Social Work Faculty

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Open Access
Examining the Role of Peer and Family Belongingness in the Mental Health of Black LGBTQ + Youth
(Taylor & Francis, 0023-09-27) Watts, Keith, J.; Wagaman, M. Alex; Eaton, Andrew, D.; Leung, Vivian, W. Y.; Craig, Shelley, L.
A sense of belonging to familial and peer networks is crucial for the mental health of LGBTQ+ youth. Black LGBTQ+ youth report feeling rejected and isolated due to their sexual and/or gender identities. Utilizing linear regression analyses, this study explored the relationship between peer and family belongingness and levels of depression, anxiety, and self-rated mental health among 181 Black LGBTQ+ youth in the United States and Canada . Findings suggest that family and peer belongingness are important factors in Black LGBTQ+ youth's mental health and warrant further study into the protective nature of peer and family relationships for this population.
Open Access
The influence of information and communication technologies on the resilience and coping of sexual and gender minority youth in the United States and Canada.
(JMIR Research Protocols, 2017-09-28) Eaton, Andrew
Background: Sexual and gender minority youth are a population in peril, exemplified by their disproportionate risk of negative experiences and outcomes. Sexual and gender minority youth may be particularly active users of information and communication technologies (ICTs), and it is important to identify the potential contributions of ICTs to their resilience and well-being. Objective: Our aim was to (1) investigate the use of ICTs by sexual and gender minority youth, (2) identify the ways that ICTs influence the resilience and coping of sexual and gender minority youth, focusing on promotion of well-being through self-guided support-seeking (particularly using mobile devices), (3) develop a contextually relevant theoretical conceptualization of resilience incorporating minority stress and ecological approaches, (4) generate best practices and materials that are accessible to multiple interested groups, and (5) identify whether video narratives are a viable alternative to collect qualitative responses in Web-based surveys for youth. Methods: Mixed methods, cross-sectional data (N=6309) were collected via a Web-based survey from across the United States and Canada from March-July 2016. The sample was generated using a multipronged, targeted recruitment approach using Web-based strategies and consists of self-identified English-speaking sexual and gender minority youth aged 14-29 with technological literacy sufficient to complete the Web-based survey. The survey was divided into eight sections: (1) essential demographics, (2) ICT usage, (3) health and mental health, (4) coping and resilience, (5) sexual and gender minority youth identities and engagement, (6) fandom communities, (7) nonessential demographics, and (8) a video submission (optional, n=108). The option of a 3-5 minute video submission represents a new research innovation in Web-based survey research. Results: Data collection is complete (N=6309), and analyses are ongoing. Proposed analyses include (1) structural equation modeling of quantitative data, (2) grounded theory analysis of qualitative data, and (3) an integrative, mixed methods analysis using a data transformation design. Theoretical and methodological triangulation of analyses integrates an interwoven pattern of results into a comprehensive picture of a phenomenon. Results will be reported in 2017 and 2018. Conclusions: This research study will provide critical insights into the emerging use of ICTs by sexual and gender minority youth and identify intervention strategies to improve their well-being and reduce risks encountered by this vulnerable population. Implications for practice, research, and knowledge translation are provided.
Open Access
Barriers to addressing HIV-Associated Neurocognitive Disorder (HAND): Perspectives of community-based service providers
(Journal of HIV/AIDS and Social Services, 2018-02-23) Eaton, Andrew
HIV-Associated Neurocognitive Disorder (HAND) is an emergent public health issue in developed countries. Consequently, people living with HIV who experience HAND will increasingly require support from community-based HIV service providers. The objective of our qualitative study was to identify barriers service providers face in addressing HAND among people living with HIV. Thirty-three providers from 22 AIDS service organizations across Ontario, Canada, were interviewed. Using thematic analysis, three types of barriers were identified: (a) personal/professional, (b) service access, and (c) systemic. This paper draws attention to HAND-related obstacles that service providers encounter in their work and presents options to overcome them.
Open Access
Strategies employed by community-based service providers to address HIV-associated neurocognitive challenges: A qualitative study
(Journal of the International Association of Providers in AIDS Care, 2019-01-23) Eaton, Andrew
Background: HIV-associated neurocognitive disorders and other causes of neurocognitive challenges experienced by people living with HIV (PLWH) persist as public health concerns in developed countries. Consequently, PLWH who experience neurocognitive challenges increasingly require social support and mental health services from community-based providers in the HIV sector. Methods: Thirty-three providers from 22 AIDS service organizations across Ontario, Canada, were interviewed to determine the strategies they used to support PLWH experiencing neurocognitive difficulties. Thematic analysis was conducted to determine key themes from the interview data. Results: Three types of strategies were identified: (a) intrapersonal, (b) interpersonal, and (c) organizational. Intrapersonal strategies involved learning and staying informed about causes of neurocognitive challenges. Interpersonal strategies included providing practical assistance, information, counseling, and/or referrals to PLWH. Organizational strategies included creating dedicated support groups for PLWH experiencing neurocognitive challenges, partnering with other organizations with services not available within their own organization, and advocating for greater access to services with expertise and experience working with PLWH. Conclusion: Through concerted efforts in the future, it is likely that empirically investigating, developing, and customizing these strategies specifically to address HIV-associated neurocognitive challenges will yield improved social support and mental health outcomes for PLWH.
Open Access
The ART of conversation: Feasibility and acceptability of a pilot peer intervention to help transition complex HIV-positive people from hospital to community
(BMJ Open, 2019-03-30) Eaton, Andrew
Objectives To pilot a peer-based intervention for people living with HIV who used substances, had challenges with antiretroviral adherence and would be discharged from hospital to community. Study design A community-based, quasi-experimental pilot intervention study designed to assess feasibility, acceptability and connection to a community-based HIV organisation. Setting This study was conducted in Toronto, Canada, at Casey House (CH; hospital for people living with HIV) in collaboration with the AIDS Committee of Toronto (ACT; community-based HIV organisation). Participants People living with HIV who were CH inpatient between 1 April 2017 and 31 March 2018, struggled with antiretroviral adherence, actively used substances and would be discharged to community were eligible. Forty people met criteria, 19 were approached by an inpatient nurse and 17 consented. Average age was 48.8 years (SD=11.4), 58.8% were male and participants averaged 7.8 physical and mental health comorbidities (SD=3.1). Intervention Titled ’The ART of Conversation', the three-pronged personalised intervention was developed through input from CH clients and ACT volunteers, all living with HIV. Intervention components were (a) predischarge goal-setting (adherence, substance use and self-identified goal) with the study nurse; (b) predischarge meeting with an HIV+ peer volunteer (PV) and (c) nine postdischarge phone calls between PV and participant, once per day for 3 days, then once per week for 6 weeks. Primary outcomes Feasibility was measured through proportion of eligible participants recruited and PV availability. Acceptability was assessed through participant interviews at three times (preintervention, post-intervention and 6 weeks follow-up) and through PV call logs. Client records determined connection to ACT within the study timeframe. Results Twelve participants completed the intervention and nine connected with ACT. Predischarge goal-setting and PV meeting were both feasible and acceptable. Postdischarge phone calls were a challenge as half of completers missed at least one call. Conclusions Although predischarge goal-setting and PV meeting were feasible, methods to maintain connection following discharge require further investigation.
Open Access
An affirmative coping skills intervention to improve the mental and sexual health of sexual and gender minority youth (Project Youth AFFIRM): Protocol for an implementation study
(JMIR Research Protocols, 2019-06-06) Eaton, Andrew
Background: Sexual and gender minority youth (SGMY, aged 14-29 years) face increased risks to their well-being, including rejection by family, exclusion from society, depression, substance use, elevated suicidality, and harassment, when compared with their cisgender, heterosexual peers. These perils and a lack of targeted programs for SGMY exacerbate their risk for HIV and other sexually transmitted infections. Cognitive behavioral therapy (CBT) interventions support clients by generating alternative ways of interpreting their problems and beliefs about themselves. CBT, tailored to the experiences of SGMY, may help SGMY improve their mood and coping skills by teaching them how to identify, challenge, and change maladaptive thoughts, beliefs, and behaviors. Based on the promising results of a pilot study, a CBT-informed group intervention, AFFIRM, is being tested in a pragmatic trial to assess its implementation potential. Objective: The aim of this study is to scale-up implementation and delivery of AFFIRM, an 8-session manualized group coping skills intervention focused on reducing sexual risk behaviors and psychosocial distress among SGMY. Our secondary aim is to decrease sexual risk taking, poor mental health, and internalized homophobia and to increase levels of sexual self-efficacy and proactive coping among SGMY. Methods: SGMY are recruited via flyers at community agencies and organizations, as well as through Web-based advertising. Potential participants are assessed for suitability for the group intervention via Web-based screening and are allocated in a 2:1 fashion to the AFFIRM intervention or a wait-listed control in a stepped wedge wait-list crossover design. The intervention groups are hosted by collaborating community agency sites (CCASs; eg, community health centers and family health teams) across Ontario, Canada. Participants are assessed at prewait (if applicable), preintervention, postintervention, 6-month follow-up, and 12-month follow-up for sexual health self-efficacy and capacity, mental health indicators, internalized homophobia, stress appraisal, proactive and active coping, and hope. Web-based data collection occurs either independently or at CCASs using tablets. Participants in crisis are assessed using an established distress protocol. Results: Data collection is ongoing; the target sample is 300 participants. It is anticipated that data analyses will use effect size estimates, paired sample t tests, and repeated measures linear mixed modeling in SPSS to test for differences pre- and postintervention. Descriptive analyses will summarize data and profile all variables, including internal consistency estimates. Distributional assumptions and univariate and multivariate normality of variables will be assessed. Conclusions: AFFIRM is a potentially scalable intervention. Many existing community programs provide safe spaces for SGMY but do not provide skills-based training to deal with the increasingly complex lives of youth. This pragmatic trial could make a significant contribution to the field of intervention research by simultaneously moving AFFIRM into practice and evaluating its impact.
Open Access
Filmed simulation to train peer researchers in community-based participatory research
(Oxford University Press, 2019-09) Eaton, Andrew D.
Peer researchers share identities and/or experiences with a study population. Their involvement is crucial to community-based participatory research (CBPR), however there is a lack of attention to training peer researchers. A blended learning (multimodal) training curriculum for peer researchers in CBPR has been developed; its key component is the use of filmed simulation. In two instances, HIV-positive peer researchers were filmed during simulation and then watched their simulation to reflect on their performance. Such an activity can accommodate multiple learning styles (e.g., learning best through practice, listening, or seeing) and help refine verbal and non-verbal interview skills. The activity can also benefit social work researchers, who can see interview guides in practice and refine accordingly prior to data collection. This article discusses the educational benefits of filmed simulation for peer researchers, the reciprocal benefits that academic researchers may gain from the activity, and practical considerations for implementation of this activity in community-based settings.
Open Access
Connecting MSW students to community-based practicum: Feasibility and acceptability of panel presentations
(Taylor and Francis Group, 2019-09-03) Eaton, Andrew D.; Katz, Ellen; McKee, Eileen; Russell, Denise
Foundation-year MSW students in Canada often have their first practicum in community-based agencies. Orientation can be challenging as many students aim for hospital placements. Site visits are widely used for practicum orientation in Canada, however drawbacks include intensive resources and difficulty standardizing the experience. As a site visit alternative and to inspire students for community-based practicum, panel presentations were piloted to assess feasibility and acceptability. Thirty-seven panelists (primarily field instructors) presented to 135 MSW students in October 2017. Most students (90%, n=122) completed an evaluation form and 54% of panelists (n=20) completed a follow-up survey. Panels were feasible and acceptable to students and presenters. This paper details the orientation activity with considerations for research and practice.
Open Access
Protocol for a pilot randomised controlled trial evaluating feasibility and acceptability of cognitive remediation group therapy compared with mutual aid group therapy for people ageing with HIV-associated neurocognitive disorder (HAND) in Toronto, Canada.
(BMJ Open, 2019-10-31) Eaton, Andrew
Introduction HIV-associated neurocognitive disorder (HAND) may affect 30%–50% of people ageing with HIV. HAND may increase stress and anxiety, and impede coping. Psychosocial group therapy may ameliorate HAND’s symptoms, yet the ideal intervention is unclear. This protocol outlines a pilot randomised controlled trial (RCT)—designed using community-based participatory research—to pilot cognitive remediation group therapy (CRGT) against an active comparator. Methods and analysis This is a pilot, parallel design, two-arm RCT that will recruit participants diagnosed with the mild neurocognitive disorder form of HAND from a neurobehavioural research unit at a tertiary care hospital in Toronto, Canada. Eligibility criteria include age ≥40 years, known HIV status for 5+ years, English fluency, able to consent and able to attend 8 weeks of group therapy. Eligible participants will be randomised to one of two treatment arms, each consisting of eight-session group interventions delivered once weekly at 3 hours per session. Arm 1 (novel) is CRGT, combining mindfulness-based stress reduction with brain training activities. Arm 2 (active control) is mutual aid group therapy. The primary outcomes are feasibility, measured by proportions of recruitment and completion, and acceptability, determined by a satisfaction questionnaire. The secondary outcome is intervention fidelity, where content analysis will be used to assess facilitator session reports. A between-group analysis will be conducted on exploratory outcomes of stress, anxiety, coping and use of intervention activities that will be collected at three time points.
Open Access
QueerVIEW: Protocol for a Technology-Mediated Qualitative Photo Elicitation Study With Sexual and Gender Minority Youth in Ontario, Canada
(JMIR Publications, 2020-08-20) Eaton, Andrew
Background: The experiences of resilience and intersectionality in the lives of contemporary sexual and gender minority youth (SGMY) are important to explore. SGMY face unique experiences of discrimination in both online and offline environments, yet simultaneously build community and seek support in innovative ways. SGMY who identify as transgender, trans, or gender nonconforming and have experiences with child welfare, homelessness, or immigration have been particularly understudied. A qualitative exploration that leverages technology may derive new understanding of the negotiations of risk, resilience, and identity intersections that impact the well-being of vulnerable SGMY. Objective: The objectives of the QueerVIEW study were to (1) enhance understanding of SGMY identities, both online and offline, (2) identify experiences of intersectionality among culturally, regionally, and racially diverse SGMY in Ontario, Canada, (3) explore online and offline sources of resilience for SGMY, and (4) develop and apply a virtual photo elicitation methodological approach. Methods: This is the first study to pilot a completely virtual approach to a photo elicitation investigation with youth, including data collection, recruitment, interviewing, and analysis. Recruited through social media, SGMY completed a brief screening survey, submitted 10 to 15 digital photos, and then participated in an individual semistructured interview that focused on their photos and related life experiences. Online data collection methods were employed through encrypted online file transfer and secure online interviews. Data is being analyzed using a constructivist grounded theory approach, with six coders participating in structured online meetings that triangulated photo, video, and textual data. Results: Data collection with 30 participants has been completed and analyses are underway. SGMY expressed appreciation for the photo elicitation and online design of the study and many reported experiencing an emotional catharsis from participating in this process. It is anticipated that results will form a model of how participants work toward integrating their online and offline experiences and identities into developing a sense of themselves as resilient. Conclusions: This protocol presents an innovative, technology-enabled qualitative study that completely digitized a popular arts-based methodology—photo elicitation—that has potential utility for contemporary research with marginalized populations. The research design and triangulated analyses can generate more nuanced conceptualizations of SGMY identities and resilience than more traditional approaches. Considerations for conducting online research may be useful for other qualitative research.
Open Access
Training peers to ease hospital discharge: A community-clinical partnership in complex HIV care
(Johns Hopkins University Press, 2020-08-26) Eaton, Andrew D.; Chan Carusone, Soo; Ceranto, Andre; Craig, Shelley L.; Busch, Adam; McCullagh, John W.
As many people now live with HIV as a complex, chronic health condition that may require frequent medical and psychosocial services, a potential new role for HIV-positive peers involves support during an inpatient admission that extends past discharge to improve the transition home from hospital.
Open Access
Describing a Clinical Group Coding Method for Identifying Competencies in an Allied Health Single Session
(Journal of Multidisciplinary Healthcare, 2020-10-09) Eaton, Andrew
Introduction: Competencies that integrate research findings and practice expertise are necessary to maintain comprehensive evidence-based practice for allied health professions, such as social work. The context of modern multidisciplinary healthcare, especially in acute or emergency settings, means that an individual clinician may only have a single session with a patient. Maximizing the benefit of single sessions requires advanced competence that extends beyond diagnostics and biomedical treatments to the impact of social systems on health outcomes; multi-level advocacy for reduction of existing health disparities and equity in access to health and mental health services; and “working knowledge” of non-pharmacological treatments. Methods: This study employed a practice-based research methodology whereby health social workers group coded 32 simulation videos, drawn from an advanced social work practice course, to develop a practice-based competency framework that incorporates these advanced skills. Constructivist grounded theory was employed through a cyclical coding process of viewing video data, identifying and discussing skills and competencies, and summarizing/synthesizing the discussions for critical reflection. Results: The resulting Clinician Group Coding Method utilized systematic and collaborative group coding of practice simulation videos by three clinicians and two researchers to identify relevant competencies for a single session. Emphasis was placed on the progressive phases of single-session patient interactions (eg, joining, working, ending), a practice format that frequently occurs in social work and other allied health professions. These phases include themes of preparing, agenda setting and refining, addressing context, providing education, planning the next steps, and encouraging success. Discussion: The group coding process allowed for immediate discussions and clarifications, supporting the clinicians to synthesize their experiences toward shared understandings of “best practices” in single-session healthcare contexts. This approach facilitated the understanding of critical actions that allied health clinicians could undertake to improve single-session interactions. This practice-based competency framework may have significant utility for multidisciplinary healthcare education and practice.
Open Access
Can social media participation enhance LGBTQ+ youth wellbeing? Development of the social media benefits scale
(SAGE Publications, 2021-01-23) Craig, Shelley L.; Eaton, Andrew D.; McInroy, Lauren B.; Leung, Vivian W. Y.; Krishnan, Sreedevi
Social media sites offer critical opportunities for lesbian, gay, bisexual, trans, queer, and other sexual and/or gender minority (LGBTQ+) youth to enhance well-being through exploring their identities, accessing resources, and connecting with peers. Yet extant measures of youth social media use disproportionately focus on the detrimental impacts of online participation, such as overuse and cyberbullying. This study developed a Social Media Benefits Scale (SMBS) through an online survey with a diverse sample (n = 6,178) of LGBTQ+ youth aged 14–29. Over three-quarters of the sample endorsed non-monosexual and/or and gender fluid identities (e.g., gender non-conforming, non-binary, pansexual, bisexual). Participants specified their five most used social media sites and then indicated whether they derived any of 17 beneficial items (e.g., feeling connected, gaining information) with the potential to enhance well-being from each site. An exploratory factor analysis determined the scale’s factor structure. Analysis of variance (ANOVA) and Sheffe post hoc tests examined age group differences. A four-factor solution emerged that measures participants’ use of social media for: (1) emotional support and development, (2) general educational purposes, (3) entertainment, and (4) acquiring LGBTQ+-specific information. Bartlett’s test of sphericity was significant (χ2 = 40,828, p < .0005) and the scale had an alpha of .889. There were age group differences for all four factors (F = 3.79–75.88, p < .05). Younger adolescents were generally more likely to use social media for beneficial factors than older youth. This article discusses the scale’s development, exploratory properties, and implications for research and professional practice.
Open Access
Can Social Media Participation Enhance LGBTQ+ Youth Well-Being? Development of the Social Media Benefits Scale
(Social Media + Society, 2021-01-23) Eaton, Andrew
Social media sites offer critical opportunities for lesbian, gay, bisexual, trans, queer, and other sexual and/or gender minority (LGBTQ+) youth to enhance well-being through exploring their identities, accessing resources, and connecting with peers. Yet extant measures of youth social media use disproportionately focus on the detrimental impacts of online participation, such as overuse and cyberbullying. This study developed a Social Media Benefits Scale (SMBS) through an online survey with a diverse sample (n = 6,178) of LGBTQ+ youth aged 14–29. Over three-quarters of the sample endorsed non-monosexual and/or and gender fluid identities (e.g., gender non-conforming, non-binary, pansexual, bisexual). Participants specified their five most used social media sites and then indicated whether they derived any of 17 beneficial items (e.g., feeling connected, gaining information) with the potential to enhance well-being from each site. An exploratory factor analysis determined the scale’s factor structure. Analysis of variance (ANOVA) and Sheffe post hoc tests examined age group differences. A four-factor solution emerged that measures participants’ use of social media for: (1) emotional support and development, (2) general educational purposes, (3) entertainment, and (4) acquiring LGBTQ+-specific information. Bartlett’s test of sphericity was significant (χ2 = 40,828, p < .0005) and the scale had an alpha of .889. There were age group differences for all four factors (F = 3.79–75.88, p < .05). Younger adolescents were generally more likely to use social media for beneficial factors than older youth. This article discusses the scale’s development, exploratory properties, and implications for research and professional practice.
Open Access
Community engagement in Canadian health and social science research: Field reports on four studies
(University of Saskatchewan, 2021-04-15) Eaton, Andrew
Community engagement is a hallmark of Canadian health and social science research, yet we lack detailed descriptions of pragmatic peer engagement possibilities. People personally affected by a study’s topic can actively contribute to design, data collection, intervention delivery, analysis, and dissemination yet the nature and scope of involvement can vary based on context. The shift from academic to community-based research teams, where peers who share participant identities assume a leadership role, may be attributed to the HIV/AIDS response where community co-production of knowledge has been a fundamental component since the epidemic’s onset. This article discusses four health and social science studies from a community-based participatory research (CBPR) framework and synthesizes the strengths and limitations of community engagement across these endeavours to offer lessons learned that may inform the design of future CBPR projects.
Open Access
Engaging the Senses in Qualitative Research via Multimodal Coding: Triangulating Transcript, Audio, and Video Data in a Study With Sexual and Gender Minority Youth
(SAGE Publications, 2021-04-30) Eaton, Andrew
The variety of formats in which qualitative data may be collected have been explored within the methodological literature. Yet, the multiple options for coding these data formats have not been comprehensively detailed. While transcript analysis is widely used across disciplines, it may have limitations—particularly for research involving marginalized populations. This paper presents a multimodal coding approach as a methodological innovation for triangulating three data formats (transcript, audio, and video), detailed through the application of this analytic approach during a qualitative study exploring media engagement with sexual and gender minority youth (SGMY). Nineteen semi-structured interviews with SGMY were filmed and transcribed. Nine independent coders then utilized the innovative multimodal approach to code the three data formats using a constructivist grounded theory framework. Some codes were similar across modalities, such as those related to safety issues and finding identity and community through media. Others differed between modalities, such as those related to participant affect, perceived contradictions, discrepancies between verbal statements and body language, level of comfort and engagement, and distress when discussing traumatic experiences. Video coding captured the broadest range of emotions and experiences from marginalized youth, while transcripts provided the most straightforward form of data for coding. Multimodal coding may be applicable across qualitative approaches to enrich analyses and account for potential biases, thereby enhancing analytical lenses in qualitative inquiry. Methodological strategies for coding and integrating data types are discussed.
Open Access
Efficacy of affirmative cognitive behavioural group therapy for sexual and gender minority adolescents and young adults in community settings in Ontario, Canada
(BMC Psychology, 2021-06-07) Eaton, Andrew
Objective This study tested the efficacy of AFFIRM, a brief affirmative cognitive-behavioural group intervention tailored to reduce psychosocial distress and improve coping among sexual and gender minority adolescents and young adults (SGMY). Method SGMY (n = 138; M age = 22.44) were allocated to immediate 8-week AFFIRM intervention delivered at 12 community-based organisations or an 8-week waitlisted control. At baseline, post-intervention or post-waitlist, participants completed self-reported assessments of depression, hope, coping, and stress appraisal. Implementation outcomes of feasibility and acceptability were also assessed. Results Compared to waitlist, SGMY in the intervention condition significantly reduced their depressive symptoms (b = − 5.79, p = .001) as well as increased reports of hope (agency: b = 0.84, p = .001; pathway: b = 0.79, p = .001), and coping by emotional support (b = 0.59, p < .001), instrumental support (b = 0.67, p < .001), positive framing (b = 0.59, p < .001), humour (b = 0.36, p = .014), planning (b = 0.49, p < .001) as well as reflective coping (b = 0.27, p = .009). Intervention participants were also less likely to perceive stress as a threat (b = − 0.43, p = .001), and more likely to perceive stress as challenge (b = 0.67, p < .001) and have the resources to deal with that stress (b = 0.38, p = .016) in comparison to waitlisted control participants. All outcomes had medium to large effect sizes. AFFIRM participants reported low attrition (8.5%) and high levels of engagement and acceptability (e.g. 99% agreed intervention was relevant to their lives). Over 63% of the community organizations that participated in the training hosted AFFIRM at least once during the study. Conclusions Results demonstrate efficacy for the community-based implementation of an affirmative clinical intervention designed for SGMY to address depression and foster coping with universal and minority stressors.
Open Access
Towards an integrative self: a digital photo elicitation study of resilience among key marginalized populations of sexual and gender minority youth
(Informa UK Limited, trading as Taylor & Francis Group., 2021-08-10) Eaton, Andrew
Purpose: Sexual and gender minority youth (SGMY) experience unique challenges related to identity and disclosure, and cope in vibrant ways. Qualitative research has not yet fulsomely explored the risk, resilience, and identity intersections that impact vulnerable SGMY wellbeing. Methods: This digital photo-elicitation study (QueerView) recruited thirty SGMY (aged 14–29) from priority populations that had one or more of the following experiences: trans and gender diverse, homelessness, child welfare, and immigration. From submission of fifteen photos representing resilience and a semi-structured interview via web conferencing, constructivist grounded theory was utilized for multimodal analysis of photos, interview video, and interview transcript. Triangulation, an audit trail, and member checking were employed to support trustworthiness. Results: A visual model emerged showing how participants work towards an integrative self, with themes of reflecting and knowing, discrimination and intersectional challenges, connecting, performing, curating, coping, (re)defining and (re)creating, growing and being. Sub-themes of the impact of family dynamic and values, mental health and trauma, and the cathartic benefit from advocacy and leadership offered insight. Participant images were captured in a digital gallery. Conclusions: QueerView animates the complex lives of multiply marginalized SGMY and their intersectional strengths and challenges while demonstrating the utility of a digital multimodal approach.
Open Access
Cognitive remediation group therapy compared to mutual aid group therapy for people aging with HIV-associated neurocognitive disorder: randomized, controlled trial
(Taylor and Francis Group, 2021-08-21) Eaton, Andrew D.; Craig, Shelley L.; Rouke, Sean B.; Sota, Teresa; McCullagh, John W.; Fallon, Barbara A.; Walmsley, Sharon L.
Cognitive impairment is an important comorbidity for people aging with HIV, and group therapy may ameliorate the associated anxiety and stress. Combination psychosocial interventions may have better outcomes than single technique approaches. A pilot, parallel design, two-arm trial randomized people aging with HIV-Associated Neurocognitive Disorder (HAND) to Cognitive Remediation Group Therapy (Experimental; combination of brain training activities and mindfulness-based stress reduction) or Mutual Aid Group Therapy (Control). Outcomes were feasibility, acceptability, fidelity, and exploratory measures of anxiety, stress, coping, and use of mindfulness and brain training activities. Amongst forty contacted participants, 15 replied, 12 recruited, and 10 completed. Assessors confirmed intervention delivery with satisfactory fidelity. The novel arm had statistically significant improvements in stress and mindfulness use compared to control, and brain training and mindfulness use sustained at 3-month follow-up. Requiring a HAND diagnosis made recruitment challenging. Further research should broaden eligibility to people aging with HIV and cognitive challenges.
Open Access
Mitigating risks and building resilience to HIV/AIDS: Perspectives of HIV-negative, middle-aged and older men who have sex with men.
(Community Psychology in Global Perspective, 2021-09-12) Eaton, Andrew
Purpose: Although ample research has been conducted on resilience to HIV/AIDS, most studies have utilized quantitative methods and focused almost exclusively on people living with HIV/AIDS. A relatively untapped source of knowledge is the perspectives of HIV-negative, middle-aged and older men who have sex with men (MSM) who have been navigating risks and building resilience to HIV/AIDS since the 1980s. Our qualitative, community-based participatory research study examined the perspectives of HIV-negative, middle-aged and older MSM on factors that helped mitigate the risks of and build resilience to HIV/AIDS. Methods: In collaboration with community-based organizations, fourteen participants were recruited for in-depth interviews. Participants were aged 40 or older, identified as HIV-negative MSM, and resided in Ontario, Canada. Thematic analysis of interviews revealed salient themes. Results: Three themes were identified: (1) individual attributes (e.g., self-awareness/control), (2) protective relational factors (e.g., meaningful sexual relationships), and (3) community-based resources (e.g., competent healthcare/service providers). Conclusion: HIV-negative, middle-aged and older MSM recognized factors that helped mitigate risks of contracting and build resilience to HIV/AIDS based on their own lived experiences. Some of these factors have not been explicitly identified or extensively discussed in extant academic literature, and are worth considering in the development of community-based HIV/AIDS prevention and intervention programs.

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