@article{nokey,

title = {Sexual and Gender Minority Emerging Adults Eliciting Narratives (SEEN): A Feasibility Pilot Study},

author = {Jennifer T. Tran and Jessica Webster and José A. Bauermeister and Tyler Burgese

},

doi = {https://doi.org/10.1080/19359705.2025.2536489},

issn = {1935-9713},

year  = {2025},

date = {2025-08-04},

urldate = {2025-08-04},

journal = {Journal of Gay & Lesbian Mental Health},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {A Decarceral Response to HIV Criminalization in the Black LGBTQIA+ Community},

author = {Louis Listerud and Steven Meanley and Alana Richards and Blake Kosciow and Stephen Bonnett},

url = {https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2025.308110?journalCode=ajph},

doi = {https://doi.org/10.2105/AJPH.2025.308110},

issn = {1157–1165},

year  = {2025},

date = {2025-06-11},

urldate = {2025-06-11},

journal = {American Journal of Public Health},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Yu2025c,

title = {Mediation Analysis of Internalized Homophobia, Self-esteem and Mental Health in Adolescent Sexual Minority Men: A Repeated Measures Study},

author = {Hyunmin Yu and Jennifer T. Tran and Stephen Bonett and James R. Wolfe and Keith J. Horvath and Amanda D. Castel and Lisa B. Hightow-Weidman and Patrick Sullivan and José A. Bauermeister},

doi = {10.1177/0044118x251338311},

issn = {1552-8499},

year  = {2025},

date = {2025-05-09},

urldate = {2025-05-09},

journal = {Youth & Society},

publisher = {SAGE Publications},

abstract = {<jats:p>

            Internalized homophobia (IH) negatively impacts the mental health of adolescent sexual minority men (ASMM), while self-esteem is posited to bolster their mental health. In a repeated-measures study with 599 ASMM (Mean age = 16.2 [

            <jats:italic>SD</jats:italic>

             = 1.3]; 75.6% racial and ethnic minorities), longitudinal structural equation models investigated the relationships among IH, self-esteem, and mental health (depression and anxiety), as well as the mediating role of self-esteem. Higher self-esteem at earlier time points was significantly associated with lower anxiety and depressive symptoms. The hypothesized mediation pathways were not statistically significant. Subgroup analyses revealed that the protective effect of self-esteem against anxiety was significant for racial and ethnic minority ASMM but not for their non-Hispanic White counterparts. These findings highlight the need for tailored interventions that address the unique experiences of ASMM from diverse racial and ethnic backgrounds.

          </jats:p>},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Yu2025e,

title = {Inclusive Hospital Policies, Nurse Burnout, and Job Turnover},

author = {Hyunmin Yu and José A. Bauermeister and Matthew D. McHugh and Tari Hanneman and Karen B. Lasater},

doi = {10.1097/nnr.0000000000000834},

issn = {1538-9847},

year  = {2025},

date = {2025-05-07},

publisher = {Ovid Technologies (Wolters Kluwer Health)},

abstract = {Abstract

          

            Background

            Organizational turnover among nurses is associated with high levels of burnout, which may be exacerbated by workplace discrimination and exclusionary organizational policies. The theory of inclusive organizations suggests that fostering inclusive workplace environments can positively affect job retention.

          

          

            Objectives

            This study examined the role of inclusive hospital policies in shaping nurses’ intentions to leave employment. We hypothesized that inclusive policies would reduce turnover intentions among all nurses, with a stronger effect among those experiencing high burnout.

          

          

            Methods

            This cross-sectional study analyzed three survey datasets from 2021: the RN4CAST-NY/IL data collected from registered nurses in New York and Illinois; the Healthcare Equality Index data, which assesses and scores hospitals’ inclusion efforts for lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender-diverse individuals; and the American Hospital Association Annual Survey. The dependent variable was nurses’ intent to leave their employer within a year. The independent variable was the Healthcare Equality Index score, with nurses’ high burnout serving as the moderating variable. Multilevel logistic regression with cross-level interaction was employed for the analysis.

          

          

            Results

            A total of 6,294 nurses from 111 hospitals were included in the study. An increase in the total Healthcare Equality Index score was associated with decreased odds of nurses intending to leave their employer. Nurses experiencing high burnout were more likely to intend to leave their employer compared to those without high burnout. Nurses’ high burnout status did not moderate the relationship between hospitals’ Healthcare Equality Index scores and nurses’ intent to leave.

          

          

            Discussion

            Inclusive hospital policies positively affect job retention regardless of nurses’ burnout status. Healthcare organizations should foster inclusive and supportive environments as one strategy to improve nurse retention and organizational stability.

          },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {System-Level Factors Contributing to Burnout and Professional Well-Being Among Transgender and Gender-Diverse Nurses},

author = {Hyunmin Yu and Celsea Tibbitt and J. Margo Brooks Carthon and Karen B. Lasater and José A. Bauermeister and Matthew D. McHugh},

url = {https://www.liebertpub.com/doi/full/10.1089/heq.2024.0196},

year  = {2025},

date = {2025-05-01},

urldate = {2025-05-01},

journal = {Health Equity},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Watson2025,

title = {Acceptability and feasibility of HIV self-testing integration into publicly-funded HIV prevention services: Perspectives from HIV testing agency staff that provide HIV testing services to sexual and gender minority youth in Philadelphia County},

author = {Dovie L. Watson and Stephen Bonett and Steven Meanley and Sarah M. Wood and Kathleen A. Brady and José A. Bauermeister},

editor = {Hamufare Mugauri,},

doi = {10.1371/journal.pone.0320290},

issn = {1932-6203},

year  = {2025},

date = {2025-03-25},

journal = {PLoS ONE},

volume = {20},

number = {3},

publisher = {Public Library of Science (PLoS)},

abstract = {

Background

Increasing HIV testing among priority populations is a primary strategy of the Ending the HIV Epidemic initiative. In October 2019, the Philadelphia Department of Public Health (PDPH) established a program to distribute publicly-funded HIV self-testing (HIVST) kits to Philadelphia County residents aged 16 years and older.





Methods

Through a community-academic partnership, we used a cross-sectional sequential transformative mixed-methods design to examine perceived organizational factors, opportunities, and challenges to HIVST integration among agency staff at PDPH-funded agencies early in the COVID-19 pandemic due to decreased access to traditional in-person HIV testing services with a focus on agencies whose client populations included sexual and gender minority clients assigned male sex birth aged 13 to 24 years (not the sole population served at each agency). We integrated data from online surveys conducted with HIV testers (test counselors and testing leads), agency leaders (agency leads and directors), and care navigators (n =  42), and semi-structured interviews with HIV testers and agency leaders (n =  11) employed at PDPH-funded agencies.





Results

Many staff were familiar with HIVST (79%), and approximately two-thirds (64%) were likely to encourage HIVST to clients. In interviews, perceived benefits of HIVST integration were increased access to HIV testing, accommodation for client privacy, decreased risk of stigmatizing encounters, and testing program adaptability. Perceived challenges were loss of connection with clients, suboptimal linkage to HIV treatment and prevention services after self-testing, concerns regarding clients’ correct use or interpretation of test results, and client preference.





Conclusions

Agency staff described HIVST as a useful tool for expanding low-barrier HIV testing services; however, staff foresaw potential implementation challenges. To optimize HIVST as a long-term strategy, resources are needed to increase familiarity and comfort with HIVST and enhance staff’s capacity to establish meaningful client connections and link clients to post-test HIV treatment and pre-exposure prophylaxis services.

},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Yu2025b,

title = {Impact of hospitals’ LGBTQ+ inclusion efforts on patient satisfaction from 2016 to 2023: a retrospective longitudinal observational study},

author = {Hyunmin Yu and Matthew D. McHugh and José A. Bauermeister and Tari Hanneman and Heather Brom},

doi = {10.1136/bmjqs-2024-018235},

issn = {2044-5423},

year  = {2025},

date = {2025-03-06},

urldate = {2025-03-06},

journal = {BMJ Qual Saf},

publisher = {BMJ},

abstract = {<jats:sec><jats:title>Background</jats:title><jats:p>Given the emphasis on promoting inclusive policies, we investigated the relationship between US hospitals’ inclusion efforts for lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender-diverse (LGBTQ+) populations and patient satisfaction from 2016 to 2023.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This retrospective longitudinal observational study analysed 6 years of data between 2016 and 2023 from the Healthcare Equality Index (HEI), which measures hospitals’ LGBTQ+ inclusion efforts, and the Hospital Consumer Assessment of Healthcare Providers and Systems, which measures patient satisfaction. Generalised estimating equations (GEE) were used to obtain population-averaged estimates of the association between hospitals’ LGBTQ+ inclusion efforts—assessed by (1) their participation and (2) performance in the HEI (range: 0–100)—and patient satisfaction—measured by (1) patients’ hospital rating (range: 0–100) and (2) willingness to recommend the hospital (range: 0–100). We accounted for hospital characteristics, including medical teaching status, specialised service capability, hospital size, ownership, system membership, region and metropolitan location.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Compared with hospitals that never participated in the HEI, those that occasionally participated reported a 0.33-point higher patient rating (p=0.019, 95% CI 0.05, 0.60) and a 0.49-point higher patient recommendation score (p=0.011, 95% CI 0.11, 0.87). Those who always participated reported a 1.30-point higher rating (p<0.001, 95% CI 0.89, 1.70) and a 1.90-point higher recommendation score (p<0.001, 95% CI 1.36, 2.44). Among hospitals that participated in the HEI, a 10-point increase in the total HEI score was associated with a 0.10-point increase in patient ratings (p=0.031, 95% CI 0.01, 0.20) and a 0.15-point increase in patient recommendations (p=0.023, 95% CI 0.02, 0.28).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Hospitals engaging in LGBTQ+ inclusion efforts are associated with higher patient satisfaction.</jats:p></jats:sec>},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Yu2025,

title = {LGBTQ+ Inclusive Policies, Nurse Job Outcomes, and Quality of Care in Hospitals},

author = {Hyunmin Yu and Matthew D. McHugh and José A. Bauermeister and Tari Hanneman and Karen B. Lasater},

doi = {10.1001/jamanetworkopen.2025.1765},

issn = {2574-3805},

year  = {2025},

date = {2025-03-03},

journal = {JAMA Netw Open},

volume = {8},

number = {3},

publisher = {American Medical Association (AMA)},

abstract = {ImportanceDespite emphasis on the establishment of inclusive hospital policies, the impact of these policies on employees and organizations remains unknown.ObjectiveTo evaluate the association between inclusive policies for lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender minority (LGBTQ+) and nurse job outcomes as well as nurse-reported quality of care.Design, Setting, and ParticipantsThis cross-sectional study analyzed 4 survey datasets from 2021: the RN4CAST-NY/IL, including registered nurses from New York and Illinois, and the Healthcare Equality Index (HEI) data. The HEI evaluates and scores US health care facilities that voluntarily participate based on their LGBTQ+ inclusivity in policies, such as nondiscrimination policies and LGBTQ+ inclusive clinical services. The study used American Hospital Association Annual Survey data for hospital characteristics and Magnet organization data to classify hospitals by Magnet status. Data analyses were performed in December 2024.Main Outcomes and MeasuresNurse job outcomes included burnout and job dissatisfaction. Quality of care outcomes included nurses’ perceptions of care quality and their likelihood of recommending their hospital. The independent variable was LGBTQ+ Healthcare Equality Leader (HEI Leader) status, which signified hospitals with the highest levels of LGBTQ+ inclusion. Multilevel logistic regression models included nurse-level (age, race and ethnicity, gender, and years of experience at the current hospital) and hospital-level (Magnet status, size, teaching status, specialized service capability, and ownership) covariates.ResultsA total of 7343 nurses (mean [SD] age, 44.9 [13.4] years; 6584 [89.6%] women) from 111 hospitals were included in the study. Nurses in hospitals with HEI Leader status had lower odds of high burnout (adjusted odds ratio [AOR], 0.69; 95% CI, 0.52-0.92) and lower odds of job dissatisfaction (AOR, 0.62; 95% CI, 0.45-0.86) compared with those in hospitals without the status. They also had higher odds of reporting excellent or good quality of care (AOR, 1.83; 95% CI, 1.23-2.73) and higher odds of recommending their hospital (AOR, 1.72; 95% CI, 1.19-2.50).Conclusions and RelevanceIn this cross-sectional study, nurses in hospitals with high LGBTQ+ inclusion reported more favorable job outcomes and care quality. Hospitals should understand that implementing LGBTQ+ inclusive policies goes beyond compliance or diversity; it is essential for improving the work climate, enhancing staff well-being, and optimizing care delivery.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ancheta2025,

title = {Knowledge and attitudes of school nurses in caring for sexual and gender minority youth: A national survey},

author = {April J. Ancheta and Catherine C. McDonald and Dalmacio Dennis Flores and Kaja Darien and Nadia L. Dowshen},

doi = {10.1016/j.outlook.2025.102350},

issn = {0029-6554},

year  = {2025},

date = {2025-03-00},

journal = {Nursing Outlook},

volume = {73},

number = {2},

publisher = {Elsevier BV},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Yu2024,

title = {The Relationship Between a Hospital's Magnet Status and LGBTQ+ Inclusivity in Policies and Practices in US Hospitals},

author = {Hyunmin Yu and Stephen Bonett and Dalmacio Dennis Flores and Steven Meanley and Seul Ki Choi and Tari Hanneman and José A. Bauermeister},

doi = {10.1002/nur.22422},

issn = {1098-240X},

year  = {2025},

date = {2025-02-00},

journal = {Research in Nursing & Health},

volume = {48},

number = {1},

pages = {30--40},

publisher = {Wiley},

abstract = {ABSTRACTLGBTQ+ individuals face discrimination in healthcare settings. Magnet hospitals have been associated with positive patient outcomes, yet it remains uncertain whether Magnet designation is associated with hospitals' LGBTQ+ inclusivity in policies and practices. This study examined 801 American hospitals across 47 states that participated in the Healthcare Equality Index (HEI) in 2021. Multilevel modeling was utilized to investigate the association between Magnet status and HEI scores, adjusting for hospital type and state‐level covariates, including LGBTQ+ inclusiveness in laws, political climate, racial/ethnic minority population, and Medicaid expansion status. Among the 801 hospitals, 32.1% (257 hospitals) held Magnet status. Magnet hospitals demonstrated higher HEI scores compared to non‐Magnet hospitals (γ = 2.13, p = 0.022), despite significant variations across states (intraclass correlation = 0.22). No significant cross‐level interactions were found. Overall, Magnet designation is independently associated with improved LGBTQ+ inclusivity in hospitals regardless of the state in which the hospital is located. Policymakers and healthcare leaders should consider leveraging the Magnet Recognition Program as a benchmark for promoting LGBTQ+ inclusivity within hospitals. Additionally, all healthcare institutions should prioritize comprehensive evaluations and improvements to their policies and practices to ensure inclusivity for LGBTQ+ patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Tran2025,

title = {Experiences of Peer Mentoring Sexual and Gender Minority Emerging Adults Who Are at Risk for Suicide: Mixed Methods Study},

author = {Jennifer T. Tran and Jessica Webster and James R. Wolfe and Jennifer Ben Nathan and Lindiwe Mayinja and Marin Kautz and Maria A. Oquendo and Gregory K. Brown and David Mandell and Danielle Mowery and José A. Bauermeister and Lily A. Brown},

doi = {10.2196/67814},

issn = {2561-326X},

year  = {2025},

date = {2025-01-29},

urldate = {2025-01-29},

journal = {JMIR Form Res},

volume = {9},

publisher = {JMIR Publications Inc.},

abstract = {<jats:sec>

            <jats:title>Background</jats:title>

            <jats:p>Sexual and Gender Diverse Youth (SGDY) are at increased risk for suicide due to unique experiences including discrimination, family or friend rejection, and low positive affect. Peer mentors (PMs) may offer a unique opportunity for intervention but are underutilized for suicide prevention among SGDY.</jats:p>

          </jats:sec>

          <jats:sec>

            <jats:title>Objective</jats:title>

            <jats:p>Little is known about the training needed for PMs when working with SGDY at risk for suicide. We developed an intervention, Supporting Transitions to Adulthood and Reducing Suicide (STARS), to improve suicide prevention among SGDY and increase social support, coping, and positive effects. PMs were trained by a licensed clinical therapist and provided a manual. PMs meet virtually for 6 weeks, providing social support, strategies to diminish the impact of discrimination, connection to safe spaces, and reinforcement of intentions to use Safety Plans with mentees.</jats:p>

          </jats:sec>

          <jats:sec>

            <jats:title>Methods</jats:title>

            <jats:p>To understand PMs’ experiences in their role, including distress, fidelity to the manual, and perceptions of feasibility and acceptability of STARS and mentees’ Safety Plan, we collected survey data from mentees and PMs as well as in-depth interviews with PMs after the completion of the intervention.</jats:p>

          </jats:sec>

          <jats:sec>

            <jats:title>Results</jats:title>

            <jats:p>As of September 2024, all peer mentees (N=64) have completed the study and all PMs have finished providing sessions for peer mentees. PMs (n=5) reported overall high comfort (8.52) and low distress (1.93) during sessions. All 5 PMs had high fidelity (>90%) to the PM intervention training. All 5 PMs reported high feasibility (17.50), acceptability (20), and appropriateness (20) of the STARS intervention. Mentees (n=27) reported high confidence ratings (3.54) in speaking with their PMs.</jats:p>

          </jats:sec>

          <jats:sec>

            <jats:title>Conclusions</jats:title>

            <jats:p>Peer mentorship for SGDY who are at risk for suicide was feasible and acceptable by PMs and mentees alike. PMs reported that they felt comfortable and confident during the sessions. Mentees also reported confidence in working with their PMs. Future research should explore the optimal strategies to support PMs and mentees as they engage in suicide prevention work as well as incorporate feedback from the PMs in this study to ensure optimal outcomes.</jats:p>

          </jats:sec>

          <jats:sec>

            <jats:title>Trial Registration</jats:title>

            <jats:p>ClinicalTrials.gov NCT05018143; https://clinicaltrials.gov/study/NCT05018143</jats:p>

          </jats:sec>

          <jats:sec>

            <jats:title>International Registered Report Identifier (IRRID)</jats:title>

            <jats:p>RR2-10.2196/48177</jats:p>

          </jats:sec>},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Choi2025,

title = {Impact of a Virtual Care Navigation Service on Member-Reported Outcomes Among Lesbian, Gay, Bisexual, Transgender, and Queer Populations: Case Study},

author = {Seul Ki Choi and Jaclyn Marshall and Patrina Sexton Topper and Andrew Pregnall and José A. Bauermeister},

doi = {10.2196/64137},

issn = {2561-326X},

year  = {2025},

date = {2025-01-09},

urldate = {2025-01-09},

journal = {JMIR Form Res},

volume = {9},

pages = {e64137--e64137},

publisher = {JMIR Publications Inc.},

abstract = {<jats:title>Abstract</jats:title>

          <jats:sec sec-type="background">

            <jats:title>Background</jats:title>

            <jats:p>While the significance of care navigation in facilitating access to health care within the lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) communities has been acknowledged, there is limited research examining how care navigation influences an individual’s ability to understand and access the care they need in real-world settings. By analyzing private sector data, we can bridge the gap between theoretical research findings and practical applications, ultimately informing both business strategies and public policy with evidence grounded in real-world efficacy.</jats:p>

          </jats:sec>

          <jats:sec sec-type="objective">

            <jats:title>Objective</jats:title>

            <jats:p>The objective of this study was to evaluate the impact of specialized virtual care navigation services on LGBTQ+ individuals’ ability to comprehend and access necessary care within a national cohort of commercially insured members.</jats:p>

          </jats:sec>

          <jats:sec sec-type="methods">

            <jats:title>Methods</jats:title>

            <jats:p>This case study is based on the experience of commercially insured members, aged 18 or older, who used the LGBTQ+ Health Care Navigation (LGBTQ+ Navigation) service by Included Health between January 26 and July 31, 2023. Care coordinators assisted members by connecting them with vetted identity-affirming in-network providers, helping them navigate and understand their LGBTQ+ health benefits, and providing education and advocacy for clinical and nonclinical needs. We examined the impact of navigation on 5 member-reported outcomes. In addition to reporting the proportion who agreed or strongly agreed, we calculated an impact score that averaged assigned numerical values to all 5 question responses (1=strongly disagree to 5=strongly agree) for each respondent. We used ANOVA with Tukey post hoc tests and <jats:italic>t</jats:italic> tests to explore the relationships between the impact score and member characteristics, including optional self-reported demographics.</jats:p>

          </jats:sec>

          <jats:sec sec-type="results">

            <jats:title>Results</jats:title>

            <jats:p>Out of 4703 LGBTQ+ Navigation cases, 7.53% (n=354) had member-reported outcomes. A large majority of LGBTQ+ members agreed or strongly agreed that care navigation resulted in less stress (315/354, 89%), less care avoidance (305/354, 86.2%), higher confidence in finding an identity-affirming provider (327/354, 92.4%), improved ability to comprehend health care information (312/354, 88.1%), and improved ability to engage with providers (308/354, 87%). The average impact score was 4.44 (SD 0.69), with statistically significant differences by gender identity (<jats:italic>P</jats:italic>=.003), race (<jats:italic>P</jats:italic>=.01), ethnicity (<jats:italic>P</jats:italic>=.008), and pronouns (<jats:italic>P</jats:italic>=.02). The scores were highest for members with multiple gender identities (mean 4.56, SD 0.37), and members who did not provide their race, ethnicity, or their pronouns (mean 4.55, SD 0.64). Impact scores were lowest for transgender members (mean 4.11, SD 0.95).</jats:p>

          </jats:sec>

          <jats:sec sec-type="conclusions">

            <jats:title>Conclusions</jats:title>

            <jats:p>The LGBTQ+ Navigation service, by enhancing members’ comprehension and use of necessary care, demonstrates potential public health utility and value. Continuous evaluation of navigation services can serve as a supplementary tool for employers seeking to promote health equity and improve belonging among employees. This is particularly important as discrimination and stigma against LGBTQ+ communities persist in the United States. Therefore, scalable and system-level changes that use navigation services are essential to reach a larger proportion of the LGBTQ+ population.</jats:p>

          </jats:sec>},

keywords = {},

pubstate = {published},

tppubtype = {article}

}