Youth Kicks! An LGBTQ Youth Counter Tobacco Project’s Next Steps

by Emilia Dunham

Program Associate

Some of you may remember the LGBTQ youth anti-tobacco campaign, Youth Kicks, I was working on with the National Youth Advocacy Coalition. We started a little less than a year ago with the staff support NYAC, and a few of us met up at Creating Change to discuss strategy and goals. Unfortunately, there were some challenges as NYAC closed its doors back in the Spring. This came as quite a shock to the LGBTQ and youth communities across the country, and the loss of NYAC leaves a big gap to fill in the LGBTQ community.

Shortly after NYAC shut its doors, we at the Network decided to take on the project, and even after the timeframe of the project ended, many of the youth graciously agreed to volunteer even after this time. With conference calls once or twice a month, these youth experts came together to form some what-we-believe-to-be effective strategies to aid in harm reduction of tobacco prevalence in LGBTQ youth communities.

Finally after many conversations of discussing the project, we decided on some messaging and image concepts, which were sent to yet another dedicated volunteer, Jean Calomeni of Project Filter, who is responsible for some stellar ads in response to Camel Snus’ aggressive targeting of LGBT communities.

Although I am afraid this is just a teaser as the final product is not complete, though the drafts are quite stunning, so you’ll have to hang tight but expect some great designs that you’ll be able to share at your agencies and beyond.

However I would like to take a moment to introduce our committee members:

Carla Mena was born in Lima, Peru. She came to the US in the year 2001; she graduated from high school with an honors GPA and became the first National Honors Society Hispanic member at Sanderson High School in Raleigh. During her freshmen year of high school, Carla joined El Pueblo’s youth (No Fumo) program and has been a key volunteer since then; it was through El Pueblo and her own experiences that Carla discovered her passion for social justice. Carla is currently attending Meredith College, majoring in Biology. At Meredith, Carla has organized several programs to make the Meredith community more aware of the issues affecting the Latino community, as well as events to share its cultural richness. Carla is currently serving as the Youth Reproductive Health (Our Rights Have no Borders) Intern at El Pueblo Inc. Carla is passionate about access to higher education, human rights and social justice.

Ariel Cerrud is a graduate of Portland State University in Portland, Oregon, majoring in Political Science with a Minor in Communication Studies. As a youth activist, he has advocated on behalf of various governmental, non-governmental, community and advocacy entities. Ariel’s advocacy work has revolved around youth focused areas including youth character and leadership development and health disparities in young people including working towards curving adolescent risky behaviors.  Ariel’s most recent advocacy work has been on behalf of Advocates For Youth, as a Peer Educator for YouthResources.com, a website by and for gay, lesbian, bisexual, transgender, and questioning (GLBTQ) youth. Ariel also provides content and materials for Amplify Your Voice, Advocates for Youth new interactive website that serve as a vehicle for youth-led, grassroots online activism. In his professional life, Ariel works as a Program Director for Boys & Girls Clubs of Portland. Under his role, he provides guidance to youth ages 6-18 and instills within each of them a sense of belonging, power and influence over their lives. He works to enable all youth to reach their full potential as productive, responsible and caring citizens and instills these potentials in every program and activity he leads.

Chase Andrews is a 24 year old, Atlanta native and a recent graduate of Georgia State University. He holds a Bachelors of Arts in Communication with a minor in Psychology. He’s is the former Program Coordinator for the Department of Student Health Promotion at his alma mater. He got his start as a peer health educator in 2005, from there his interest in health education and HIV prevention blossomed. In August of 2010, he joined the AID Atlanta staff as the Recruitment and Retention Specialist for the Evolution Project. When he’s not doing HIV prevention work he’s a filmmaker. In 2009 he started a small production company, Eight Peace Productions, LLC. He’s currently working on short film entitled: Emotionally Safe Sex: Beyond Barrier Methods. Ultimately, Chase aims to combine his passion for LGBT youth, HIV prevention, and film to create provocative media/art.

Lexi Adsit, a familiar face, is a fierce queer transwomyn of color. She blogged for us at the Philly Trans Health Conference. She is studying at San Francisco State University majoring in Raza Studies with a minor in counseling. Her activism led her to many non-profits in the San Francisco Bay Area and a larger network of like-minded people whom she has worked with since high school. She is in the middle of various projects, including YouthKicks, ranging from being an online peer educator with Advocates For Youth (AFY) to interning at the ACLU of Northern California in the Friedman Education Youth Program to more recently working as a Coordinator for YouthNoise.  She is also a proud part of the femme shark and INCITE! Movement. She dreams of being a counselor for queer youth and run a homeless shelter for queer and trans youth in the Bay Area.

Ernesto, another familiar face, is a twenty-something aged youth from Portland Oregon. Currently he works for Cascade AIDS Project as youth technology specialist where he engages young people in creating healthy sexuality for themselves and their peers through social media. As an LGBT youth of color Ernesto has worked in various positions in local, state and national organizations to address some of the serious health inequities that exist for young people in America. As a 4th year member of Advocates for Youth initiatives, Ernesto is glad to bring his diverse experiences to the work he does in creating safe and supportive spaces for youth. You may also recall Ernesto served on our Steering Committee and was featured in a recent issue of Sharing Our Lessons: From Queer Youth to Public Health Leader.

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.”

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.

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

Successful Response on Creating Change 2011 Action Alert!

Staff in Puerto Rico: Gustavo, Emilia & Scout

Network Staff

by Network Staff

Gustavo, Emilia and Scout

 

We have some exciting news to share!

You may remember our action alert at/after Creating Change 2011, petitioning the CDC to include LGBT people/questions in data collection. We receiving almost 500 signatures through in-person and online petition, and we are happy to share the letter we received from CDC Director Thomas Frieden. The CDC acknowledged the gaps in research and funding, as well as clarified their committment to prioritizing LGBT data collection and funding. The letter outlined a number of projects the CDC is working on to include more research and data collection of LGBT people:

  1. The recent release of a National Health Statistics Report by the National Center for Health Statistics, which includes data on sexual identity and behavior from the National Survey of Family Growth. This report is available online at www.cdc.gov/nchs/data/nhsr/nhrs036.pdf.
  2. A collaborative effort between the Centers for Disease Control and Prevention (CDC) and other agencies throughout HHS to develop and test questions on sexual orientation and gender identity in order to improve both the quality and quantity of such data.
  3. A Surveillance Summary under development at CDC for publication in the Morbidity and Mortality Weekly Report on sexual identity and behavior among high school students using data from the Youth Risk Behavior Surveillance System (YRBSS) in selected jurisdictions from 2001-2009.
  4. A review of the existing LGBT data by the Office of the Assistant Secretary for Health, which will result in the generation of baselines and targets addressing LGBT health disparities through the Healthy People 2020 initiative. This process will include meetings with the LGBT data experts and stakeholders to provide transparency and opportunities for input.

To read the entire document, read the copy below or click on the link for the PDF: Frieden Letter to Network

Action Alert: Letter to CDC to Include LGBTs in Data Collection!

by Emilia Dunham

Network Program Associate

You may recall our report from Creating Change when we mentioned a letter to CDC we were circulating to urge CDC to include LGBT questions on their surveys. At Creating Change we asked folks to sign on to the letter in person and received over 250 signatures! However, before we send the letter, we’d like to offer the opportunity to anyone who wasn’t in Minneapolis that week.

EDIT: A recent blog entry by Scout shows that the Institute of Medicine’s new report urges the need for LGBT data collection.

Dear CDC:

You just released a report on health disparities – what does it say about LGBT health? No data.

At the same time you released $45M for state data collection. How much went to collecting LGBT data? $0

Please fix this problem. We applaud you for calling for data collection in your disparity report. Now we ask you to follow through and do it. Please make LGBT data collection a routine part of all your health surveys. Our health depends on it.

Sincerely,

You

If you haven’t already done so, please take just a minute to sign on in support of LGBT inclusion. Click here to sign.

Please respond by April 1st, 2011.

***NEW DEADLINE: TUESDAY, MARCH 22ND, 2011*** Signatures will be accepted through April 1st, but may not be time to include in official letter.

Thank you!

The Network

What stands out at Creating Change 2011? More Health.

 

Emilia Dunham, Network Program Associate

Emilia Dunham

Program Associate, reporting on Creating Change 2011

We all know at this point that it’s important to continue the energy and discussions from conferences to really create progress on important LGBT issues. For that reason, I wanted to point out a theme that supports the great work of the Network. In CC 2011, there was greater of emphasis on health at Creating Change this year than in other years. As evidenced by the many health workshops (for instance) reported by former Program Associate Sasha Kaufmann discussing legislation to protect PLWHIV and Megan Lee reporting on a fantastic program called Project H-E-A-L-T-H to our CC Action Alert on national LGBT data collection to the mention of LGBT benefit from healthcare reform in the State of the Movement address.

Significant Health Theme

You may recall from memory/comparison of the last two conferences, or you can check out our blog entries from past Creating Changes, that 2011 Creating Change had a much larger focus on LGBTQ health than CC 2010. Staff and guest bloggers highlight this theme in their blogs. For instance guest blogging scholar Dean Andersen’s  posts discuss needs for individual and national LGBT health promotion.

Given that our Network’s focus is on health and tobacco, we were very pleased that health was a main focus of CC 2011. That fact could not be any more apparent than from the National Gay and Lesbian Taskforce’s  Executive Director, Rea Carey’s “State of the Movement” speech when she said:

“Healthcare reform will change the lives of more LGBT people than any single piece of legislation we’ve been working on all year.”

How health, policy and research intersect and why that matters

Not only does Rea’s quote emphasize that the most meaningful advancement for LGBT people has been health legislation (which may be surprising and enlightening for many folks to hear), but it speaks to how issues of public policy, LGBT advocacy and health intertwine. The fact that these issues are so connected is common sense in achieving our needs, but also shows the Network is really on the forefront for tackling LGBT inequality as we focus on LGBT data collection/inclusion and health through a social justice lens. For more on what’s being done on the national level around these issues Scout’s blog entry on the workshop provides a wonderful synthesized list from Obama’s appointees speaking directly to these issues. Rea Carey, National Gay and Lesbian Task Force

To echo the theme of healthcare, at this plenary session, the National Gay and Lesbian Task Force/National Center for Transgender Equality report Injustice at Every Turn was distributed to all. As you may know, that was the largest national trans study which I discussed in a previous post which discussed health components at greater length due to our support (i.e. tobacco and alcohol use).

What About Tobacco?

Unfortunately, the issue of LGBT tobacco control was quiet this year apart from our own advocacy. As mentioned, in NCTE’s Mara Keisling’s presention of their joint survey, the Network was praised for our support in including tobacco within the questionnaire. In addition, I am chairing a committee with the National Youth Advocacy Coalition called Youth Kicks, which I discussed in my first CC post as a committee to address LGBT tobacco harm reduction through national media campaign.

Despite quietness on tobacco, it’s important to see how LGBT health overlaps with issues such as tobacco, for instance in terms of data. There was workshop after workshop after workshop about the need to include LGBT people in national data collection at several levels. The reason for this? We all know LGBT people experience disparities, but it’s harder to prove without numbers which is why our activity at Creating Change was to call on the CDC to include LGBT people in national surveys since we are often tabled on general health disparity conversations and have harder case in proving needs for funding without numbers.

Fortunately, it’s becoming much easier to discuss LGBT tobacco issues than ever before with the interconnectedness of policy, health, research and advocacy, so this conference revealed how the time is right to do some great work on these issues.