ObjectiveTo review literature on Community Health Workers' (CHW) role in providing tobacco cessation programming and offer recommendations for future research and programming based on findings.Data SourcesPubMed, Scopus, and Academic Search Complete.Study Inclusion and Exclusion CriteriaThe first author screened and selected articles that (1) were published after 2000; (2) used CHWs; (3) included tobacco cessation as a primary objective; and (4) were conducted in the United States. Twenty articles met the criteria and were analyzed.Data ExtractionData were extracted and organized in a table that included: author, title, publication year, study design, intervention characteristics (type, length, setting, and description), primary outcome, summary of outcomes, and strengths/limitations.Data SynthesisData were analyzed based on study characteristics and grouped thematically.ResultsTwenty studies demonstrated positive associations between CHW engagement and improved cessation outcomes across populations, including public housing residents and racial/ethnic minorities. CHWs contribute to successful cessation through four mechanisms: repetitive/consistent interactions, provision of medical therapies, wraparound services addressing the social determinants of health (SDOH), and psychosocial support to improve mental health and well-being.ConclusionThis study highlights the ability of CHWs to reach diverse populations and establish trust through shared experiences and understanding of barriers to cessation. Key recommendations include expanding research to engage underrepresented populations such as sexual and gender minorities, veterans, and unhoused people; prioritizing sustained CHW-patient engagement; incorporating medical therapies and culturally tailored cessation aids; and developing comprehensive programming that addresses the SDOH along with cessation.

Clinical trials involving sexual minority adolescents and young men in low- and middle-income countries have historically been limited due to a combination of structural, social, and scientific barriers that often hinder their participation. In addition, researchers lack the cultural competence or knowledge of inclusive recruitment strategies to effectively engage these populations. In this commentary, we describe the experiences, challenges, and opportunities in establishing youth advisory boards as a pathway to entry into the community, overcoming exclusion, building trust, and incorporating the voices of under-served sexual minority adolescents and young men in clinical trials and the development of community-informed interventions.Trial registration: ClinicalTrials.gov NCT06350682. Registered on February 10, 2026.

Social learning theory posits that experiencing negative substance use consequences contributes to reductions in subsequent use. However, relatively few studies have examined prospective effects of substance use consequences on subsequent use; those that have focus exclusively on alcohol and have produced mixed results. The current study aimed to advance our understanding of daily effects of consequences on subsequent use by examining these associations for cannabis, determining if consequences accumulate over time and how long they continue to influence use, and identifying moderators (i.e., cannabis use problems; motives for use) of these associations. We used EMA data (2 observations per day for 14 days) from 593 young adult females who regularly used cannabis. The sample included a majority sexual minority women and gender diverse individuals (77.6%) and a comparison group of heterosexual cisgender women (22.4%). Recent cannabis consequences were associated with a decreased likelihood of subsequent use among individuals with fewer cannabis use (CU) problems. Coping motives also moderated associations between consequences and subsequent CU, with consequences only associated with lighter next-day use when coping motives were not endorsed on the next day. Findings also suggest that consequences accumulate across days and cumulative consequences over the past five days continue to influence CU. These findings indicate that individuals with severe CU problems may not respond with behavioral change to consequences, while individuals with fewer CU problems reduce use following consequences. This may result from differences in perceptions of the aversiveness of consequences, which should be examined by future research.

Sexually minoritized men (SMM) experience sexual minority stress, a product of exposure to prejudice, discrimination, and heterosexism. This study sought to identify the latent profiles of sexual minority stress among SMM with HIV who use methamphetamine and to examine the correlates associated with profile membership. A cross-sectional examination of 104 participants in San Francisco self-reported their experiences with sexual minority stress. A latent profile analysis was used to characterize the underlying "profiles" or subgroups of participants. ANOVA and Chi-square analysis were used to examine sociodemographic characteristics, psychological health, substance use, and HIV-related health associated with each profile. Participants' mean age was 43 years old (SD = 9); most identified as Black, Hispanic, or Other racial and ethnic identities (57%), and had been diagnosed with HIV for 13 years (SD = 9) on average. Our findings revealed four distinct profiles: (1) High Concealment, Moderate Prejudice Events, (2) Low Concealment, High Prejudice Events, (3) Low Sexual Minority Stress, and (4) High Sexual Minority Stress. Members of the High Sexual Minority Stress profile had the highest mean addiction severity scores and the greatest endorsement of feelings of shame and guilt. Notably, each profile had clinically significant PTSD and depression scores, even among those who experienced stressful events to a lesser extent. Our findings suggest that sexual minority stress plays a critical role in substance use and mental health outcomes. Additional research is needed to elucidate the other facets of stress in SMM that use substances.

Background Lesbian, gay, bisexual, transgender and other gender and sexual minority people (LGBTQ+) individuals face dramatic inequities in health outcomes across the US and especially those residing in the Deep South due to pervasive LGBTQ+-related stigma and discrimination. A significant barrier repeatedly noted is the lack of clinicians trained to provide LGBTQ+-affirming care. Given that nurses play a critical role in patient care, research was needed to inform the development and piloting of LGBTQ+-specific curriculum for nursing faculty. Methods We conducted a multiple-methods study consisting of a PRISMA-ScR–guided scoping review and qualitative descriptive interviews. A systematic search of PubMed identified studies relevant to LGBTQ+ nursing education, and 62 articles met criteria for inclusion and thematic synthesis. To further contextualize these findings, we conducted individual qualitative interviews with nursing students and faculty ( n = 21) to explore experiences with LGBTQ+-related curriculum and instructional practices. Results Our multiple-methods results fall into two broad domains: (1) Course content (i.e., LGBTQ+-focused theories, evolving terms and concepts, empirical evidence of health inequities, and clinical considerations); (2) Considerations on how best to deliver the course (i.e., balancing hybrid modalities, varying lengths, balancing personal and lived experience among instructors, and minimal costs, and use of validated scales in combination with qualitative questions for the evaluation). Discussion and conclusion Given the substantial number of LGBTQ+ people across the US (2024 Gallup Poll shows 9.3% of the country's population identifies as LGBTQ+), and especially in the South (home to the largest LGBTQ+ population across Census Bureau regions), we are unlikely to ‘make America healthy again' without addressing the needs of LGBTQ+ communities. To do so, structural-level change that engages the providers in our health systems, and specifically the nurses who have the most touchpoints with our patients, is needed to reconcile the promise of good health and its achievement. Our results provide a clear roadmap to educating our nursing faculty and empowering them to deliver on our collective commitment to achieve the highest attainable standard of health for all.

Introduction: Flourishing is a key indicator of positive mental health and psychosocial functioning. However, evidence on the measurement performance of the Flourishing Scale (FS) in sexual and gender minority (LGBT/SGM) populations in the Spanish-speaking Caribbean remains limited. Objective: To evaluate the psychometric properties of the FS among LGBT adults in Puerto Rico. Method: Participants were recruited online (N = 300). Given item-level and multivariate non-normality, a robust one-factor CFA was estimated and examined global fit, standardized loadings, and reliability (α, ω). Evidence for validity included (a) Average Variance Extracted (AVE) as an indicator-level convergence index and (b) associations with external criteria (PHQ-8, GAD-7). Multi-group CFA tested configural, metric, and scalar invariance across gender identity and sexual orientation. Results: The robust CFA supported a unidimensional structure with strong standardized loadings and high internal consistency. AVE exceeded .50, indicating adequate indicator-level convergence within the measurement model. As hypothesized, FS scores correlated negatively with PHQ-8 and GAD-7. Multi-group CFA supported metric and scalar invariance by gender identity and scalar invariance by sexual orientation, with borderline evidence at the metric step, enabling latent-mean comparisons under supported conditions. Conclusions: The FS is a brief, reliable, and valid indicator of psychological flourishing among LGBT adults in Puerto Rico, suitable for research, screening, and program evaluation; however, convergent validity with an independent positive well-being measure should be established in future work.

Negotiating Conflicting Identities among Heterosexually Married Sexual Minority Men Living with HIV in China

Sexual and gender minority nurses' minority stress in the workplace: A scoping review.

Substance use behaviours among sexual and gender minorities with a history of adverse childhood experiences: a systematic review and narrative-synthesis.

Health among sexual and gender minority people affected by armed conflict and forced displacement: Call for a biocultural and minority stress framework.

Unpacking the link between adverse childhood experiences and mental health disparities among Chinese men who have sex with men: The mediating role of filial piety and internalized homophobia.

Sexual Violence Among U.S. High School Students: Differences by Sexual Identity, 2023.

Development of lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other gender and sexual minority (LGBTQIA+) identities and a disability identity is critical for positive mental health outcomes for LGBTQIA+ autistic individuals. To understand identity development and evaluate the resonance of support among a large sample of LGBTQIA+ autistic adults. A sequential mixed-methods, participatory approach. Data collection for both phases occurred remotely. LGBTQIA+ autistic adults completed the qualitative phase and the survey (Ns = 57 and 107, respectively). Phase 1, the qualitative phase, included semistructured interviews and focus groups based on queer, crip, and intersectionality theories. Questions related to identity exploration and development. Themes regarding barriers and supports were used to develop a survey, used in Phase 2, to collect quantitative data to confirm the resonance of the findings. Participants described exposure, personal research, trial and error, and individuals external to the LGBTQIA+ and autistic communities as contributing to their evolving identities. If these contributing factors were positive, people described experiencing narrative gain, whereby they felt a sense of relief and pride over their identities, and if they were negative participants reported going through a journey toward self-acceptance. Occupational therapy practitioners can support LGBTQIA+ autistic adults in the identity development process by fostering connections with other LGBTQIA+ autistic individuals, providing accessible sexual health education supporting personal research and providing accessible resources, offering opportunities to explore identities through creative means, and creating supportive environments and safe spaces for self-exploration. Plain-Language Summary: Identity development is the process of understanding who you are. Occupational therapy practitioners can help support positive identity development for LGBTQIA+ autistic clients. In Phase 1 of the study, we talked to 57 LGBTQIA+ autistic people and asked them how they learned they were LGBTQIA+ and autistic. We used what we learned from those people to create survey questions, and we asked another 107 LGBTQIA+ autistic people whether the findings from our conversations in Phase 1 resonated with them as well. LGBTQIA+ autistic participants reported that they found it helpful to be exposed to people with diverse LGBTQIA+ and autistic identities; to be connected with articles, blogs, and people online who held diverse LGBTQIA+ and autistic identities; and to trial different identities. They also said it was helpful if people who were not LGBTQIA+ or autistic were supportive during this process. When people had more help, they had better acceptance of themselves. When people had less help, they said they had to learn to accept themselves. Positionality Statement: In this article, we use the term LGBTQIA+ (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other gender and sexual minority identities) to refer to a spectrum of marginalized sexual orientations (e.g., lesbian, gay, bisexual, asexual), gender identities (e.g., transgender, nonbinary, agender), and biological variations in sex characteristics (e.g., intersex). We recognize that these identities are distinct but often interrelated, and unless otherwise specified we use LGBTQIA+ inclusively to reflect participants' self-identification. The first author is a White, straight, cisgender female with a history of generalized anxiety disorder. The second author is a mixed-race, queer, cisgender woman who is multiply neurodivergent, including autism, attention deficit hyperactivity disorder, and posttraumatic stress disorder. The third author is a White, queer, nonbinary autistic person. The fourth author is a White, straight, cisgender female. The research team has varied experience and expertise in conducting research. The first author has a PhD and is a licensed occupational therapist, the second author has worked for many years in research laboratories as a research assistant and coordinator and is a licensed occupational therapist, the third author has a background in quantitative designs and statistical analyses and has worked as a research assistant, and the fourth author worked as a research assistant while in graduate school and is a licensed occupational therapist.

133. From Recruitment to Retention: Sexual and Gender Minority Youth Participation in a Substance Use Screening and Brief Intervention Trial

224. Overlooked in Primary Care: a Scoping Review on Substance Use Interventions for Sexual and Gender Minority Youth

231. Peer and Parent Pressure: How Perceived Attitudes Protect Against Cannabis Use in Gender & Sexual Minority Youth

Folk devils? Perceived lack of traditional values explains youth-related stereotypes of sexual minorities and Black men

187. Post-traumatic stress disorder and polycystic ovary syndrome among sexual minority young adults

Nicotine and cannabis vaping among U.S. emerging young adults: Findings from 2022 and 2023 National Survey on Drug Use and Health.

Black sexual and gender minority youth (SGMY) face significant disparities in suicidal thoughts and behaviors. Minority Stress Theory (MST) posits that the minoritized social statuses of sexual and gender minority individuals increases experiences of discrimination and victimization, which may increase poor mental health and lead to suicide. Such experiences are further complicated for racial and ethnic minority individuals who hold multiple marginalized positions and thus experience intersectional minority stress. Little research has examined how Black SGMY experience intersectional minority stressors and how these experiences impact suicidal thoughts and behaviors. In this phenomenological study, we explored experiences of minority stress at the intersection of race and sexual and/or gender identity and examined how such experiences can contribute to suicidal thoughts and behaviors. We conducted in-depth interviews with 22 Black SGMY ages 16-24 in Milwaukee, WI. We identified five themes surrounding the compounding minority stressors Black SGMY faced that contributed to poor mental health and suicidal thoughts and behaviors: (1) the journey of self-acceptance; (2) familial rejection; (3) societal marginalization; and (4) suicidal thoughts and behaviors as an escape from oppression. Our findings suggest effective suicide prevention strategies for Black SGMY should move beyond universal models and incorporate culturally responsive and identity-affirming strategies. In addition, peer-led support and community-based programming may be important avenues for affirming and protecting the lives of Black SGMY.