approach for estimating sexual orientation-related health risk that accounts for the unique and shared variance of sexual identity across other measures of sexual orientation (i.e., attraction and behavior). We argue and illustrate that this approach provides specificity not demonstrated by approaches that independently estimate and compare health risk based on sexual identity, attraction, and behavior. Methods: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III, collected in 2012–2013 (N = 36,309, ages 18 and older). The Karlson-Holm-Breen method tested the degree to which attraction- and behavior-based disparities in mental health and substance use disorders change after adjusting for sexual identity. Results: Sexual attraction- and behavior-based disparities in mental health and substance use disorders statistically varied when comparing models that did and did not adjust for sexual identity. Adjusting for sexual identity appeared to have a larger influence on attraction- and behavior-based health associations among men; sexual minority and majority differences were attenuated on nearly every outcome after adjusting for sexual identity. This attenuation was less common among women. Among women, some behavior-based disparities were wider in sexual identity-adjusted models relative to unadjusted models. Conclusion: We demonstrate more accurate approaches to capturing and comparing sexual orientation-related health disparities across multiple measures of sexual orientation, which account for the shared variance between sexual identity and measures of attraction and behavior. Adjusted estimates provide more specificity regarding relative health risk across specific subgroups of sexual minority people, and the intervention and prevention strategies needed to address them.
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MPRC People
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Jessica N Fish, Ph.D.
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Jessica N Fish Publications
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Cultural adaptation of ‘Healthy Dads, Healthy Kids’ for Hispanic families: applying the ecological validity model
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Background Healthy Dads Healthy Kids (HDHK) is a unique lifestyle obesity intervention for fathers and children that demonstrated weight loss among the fathers and behavior change among fathers and children in Australia. The program is gender-tailored to specifically target fathers for weight loss and 5–12 year old children for obesity prevention. The aim of this formative study was to examine an Expert Panel’s and Hispanic Family Panel’s perceptions about the program and suggestions for the cultural adaptation of HDHK for Hispanic families in southwestern US. Methods Forty-four Hispanic participants (22 fathers, 13 mothers and 9 children) made up the Family Panel. They participated in 1–5 study contacts (focus groups, online survey, and/or interviews). The scripts and qualitative guides assessed participants’ perceptions of the HDHK content and material using the Ecological Validity Model. Studies were conducted in English or Spanish, depending on the preference of the participant. Focus groups and interviews were audio-recorded, transcribed, translated, and thematically coded. Findings were reviewed with the Expert Panel who helped inform the cultural adaptation. Results 80% of parents were foreign-born, 57% spoke only Spanish at home, and 60% did not graduate from high school. Several themes emerged to inform the cultural adaptation of the program. Parents agreed with the HDHK goals and recommended the program place greater emphasis on parenting and limiting children’s screen time. Some mothers and fathers wanted greater mother engagement. Weekly videos and a Facebook group emerged as favorite alternative options to engage mothers. Greater promotion of familism (inclusion and impact on whole family) was recommended for the program goals and activities. Gender roles for mothers and fathers, and differences in how fathers interact with male and female children, emerged and should be considered in program activities. Several barriers to father engagement surfaced, including lack of time due to work schedules, physically demanding jobs, concerns of caring for children without mother, fathers’ current fitness/weight, and lack of knowledge of how to eat more healthfully. The reading level of the HDHK materials was too high for some parents. Conclusion Findings from these formative qualitative studies informed the cultural adaptation of HDHK for Hispanic families, to account for literacy level, cultural values, and barriers to participation and engagement.
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MPRC People
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Natasha Cabrera, Ph.D.
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Natasha Cabrera Publications
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Gender inequalities and household fuel choice in India
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The use of solid cooking fuels—wood, straw, crop residue, and cow-dung cakes—is associated with higher levels of environmental pollution and health burden. However, even in an era when incomes have grown and poverty has declined, the proportion of Indian households using clean cooking fuels such as kerosene or Liquefied Petroleum Gas (LPG) has increased only slightly. Even among the wealthiest quintile, only about 40 percent of the households rely solely on clean fuel. Since the chores of cooking and collection of fuel remain primarily the domain of women, we argue that intra-household gender inequalities play an important role in shaping the household decision to invest in clean fuel. Analyses using data from the India Human Development Survey (IHDS), a panel survey of over 41,000 households conducted in two waves in 2004-05 and 2011–12, respectively, show that women's access to salaried work and control over household expenditure decisions is associated with the use of clean fuel.
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MPRC People
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Sonalde Desai, Ph.D.
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Sonalde Desai Publications