Laura A. Szalacha

Having the right chemistry: a qualitative study of mentoring in academic medicine.

Purpose To develop a deeper understanding of mentoring by exploring lived experiences of academic medicine faculty members. Mentoring relationships are key to developing productive careers in academic medicine, but such alliances hold a certain “mystery.” Method Using qualitative techniques, between November 1999 and March 2000, the authors conducted individual telephone interviews of 16 faculty members about their experiences with mentoring. Interviews were taped and transcribed and authors identified major themes through multiple readings. A consensus taxonomy for classifying content evolved from comparisons of coding by four reviewers. Themes expressed by participants were studied for patterns of connection and grouped into broader categories. Results Almost 98% of participants identified lack of mentoring as the first (42%) or second (56%) most important factor hindering career progress in academic medicine. Finding a suitable mentor requires effort and persistence. Effective mentoring necessitates a certain chemistry for an appropriate interpersonal match. Prized mentors have “clout,” knowledge, and interest in the mentees, and provide both professional and personal support. In cross-gender mentoring, maintaining clear boundaries is essential for an effective relationship. Same-gender or same-race matches between mentor and mentee were not felt to be essential. Conclusions Having a mentor is critical to having a successful career in academic medicine. Mentees need to be diligent in seeking out these relationships and institutions need to encourage and value the work of mentors. Participants without formalized mentoring relationships should look to peers and colleagues for assistance in navigating the academic system.

Safer Sexual Diversity Climates: Lessons Learned from an Evaluation of Massachusetts Safe Schools Program for Gay and Lesbian Students

This article investigates students’ perceptions of the sexual diversity climate (SDC) in Massachusetts secondary schools, based on the implementation of the recommendations of the Safe Schools Program for Gay and Lesbian Students (SSP). Data were collected from 1,646 students in a stratified random sample of 33 schools. There were statistically significant positive differences in SDC where one or more of the SSP recommendations were implemented, with differential effects by gender. This study is designed to provide information to other states, municipalities, school systems, high schools, and individual teachers on ways to establish safer sexual diversity climates in schools to benefit all students.

AIDS-Related Risk Among Adolescent Males Who Have Sex With Males, Females, or Both: Evidence From a Statewide Survey

OBJECTIVES This study examined the prevalence of AIDS-related risk behaviors among adolescent males with female, male, and both-sex sexual partners and explored factors related to these behaviors. METHODS Three waves of a population-based survey provided data on male high school students: 3065 with only female sexual partners, 94 with only male partners, and 108 with both. Logistic regression analyses were used to examine AIDS-related outcomes. RESULTS Youths with any same-sex experience reported less school AIDS education. Bisexual experience predicted multiple sexual partners, unprotected intercourse, sexually transmitted disease, and injection drug use. School AIDS education and condom instruction predicted less AIDS-related risk. CONCLUSIONS Bisexually active adolescent males report especially high levels of AIDS risk behavior. School-based AIDS prevention should address the needs of all sexually active youths.

Dimensions of sexual orientation and HIV-related risk among adolescent females: evidence from a statewide survey.

OBJECTIVES We examined the relationship of 2 dimensions of sexual orientation--sexual identity and sex of partners--with self-reported behaviors and experiences to identify factors that may place adolescent females at risk of HIV/AIDS. METHODS We gathered data on sexually experienced female high school students from 4 waves of a population-based survey. We used logistic regression analyses to investigate the association between their sexual identity (3666 heterosexual; 184 lesbian, gay, or bisexual; 113 not sure) and sex of partners (3714 male only, 79 female only, and 180 both males and females) with HIV-related risk behaviors. RESULTS Self-defined sexual identity was often inconsistent with sex of sexual partners. Sexual identities other than heterosexual and having same-sex partners (either exclusively or in addition to male partners) were associated with high rates of several HIV-related risk behaviors. Coerced sexual contact was significantly associated with every risk outcome. AIDS education in school predicted lower HIV risk on 4 of 6 indicators. CONCLUSIONS Programs to prevent HIV infection among adolescent females should take into account the complexity of sexual orientation and should address the needs and behaviors of sexual-minority youths.

Substance abuse and mental health disparities: Comparisons across sexual identity groups in a national sample of young Australian women

A growing body of research amply documents health disparities related to substance abuse among sexual minority women. However, relatively little research has examined risk factors or predictors of substance use in this population and even less has explored differences among sexual minority subgroups. Using data from 8850 women aged 25-30 years in the 2003 survey of the Australian Longitudinal Study on Womens Health Survey (ALSWH) we compared rates of substance use (alcohol, marijuana and other illicit drugs) and potential predictors (e.g., depression, anxiety, perceived stress, lower levels of social support) across four sexual identity groups-exclusively heterosexual, mainly heterosexual, bisexual and lesbian. Using statistical weighting of the sample and controlling for demographic characteristics we fitted logistic regression models to estimate adjusted odds ratios for substance use. Compared with exclusively heterosexual women sexual minority women reported significantly higher levels of substance use-but there was notable variation among the three sexual minority subgroups. Women who identified as mainly heterosexual were significantly more likely than exclusively heterosexual women to report at-risk drinking and those who identified as bisexual were more likely to report marijuana use. Mainly heterosexual and bisexual women were also more likely to report binge drinking. Findings implicate stress as an important predictor of substance use and emphasize the need for research that more systematically examines the relationships between minority stress and substance use in sexual minority women. Findings of variations in risk across sexual minority subgroups suggest prevention and intervention strategies aimed at reducing health disparities should be targeted toward specific sexual minority subgroups.

Relationships of gender and career motivation to medical faculty members' production of academic publications

PURPOSE: To evaluate the relationships between both internal and external career-motivating factors and academic productivity (as measured by the total numbers of publications) among full-time medical faculty, and whether these relationships differ for men and women. METHOD: In 1995 a 177-item survey was mailed to 3,013 full-time faculty at 24 randomly selected U.S. medical schools stratified on area of medical specialization, length of service, and gender. Two-tailed t-tests and regression analyses were used to study the data. RESULTS: A total of 1,764 faculty were used in the final analyses. The women had published two thirds as many articles as had the men (mean, 24.2 vs. 37.8). Intrinsic and extrinsic career motivation were rated similarly (on a three-point scale) by the women and the men: intrinsic career motivation was rated higher (womens mean rating: 2.8, mens mean rating: 2.9) than was extrinsic career motivation (mean rating: 2.1 for both). The main findings of the regression analyses were (1) intrinsic career motivation was positively associated, and extrinsic career motivation was negatively associated, with the number of publications; (2) publication rates were higher for the men than for the women after controlling for career motivation; and (3) there was no significant effect of gender on these relationships. CONCLUSION: The women faculty published less than did their men colleagues, but this difference cannot be accounted for by gender differences in career motivation. Further research on institutional support, family obligations, harassment, and other factors that could affect academic productivity is necessary to understand the gender difference in numbers of publications.

Sexual victimization and hazardous drinking among heterosexual and sexual minority women

AIMS Although research shows that sexual minority women report high rates of lifetime sexual victimization and high rates of hazardous drinking, investigators have yet to explore the relationships between sexual victimization and hazardous drinking in this population. In addition, because the rates of these problems may vary within the sexual minority population, we examined and compared relationships between sexual victimization and hazardous drinking in exclusively heterosexual and sexual minority (mostly heterosexual, bisexual, mostly lesbian and exclusively lesbian) women. METHOD Data from 548 participants in the National Study of Health and Life Experiences of Women and 405 participants in the Chicago Health and Life Experiences of Women study were pooled to address these relationships. We compared hazardous drinking, childhood sexual abuse (CSA), adult sexual assault (ASA), and revictimization (both CSA and ASA) across the five sexual identity subgroups. We then fit a multilevel general linear model to examine group differences in the relationships between hazardous drinking and sexual victimization and to test for potential interactions between victimization and identity on hazardous drinking. RESULTS Sexual minority women reported higher levels of hazardous drinking and higher rates of CSA and sexual revictimization than did exclusively heterosexual women. Revictimization was the strongest predictor of hazardous drinking among women who identified as mostly heterosexual and mostly lesbian. CONCLUSIONS This study extends previous research by examining associations between sexual victimization and hazardous drinking in heterosexual and sexual minority women and by exploring within-group variations in these associations among sexual minority women. Higher rates of lifetime sexual victimization and revictimization may help to explain sexual minority womens heightened risk for hazardous drinking. The findings highlight the need for additional research that examines the meanings of sexual identity labels to more fully understand differences in risk within groups of sexual minority women as well as how sexual identity may affect responses to and interpretations of sexual victimization.

Educating Teachers on LGBTQ Issues: A Review of Research and Program Evaluations.

“Research into Practice” includes reviews of educational policies and procedures, professional development and practice, pedagogy, school climates, and curriculum development with foci on students, teachers, administrators, counselors, youth group advisors, and parents at all levels of education. Annotations of research studies included here encompass both those recently completed and those inprogress that may be of interest to practitioners, policy makers, and scholars/researchers. Submissions to this feature section or suggestions for specific areas of focus should be directed to Laura Szalacha at <Laura_Szalacha@Brown.edu>.

Health Status, Health Service Use, and Satisfaction According to Sexual Identity of Young Australian Women

OBJECTIVES we sought to compare physical and mental health status, health service use, and satisfaction among young Australian women of varying sexual identity; and to explore associations of all of these variables with satisfaction with their general practitioner (GP). METHODS data are from the youngest cohort of women in the Australian Longitudinal Study on Womens Health surveyed in 2003. The sample included women aged 25 to 30 who identified as exclusively heterosexual (n = 8,083; 91.3%), mainly heterosexual (n = 568; 6.4%), bisexual (n = 100; 1.1%), or lesbian (n = 99; 1.1%). Univariate analyses compared self-reported mental health, physical health, access to GP services, and satisfaction across the four sexual identity groups. Linear regression, controlling for education, income, and residence, was used to identify factors associated with GP satisfaction. RESULTS sexual minority women (lesbian, bisexual, and mainly heterosexual) were significantly more likely than were heterosexual women to report poorer mental health and to have more frequently used health services; depression was strongly associated with mental health services use. Bisexual and mainly heterosexual women were most likely to report poorer general health, abnormal Pap tests, sexually transmissible infections, urinary tract infections, hepatitis B or C virus infection, and asthma. Lesbians were most likely to have never had a Pap test or be underscreened. All sexual minority women had lower continuity of GP care and lower satisfaction with that care than heterosexual women. CONCLUSION underlying social determinants of physical and mental health disparities experienced by sexual minority women require exploration, including the possible effects of discrimination and marginalization on higher levels of risk taking. Lower continuity of care and lower satisfaction with GP services also need further investigation.

‘Flying below the radar’: a qualitative study of minority experience and management of discrimination in academic medicine

Objectives  This paper aims to give voice to the lived experience of faculty members who have encountered racial or ethnic discrimination in the course of their academic careers. It looks at how they describe the environment for minorities, how they manage discrimination and what institutions and majority‐member faculty can do to improve medical academe for minority members.