How to read a paper about inequality in respiratory disease: Basic epidemiological principles and how inequalities are measured

Health inequalities in respiratory disease are widespread, and monitoring them is important for advocacy, the design and delivery of health services, and informing wider health policy. In this chapter, we introduce the different ways in which health inequalities can be quantified, including measures that quantify absolute and relative inequalities, and those that measure gaps between groups or differences across the entire social gradient. We consider the strengths and limitations of these different approaches and highlight things to look out for when reading a paper on health inequalities in respiratory health. These include how common the outcome is and whether other factors have been adjusted for, as both can have a crucial impact on interpretation and can lead to misleading conclusions.Copyright © ERS 2023.

Lesbian, Gay, Bisexual, Queer, Questioning and Transgender, Nonbinary, Genderqueer, and Gender Questioning Adult Alcohol Use Outcomes Associated with State Alcohol-Related Laws During the Coronavirus Pandemic in the United States.

Purpose: We assessed how COVID-19-related alcohol sales policies influenced alcohol use behaviors during the pandemic for U.S. adults of diverse sexual (lesbian, gay, bisexual, queer, questioning [LGBQ]) and gender identities (transgender, nonbinary, genderqueer, and gender questioning [T/NB/GQ]). Methods: Time-specific, state-level, restaurant, bar, and off-premise alcohol policy data were collected from the National Institute on Alcohol Abuse and Alcoholism-sponsored Alcohol Policy Information System and merged with the 2020 Behavioral Risk Factor Surveillance System survey data. Treatments included bar, restaurant, and delivery alcohol sales policies. Outcomes included past 30-day drinking frequency, quantity, and heavy episodic drinking (HED). We fitted negative binomial regression models for all outcomes, clustered standard errors by state and used sample weights. We also controlled for seasonality, state Alcohol Policy Scale scores, pre-/postpandemic time period, and included demographic control variables in our cross-sectional analyses. Results: The sample included 10,505 adults identifying as LGBQ and 809 as T/NB/GQ from 32 states. Restaurant and bar closures were associated with less alcohol use for LGBQ respondents. Outdoor-only policies at bars were also associated with significantly less quantity of use and HED for T/NB/GQ adults in the sample. Off-premise home delivery was associated with greater quantity of use for LGBQ respondents and less frequency for T/NB/GQ respondents. Conclusion: The COVID-19-related alcohol sales policy changes offer an opportunity to better understand alcohol policy and availability's influence on drinking behaviors among sexual and gender-diverse populations in the United States.

Mental Health Disparities Among Cisgender, Transgender, and Gender Nonconforming College Students in the United States

Many researchers attribute factors of identity, acculturation, sexual orientation, and substance use and other maladaptive behaviors as potential risk factors associated with increased mental illnesses reported by college students (Castillo & Schwartz, 2013;Wyatt & Oswalt, 2013). [...]the COVID-19 pandemic has further exacerbated mental health problems in college students (Lopez Steinmetz et al., 2021;Son et al., 2020), with 71% experiencing more stress, anxiety, problems with concentration, and worry about a loved one's health as well as their own (Son et al., 2020). Approximately 75% of first-year college students with any mental illness do not seek help (Bruffaerts et al, 2019). [...]there is a growing need to address possible factors contributing to reduced help seeking and to identify vulnerable groups in college populations (Castillo & Schwartz, 2013). Men's decreased treatment utilization may be in part due to shame, stigma, and parental and peer norms toward seeking out mental health services (Seehuus et al, 2021). Given the impact that gender-related stressors play in the rise of mental illness in college students, this study aims to bridge the gap in mental health clinicians' and researchers' understanding of how diverse gender identities influence mental health-related outcomes and mental illness. [...]this study addresses two research questions: (1) Do gender differences (i.e., between cisgender men, cisgender women, and TGNC individuals) exist among college students in the prevalence of mental illness, utilization of psychological services, and mental health-related outcomes (i.e., psychological distress, stress, resilience, overall health, and loneliness)? (2) Do mental health-related variables differentially predict mental illness diagnoses among college students? METHOD Participants and Data Collection The ACHA (2020) National College Health Assessment-Ill Fall 2020 (NCHA-III) is a survey that gathers information regarding students' health.

A Rose by Any Other Name: Gender-Affirming Care and Severe Mental Illness

The transgender population has higher rates of psychiatric disorders and stigma within medical settings. Literature suggests that gender-affirming care is the standard when working with such patients. There are limited studies regarding treating these patients with severe mental illness (SMI). This article explores how to treat SMI that impacts patients' reality to the point where their assigned sex cannot be acknowledged. The case presented is that of a transgender woman, where clarification of her natal sex was crucial to treatment. The patient denied her natal sex, endorsing a history of miscarriage. Studies on treatment of transgender SMI patients are limited. Gender-affirming treatment is the standard of care for these patients. Training how to ask pertinent questions and communicate effectively is necessary to prevent misdiagnosis, unnecessary treatment, and agitation. [Psychiatr Ann. 2023;53(5):221–223.]

TRANSGENDER PERSON-CENTERED CARE IN PANDEMIC TIMES

Introduction and Objectives: This article aims to outline the need for a person-centered approach to sexual health for transgender people in COVID-19 pandemic times.Methods: These involved reviews of international healthcare standards and the principles and strategies of person-centered health care, which articulate science and humanism. Ethical imperatives, including respect for all persons' dignity and "first do not harm” as well as scientific considerations, including recognition of the eco-bio-psycho-social-spiritual multidimensionality of person and health were attended to.Results: The approach outlined here attends to Universal Sexual Rights, and the multidimensionality of persons' sexual diversity, in the context of the current pandemic. This is illustrated through the Gender Identity Law enacted by the Argentine Ministry of Health in 2014 and its 2020 amendment, formulated in the face of the pandemic. The healthcare approach outlined here involves recommendations to promote access to health care for transgender, transvestite, and sexual non-binary people in the context of the pandemic.Conclusions: All persons can present and experience a unique and multidimensional sexual profile that should be assessed thoroughly within the multidimensional framework of total health and total person. Health care should be scientifically thorough, provided prudently, informed by the "first do not harm” ethical principle, fully respectful of human and sexual rights and responsibilities, and aimed at advancing total health and complete well-being for all throughout their life course.

Under-researched populations and topics in sport and exercise medicine (SEM)

Correspondence to Dr Sharief Hendricks, Division of Physiological Sciences and Health through Physical Activity, Lifetsyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape 7725, South Africa;sharief.hendricks01@gmail.com In this South African Sports Medicine Association (SASMA) edition of BJSM, we spotlight work on under-researched populations and topics in sport and exercise medicine (SEM). Youth sport, TGNC athletes and mental health Access to athlete mental health care, like physical care, can be considered a resource that allows athletes to function, cope with stress, perform and achieve their goals. In 2019, the IOC established the Mental Health Working Group to develop an assessment battery for the early identification of mental health symptoms and disorders in elite athletes.3 The internal consistency of the mental health assessment battery has been tested in elite athletes, but can the same internal consistency be shown for student athletes?

Introduction

[...]shifting ideologies surrounding "the family” inform and carry implications for economic, political, cultural, and social practices and activities. [...]of this dominance and influence of the family, this special issue centers on family-focused library and information science (LIS) research and is borne from conversations and reflections posed at a 2019 iConference Session for Interaction and Engagement of the same name. [...]in "Students and Parents: How Academic Libraries Serve a Growing Population,” Marta Bladek employs multiple sources of data to draw attention to the challenges and barriers postsecondary students who are also parents must contend with as they attempt to access academic library services and supports. [...]the articles in this issue also highlight the diverse areas within LIS that may be enriched by a consideration of the family context, including the study of information practices (Han;McKenzie;Ortiz-Myers and Costello), archival practices and personal information management (Krtalić, Dinneen, Liew, and Goulding), consumer health information (Charbonneau and Akers), reader response theory (Velez), early literacy (Prendergast and Sharkey), and library service provision (Bladek).

Development of a national cystic fibrosis patient and caregiver experience of care survey

Background: Since 2015, the Cystic Fibrosis Foundation (CFF) has collected and reported experience-of-care (XoC) data. Data collection was discontinued with the onset of the COVID-19 pandemic in 2020. In 2021, CFF convened a steering committee of a person with cystic fibrosis (CF), caregivers, and clinicians to develop a XoC survey to help understand and improve the XoC at CFF accredited programs. Method(s): Using prior CFF patient and family XoC surveys (2015-2020 pediatric and adult versions) [1,2] and a telehealth survey created in 2020 [3], draft pediatric and adult versions of the survey were developed. The steering committee and CFF leaders conducted three rounds of reviewand revision. After the surveys were professionally translated into Spanish, and the CFF Spanish Speakers Committee reviewed them, the surveys were programmed into Qualtrics for data collection. The data collection process was piloted with selected programs before a national launch. Result(s): Pediatric and adult surveys were developed in English and Spanish. The surveys cover in-person and telehealth (phone/video) visits and visits that are a mix of in-person and telehealth. The topics include interactions with care team members, relationship-centered care, care planning, shared decision-making, overall quality of care, race and ethnicity, gender identity, infection, prevention and control, quality of the virtual connection, and experience with remote monitoring. People with CF (PwCF) and their families are invited to complete a survey once every 6 months by text or email. PwCF and family contact data (email and mobile phone number) are stored in CFF's CFSmartReports Patient and Family Tool. After a clinic visit, contact data are electronically transferred to the Qualtrics platform to trigger a survey invitation. Responses are anonymous and reported back to programs via an electronic dashboard in near-real time. The data collection process was tested with three pediatric and three adult care programs for 3 weeks before the national launch on October 25, 2021. More than 2,000 PwCF and their families have completed a survey. Conclusion(s): The new XoC surveys offer PwCF and their families an opportunity to share feedback about their in-person and virtual care experiences. Efforts are underway to create a national report for dissemination and to engage programs with the data reported in their dashboards to celebrate what PwCF and their families appreciate about their care and to work together with them to improve gaps.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Demographic factors associated with COVID-19 vaccine perceptions amongst healthcare and law enforcement workers

Introduction: The emergence of COVID-19 and the development of subsequent vaccines have both significantly impacted the lives and work of essential workers such as those who are healthcare, first responders, and law enforcement. Data has shown that these groups are all at a higher occupational risk for COVID-19 exposure, and therefore public health policy has prioritized the vaccination of this group, including mandating vaccines in this population. However, the perceptions of COVID-19 vaccines in this group are not clear and require examination. Methods: A cross-sectional analysis was conducted to examine the psychosocial factors associated with vaccine perceptions amongst healthcare and law enforcement professionals. An online survey was distributed to (n=216) between May 5, 2021, and August 25, 2021, and analyzed using a Chi-squared test for independence and Spearman correlation coefficient test. Results: It was found that race was significantly associated with four statements regarding COVID-19 vaccine attitudes and perceptions, gender identity was not associated with any statements, ethnicity was associated with two statements, and education level was associated with nine statements. Further analysis using a Spearman correlation coefficient found education to be associated with one statement regarding perceived safety (p=0.006) and another statement regarding perceived benefits (p=0.001). Conclusion: These findings are largely preliminary, but they provide insight into psychosocial factors associated with COVID-19 vaccine perception. It was found that all factors except for gender identity were associated with COVID-19 vaccine attitudes among healthcare and law enforcement professionals. Additional analysis found that higher education level was associated with higher perceived benefits and lower perceived barriers regarding COVID-19 vaccines.

Side Effects of the Sinopharm/BBIBP COVID-19 Vaccine among Iranian Healthcare Workers: A Gender Assessment

Background: Since the outbreak of COVID-19, vaccination has been considered as an important measure against it. Side effects have always been an inseparable component of vaccination, which in this study, Sinopharm vaccine, its side effects and the differences of their manifestation amongst men and women have been investigated. Objective(s): This study aimed to compare the side effects of the Sinopharm vaccine among men and women working in some medical centers in Tehran, Iran. Method(s): This cross-sectional descriptive-analytical study on 890 healthcare workers of 7 medical centers in Tehran within 2 months, from late June to late August 2021. The samples were selected by the complete enumeration method, and the required data were collected using a questionnaire. Only those who received the Sinopharm vaccine at least 10 days before the study were included. Result(s): Of 890 participants, 22.96% and 77.30% were women and men, respectively, and 65.8% of women and 78.1% of men were in the age range of 20-29 years. It was revealed that 74.75% of women and 26.16% of men had at least one side effect. The incidence of at least one side effect was significantly higher in women than in men (P<0.001). It was also found that 12 side effects were significantly higher in women than in men. Most men and women had side effects within the first 24 h after vaccination. There was no significant difference in taking therapeutic measures to reduce or minimize the post-vaccination complications between men and women;however, 9.4% of men and 27.2% of women reported a decline in their ability to perform daily activities as they were unable to do their everyday tasks the day after vaccination which was significantly different between the two groups (P<0.001). Conclusion(s): The results showed that the occurrence rate of side effects after receiving the Sinopharm vaccine was significantly higher in women than in men. Moreover, women were significantly less able to perform daily routines than men.Copyright © 2022, Author(s).

Pengetahuan HIV/AIDS dan Faktor Keterlibatan dalam Hubungan Romantik serta Ketertarikan Seks Sesama Jantina : Kajian Kes dalam kalangan Mahasiswa Gay

Kajian ini bertujuan meneroka pengetahuan mahasiswa tentang risiko jangkitan HIV/AIDS, faktor keterlibatan dalam hubungan romantik dan ketertarikan seks sesama jantina. Masih kurang kajian yang memberi tumpuan kepada amalan hubungan romantik dan ketertarikan seks sesama jantina serta kesedaran mahasiswa tentang HIV/AIDS impak daripada tingkah laku seks berisiko ini. Banyak kajian terdahulu lebih menumpu kepada faktor keterlibatan dalam hubungan romantik dan ketertarikan seks sesama jantina tanpa mengaitkannya dengan kesedaran mahasiswa gay terhadap jangkitan HIV. Kajian ini menggunakan pendekatan kajian kes dan direkabentuk bersesuaian kaedah kajian kualitatif. Seramai empat informan dalam kalangan mahasiswa Institusi Pengajian Tinggi di Malaysia yang membuat pengakuan identiti gay telah terlibat dalam kajian ini. Pemilihan informan adalah menggunakan teknik Persampelan Snow Ball. Pengumpulan data telah dijalankan secara atas talian dengan menggunakan medium Google Meet. Semua informan ditemubual dalam talian secara konferen video. Data temu bual dianalisis menggunakan analisis tematik. Hasil analisis menunjukkan terdapat empat faktor risiko keterlibatan mahasiswa dalam hubungan romantik dan tingkah laku seksual sesama jantina iaitu (i) pengalaman menjadi mangsa gangguan seksual semasa kecil, (ii) faktor naluri semulajadi, (iii) pengaruh rakan/komuniti berisiko gay dan (iv) pengaruh negatif daripada media sosial dan internet. Informan juga mempunyai pengetahuan asas tentang risiko jangkitan HIV. Walau bagaimanapun, kesemua informan percaya tingkah laku mereka mempunyai risiko rendah dan tidak mudah untuk dijangkiti HIV. Salah faham tentang risiko jangkitan HIV bagi seks tidak selamat dan seks luar tabi' dipercayai mendorong amalan hubungan seks sesama jantina dilakukan tanpa rasa takut dan menurunnya keprihatinan kepada seks selamat dalam kalangan mahasiswa gay. Kajian mencadangkan salah faham tentang risiko jangkitan HIV sebagai faktor baharu penyebab amalan seks sesama jantina yang berterusan dalam kalangan informan yang dikaji. Intervensi perlu dibentuk bersesuaian faktor risiko hubungan romantik dan tingkah laku seksual sesama jantina agar ia dapat dibendung daripada menular dalam kalangan mahasiswa gay.Alternate :This study aims to explore the knowledge of HIV/AIDS infection risk and the factors that contribute to same-sex romantic relationship involvement and same-sex sexual attractions among university students. Less studies have been done focusing on same-sex romantic relationships and same-sex sexual attraction among self-identified gay university students and their awareness of the HIV/AIDS impact due to risky sexual behaviour. Many previous studies were found to focus only on gay students' romantic relationships and samesex sexual attraction involvement factors without relating these factors with their awareness of HIV infection. This study uses a case study approach and is designed following qualitative research methods. Four students who self-identified as gay were selected as informants. Snow Ball Sampling is used as the informants' selection technique. Data collection was conducted online using the Google Meet platform. All informants were interviewed online via video conference. The thematic analysis has been used to analyse the interview data. The study analysis demonstrated four risk factors conduce to a same-sex romantic relationship and samesex sexual behaviours among gay students: (i) sexual abuse experienced during childhood;(ii) same-sex sexual attraction as an instinct factor;(iii) gay friends/community influenced and (iv) internet and social media negative influence. All informants are identified to have basic HIV risk infection knowledge. However, those in a same-sex relationship believe same-sex romantic relationships and same-sex sexual practices have a low risk of HIV infection. The misunderstanding of HIV infection in same-sex sexual practices and unsafe sex is believed to contribute to a consistent no fear of same-sex sexual practices and less concern towards safe sex among ay students. This study suggests a misunderstanding of HIV infection as the new factor contributing to continuous same-sex sexual practices among studied informants. Intervention needs to be developed tailored to the same-sex romantic relationship and same-sex sexual attraction risk factors to curb the spread among gay students.

Exclusionary Behaviors Reinforce Historical Biases and Contribute to Loss of Talent in the Earth Sciences

Geosciences remain one of the least diverse fields. Efforts to diversify the discipline need to address the role of hostile and exclusionary work and learning environments. A workplace climate survey distributed to five professional organizations illustrates varied experiences of earth and space scientists over a 12-month period (pre-COVID). A majority experienced positive interactions in the workplace. However, scientists of color, women and non-binary individuals, scientists with disabilities, and lesbian, gay, bisexual, queer, pansexual, and asexual (LGBQPA+) scientists more frequently experienced negative interactions, including interpersonal mistreatment, discriminatory language, and sexual harassment. Geoscientists of color were more likely to experience devaluation of their work than white scientists. More than half of women and non-binary respondents, as well as those who identify as LGBQPA+ experienced identity-based discriminatory remarks. Disabled geoscientists were more likely to hear negative identity-based language than those who did not disclose a disability. Overall, 14% of all respondents experienced sexual harassment in the previous year. Rates were greatest for historically excluded groups: non-binary (51%), LGBQPA+ (33%), disabled (26%), women (20%), and geoscientists of color (17%). A majority of geoscientists reported avoiding their colleagues and almost a third considered leaving their institution or a career change. Historically excluded groups were more likely to report opting out of professional activities with potential career consequences. To address continued exclusion and low retention in the earth and space sciences, recruitment is not enough. We need to create environments that ensure opportunities for all to thrive.

A narrative exploration into the intersection of Division I Black student-athlete environment, identity, and mental health

The study examined narrative counter-stories of 10 Division I Black student-athlete experiences at the intersection of race, gender, sport activism, and mental health while attending predominantly White institutions (PWIs) in the Midwest amid ongoing racial and social injustices throughout the United States. The theoretical frameworks utilized throughout the literature and study were critical race theory, intersectionality, and the ecological perspective, which highlighted gaps in the literature, research, policies, procedures, initiatives, and support systems in place for Division I Black student-athlete environment, identity, and mental health.The sample consisted of participants who are Black student-athletes currently competing an NCAA Division I PWI in the Midwest. Purposeful and snowball sampling strategies were intentionally chosen to effectively recruit a population that is historically harder to reach. The participant's counter-story and analysis followed individual interview analysis and a group analysis through the lens of Fraser?s (2004) data analysis phases, both CRT and intersectionality frameworks, and the ecological perspective.Findings from the critical race qualitative narratives suggested there are gaps in adequately supporting Division I Black student-athletes attending PWIs in the Midwest. Furthermore, the participants did not feel acknowledged or validated yet felt somewhat supported. Participants acknowledged challenges including racism, microaggressions, and added pressures at the intersection of race, gender, sport, and advocacy. Division I Black female student-athletes reported adding gender identity to the intersection of race, sport, and activism added another layer of challenges, although those challenges also served as a motivational force to be the representation that is needed throughout PWIs and athletics departments.The experiences of the Division I Black student-athlete attending PWIs in the Midwest are unique and complex in nature. There were several limitations associated with this study including limited generalizability, sampling issues, geographical location, data collection compromise due to time and space (i.e., COVID, virtual zoom platform), and some researcher bias despite effort. Aligning with the argument that there is not a one size that fits all nor experience, the findings from the study cannot be generalizable experiences of Black student-athletes across sport participation types, institutional contexts, academic performance levels, or one's overall mental health and well-being. The review and study served as a baseline for future studies concluding with implications for Black student-athletes, the NCAA, member institutions, athletic administrators, and counselor educators and helping professionals to better support Division I Black student-athlete identity, mental health, and well-being at PWIs in the Midwest. Furthermore, concluding how environment needs to be considered when considering better ways of supporting Division I Black student-athlete mental health. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

GENDER-BASED VIOLENCE DURING COVID-19 PANDEMIC IN INDIA: LITERATURE REVIEW

Gender-based violence (GBV) is a globally prevalent human rights issue that involves social determinants like norms, values, power relations, socioeconomic situations, etc. Key indicators include domestic violence, intimate partner violence, and harassment. This paper reviews the literature published in academic journals, government and NGO reports and mass media reports to understand the roots of GBV against women in India and the factors leading to its increased intensity during the COVID-19 pandemic. As GBV, with slight geographical variations, mostly remains unreported in India, the same pattern is reported by the available literature, thereby the total number of victims remains unrecorded. The COVID-19 preventive measures, such as quarantine and limited services, further enhanced the already persistent gender-based inequalities and also restricted possibilities for reporting. With limitations of the study, the paper is focused only on female-specific cases thereby leaving out the sections such as males, LGBTQ, and other categories outside of the scope of the study. Summing up, recommendations based on analysis are given for policy framing, legal advocacy, administrative accountability, and counselling purpose to ensure a holistic strategy and not a piecemeal approach with emphasis on making an attitudinal change to combat GBV. This paper concluding observation is that long-term structural changes in social attitudes and behaviours and treating women with equity are essential for eradicating gender-based violence. In all such endeavours, women's active participation is essential. Finally, women's active agency will ensure a positive and robust change in containing and eradicating gender-based violence.

How college women navigate power imbalances in hookup culture: A phenomenological study

Hookup culture is frequently branded as promoting female empowerment, yet many detrimental effects of hooking up have been documented for women. The present study investigates the lived experience of college women in hookup culture through a phenomenological research method, paying special attention to their experiences of empowerment and/or disempowerment. An intersectional feminist lens is utilized to include how college women's experiences with power are also shaped by multiple identities in addition to gender, such as race and sexual orientation. Additionally, this dissertation explores how the coronavirus pandemic has impacted hookup culture. Six diverse college women were interviewed, their interviews coded for themes. The seven overarching themes participants spoke about were: women as sexual objects, consent in hookup culture, communication in hookup culture, the social effects of hookup culture, the emotional effects of hookup culture, the role of the pandemic on hookup culture, and their experiences of power and identity in hookup culture. This study concludes that hookup culture is not always as advertised, with significant disempowering aspects that women are sometimes silenced from voicing. A continued power imbalance between men and women may shape the way college students interact sexually. Implications for psychotherapy, program development, and future research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

165. Prevalence and Sociodemographic Correlates of Suicidality Among Sexual and Gender Minority Youth Residing in the South

Purpose: Rates of suicidal ideation and attempts among adolescents, especially young sexual and gender minority (SGM) adolescents, have been on the rise over the last several years. The COVID-19 pandemic has only exacerbated risk factors for suicidality and introduced additional barriers to accessing needed medical care and other help-seeking resources. This study sought to estimate the prevalence of suicidal thoughts, plans, and attempts among young SGM adolescents residing in the South, a geographic region with high unmet health needs, greater multi-level experiences of discrimination, and a hostile policy landscape marked by numerous anti-LGBTQ bills and few protections on the basis of sexual and gender identity. Methods: Tailored social media advertising was used between July 2021 and April 2022 to recruit and enroll 384 SGM adolescents aged 13-17 years residing in eight southeastern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee). Study staff used multiple authentication procedures to verify the uniqueness and validity of each enrollment. Respondents completed an online cross-sectional survey that assessed prior suicidality (thoughts, plans, attempts). Respondents were provided a number of help-seeking resources at the conclusion of the survey. The mean respondent age was 16.1 years (SD = 1.0), and respondents were primarily female (45.6%, n=175), bisexual (38.0%, n=146), and non-Hispanic White (52.6%, n=202). We used unadjusted and adjusted logistic regression analyses to identify sociodemographic, health, and relationship correlates of prior suicidal ideation and attempts. Results: Overall, 70.6% (n=271) of SGM adolescents reported ever having serious suicidal thoughts. Of these respondents, 74.9% (n=203) had planned and 43.9% (n=119) had attempted suicide. Adjusted analyses showed that the likelihood of prior suicidal ideation was higher among respondents who identified as Hispanic (AOR: 2.7;95% CI: 1.1, 7.0), non-Hispanic Multiracial (AOR: 4.1;95% CI: 1.2, 13.9), and non-Hispanic White (AOR: 3.0;95% CI: 1.4, 6.3) as compared to non-Hispanic Black, and was twice as high among respondents 17 years of age (AOR: 2.3;95% CI: 1.1, 5.0) compared to those 15 years of age. Having a diagnosed disability (AOR: 3.4;95% CI: 1.9, 6.1) and poor parental relationship quality (AOR: 2.3;95% CI: 1.2, 4.1) were also associated with an increased likelihood of prior suicidal ideation. The likelihood of prior attempted suicide was significantly greater among SGM adolescents who reported poor parental relationship quality (AOR: 2.0;95% CI: 1.1, 3.6), a diagnosed disability (AOR: 2.1;95% CI: 1.1, 4.0), and a chronic health condition (AOR: 2.5;95% CI: 1.4, 4.7). Conclusions: The prevalence of lifetime suicidality was quite high among SGM adolescents in the South, even higher than estimates reported by national studies among similarly aged adolescents. The findings suggest the immediate need for tailored efforts to prevent and address suicidality among SGM adolescents, especially given the compounding effects of the COVID-19 pandemic on adolescents' health. The findings also suggest the need to intervene with the parents of SGM adolescents or increase acceptance and connectedness in other close relationships. Sources of Support: This study was funded by the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control (K01CE003226).

Food Insecurity and Health Behaviors Among a Sample of Undergraduate Students at an Urban University

Students at universities are experiencing food insecurity, which may be associated with health behaviors. In a pilot study to build a survey that assesses food insecurity and health behaviors among undergraduates, we distributed the survey before (Wave 1;fall 2019) and during (Wave 2;summer 2020) COVID-19. During Wave 1, 41% of students reported food insecurity and 61% met criteria for poor sleep. In Wave 2, 26% reported food insecurity and 49% met criteria for poor sleep. Students experiencing food insecurity were more likely to report poor sleep. This survey will inform recruitment and design of a scaled-up multi-campus study. (100/100 words). © 2022 Taylor & Francis Group, LLC.

62. The Impact of Telemedicine on Access to Gender-Affirming Care for Rural Transgender and Gender Diverse Youth

Purpose: Transgender and gender-diverse (TGD) youth are highly susceptible to negative health sequelae including high rates of depression, suicidal ideation, self-harm, and suicide attempts. Rural TGD youth have the added difficulties of living amid people who may hold more negative views toward gender diversity, and a dearth of TGD care, leaving them with far less support than their urban counterparts. The rapid expansion of telemedicine during the initial months of the coronavirus pandemic of 2019 enhanced access to many populations but it is not clear how this has impacted access for rural TGD youth, particularly those living in areas with limited broadband access. As such, the purpose of this research was to explore access to care for TGD youth by determining how telemedicine impacts appointment attendance for rural TGD youth. Methods: We used a retrospective quantitative design and an encounter-level dataset to evaluate the study purpose. We extracted a secondary data set from the electronic medical record (EMR) of an adolescent and young adult (AYA) clinic that provides gender-affirming (GA) care. The clinic is the only one of its kind in the state, and serves both rural and urban populations. In addition to EMR data, address data was used to develop rurality and distance to care variables. All visits to the clinic from March 2020 through December 2021 were included in the data. Descriptive statistics and bivariate analyses were conducted to characterize the population and multivariate analysis were used to model the association between visit attendance and covariates of interest. Specifically, logistic regression with GEE was implemented to account for repeated measurements and within-patient correlation. Results: Nearly 3000 unique patients were identified from over 18,000 visits during the study period, with 984 visits (5.5%) identified as related to GA care;386 (39.2%) of these visits were by patients from rural areas. During the study period 4917 (27.4%) of all encounters were scheduled for telehealth compared with 149 (15.1%) of GH visits. Although the overall no-show rate for the clinic was 10.9%, the rate for GA visits was significantly lower (6.5%;p<.001) and the rate for GA visits for patients from rural counties was even lower (5.7%, compared with 8.93% for non-GA rural visits). The NS rate for GA telemedicine visits was 0.0%. In multivariable analysis, GA visits were associated with a 42% reduction in odds of NS after adjusting for rurality, telemedicine visit, age (over 18 vs. under 18), travel time, and patient's gender identity. Conclusions: AYA from rural areas who are seeking GA care are less likely to no-show for clinic and telemedicine visits than patients seeking other types of care and from non-rural areas, suggesting that this care is highly valuable to patients. Our results indicate that ensuring a reliable telemedicine connection for rural AYA is an important component of providing access to GA care. Sources of Support: This project was supported by a grant from the Daisy Foundation.