142nd APHA Annual Meeting and Exposition

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A social ecological approach to understanding correlates of breast health among a sample of gender non-conforming sexual minority women in Toronto, Canada

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 1:30 PM - 1:45 PM

Ashley Lacombe-Duncan, M.S.W. , Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
Carmen H. Logie, Ph.D. , Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON
Background: Sexual minority women (SMW) experience significant and pervasive mental and physical health disparities. Given the increasing attention to biological risk factors for breast cancer among SMW, understanding multi-level (individual, social, structural) factors correlated with clinical breast exams (CBE), may inform a deeper understanding of factors associated with breast health for SMW. 

Methods: A cross-sectional internet-based survey was conducted with 160 gender non-conforming SMW in December 2011.  The 105-item survey assessed socio-demographic variables, health outcomes, and individual, social and structural factors.  We conducted descriptive analyses followed by logistic regression analyses based on the social ecological framework to assess correlates of having a CBE in the past 2 years.   

Results:  Women were a mean age of 31.1 years (SD:8.0); most were white (64.4%), had at least some post-secondary education (87.5%) and identified as queer (53.1%).  In multivariate logistic regression, significant predictors of having a CBE within the past two years included higher age, higher mean scores of depression and self-esteem, and their healthcare provider (HCP) knowing their sexual orientation.  Higher mean gender non-conformity stigma and overall sexual risk practices scores were associated with reduced likelihood of having a CBE within the past two years.   

Conclusions:  These findings enhance understanding of intrapersonal (self-esteem, depression), interpersonal (sexual risk practices), social (gender non-conformity stigma) and structural (HCP assessment of sexual orientation) factors correlated with breast health among SMW.  More research is needed to understand the complex interplay of these factors to inform multi-level interventions to address health disparities, enhance HCP competence and challenge stigma.

Learning Areas:

Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related education
Public health or related research

Learning Objectives:
Describe the application of an ecological approach to exploring health disparities among sexual minority women Name factors correlated with having had a CBE within the past two years among a sample of sexual minority women Discuss the potential public health implications of these findings

Keyword(s): Lesbian, Gay, Bisexual and Transgender (LGBT), Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student at the Factor-Inwentash Faculty of Social Work (FIFSW), Univeristy of Toronto. I have conducted research and evaluation in community organizations and hospitals focused on health access, equity and services for diverse populations. For this work I have been mentored by Dr. Carmen Logie, principal investigator of this study, Assistant Professor at the FIFSW, and a leading scholar in health equity, intersectional forms of stigma, access to care, and health outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.