As we age: listening to the voice of LGBTQ older adults.

The LGBT+ community is gaining long-overdue public health attention within the rapidly expanding demographic of older adults. As a group, LGBT+ older adults represent a range of diverse biopsychosocial needs and life experiences that may differ markedly from the general population. This has translated into health disparities experienced by this group and the emergence of policies calling for improved services for this community. In response, this qualitative study engaged ten focus groups (a total of 48 participants) throughout one mid-Atlantic state to better understand the experiences and perceptions of LGBT+ older adults regarding their expectations and needs as they age. Themes included (1) an emphasis on the nuance of connection as an aging LGBT+ adult; (2) a rich discussion of experiences with and expectations for quality of services as this group ages; (3) the realities of planning for future living arrangements as a member of this population; and (4) a clearer understanding of the two sides of advocacy for this group, as a personal responsibility and a call for allyship. Based on insights shared by participants, implications are discussed for improved and more visible engagement of this community within our heath and humans service sectors. We also affirm the need for greater attention from researchers and policy makers in respect to the whole health needs of this group. As a society and as professionals, we need to respond to these needs in better support of equity in the aging process for LGBT+ older adults.

Recruiting for diversity: a pilot test of recruitment strategies for a national alcohol survey with mail-in genetic data collection.

We assessed the feasibility and acceptability of collecting a saliva sample for DNA through the mail from a national sample of drinkers and examined whether targeted messaging would increase the response rates of Black/African American and Hispanic/Latino participants. We invited respondents from two prior national population surveys to participate in a brief telephone survey regarding recent alcohol use and to mail in a self-administered saliva sample. Blacks/African Americans, Hispanics/Latinos, and Whites had similar rates of consenting to participate. A higher proportion of respondents with a college education and a family history of alcohol problems consented. The differences in participation between respondents receiving targeted and general messaging were not statistically significant. This study provides preliminary evidence for the feasibility of recruiting diverse participants into a genetic study of alcohol use disorder.

Learning from Latino voices: Focus Groups' Insights on Participation in Genetic Research.

BACKGROUND AND OBJECTIVES: There is a paucity of genetics research examining alcohol use among Latinos. The purpose of this study is to examine Latino perceptions of participation in alcohol studies that collect biological samples, an important precursor to increasing their participation in genetics research. METHODS: A synthesis of the literature addressing participation of racial/ethnic minorities in alcohol genetics research was undertaken. We developed a framework of themes related to barriers and facilitators for participation, which we then used to analyze two focus groups held with 18 Latino participants. RESULTS: From the literature review, we identified nine themes related to facilitators of and barriers to participation. They are, on continua: curiosity to disinterest; trust to mistrust; understanding to confusion; safety to danger; inclusion to exclusion; sense of connection to disconnection; hope to despair; ease to hassle; and benefit to cost. Another theme emerged from the focus groups: previous experience to no previous experience with health research. CONCLUSIONS: Applying the themes from the literature review to Latino perspectives on providing biological samples for alcohol research helps expand their definition and applicability. Consideration of these themes when designing recruitment/retention materials and strategies may encourage Latino participation in alcohol genetics research. SCIENTIFIC SIGNIFICANCE: An understanding of these themes and their significance for Latinos is offered in the form of "guiding questions" for researchers to consider as we strive for more inclusive research. Focus group participants were Mexican American; future research should further explore perspectives of this heterogeneous demographic group by studying other Latino subgroups. (Am J Addict 2017;26:477-485).

Review: Environmental influences on alcohol use: Informing research on the joint effects of genes and the environment in diverse U.S. populations.

BACKGROUND AND OBJECTIVES: This review aimed to inform the current state of alcohol research on the joint effects of genes and the environment conducted in U.S. racial/ethnic minority populations, focusing on African Americans, Latinos/Hispanics, Asians, and American Indians. METHODS: A key-word and author-based search was conducted and supplemented with direct contact to researchers in this area to ensure a comprehensive inclusion of published, peer-reviewed studies. These studies were considered in terms of the racial/ethnic population groups, phenotypes, genetic variants, and environmental influences covered. Research findings from alcohol epidemiologic studies were highlighted to introduce some potential environmental variables for future studies of gene and environment (G-E) relationships. RESULTS: Twenty-six (N = 26) studies were reviewed. They predominantly involved African American and Asian samples and had a very limited focus on Latinos/Hispanics and American Indians. There was a wide range of alcohol-related phenotypes examined, and studies almost exclusively used a candidate gene approach. Environmental influences focused on the most proximate social network relationships with family and peers. There was far less examination of community- and societal-level environmental influences on drinking. Epidemiologic studies informing the selection of potential environmental factors at these higher order levels suggest inclusion of indicators of drinking norms, alcohol availability, socioeconomic disadvantage, and unfair treatment. CONCLUSIONS: The review of current literature identified a critical gap in the study of environments: There is the need to study exposures at community and societal levels. SCIENTIFIC SIGNIFICANCE: These initial studies provide an important foundation for evolving the dialogue and generating other investigations of G-E relationships in diverse racial/ethnic groups. (Am J Addict 2017;26:446-460).

A psychiatric medication decision support guide for social work practice with pregnant and postpartum women.

In their work in human services organizations and community agencies across service sectors, social workers encounter pregnant and postpartum women experiencing mental health challenges. This article offers an evidence-informed Decision Support Guide designed for use by social workers working with pregnant and postpartum women who are struggling with complicated decisions about psychiatric medication use. The guide is built on contemporary notions of health literacy and shared decision making and is informed by three areas: (1) research into the lived experiences of pregnant and postpartum women and health care providers around psychiatric medication decision making, (2) a critical review of existing decision aids, and (3) feedback on the strategy from social work practitioners who work with pregnant and postpartum women. Emphasizing the relational nature of social work in supporting effective health-related decision making, the guide relies on maintaining a collaborative practice milieu and using a decision aid that engages clients in discussions about mental health during and around the time of pregnancy. The guide offers social workers a practice tool to support responsive and compassionate care by embracing their roles in problem solving and decision making, providing emotional and psychosocial support, and making appropriate referrals to prescribers.

Contemporary health-related decision aids: tools for social work practice.

The escalating complexity in health-related decisions that people face have important implications for social work interventions. This article explores the nature of these implications within the context of decisional conflict, shared decision making, and the use of decision aids. In addition, the authors present the findings of a content analysis of 29 contemporary health-related decision aids. Emergent categories from this analysis are presented as a resource for social workers as they encounter, adapt, and create decision aids in their work to help address the health-related needs of their clients.