Allison P Squires

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Transgender and gender-diverse (TGD) adults experience health disparities related to stigma and discrimination. Mistreatment and substandard primary care contribute to these inequities.

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Prior literature has shown inequities in patient-clinician interactions experienced by individuals with chronic low back pain (CLBP) with underlying pain-related stigmatization and invalidation. Yet, there is a notable gap in understanding how these inequities intersect with multiple systems of oppression, including racism and sexism. This qualitative study examined intersectional perspectives and experiences of patient-clinician interactions among individuals with CLBP. Semi-structured interviews were conducted after the participants engaged in simulated enhanced or limited patient-clinician interactions as part of an experimental study. Participants were asked to compare the simulated patient-clinician interaction to their real-life patient-clinician interactions for their CLBP. The study included 50 participants with CLBP for at least three months and half the days in the past six months. Participants were Black and multi-racial women (n=14), Black and multi-racial men (n=12), non-Hispanic White women (n=12), and non-Hispanic White men (n=12). A basic qualitative approach with principles from constructivist grounded theory and intercategorical intersectional research were used to propose three core categories when describing inequities in patient-clinician interactions: higher-level systems (subcategories: institutional, community, macro-level), the patient-clinician interaction (subcategories: being taken seriously, person-centered care), and effects of the patient-clinician interaction (subcategories: indirect, direct effects). Inequities were identified across all categories, disproportionately affecting Black and multi-racial women. Black and multi-racial women also distinctly shared a wider range of both positive and negative patient-clinician interactions and effects from these interactions, and potential pathways to more equitable care. These findings highlight the need for multi-level interventions to promote more equitable care for individuals with CLBP. PERSPECTIVE: This qualitative study examined intersectional perspectives and experiences of patient-clinician interactions among individuals with CLBP. Multiple intersecting systems shaped inequities in patient-clinician interactions. Black and multi-racial women shared the broadest range of patient-clinician interactions, distinctly discussed intersecting systems of oppression, and highlighted pathways to more equitable care.

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Human-centered design (HCD) is increasingly applied in global sexual and reproductive health research to engage communities in creating person-centered interventions, yet it remains underutilized in the United States (US). A stronger theoretical understanding of HCD can support nurses to apply it as a novel approach to address persistent sexual and reproductive health inequities. This narrative review analyzes 10 US-based family planning HCD studies using the concept of epistemic stance to clarify how knowledge is created and evaluated through HCD. Findings show that HCD embodies a pluralistic stance grounded in creativity, context, and shared expertise, supporting nursing's philosophical commitment to relational, person-centered care.

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Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder. However, current lifestyle recommendations may not be appropriate for all individuals with PCOS. To best tailor an intervention for individuals with PCOS, an understanding of their preferred intervention characteristics is needed.

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Despite national attention to address disparities in health care, significant language-based health inequities exist in the United States.

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Sex education is a vital component of healthy adolescent development, yet its effectiveness is often compromised by socio-structural factors, particularly among marginalized youth. In New York City, Black and Hispanic adolescents face disproportionately adverse sexual and reproductive health outcomes (highest rates of births/sexually transmitted infections). This qualitative secondary analysis explores how socio-structural factors within educational, healthcare, and community contexts influence Black and Hispanic adolescent mothers' access, understanding, and application of sex education. Directed content analysis, guided by the socio-ecological model, was performed on semi-structured interview data from 16 Black and Hispanic adolescent mothers (14-19 years old) to examine factors at the individual, interpersonal, organizational, community, and structural levels. Interconnected barriers were revealed across all levels. Individually, untimely education and emotional readiness were key challenges, although motherhood acted as a transformative catalyst. While interpersonal and community barriers included parental taboos and social stigma, organizational gaps in curricula and provider training were compounded by structural factors of race and socioeconomic status, leading to marginalized access. Sex education for this population is undermined by these systemic barriers, demanding consistent, culturally sensitive programming.

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Lifestyle behaviors are a potential adjunctive treatment for depression in emerging adults (18-25 years), but the combination of behaviors associated with depression remains unclear. 2,019 emerging adults from the National Health and Nutrition Examination Survey between 2011 and 2018 were selected. Latent class analysis (LCA) identified patterns of lifestyle behaviors (diet [Dietary Inflammatory Index], sleep [quantity/quality], physical activity, sedentary behavior, substance use [alcohol/smoking]). Multiple logistic regression examined associations between lifestyle patterns and depression. LCA identified 6 male classes and 5 female classes. Compared to the Healthy reference group, males in the Poor Sleep Sedentary Drinkers (aOR [95% CI]: 4.40 [1.10, 17.55], = 0.032) and Pro-inflammatory Diet (PID) Smokers Drinkers (aOR [95% CI]: 6.11 [1.94, 19.25], = 0.002) groups and females in the PID Smokers Drinkers (aOR [95% CI]: 4.96 [2.07, 11.89], < 0.001), Trouble Sleeping (aOR [95% CI]: 6.65 [2.17, 20.33], < 0.001), and PID Sedentary (aOR [95% CI]: 4.74 [1.37, 16.35], = 0.012) groups had increased odds of depression. We found unique sex-specific lifestyle patterns associated with depression (males: diet, sleep [quantity/quality], sedentary behavior, substance use; females: sleep quality). Lifestyle behaviors should be comprehensively targeted to prevent and treat depression in emerging adults.