Gender Affirmation in Adult Primary Care

Nurse practitioners in primary care are well positioned to mitigate the barriers to care and the health disparities that transgender and gender nonconforming individuals experience. This article synthesizes best practices in caring for transgender and gender nonconforming patients. Key domains highlighted include (1) inclusive communication strategies, (2) gender-affirming interventions, and (3) mental health considerations.     

Cognitive interviewing to improve women's empowerment questions in surveys: Application to the health and nutrition and intrahousehold relationships modules for the project‐level Women's Empowerment in Agriculture Index

In 2015, the United Nations adopted the Sustainable Development Goals, which include fostering gender equality and women's empowerment and ending hunger and malnutrition. To monitor progress and evaluate programmes that aim to achieve these goals, survey instruments are needed that can accurately assess related indicators. The project‐level Women's Empowerment in Agriculture Index (pro‐WEAI) is being developed to address the need for an instrument that is sensitive to changes in empowerment over the duration of an intervention. The pro‐WEAI includes new modules with previously untested survey questions, including a health and nutrition module (focused on women's agency in this area) and an intrahousehold relationships module. This study uses cognitive interviewing to identify how new survey questions might be misinterpreted and to understand what experiences women are referencing when they respond to these questions. This was undertaken with the goal of informing revision to the modules. The study was conducted in Bangladesh with women from nuclear, extended, and migrant‐sending households and from two regions of the country to identify difficulties with interpretation and response formulation across these groups. Findings revealed that questions were generally understood, but participants occasionally responded to the wrong part of the question, did not understand key phrases, or were uncomfortable with questions. The findings also suggested ways to revise the modules and strengthen the pro‐WEAI. The revised pro‐WEAI health and nutrition and intrahousehold relationships modules will advance the ability to measure changes in these domains and their relationship with the health and nutritional status of women and their children.     

Sociodemographic determinants of Malaysian household’s use of and expenditure on alcohol: a regional comparison

Abstract

Aims: Alcohol consumption has become a serious public health concern. The objective of the present study is to investigate sociodemographic factors associated with alcohol consumption across regions of Malaysia.

Methods: Data are obtained from the Malaysian Household Expenditure Survey 2014, which contains 10,665 observations. Double-hurdle model is used to examine the consumption decision and amount decision of alcohol among households. Analyses are stratified by regions (Northern, East coast, Central and Southern).

Findings: Results show that age, household size, gender, ethnicity, marital status, education, employment status, location of residence and tobacco consumption are independently associated with alcohol consumption. Households headed by males and well-educated individuals are more likely to consume alcohol and also spend more compared with households headed by females and less-educated individuals. Being employed, non-Bumiputera and tobacco consumption seem to increase the likelihood of consuming alcohol. Household size is negatively associated with the amount spent on alcohol.

Conclusion: In conclusion, sociodemographic factors play an important role in determining alcohol consumption. It appears that factors associated with alcohol consumption vary across regions. Hence, policies that address regional differences in the sociodemographic factors associated with alcohol consumption are needed.     

The combined relations of gender,enculturation, and depressive symptoms with health risk behaviors in Mexican-Americans: a moderated mediation analysis

ABSTRACT

Objectives: The present study investigated the relationships of enculturation and depressive symptoms with health risk behavior engagement in Mexican-American college students and examined how these relationships differed by gender. Previous research has noted consistent gender differences in health risk behavior (e.g. alcohol use, substance use, and risky sexual behavior) among Latina/os, and emphasized the role of U.S. acculturation in this difference. Research examining the role of heritage cultural retention (i.e. enculturation), and including the added influence of mental health variables, such as depressive symptoms, is currently lacking. This study sought to address this gap.

Design: A large sample (N?=?677) of Mexican-American college students from four universities (located in New York, California, Florida, and Texas) completed an online questionnaire assessing health risk behaviors and corresponding variables.

Results: We found that males who endorsed more behavioral enculturation and depressive symptoms were more likely to engage in health risk behavior than all others in the sample. Contrary to previous literature, no relationship was found between behavioral enculturation and health risk behavior in females.

Conclusion: The current study found behavioral enculturation to be associated with depressive symptoms, and in turn with health risk behaviors among the males in our sample. Additional research will be needed to identify the mechanism underlying the relationship between enculturation and depressive symptoms as well as between depressive symptoms and risky behavior.