Search Results (40)

Background/Objectives: There is scientific evidence showing that body- and/or body weight-related blaming, guilting, and shaming continue to be both promoted and tolerated in many societal contexts, including schools and healthcare settings. A deeply ingrained belief still prevails among many individuals that inducing these negative emotions can serve as a motivator for children and adolescents to engage in obesity treatment. Therefore, the aim of this systematic review is to examine these emotions (blame, guilt, shame) in relation to body weight and their impact on psychological functioning within the pediatric population affected by overweight and obesity. Methods: Articles were searched up using PubMed and Web of Science in June 2023 and March 2025. The search was conducted without limiting the years of publication. The inclusion criteria included the following: (1) pediatric samples, (2) full text available, and (3) original research articles. Articles were excluded if they were editorials, letters, replies from authors, review articles, and articles without a full text. Results: The initial search returned 199 results. A total of 16 articles were included in the study. Analysis of the collected records revealed associations between body- or weight-related blame, guilt, and shame and various aspects of psychological functioning in the pediatric population such as (a) interpersonal context (e.g., social stigma, bullying, teasing history, social connectedness, weight-related language used by parents in conversations with children and adolescents; (b) intrapsychic context—relationship with eating and food (e.g., binge eating, dietary restraint, emotional eating, and the risk of developing eating disorders); (c) intrapsychic context—self-perception (e.g., self-esteem, feelings of worthlessness, self-compassion, self-efficacy, perceived control); (d) intrapsychic context—emotional functioning (e.g., emotional distress, anxiety, depression, emotion regulation strategies); and (e) intrapsychic context—additional psychological factors (e.g., mindfulness, quality of life, willingness to seek help, and motivation for both help-seeking and sustaining successful lifestyle changes). Conclusions: Understanding the dynamics of body- and/or weight-related blame, guilt, and shame among children and adolescents with overweight and obesity is essential for developing effective support systems that enhance their well-being and psychological resilience in both the prevention and treatment of obesity. Further research is needed to explore the relationships between body- and weight-related blame, guilt, and shame and psychological functioning in pediatric populations with overweight and obesity, including the dynamics of child–parent–healthcare provider interactions, the context of parenting skills and attitudes that support the child during obesity treatment, the long-term consequences of body- and weight-related blame, guilt, and shame, the relationship between healthcare providers’ tendencies to engage in body- and weight-related shaming or blaming and their communication skills and mental well-being (e.g., levels of professional burnout, emotion regulation skills, and personality traits), as well as the influence of social media on body- and weight-related shame, guilt, and blame. Full article

Background/Objectives: This study aimed to explore the barriers and facilitators influencing initial self-disclosure among individuals diagnosed with human papillomavirus (HPV)-related cancers, as well as examine the post-disclosure experiences of affected individuals. Emphasis was placed on understanding the roles of perceived and internalized stigma in these interpersonal communication encounters. Methods: Semi-structured interviews were conducted with 27 participants diagnosed with an HPV-related cancer. MAXQDA was used for qualitative analysis with themes grounded in Attribution Theory and the Disclosure Model. Results: Barriers to disclosure identified among participants included privacy concerns, hesitancy to burden others, and discomfort discussing the anatomic location of their cancer. In contrast, seeking support, instances of misunderstanding HPV’s relation to cancer, and the proactive detailing of their diagnosis to avoid judgment emerged as facilitators of disclosure. While many recounted positive post-disclosure experiences, some participants expressed feelings of guilt and internalized stigma, suggesting a deeper emotional struggle in communicating about their diagnosis to others in their social support networks. Nuances in the internalized stigma were observed in specific subgroups among this patient population, such as those who identify as a sexual/gender minority. Conclusions: This study underscores the multifaceted challenges experienced among individuals diagnosed with HPV-related cancers when disclosing their diagnoses and seeking social support. This study highlights the imperative role of identifying psychosocial distress in the post-diagnosis period among individuals with HPV-related cancer. Future research should explore ways to enhance social support for this patient population by improving healthcare providers’ screening measures and providing integrated support services earlier to better address their psychosocial needs. Full article

In the United States (U.S.), Latina transgender women (LTW) are highly burdened by HIV and are prioritized for pre-exposure prophylaxis (PrEP). This study explored intersectional barriers and facilitators to PrEP uptake among LTW. Between February–November 2022, in-depth interviews were conducted with 27 LTW in the LITE Study. Participants were purposively sampled from 196 LTW in the cohort based on PrEP uptake (PrEP-naïve n = 8, PrEP-eligible and not user n = 5, current PrEP user n = 6, previous PrEP user n = 8). We conducted content analysis guided by a Modified Social Ecological Model and Intersectionality Framework. The mean age of participants was 32.3 (SD = 12.9). Themes were: (1) Intrapersonal: Medical distrust, acceptability of PrEP modalities, and concerns about long-term health; (2) Interpersonal: Mistreatment in healthcare, discrimination-related healthcare avoidance, difficulty finding trans-competent providers, language barriers, and shame and stigma; and (3) Structural: PrEP in the context of limited access to gender-affirming care and widespread silicone use, immigration status, economic marginalization, lack of community outreach, transphobia and anti-transgender legislative contexts, and xenophobia. This study found multilevel intersectional barriers influence PrEP uptake and persistence. Culturally tailored HIV prevention efforts are needed to address LTW-specific barriers, provide information on programs subsidizing PrEP, and implement policy change to ensure equitable PrEP access. Full article

Postpartum depression (PPD) is a severe mental health condition that affects women following childbirth and is marked by persistent sadness, anxiety, fatigue, and difficulty functioning. Unlike the temporary “baby blues”, PPD is more severe and long-lasting, potentially leading to negative consequences for mother and child. Globally, PPD impacts approximately 10–20% of postpartum women, with prevalence influenced by genetic, hormonal, psychological, and socio-environmental factors. Early detection is crucial, with screening tools such as the Edinburgh Postnatal Depression Scale (EPDS) commonly used in clinical practice. Treatment options include pharmacological interventions such as selective serotonin reuptake inhibitors (SSRIs), psychological therapies like cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), and lifestyle modifications. Despite the growing awareness of PPD, stigma remains a significant barrier to treatment, discouraging many women from seeking help. In low-income countries, where mental health care is often underfunded, accessing professionals trained in perinatal mental health presents an even greater challenge. This gap underscores the urgent need for a collaborative, multidisciplinary approach involving obstetricians, psychiatrists, pediatricians, and midwives to ensure comprehensive support and care for affected individuals. Full article

Background: Globally, approximately 65% of adolescents undergoing antiretroviral therapy (ART) adhered to their treatment, whereas only 55% achieved viral suppression in 2023. The low rate of viral suppression is concerning, as elevated viral loads are associated with a heightened risk of opportunistic infections, progression to advanced HIV disease, increased mortality, and greater HIV transmission rates. We conducted this scoping review to identify the facilitators and barriers to ART adherence among adolescents and young adults (AYAs) in sub-Saharan Africa (SSA). Methods: We conducted this scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. We searched for peer-reviewed articles published in English from 2014 to 2024 across the SCOPUS, ScienceDirect, PubMed, Africa Journals Online, and Google Scholar databases. Two reviewers independently selected the articles and extracted the data. We used NVivo to develop codes and categories of facilitators and barriers. Results: We used 30 articles reporting on studies conducted in 13 countries in this review. The total number of participants in the studies was 12,250. Sixteen articles reported on qualitative studies, nine on quantitative studies, and five on mixed-methods studies. This scoping review identified various personal (14 articles), interpersonal and social (15 articles), healthcare system-related (9 articles), medication-related (7 articles), and economic (2 articles) factors that facilitate ART adherence among AYAs. Additionally, the scoping review also identified various personal (28 articles), interpersonal and social (13 articles), healthcare system-related (14 articles), medication-related (20 articles), school- or work-related (6 articles), and economic (14 articles) factors that hinder ART adherence among AYAs. Conclusions: Enhancing ART adherence in AYAs requires multiple strategies, including the reduction of internalized stigma, implementation of community awareness campaigns, harm reduction approaches for AYAs who misuse substances, comprehensive education on HIV, and the provision of support from school staff and leadership, alongside the adoption of differentiated service delivery (DSD), which encompasses home-based ART delivery, refills at private pharmacies, community ART distribution centers, and patient-led community ART refill groups, as well as multi-month dispensing practices. Full article

Due to several interpersonal, social, and organizational challenges, dental health has been occasionally compromised in the transgender population. There is a lack of awareness among transgender persons to access affordable trans-competent oral health care. More information is required to identify and assess the oral health condition of this population in order to encourage better access to oral healthcare and effectively influence public health policy and practice. This systematic review aims to provide evidence about the status of oral health and hygiene of the transgender population across the globe. A systematic literature search using keywords and MESH search terms was conducted using PubMed, Medline, Google Scholar, and EBSCO online databases. The references of included journal articles were manually searched and appropriate studies were included, which were then critically appraised using the Joanna Briggs Institute (JBI) tool and the Newcastle–Ottawa protocol for the risk of bias assessment of prevalence studies, with each study assessed by two independent reviewers. Based on the search procedures, a total of 2026 articles were initially screened and, after evaluation, 20 were included in the systematic review. Transgender persons often face stigma and discrimination in dental healthcare settings, which affects their oral health status. A greater prevalence of substance abuse stemming from anxiety, lack of adequate education, and poor socioeconomic status leads to an increased prevalence of oral health diseases in this marginalized population. There is a need for policies and reforms to appraise their oral health and hygiene status and improve access to oral health services in this population. Full article

Because psychedelics have been found to increase psychological traits like openness, mental flexibility, and interpersonal perceptiveness, some researchers believe that psychedelics could help individuals cope with the psychological effects of discrimination. However, it is still unclear whether psychedelic use can help manage the internalized stigma that deters formal mental health treatment. This study investigates the impact of six measures of psychedelic use (MDMA, psilocybin, DMT, ayahuasca, peyote/mescaline, and LSD) on psychological distress (Kessler Psychological Distress Scale) and internalized stigma. The study used data from the National Survey of Drug Use and Health (NSDUH) from 2008 to 2019, with a sample size of 458,372 participants. Ordinary least square regression models were conducted using Stata 18. Gender analysis found that among men, ayahuasca use was linked to reduced stigma perception associated with higher distress. For women, DMT use was linked to reduced stigma perceptions when experiencing higher distress. However, results find that individuals who have used MDMA and psilocybin reported heightened perceptions of stigma associated with increased psychological distress. Among women, MDMA and psilocybin use was associated with a higher perception of stigma when they experienced distress. These findings suggest that, overall, psychedelics may not reduce the impact of distress on the perception of stigma, especially for women. Full article

Background: Participation in targeted screening reduces lung cancer mortality by 30–60%, but screening is not universally available. Therefore, the study aimed to synthesize the evidence and identify facilitators and barriers to lung cancer screening participation globally. Methods: Two reviewers screened primary studies using qualitative methods published up to February 2023. We used two-phase synthesis consistent with a meta-study methodology to create an interpretation of lung cancer screening decisions grounded in primary studies, carried out a thematic analysis of group themes as specific facilitators and barriers, systematically compared investigations for similarities and differences, and performed meta-synthesis to generate an expanded theory of lung cancer screening participation. We used the Social Ecological Model to organize and interpret the themes: individual, interpersonal, social/cultural, and organizational/structural levels. Results: Fifty-two articles met the final inclusion criteria. Themes identified as facilitating lung cancer screening included prioritizing patient education, quality of communication, and quality of provider-initiated encounter/coordination of care (individual patient and provider level), quality of the patient–provider relationship (interpersonal group), perception of a life’s value and purpose (cultural status), quality of tools designed, and care coordination (and organizational level). Themes coded as barriers included low awareness, fear of cancer diagnosis, low perceived benefit, high perceived risk of low-dose computerized tomography, concern about cancer itself, practical obstacle, futility, stigma, lack of family support, COVID-19 fear, disruptions in cancer care due to COVID-19, inadequate knowledge of care providers, shared decision, and inadequate time (individual level), patient misunderstanding, poor rapport, provider recommendation, lack of established relationship, and confusing decision aid tools (interpersonal group), distrust in the service, fatalistic beliefs, and perception of aging (cultural level), and lack of institutional policy, lack of care coordinators, inadequate infrastructure, absence of insurance coverage, and costs (and organizational status). Conclusions: This study identified critical barriers, facilitators, and implications to lung cancer screening participation. Therefore, we employed strategies for a new digital medicine (artificial intelligence) screening method to balance the cost–benefit, “workdays” lost in case of disease, and family hardship, which is essential to improve lung cancer screening uptake. Full article

Disorganized speech is a critical barrier to recovery in schizophrenia, with profound negative impacts on one’s ability to engage with the world. Despite the limited efficacy of existing treatments in addressing disorganization, a qualitative analysis of what leads to disorganization in patient narratives has been lacking. This study addresses this gap through inductive thematic analysis of 30 narrative interviews with individuals with schizophrenia, matched based on whether Formal Thought Disorder (FTD) is present. Through this analysis, we identified four core themes (alienation, interpersonal tension, personal benchmarks, and adverse experiences) and eight subthemes. Our findings suggest that disorganization may serve as a protective mechanism against psychological distress and highlight how the severity of FTD influences these themes. Alienation, particularly due to illness-related stigma, emerged more prominently in those with FTD. The themes of personal benchmarks and interpersonal tension pointed towards a heightened sensitivity to social interactions and self-perception among those with schizophrenia. Adverse experiences, encompassing past challenges, suggest a potential link between trauma and symptom exacerbation. Our qualitative analysis of what themes precede disorganized speech has implications for tailoring psychotherapy. By considering an individual’s specific triggers and level of disorganization, therapy may be more effectively targeted to improve recovery-based outcomes. By identifying themes within patient narratives, this study advances our understanding of the qualitative aspects preceding disorganized speech in schizophrenia, paving the way for more personalized and effective recovery-focused interventions. Full article

The lived experiences of homeless and unstably housed women, including their health-related priorities, are understudied in smaller metropolitan and rural communities. In this study, we partnered with a day center for women who experience homelessness in Spokane, Washington. We used Photovoice, a community-based participatory action research method, to explore the health-related concerns, needs, and behavior of women who are homeless or unstably housed. Participant-generated photographs and group interview data were analyzed using thematic analysis. Three themes were generated: “These are my supports”, “I’m trying to make my health better”, and “[My] choices are very limited”. The themes illustrated individual, interpersonal, community, and societal strengths and vulnerabilities aligned with the social ecological model. Participants demonstrated resourcefulness, creativity, and hope as they strived toward health improvement. Trauma-informed, strengths-based approaches that respect the autonomy of homeless and unstably housed women and that amplify their voices are needed to minimize power imbalances in research, policy, and practice. This includes an imperative for healthcare and social work programs to ready graduates to deliver effective, empathic services by increasing their knowledge of social determinants of health and of the stigma faced by marginalized communities. Moreover, collaborating with these communities when designing, implementing, and evaluating services is critical. Full article

This project documents the service outcomes that caregivers value most. A diverse group of caregivers, representing six regions of the United States, participated in two rounds of virtual one-hour focus groups. In round 1, participants identified what they hoped to gain from using behavioral health services for themselves, their families, and their child and discussed what made services a positive experience for them. They then reported their top-three most-hoped-for outcomes. In round 2, groups validated and refined summary findings from round 1. Caregivers prioritized service quality outcomes, primarily. They expressed a desire for an accessible, respectful, and supportive treatment environment, underpinned by well-trained and culturally responsive professionals. Caregivers also desire seamless cross-sector provider collaboration and care transitions, which integrate the insights and preferences of families and children themselves to craft a customized care plan. Priority outcomes not related to service quality included hoping to gain increased knowledge, resources, and tools and techniques to support the mental health needs of their children, to see their children improve their daily functioning and for their child develop more effective interpersonal communication skills. Caregivers also reported hoping to experience less stigma related to the mental health needs of their children and to achieve personal fulfillment for themselves and their children. Research, policies, and mental health services should prioritize and be designed to address the outcomes that matter to youth and families. Full article

In the face of ongoing interpersonal and structural violence towards sex workers in Canada, this research inquiry explores nine women and gender-diverse sex workers’ experiences of place identity within their workplaces. Employing multisensory and arts-based ethnographic fieldwork, the co-researchers storied their embodied place-based experiences of identity. The research findings illuminate place-identity processes within sex workplaces, suggesting that the context, materiality, and multisensory atmospheres of the co-researchers’ work environments were entwined with internal and external self-concepts. The co-researchers created personalized multisensory atmospheres in their workplaces through the use of colour, visual art, and music. Having workplaces that positively supported place identity fostered workplace comfort, control, and empowerment. Ultimately, this research suggests that place-identity processes in sex workplaces have the possibility to resist and shift sex work stigma. Full article

Background: Sexual satisfaction is a complex, multifaceted, and broad concept that is influenced by several factors. The minority stress theory posits that sexual and gender minorities are at a particular risk for stress due to stigma and discrimination at the structural, interpersonal, and individual levels. The aim of this systematic review and meta-analysis was to evaluate and compare the sexual satisfaction between lesbian (LW) and heterosexual (HSW) cisgender women. Methods: A systematic review and meta-analysis were conducted. We searched the PubMed, Scopus, Science Direct, Websci, Proquest, and Wiley online databases from 1 January 2013 to 10 March 2023 to identify the published observational studies on sexual satisfaction in women according to their sexual orientation. The risk of bias in the selected studies was assessed using the JBI critical appraisal checklist for the analytical cross-sectional studies. Results: A total of 11 studies and 44,939 women were included. LW reported having orgasms during a sexual relationship more frequently than HSW, OR = 1.98 (95% CI 1.73, 2.27). In the same direction, the frequency of women reporting “no or rarely” for having orgasms during their sexual relationships was significantly lower in the LW than the HSW, OR = 0.55 (95% CI 0.45, 0.66). The percentage of the LW who reported having sexual intercourse at least once a week was significantly lower than that of the HSW, OR = 0.57 for LW (95% CI 0.49, 0.67). Conclusions: Our review showed that cisgender lesbian women reached orgasm during sexual relations more often than cisgender heterosexual women. These findings have implications for gender and sexual minority health and healthcare optimization. Full article

The aim of this qualitative research, conducted in Spring 2021, was to identify the inconveniences and the psychological and social impact of 10 days of home isolation, required by law, in non-hospitalised COVID-19 patients in Greece and to improve management. Thirty-seven semi-structured telephone interviews were conducted, audio-recorded, and transcribed verbatim. Thematic analysis identified four key emergent themes, i.e., everyday life during self-isolation, psychological issues, social issues, and information and guidance. Food provisioning was of particular concern. Solidarity was expressed to individuals in need. Isolation was not always viable due to space constraints and the necessity to care for sick family members. Fear of transmission to vulnerable groups, hospitalisation, irreversible complications, and death as well as anxiety, insecurity, guilt, and alienation were articulated. COVID-19 disrupted the normal functioning of families and led to revision of interpersonal relationships. Patients avoided re-integration in society due to the transmitter stigma and to limit the risk of infection spread in the community. Over-information promoted fear. Mild illness raised doubts about information validity. Primary care provided monitoring and psychological support. Home isolation caused disruption in various aspects of participants’ life, ranging from logistic problems to dealing with the psychological burden of isolation and illness. Primary care could play a central role in supporting patients. Full article

HIV pre-exposure prophylaxis (PrEP) use remains suboptimal among Black gay and bisexual men (GBM). Multilevel factors such as medication costs, intersectional stigma, patient-clinician communication, medical mistrust, side effect concerns, and low perceived HIV risk (PHR) are well-established PrEP initiation barriers for this group. Peer change agents (PCAs) are culturally congruent interventionists who can circumvent multilevel PrEP barriers among Black GBM. I led an intervention as a PrEP-using PCA to improve PHR and PrEP willingness among 69 Black GBM from 2019–2022 and conducted an autoethnography to better understand multilevel barriers and identify the personal/professional challenges of being an in-group HIV interventionist serving Black SMM. Findings provide novel perspectives regarding PrEP barriers, the role of cultural homophily in behavior change interventions, and how interpersonal dynamics can impact staff fatigue, protocol fidelity, and research participation. Recommendations to prepare and support culturally congruent research staff are also provided. Full article