Thesis (Ph.D. in Educational Leadership) -- University of Dayton. / Title from PDF t.p. (viewed 10/06/09). Advisor: Carolyn Ridenour. Includes bibliographical references (p. 184-200).

Mortality related to smoking continues to be one of the foremost preventable public health issues. Smoking amongst sexual minorities (those who have a sexual attraction to or sexual contact with people of the same sex and/or of both sexes or a sexual identity of gay/lesbian or bisexual) remains significantly greater than the general population and those with only opposite sex attractions or sexual contacts. While smoking prevalence has dropped since the late 1990's in the general population, smoking among sexual minorities remains disproportionately greater than heterosexuals. Methods: A secondary data analysis was completed using two United States data sets: the 2013 Youth Risk Behavior Survey (YRBS) and the first wave of the National Longitudinal Study of Adolescent to Adult Health (Add Health) dataset collected in 1994. The analyses focused on high school students, grades 9-12. The purpose was two-fold. First, the goal was to develop a profile of smoking indicators in sexual minority youth in the 1994 Add Health dataset and in the 2013 YRBS dataset. Profiles include six smoking-related indicators: 1) ever smoked; 2) age of first cigarette smoked; 3) current smoking; 4) frequent smoking; 5) daily smoking; and 6) attempts to quit smoking. Second, the goal was to compare sexual minority youth to their heterosexual peers within each data set to identify the scope of any disparities in smoking behaviors. Results: Disparities in smoking behaviors were found in both comparisons between the heterosexual and sexual minority youth. Prevalence of all smoking behaviors was greater for sexual minority youth in both data sets. The smoking disparities were greater in the sexual minority youth in the 2013 YRBS sample. Between the 1994 Add Health and 2013 YRBS samples, smoking behaviors in sexual minority youth showed a decrease in all smoking behaviors, but not as significant as their heterosexual peers. Youth who are attracted to both sexes or identify as bisexual consistently have a greater prevalence in smoking behaviors.Conclusion: A growing disparity exists between sexual minority youth and their heterosexual peers related to smoking behaviors. Public health policy and programming needs to focus on earlier prevention efforts related to psycho-sexual development with targeted policy and curriculum around the adoption of negative health behaviors in sexual minority youth, especially those who have both sex attractions, have sexual contact with both sexes or identify as bisexual.

This study examines differences in well-being between sexual minority and heterosexual college students and identifies factors associated with well-being among sexual minority college students. A secondary analysis of cross-sectional web-based survey data was conducted. Using propensity score matching, 43 sexual minority students were matched to 43 heterosexual students on age, race, sex, and year in school. Sexual minorities had significantly lower well-being scores compared to heterosexual college students. Among sexual minorities, physical activity, depression, thoughts of suicide, and sleep quality were all predictive of well-being. Understanding issues related to well-being among sexual minorities is important and strategies need to be developed to improve well-being.

Sexual minorities face unique stressors that contribute to worse mental health (Meyer, 2003). Positive psychology interventions may be able to ameliorate this. The current study pilot tested an identityspecific positive psychology intervention among 20 sexual minorities. Results suggest that the intervention reduced depressive symptoms, anxiety symptoms, and anticipated discrimination on the basis of sexual orientation. This implies that positive psychology interventions may be able to address health disparities among sexual minorities.

Individuals who identify themselves as sexual or gender minorities report experienced and anticipated stigma known as minority stress. This stigma or stress has been consistently linked with worse mental health outcomes (e.g., depression, anxiety) compared with non-stigmatized (heterosexual, cisgender) individuals. However, little is understood about sexual minorities who also identify as gender minorities. This “doubly stigmatized” subgroup of the population may be transgender or gender-nonconforming or non-binary while simultaneously holding a non-heterosexual identity. This study sought to explore whether stigma and minority stress processes were different between individuals who identified as sexual minority/ gender majority (n=148) versus sexual and gender minority (n=167). Results revealed that individuals who were both sexual and gender minorities reported significantly more depressive and anxiety symptoms, greater minority stress, and fewer support resources. Moreover, increased minority stress (anticipated discrimination) and fewer support resources explained the disparity in mental health (bootstrapped indirect effects = -.4111 se=.1720 95%CI=-.8675, -.1634) between sexual and gender SATURDAY PROGRAM • JUNE 22, 2019 103 minority versus sexual minority/gender majority participants. Community connection was further examined as a potential moderating resource. Findings are discussed in relation to multiple stigmatized identities, the intersections of sexuality and gender identity, and the need for both future research and support resources for this population.

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Gay men living with HIV (MLWH) are often adversely affected by stigma related to both their serostatus and their sexual orientation, and the experience of living with HIV appears to increase feelings of internalized homophobia (IH). Little research attention has focused, however, on factors that may buffer the impact of HIV-stigma and IH on well-being among men living with HIV. Self-compassion, which consists of self-kindness, common humanity, and mindfulness, has been associated with resilience against the negative effects of stigma on well-being. We hypothesized that HIV-stigma would be indirectly related to poorer psychological well-being through increased levels of IH. Moreover, we expected that self-compassion would attenuate the negative effects of HIV-stigma on well-being through IH. Our sample consisted of 90 ethnically diverse gay MLWH. Participants completed an online questionnaire that assessed levels of HIV-stigma, IH, self-compassion, depression, anxiety, and positive and negative affect. After controlling for a variety of sociodemographic, health, and social characteristics, results revealed that more HIV-stigma was indirectly related to more depressive symptoms and anxiety through higher IH. Moreover, self-compassion emerged as a moderator of the indirect association of HIV-stigma on higher negative affect through higher IH, such that this indirect effect was significant for those with low self-compassion, but not for those with high self-compassion. Compassion-focused practices should be explored as a means of increasing resilience among gay MLWH.

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This study explored the connection between heter/cis-normative messages (HCNM) and emerging adult wellbeing (WB) through the mediating roles of sense of belonging (SoB) and hostility (HQ) and the moderating role of affirming knowledge (AK), through the lens of Meyer’s minority stress model. After IRB approval and informed consent, 229 college-attending gender and sexual minority emerging adults took a self-report measure. The data analysis was carried out using Smart PLS 4 and SPSS. A mediation analysis was performed to assess the mediating role of SoB in the relationship between HCNM and WB. The results indicated the relationship of HCNM on WB through SoB was not significant (β = 0.16, t = 0.46, p = 0.32). Another mediation analysis was performed to assess the mediating role of HQ in the relationship between HCNM and WB. The results revealed a significant indirect effect of HCNM on WB through HQ (β = 0.10, t = 2.18, p < 0.05) which indicates a complementary partial mediating role. This study also assessed the moderating role of AK on the relationship between HCNM and SoB. The results revealed an insignificant moderating effect of AK on the relationship between HCNM and SoB (β = -0.07, t = 1.39, p = 0.08). The study’s findings have significant implications for the inclusion of AK in emerging adults. Clinicians should consider the level of SoB and HQ when discussing the impact of HCNM on WB. Future research may want to compare group differences of AK on WB in gender and sexual minority (GSM) and non-GSM emerging adults as well. Researchers may also want to investigate different forms of HCNM and see if different forms manifest increased SoB and HQ than others.