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CURRENT EFFORTS PRO LGBTT HEALTH IN PUERTO RICO

 

by Juan Carlos Vega, MLS.  

Reporting for the Citizens’ Alliance Pro LGBTTA Health of Puerto Rico, the National Latino Tobacco Control Network, and the Network for LGBT Health Equity.  Blogging from a TRANSforma Gathering of about 20 Trans women and a dozen LGBTTA researchers engaging in open conversation in an apartment in Santurce, a section of San Juan, Puerto Rico.

Local LGBTT community advocates and researchers continue to implement innovative strategies and research efforts to improve the health of LGBTT communities in Puerto Rico.  Here are some highlight of current and future local efforts.

The Committee for LGBT Issues of the Psychology Association of Puerto Rico, just published Volume 3, Number 1, 2012 issue of their electronic Bulletin, which include articles written by researchers and students alike on issues like stigma and bisexuality.  The articles, written in Spanish, include:

  • Between the street and the home: ambiguity and contradiction among Dominican sexual workers serving the tourist community by Mark B. Padilla, PhD, MPH, Assistant Professor, Department of Health Behavior and Health Education, Adjunct Assistant Professor of Anthropology, University of Michigan.
  • Diversity Within Diversity: a brief discussion about the complexity regarding bisexuality by Caleb Esteban-Reyes, B.A., Student Committee Member
  • Law vs. Politics: A Dichotomy presented to the Anti-Discrimination Committee of the U.S. Department of Justice in 2011 by Sophia Isabel Marrero, TRANSforma Consultant
  • Structural Violence as a Social Determinant of Health: Its Effects on Trans Individuals presented to the Committee for LGBT Issues of the Psychology Association of Puerto Rico during its 58th Convention in Michigan in 2011 by Sheilla Rodríguez Madera, Ph.D.

To see the full E-Bulletin click here: Diversidad E-Bulletin Vol 3 Num 1.  For more information on the Committee for LGBT Issues of the Psychology Association of Puerto Rico contact José A. Toro (jose.toro4@upr.edu) or Sheilla Rodríguez Madera (sheilla.rodriguez@upr.edu)

The TRANSforma Research Project, sponsored by the National Institutes of Health, looks into the social context of transgender and transsexual individuals in Puerto Rico. An interdisciplinary team, closely collaborating with the local Trans community, looks to explore at the influences of these social contexts and its health impact in body modification practices.  The project uses various methods to compile data in local Trans communities, including ethnographic observations within a social context, qualitative interviews, and a survey. For more information call (787) 248-1986.  They need condom and lub donations for outreach efforts!

Members of the Citizens’ Alliance Pro LGBTT Health of Puerto Rico are going to New Orleans, Louisiana for the National Latino Tobacco Control Network Face-to-Face Meeting on April 16, 2012.  Along with other CDC National Networks, we will be participating in the Promising Practices to Eliminate Tobacco-Related Disparities: The Power of Communities Conference this upcoming April 17-18, 2012.  Dra. Elba Diaz-Toro from the Medical Science Campus at the University of Puerto Rico and this blogger will be available on Tuesday, April 17, 4:15pm – 5:00pm and Wednesday, April 18, 8:00am – 8:45am to answer all your questions related to the Poster Presentation titled Community Organizing and Leadership Building in Puerto Rico Pro LGBTT (Lesbian, Gay, Bisexual, Transsexual & Transgender) Health.  We look forward to share success stories and strategies with other CDC-funded National Networks who are gathering in New Orleans.  For all the details about the conference visit: http://healthedcouncil.org/promisingpractices_2012.html

For more information on the Citizens’ Alliance Pro LGBTT Health of Puerto Rico efforts and collaborations visit: http://saludlgbttpr.webs.com/

SAVE THE DATE  |  June 29-30, 2012  |  Location in Puerto Rico to be determined!

2nd LGBTT Health Summit of Puerto Rico: the Stigma and the Health Impact in Our Communities.  Visit http://saludlgbttpr.webs.com/ for the most up to date information.

Break Free Alliance

Call for Abstracts & Scholarships: Promising Practices National Tobacco Control Conference in New Orleans

Shared by Emilia Dunham

Program Associate

 

 

We’d like to share a fantastic opportunity from our partner disparity Network, Break Free Alliance’s National Tobacco Control Conference: Promising Practices!

Call for Abstracts and Scholarship Application Now Open!

Promising Practices National Tobacco Control Conference April 17-18, 2012, New Orleans, Louisiana 
 

The call for abstracts and scholarship application process is now open for Promising Practices to Eliminate Tobacco Related Disparities: The Power of Communities, April 17-18, 2012, New Orleans, Louisiana.
 
The deadline to submit your abstract and/or your scholarship application is September 14th, 2011 at midnight, Pacific Daylight Time.
Visit our Call for Abstracts page for more information about the submission process, and our Registration/Scholarships page to find out more about scholarships.
 
Stay up to date with all things “Promising Practices” on Break Free Alliance’s conference Facebook page!

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PopCtr Mtg: Panel Discussion on Probability and Non-Probability Methods

Scoutby Scout
Director, Network for LGBT Health Equity
A project of The Fenway Institute in Boston, MA

SCIENCEBABBLE ALERT – This is a meeting for scientists, despite my efforts, some of this may get technical.

411 on the issue

Probability sampling = getting a group of people for your research that is statistically proven to be a random selection from the full population of interest, thus the statistics support you being able to draw conclusions for the full population based on the info from this random subgroup. (Like if 50% of your probability sample of LGBT people parachute, you can confidently say 50% of all LGBT people parachute.)

Non-probability sampling = any non-random sample of people. (Like if you do a survey at pride, it’s a non-probability sample.) Unfortunately, the statistics then do not support being able to generalize these findings to the full population, because there’s a chance bias might have snuck in. (Like, maybe pride participants aren’t as closeted as other LGBT people, so even if 50% of your sample are in LGBT parachuting clubs, you can’t say 50% of all LGBT people are in such clubs.)

Why’s this a big issue? Probability sample data is the gold-standard for drawing conclusions, but we have much less of this for LGBT people, mostly because LGBT measures aren’t included on the monster federal surveys that are the big probability studies.

Panel Members:

  • Dan Kasprzyk, Ph.D. Vice President of NORC (which I realize is so well known as one of 2 fanciest survey shops that his bio doesn’t even say what NORC stands for… so just know, NORC=surveys)
  • Melissa Clark, Ph.D. Brown University Department of Community Health
  • Margaret Rosario, Ph.D.
  • Jeffrey Parsons, PhD. Hunter University

The Panel

Dr. Kasprzyk led the panel off talking about some of his interesting experiences as part of the Institute of Medicine committee for the recent LGBT report. He emphasized that the choice of probability or non-probability might really not be as important as the reporting and impact of any well-designed study, regardless of the methods chosen. Then he moves onto talking about the federal surveys. “If the federal gov’t added LGBT measures to the American Community Survey, then allowed oversampling, that alone would allow the community to target populations, whether it’s regional, city, rural, you name it, and we’d be much better off. But we have to go beyond NHANES, you have to get on other surveys, NHIS and especially the Labor Force Survey would be very valuable.” He emphasized how important it was to get measures on these large full-probability surveys, “because otherwise you remain invisible.”

“Probability data is very important, it is the gold standard, in Washington, that’s what people are going to listen to. I think the real advancement in healthcare policy comes from really pushing hard with the federal government to have these questions on those surveys, and that point cannot be diminished. I think it’s really important that we actually stay focused on the federal government and become part of that health policy debate.” Dr. Kasprzyk

Dr. Clark followed (that’s Melissa to you and me) and led off by echoing all of Dr. Kasprzyk’s points. She says “”That’s usually how I end every talk I give about sexual minorities, I say ‘please help us get these questions added.'” She talked about her experience at Brown University and how much she’s been working to try to get the non-LGBT researchers to include LGBT measures. Through this effort, she’s managed to take one of the IOM report recommendations and institutionalize it, “Now when there’s a new study, people have to either include sexual minorities or explain why they are not.” Kudos to Melissa, let’s hope NIH follows suit!

Next up was Margaret Rosario. She warns us that while probability samples are important, most of our real explanatory data will come from non-probability samples because they are so much cheaper they have more latitude to go much deeper into issues, explore causal models, etc. For her, the bottom line is either approach can be useful, it’s often an issue of cost, if we have the chance to do the higher costs full-probability samples, excellent, if not, let’s just do excellent non-probability studies. Lastly she also weighs in on the importance of getting LGBT measures on the large surveys, “For the probability studies, please please, whatever we can do to get questions on there, do be able to identify the population as best we can, we should definitely do that.”

The panel was rounded out by Jeff Parsons. He talked about how it always seems there’s a flavor of the day at NIH for the newest rage for sampling, some of which are just never really viable in the field. “You can’t just count every 9th person who goes in the bar and pull them for the study, it doesn’t work.” Tonda Hughes from UIC echoes that sentiment, noting that the popular method, Respondent Driven Sampling, has never worked for her in samples of women.

As the discussion opens up to audience comments, there’s an interesting suggestion from Jim McNally, a director at ICPSR (the Intra-university Consortium of Political and Social Research, probably the largest data library in the country). one of the University of Michigan (ICPSR) scientists… “We recommend people work to create a small strong full probability sample and then ask the same questions you have on the federal surveys. That way you have policy strength to compare to the federal questions.”

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Center for Population Research in LGBT Health Holds Annual Convening

Scoutby Scout
Director, Network for LGBT Health Equity
A project of The Fenway Institute in Boston, MA

My Non-Sampling Error Experience

Ok, I’ve fled from the very exciting Netroots Nation conference to get back to Boston because today and tomorrow mark the 3rd annual convening of one of The Fenway Institute’s other major initiatives, the Center for Population Research in LGBT Health. Not only does this mean I get to hang with some of my farflung friends for two days, not only does it mean the largest gathering of trans health researchers I’ve seen, not only does it mean I get to meet many upcoming researchers involved in the mentorship program, but right now, it’s also the biggest meeting about LGBT research that occurs each year.

I came a little late, so am jumping in as the head of one of the most prestigious survey centers in the country, Dan Kasprzyk of NORC, weighs in on issues related to LGBT sampling. (He was just talking about a non-sampling error experience.) So, I’m going to focus more on the actual content now… but just wanted to start off by giving you a little bit of context to the meeting, because this is a really cool project.

Abstract of Center for Population Research in LGBT Health Project

Previous studies have shown that sexual and gender minorities have higher prevalence of life-threatening physical and mental health conditions, experience significant barriers to health care quality and access, and face substantial threats to quality of life. Population-based research is necessary to more fully understand the causes of these disparities, so that effective responses can be developed. The proposed project’s long-term objective is to create a sustainable capacity for population studies and the translation of results into practice models for sexual and gender minorities. This 5-year effort will be conducted by the Fenway Institute, supported by the Research and Evaluation Department of Fenway Community Health (FCH), a Federally-Qualified Community Health Center. FCH provides comprehensive primary health care and mental health services annually to 11,000 neighborhood residents and students in nearby colleges and to LGBT persons, primarily from Greater Boston. Approximately 55% of patients self-identify as LGBT, reporting sexual or gender minority behavior and/or identity. The project has the following specific aims to develop the infrastructure for population research regarding the health of sexual minorities: (1) develop and support a multidisciplinary faculty to advance the study of sexual and gender minority populations, (2) create a shared research library, to include selected population-based datasets and findings from a large clinical dataset, and (3) disseminate the products of our work through the internet, a monograph, and peer-reviewed journal articles.  A team of researchers with diverse qualifications has been assembled to address these specific aims, with the assistance of a National Advisory Board of experienced population scientists and technical experts. The input and collaborative work of these researchers will lead to a common framework for multidisciplinary scholarship that advances understanding of sexual minority populations and how social, cultural, and institutional factors influence their health. This work will provide a foundation for culturally competent treatment approaches and behavior change models for sexual minorities.

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Breaking News! NY Hospitals Announce Mandatory LGBT Cultural Competency Trainings

Scoutby Scout
Director, Network for LGBT Health Equity
A project of The Fenway Institute in Boston, MA
Reporting from Bellevue Hospital, NY

I’m down here in NYC and very, very happy to be at the press conference where New York City Health and Hospitals Corporation just announced mandatory LGBT cultural competency training for all their 37,000 employees! They also debuted the excellent new LGBT cultural competency video created by our friends at the The National LGBT Cancer Network. The Cancer Network created the full training to be administered to every NYC hospital employee, both the trainings and video are available for purchase or replication. (Don’t forget, the National LGBT Cancer Network is also our collaborator in our brand new LGBT Wellness NYC Marathon team.)

To have the head of all NY public hospitals reinforce that LGBT cultural competency trainings are a mandatory part of good healthcare is historic, let’s hope other cities and hospitals soon follow! See their press release here.

L to R: NYC Councilman Daniel Dromm; Liz Margolies, ED of National LGBT Cancer Network; NYC HHC President Alan D. Aviles, NYC Deputy Mayor Linda Gibbs, and HHC doctor.

Even HHS Secty Sebelius weighed in on what a big deal this is:

“I applaud the New York City Health and Hospitals Corporation for its leadership in ensuring LGBT patients are treated with the respect and dignity we all deserve. HHC has offered a path to a fairer America and HHS looks forward to seeing other efforts from care providers from around the country toward that same goal.”

We were also live-tweeting from the event with all play-by-play tweets on @lgbttobacco and @lgbthlthequity with some major help from friends on the ground @cathyrenna and @RennaComm, so check out updates there.

The video shown features the stories of several LGBT people who have experience bias in hospitals and in the healthcare system. You may have already seen an article about these trainings in Huffington Post, and an excerpt of the powerful video can be seen here:

Let’s hope the news spreads fast and other hospital systems follow suit.

See more press about this in:

  1. Advocate Magazine: NYC Hospitals Adopt LGBT Competence Training
  2. DNAinfo.com: New Hospital Program Addresses LGBT Health Woe
  3. New York Times Blog: For Public Hospital Employees, New Training on Gay Patients
  4. NY1: New Program Attempts To Eliminate Barriers For LGBT Patients
  5. Rainbow Access Initiative: Breaking News! NY Hospitals Announce Mandatory LGBT Cultural Competency Trainings
  6. University of Arkansas for Medical Science: Center for Diversity Affairs to Sponsor LGBT Cultural Competency Strategies Webinar
Break Free Alliance

Developing and Sustaining Integrated Tobacco and Chronic Disease Programs

Another Gyour1mainman post…

I went to a session focusing on Developing and Sustaining Integrated Tobacco and Chronic Disease Programs. This session was presented by Marlin Williams, from the Health Promotions Council in Philadelphia.

The Health Promotion Council was initiated originally to address hypertension through education and control programs. As the program grew they began working on other issues including tobacco control. The organization has been incorporating a wide variety of chronic disease programs in their work for quite some. He talked about “Cultural Listening” and the importance of listening to the specific needs of your diverse communities. So if your going to do an education program for a specific population you should bring members of the population together and listen to their needs and was to reach them directly. Make sense right? He also discussed how the organization changed throughout the process. It is important to have your leadership/management onboard and in support of integration which might mean taking the opportunity to educate on the benefits and taking the opportunity to address challenges with your organization as a whole. He talked about how it is important to address your program/populations needs in the process, and that some programs can integrate with ease while some should focus on its specific issues based on the community you serve. So I take from this presentation to address your programs/populations specific needs you need to listen to your communities… focus on WHY integration is or is not needed, WHAT to implement based on your communities, and HOW an integrated approach would work with your specific communities… It takes planning. It’s better to make a plan and work with your constituents moving forward then to jump right in with out the proper support and buy in from your organization or community!

Break Free Alliance

The Risks Associated with Continued Tobacco Use Among the HIV + Community

A Gyour1mainman Blog…

After lunch and the fabulous band, (which I hope you viewed the lunchtime at Hotel Monteleone blog to see the video), I attended a session presented by Danielle Grospitch from Tobacco Free Lake County. Her Presentation:  The Risks Associated with Continued Tobacco Use Among the HIV + Community was amazing. It is estimated that 50-70% of people living with HIV in the U.S. smoke. She went on to say people living with AIDS are living longer, but not if they are HIV+ and smoke.

As you may or may not know tobacco causes a reduction in the immune function, and that smoking can interfere with the metabolism of HIV medications. So as you may know and she reiterated in her presentation HIV+ individuals need to quit, and something you don’t know is that majority of HIV+ individuals want to quit. So she has been working with the HIV+ community and has implemented a cessation program to assist in a successful intervention in assisting individuals quit. She believes that in order to help people quit you need to have a comprehensive program, and look into the right NRT to assist in individuals quit attempt. For instance Bupropion (Zyban) has been fount to interfere with the efficacy of protease inhibitors used by HIV patients. She identified tasks in order to create a program and encourages everyone to become more knowledgeable and reach out to local resources if they are interested in working with the population as well as ensuring cultural diversity within your programs. She also talks about using the 5 A’s, Ask, Advise, Assess, Assist, and Arrange splashed with Motivational Interviewing. Overall this was such a great presentation and I will have to see if I can get her to do a presentation for us. I think both her and Barbra Warren have great examples of how to assist in helping HIV+ people quit. We will be sure to get them on a call together and really expand on working with this population. Stay tuned for this is the very near future.

Break Free Alliance

Promising Practices Achieving Health and Social Equity in Tobacco Control Conference Highlights

Ok, so I have been thinking about my time at the Promising Practices Achieving Health and Social Equity in Tobacco Control Conference and have to say the conference was amazing… I was overloaded with so much great information! This conference provided a wealth of knowledge, especially with the new wave of integration of chronic disease & tobacco control.  So you see a couple recap posts later this morning…

Break Free Alliance

“My Butt Hurts” “What”

I thought this was a great side to share with all of you first and foremost…

Integrating Tobacco Control into Chronic Disease Programing:

Strategic planning and Collaboration at the State and Community Level:

Breaking Down the Silos: New Hampshire (NH) Tobacco Prevention and Control’s Collaboration with Chronic Disease Programs has the audience rolling…

With reduced funding to their CDC contract NH, has shifted to integration with state-level Chronic Disease Programs.  They identified objectives of collaboration to be able to effectively move forward in the integration process.  They focused on making the NH Try To STOP TOBACCO Resource Center a more active tool that Chronic Disease Programs can promote within their services. Additionally they noted that you should have a vested interest in the Chronic Disease Programs, know the staff, program goals, and clients, capacity, coverage and  LOOK FOR OVERLAP!

So in closing, as we move forward with decreased funds we need to find ways to move forward WORKING SMARTER, NOT HARDER!

Talk with you all soon – Gustavo