Yuko Homma

Protective Factors in the Lives of Bisexual Adolescents in North America

OBJECTIVES We compared protective factors among bisexual adolescents with those of heterosexual, mostly heterosexual, and gay or lesbian adolescents. METHODS We analyzed 6 school-based surveys in Minnesota and British Columbia. Sexual orientation was measured by gender of sexual partners, attraction, or self-labeling. Protective factors included family connectedness, school connectedness, and religious involvement. General linear models, conducted separately by gender and adjusted for age, tested differences between orientation groups. RESULTS Bisexual adolescents reported significantly less family and school connectedness than did heterosexual and mostly heterosexual adolescents and higher or similar levels of religious involvement. In surveys that measured orientation by self-labeling or attraction, levels of protective factors were generally higher among bisexual than among gay and lesbian respondents. Adolescents with sexual partners of both genders reported levels of protective factors lower than or similar to those of adolescents with same-gender partners. CONCLUSIONS Bisexual adolescents had lower levels of most protective factors than did heterosexual adolescents, which may help explain their higher prevalence of risky behavior. Social connectedness should be monitored by including questions about protective factors in youth health surveys.

Trends and disparities in disordered eating among heterosexual and sexual minority adolescents

OBJECTIVE Disordered eating has decreased for all youth over time, but studies have not focused specifically on lesbian, gay, and bisexual (LGB) youth. Research has found that LGB youth report disordered eating behaviors more often compared to their heterosexual counterparts, but no studies have documented trends over time for LGB youth and considered whether these disparities are narrowing or widening across sexual orientation groups. METHOD We use pooled data from the 1999 to 2013 Massachusetts Youth Risk Behavior Surveys (N = 26,002) to investigate trends in purging, fasting, and using diet pills to lose or control weight for heterosexual and sexual minority youth. We used crosstabs, logistic regression, and interactions in regression models, stratified by sex. RESULTS The prevalence of disordered eating has decreased on all three measures across nearly all groups of heterosexual and sexual minority youth. However, we found disparities in reported disordered eating behaviors for LGB youth persisted across all survey years, with LGB students reporting significantly higher prevalence of disordered eating than heterosexuals. The disparities in fasting to control weight widened between the first and last survey waves between lesbian adolescents and heterosexual females. DISCUSSION The significant reductions over time in prevalence of disordered eating among some youth are encouraging, but the disparities remain. Indeed, the increasing prevalence of fasting, diet pill use, and purging to control weight among lesbians may warrant targeted prevention and intervention programs.

Substance Use and Sexual Orientation among East and Southeast Asian Adolescents in Canada

The purpose of this study was to examine the relationship between substance use and sexual orientation among Asian adolescents in Canada. We analyzed an East- and Southeast-Asian subsample of a province-wide, school-based survey (weighted N = 51,349). Compared to heterosexual adolescents of the same gender, gay, lesbian, bisexual, and mostly heterosexual adolescents were more likely to use alcohol, marijuana, or other illicit drugs. Particularly, sexual minority girls were at increased risk for substance use. The findings suggest the need for substance use prevention interventions that are sensitive to gender, sexual orientation, and culture.

Sexual orientation trends and disparities in school bullying and violence-related experiences, 1999–2013.

Numerous recent studies have demonstrated that schools are often unsafe for lesbian, gay, and bisexual (LGB) adolescents, who are more likely than heterosexual peers to be bullied, harassed, or victimized in school contexts. Virtually all of these studies call for change, yet none investigate whether or not it has occurred. Using repeated waves of a population-based high school survey, we examine (1) the extent to which sexual orientation differences in school bullying and violence-related experiences are reported by lesbian/gay, bisexual, and heterosexual male and female adolescents; (2) trends in school bullying and violence-related experiences for each gender/orientation group, and (3) whether disparities have changed over time. Data were drawn from eight Massachusetts biennial Youth Risk Behavior Surveys from 1999 to 2013, grouped into 4 waves totaling 24,845 self-identified heterosexual, 270 lesbian/gay, and 857 bisexual youth. Disparities between LGB and heterosexual peers were found in all indicators. Heterosexual youth and gay males saw significant reductions in every outcome between the first and last waves. Among bisexual males, skipping school due to feeling unsafe, carrying weapons in school, and being bullied all decreased, but among lesbians and bisexual females only fighting in school declined significantly. Improvement trends in school safety were more consistent for heterosexual youth and gay males than for bisexual or lesbian females. Notably, despite these improvements, almost no reduction was seen in sexual orientation disparities. Future research should identify influences leading to reduced school victimization, especially focusing on ways of eliminating persistent sexual orientation disparities. Future research should identify influences leading to reduced school victimization, especially focusing on ways of eliminating persistent sexual orientation disparities.

Psychometric Evaluation of the Six-Item Version of the Multigroup Ethnic Identity Measure with East Asian Adolescents in Canada

We examined the psychometric properties of scores on a six-item version of the Multigroup Ethnic Identity Measure (MEIM) among East Asian adolescents in Canada. A series of confirmatory factor analyses (CFA) was conducted for 4,190 East Asians who completed a provincial survey of students in grades 7 through 12. The MEIM measured highly correlated dimensions of ethnic identity (exploration and commitment). Further, multigroup CFA indicated that the scale measured the same constructs on the same metric across three age groups and across four groups with varying degrees of exposure to Canadian and East Asian cultures. The findings suggest the short version of the MEIM can be used to compare levels of ethnic identity across different age or acculturation groups.

Are we leveling the playing field? Trends and disparities in sports participation among sexual minority youth in Canada

Purpose Sports participation and physical fitness are widely beneficial for young people, yet activity levels among young people are declining. Despite growing popular media attention on the participation of sexual minority (e.g., lesbian, gay, and bisexual) youth in sports and various campaigns to improve the often homophobic climate of sports, there is limited evidence that sexual minority youth participate in sports. Our aim was to provide a current portrait of sports participation among 3 groups of sexual minority youth (e.g., lesbian, gay, and bisexual) in British Columbia, Canada, as well as to document population trends. Methods Pooled population-level data from British Columbia, Canada (n = 99,373) were used to examine trends and disparities in sports participation among sexual minority and heterosexual youth. Age-adjusted logistic regression models were used to examine changes in participation over time and disparities in participation over time (1998–2013). Results We found an overall decline in sports participation and physical activity (PA) for all youth. Sexual minority students were less likely to participate in formal sports (with a coach) and informal sports (without a coach) compared with their heterosexual peers. The disparity in participating in informal sports between heterosexual and sexual minority youth has narrowed over time for some sexual orientation groups, whereas the disparity in participating in formal sports has widened over time in some cases. Conclusion This study provides a comprehensive examination of sports participation among sexual minority youth over the past 15 years. Despite changing societal attitudes and laudable efforts to reduce homophobia in sports, results suggest that there are continued barriers to participation for sexual minority youth. Further research is needed to understand the factors that limit sports participation for these youth and to inform program development. PA is critical to lifelong health and well-being, and thus continued efforts are needed to increase the sports participation of sexual minority youth in particular.

Trends in suicidality among sexual minority and heterosexual students in a canadian population-based cohort study.

Despite evidence from numerous studies that document disparities in suicidality for sexual minorities, few have investigated whether or not these trends have improved over time, which is the objective of the current study. Using school-based population data over a 15-year period (1998 to 2013), multivariate logistic regressions were used to calculate age-adjusted odds ratios (ORs) separately by gender. Interactions were included to test widening or narrowing disparities within orientation groups, which makes this one of the first studies to test whether gaps in disparities between heterosexual and sexual minorities have widened or narrowed over time. Results show that sexual minority youth are persistently at a greater risk for suicidal behavior, a trend that has continued particularly for bisexual youth of both sexes. Results also suggest that the gap in suicidal behavior is widening among some female sexual orientation groups, yet narrowing for other male sexual orientation groups. These findings have important public health implications, especially since we see decreases in suicidal behavior for heterosexual adolescents, but not in the same way for many sexual minority youth, despite advances in social acceptance of gay, lesbian, and bisexual issues in North America.

Ethnic Identity and Sexual Initiation Among East Asian Youth in Canada

Despite the large number of East Asian youth in Canada, little is known about their health and risk behaviors. We examined the relationship between ethnic identity and sexual initiation among East Asians. This secondary analysis of a population-based survey selected 4,311 students in 7–12th grades who described themselves as East Asian (e.g., Chinese, Japanese, Korean). Gender-stratified logistic regression analyses examined whether ethnic identity was associated with sexual initiation, controlling for age, living situation, and cultural exposure. Boys with stronger commitment to their ethnic groups were less likely to have ever had sexual intercourse (aOR 0.80). Girls with higher levels of ethnic identity exploration were less likely to report sexual initiation (aOR 0.71). Stronger ethnic identity was associated with not having sexual intercourse among East Asian adolescents. The findings suggest the need to consider ethnocultural factors in future research and practice.

P3.315 Does Adjusting For Sexual Behaviour Improve the Accuracy of Population-Based Chlamydia Incidence and Screening Rates Among Adolescents in British Columbia, Canada?

Background Recent studies using setting-specific health insurance or clinical datasets have demonstrated the importance of considering sexual activity when calculating Chlamydia incidence and screening rates, particularly for adolescents. Using data from a provincial adolescent health survey we assessed the impact of adjusting for sexual activity on population-based Chlamydia incidence and screening rates among adolescents in British Columbia (BC), Canada. Methods We estimated the proportion of adolescent males (15–18 years) and females (14–18 years) who had ever had sexual intercourse (i.e., sexually active) using data from a cluster-stratified survey of public school students (Grades 7–12) completed by ∼30,000 BC students in 2003 and 2008. Using provincial Chlamydia surveillance and testing data we compared adolescent Chlamydia screening and incidence rates in BC by age and gender, using total and sexually active populations as denominators. Results During these time periods, an estimated 32% and 33% of males 15–18 years and 28% and 31% of females 14–18 years were sexually active in 2003 and 2008 respectively. Regardless of denominator used, screening and incidence rates increased with age, and were higher among females compared to males. Sexually active incidence and screening rates were consistently higher with a more pronounced impact at younger ages. For example, in 2008 screening rates among 14 year old females were 26.2% vs 2.5% in sexually active and total populations respectively, while the corresponding rates among 18 year old females were 60.2% vs 28.9% (2.1 times higher). Conclusions Using data representing the entire population of BC adolescents we demonstrated that without adjustment for sexual behaviour, adolescent Chlamydia incidence and screening rates are substantially under-estimated, particularly at younger ages. Adjusting for sexual behaviour using population survey data is essential for accurately monitoring the population impact of prevention and screening programmes among adolescents.