Andrew Eaton

Permanent URI for this collectionhttps://hdl.handle.net/10294/14540

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Open Access
Adapting Cognitive Remediation Group Therapy as an Online or Hybrid Intervention for People Aging With HIV and Cognitive Concerns: Focus Group Protocol
(SAGE Publications, 2022) Eaton, Andrew, D.; Hui, Jenny; Muchenje, Marvelous; Murzin, Kate; Carusone, Soo Chan; Ibáñez-Carrasco, Francisco; Novik, Nuelle; McCullagh, John, W.; Nicolay, Susanne; Walmsley, Sharon, L.
Cognitive impairment is a significant health issue for people aging with HIV/AIDS. Cognitive challenges can include forgetfulness, trouble concentrating, and increasing struggles to learn new skills, all of which contribute to poorer mental health and decreased quality of life. Although there is no specific drug therapy that can reverse the brain impairment, group therapies may help people aging with HIV and cognitive challenges to better cope with their symptoms when combined with their usual medical treatment and follow-up. This community-based study will involve peer-led focus groups to discuss cognitive remediation group therapy – a combination of mindfulness-based stress reduction and brain training activities tested in a pilot randomized, controlled trial – as an in-person intervention for people aging with HIV in 2019. Via a brief demographic survey and technology-mediated focus groups (n = 40) in Ontario and Saskatchewan, we will determine how the intervention could be adapted in an online or hybrid format considering the ongoing COVID-19 pandemic. Content analysis will be employed whereby a team of independent coders will code the focus group transcripts in line with the co-design framework and “Double Diamond” model of developing interventions, including intervention structure, content, and mode of delivery. Given the aging of the HIV population in Canada, increasing support will be required in addition to medical care to improve quality of life, and proactively address concerns about cognition. This protocol provides a roadmap for adapting in-person psychosocial interventions using community-based and technology-mediated methods
Open Access
Adapting Cognitive Remediation Group Therapy Online: Focus Groups with People Aging with HIV
(SAGE Publications, 2024-01) Andrew D. Eaton; Jenny Hui; Marvelous Muchenje; Taylor Kon; Kate Murzin; Soo Chan Carusone; Nuelle Novik; Adria Quigley; Kristina Kokorelias; Francisco Ibáñez-Carrasco
Cognitive health is a significant concern for people aging with HIV/AIDS. Psychosocial group therapies may help people aging with HIV who experience cognitive challenges cope with their symptoms. The COVID-19 pandemic revealed in-person group therapies need adaptation for technology-mediated delivery. Peer-led focus groups discussed adapting cognitive remediation group therapy (CRGT) as an online intervention. CRGT combines mindfulness-based stress reduction and brain training activities. Purposive sampling recruited people aging with HIV (40+) who self-identified cognitive concerns and resided in one of two Canadian provinces. Thematic content analysis was employed on transcripts by seven independent coders. Ten, 2-hour focus groups were conducted between August and November 2022. Participants (n=45) responded favorably to CRGT's modalities. Alongside support for its continued implementation in-person, participants requested online synchronous and online asynchronous formats. Preferred intervention facilitators were peers and mental health professionals. We also discuss how to adapt psychosocial HIV therapies for technology-mediated delivery.
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
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
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
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
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
Co-Creating Socio-Culturally-Appropriate Virtual Geriatric Care for Older Adults Living With HIV: A Community-Based Participatory, Intersectional Protocol
(Sage, 2023-10-06) Kokorelias, Kristina M.; Wasilewski, Marina B.; Flanagan, Ashley; Zhabokritsky, Alice; Singh, Hardeep; Dove, Erica; Eaton, Andrew D.; Valentine, Dean; Sheppard, Christine; Abdelhalim, Reham; Parpia, Rabea; Zewude, Rahel; Jamieson, Laura; Grosse, Anna; Walmsley, Sharon; Brown, Paige; Sirisegaram, Luxey
The aging cohort of persons living with human immunodeficiency virus (HIV) in Canada has reached a critical point, with nearly half now 50 years age or older. Older persons living with HIV have specific needs which can be effectively addressed by geriatric specialists. However, the recognition of HIV care as a domain of geriatrics is recent, resulting in a lack of clinical recommendations and modern care models for delivering geriatric care to this population. Virtual care has been demonstrated to reduce existing barriers to accessing HIV care in some populations but before it can be adapted to geriatric HIV care a critical first step is to acknowledge and understand disparities in socioeconomic circumstances, technology access and ability and cultural differences in experiences. This protocol marks the initial step in a comprehensive program of research aimed at co-designing, implementing, and evaluating culturally-appropriate virtual geriatric care for diverse older adults living with HIV. The study employs qualitative methods with older adults living with HIV to lay the groundwork, to inform the future development of a virtual model of geriatric care. We will explore the perspectives of diverse groups of older persons with HIV on (1) The value and necessity of culturally-tailored virtual interventions for geriatric HIV care; and (2) Recommendations on how best to engage older persons with HIV in the future co-design of a virtual model of geriatric HIV care. Ultimately, a more culturally-appropriate approach to care will foster a more inclusive and supportive healthcare system for all individuals affected by HIV including those who are aging. Researchers can utilize this research protocol to employ qualitative co-design and participatory methods with diverse older adults living with HIV.
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
Cognitive screening considerations for psychosocial clinical trials in HIV, aging, and cognition
(SAGE Publications, 2022-12-01) Eaton, Andrew D; Murzin, Kate; Hui, Jenny; McCullagh, John W; Walmsley, Sharon L; Chan Carusone, Soo
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
Community-level resources bolstering resilience to HIV/AIDS: Perspectives of middle-aged and older men who have sex with men living with HIV/AIDS
(2021-12) Liboro, Renato, M.; Yates, Tammy, C.; Fehr, Charles; Da Silva, George; Ibañez-Carrasco, Francisco; Eaton, Andrew, D.; Pugh, Daniel; Ross, Lori, E.; Shuper, Paul, A.
Most prior research on resilience to HIV/AIDS has utilized quantitative tools (e.g., scales and surveys) to examine individual-level assets (e.g., self-efficacy, hope, optimism) that researchers believe represent or approximate resilience to HIV/AIDS with minimal consideration for the perspectives of men who have sex with men (MSM), the population that has remained at greatest risk of, and the most impacted by HIV/AIDS in North America since the 1980s. The aim of this qualitative study is to identify community-level resources that bolster resilience to HIV/AIDS based specifically on the perspectives and lived experiences of middle-aged and older (MAO) MSM living with HIV/AIDS. Employing a Community-Based Participatory Research (CBPR) approach involving the meaningful and active engagement of MSM at multiple levels (i.e., as research team members, peer researchers, Community Advisory Board representatives, community partners, and study participants), forty-one MAO MSM living with HIV/AIDS from Ontario, Canada, were included in the study’s semi-structured interviews. Utilizing thematic analysis, four major themes were identified from the interview data: (a) the 2SLGBTQ+ community; (b) community-based not-for-profit organizations; (c) public health services; and (d) neighbourhood support programs. This article discusses the value of community-level resources as important additions to individual-level assets for bolstering resilience to HIV/AIDS, as well as the implications of the study’s findings and limitations for future HIV/AIDS services and research.
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
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
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
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
Entre la precarización de los derechos y la producción de subjetividad política en experiencias de jóvenes trans en México
(Universidad Nacional Autónoma de México, Centro de Investigaciones y Estudios de Género, 2022-07-01) Zamorano-Martínez, Lenin Adolfo; Ignacio, Lozano-Verduzco; Mendoza-Pérez, Juan Carlos; Eaton, Andrew, D.; Craig, Shelley, L.
El objetivo de esta investigación cualitativa fue comprender cómo operan las diferentes prácticas y los discursos que atentan contra la dignidad e integridad de jóvenes trans. Se realizaron grupos focales y entrevistas semiestructuradas a 23 jóvenes trans entre 16 y 29 años en México. A través de un análisis de contenido, se identificaron las prácticas y discursos desde los cuales se atentó contra sus derechos en diferentes dimensiones (identitaria, laboral, educativa, de salud, espacial). Además, se identificaron los actos y recursos que ejercieron para hacer frente a las diversas formas de vulneración, tales como las emociones, las tecnologías de información y comunicación, y el arte. Concluimos que las relaciones de desigualdad social se traducen en precarización de los derechos humanos y, al mismo tiempo, en la base que contribuye a resistir la precarización de los derechos y a la construcción de una subjetividad política trans.
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
Experiences of COVID‐19 pandemic‐related stress among sexual and gender minority emerging adult migrants in the United States
(Wiley, 2022-09-01) Alessi, Edward, J.; Cheung, Shannon, J.; Sarna, Vincent; Dentato, Michael, P.; Eaton, Andrew, D.; Craig, Shelley, L.
There is a dearth of research that examines COVID-19-related stress among multiply marginalised individuals who are in the developmental phase of emerging adulthood. This qualitative study investigated how the intersection of emerging adulthood, sexual and gender minority (SGM) identity, and migrant status were reflected in the experiences of SGM individuals (n = 37; ages 20–25 years old) who migrated to various parts of the United States in the last 5 years. Data were collected online using semi-structured interviews. Thematic analysis revealed that participants' developmental processes (e.g., identity exploration, building financial independence) were shaped by pandemic-related stressors, especially unemployment and financial instability. Participants who were able to maintain employment did so but at the risk of their health and safety. Findings also showed that participants experienced feelings of anxiety and depression due to social isolation, but online communication played an important role in combatting loneliness. Findings highlight the potential for trauma-informed and intersectional approaches to practice with SGM emerging adult migrants and expanded health services and temporary entitlement programs to mitigate the pandemic's effects on this population's psychosocial and financial well-being.
Open Access
Exploring caregiver experiences and support needs in end-of-life care for people living with HIV: A scoping review protocol
(Public Library of Science (PLoS), 2024-12-02) Kristina M. Kokorelias; Andrew D. Eaton; Marina Wasilewski; Tyler Redublo; Luxey Sirisegaram; Chukwudi Nnaji
Background and objectives End-of-life care supports individuals in the last few weeks or months of their life and their caregivers, offering psychosocial support, symptom management and relief, and resources. While some of the first public end-of-life care facilities were established due to HIV/AIDS, the current needs of caregivers for people living with end-stage HIV are not well understood. Caregivers provide two-thirds of the care for people living with HIV, yet their specific support needs and experiences are under-researched. Existing strategies often use a “one-size-fits-all” approach, which may not address the unique challenges faced by these caregivers, such as stigma and lack of social support. This study aims to synthesize the literature on the end-of-life care experiences and needs of caregivers for individuals living with HIV. Research design and methods A scoping review, guided by Arksey and O’Malley’s framework and the Joanna Briggs Institute’s recommendations, will be conducted. An Information Specialist will assist in developing a search strategy to be applied across databases like Medline, Embase, PsycINFO, and PubMed. Search results from each database will be imported into Covidence software for duplicate removal and title and abstract screening. Two researchers will independently screen studies using the ‘Population–Concept–Context’ (PCC) framework, with screening conducted at two levels: title and abstract, and full-text. The inclusion criteria will be piloted on a random sample of articles to ensure inter-rater agreement (kappa statistic >0.61). Disagreements will be resolved through discussion or with the involvement of a content expert if needed. Final selections will be reported using the PRISMA flow diagram, and reasons for exclusion will be documented. Discussion and implications The findings from this scoping review will provide valuable insights into the end-of-life care experiences and support needs of caregivers for individuals living with HIV. By identifying common themes and challenges, such as caregiver fatigue, emotional strain, stigma, and lack of social support, this study will underscore the inadequacy of the current “one-size-fits-all” approach in addressing the unique needs of these caregivers. This research has the potential to influence both clinical practice and policy by advocating for more personalized support strategies within end-of-life care settings.

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