Hot Topics in LGBTQI Health
Hot Topics in LGBTQI Health Tuesday, March 31, 2015 4th Annual Event Commemorating National LGBT Health Awareness Week Sponsored by the Rutgers Biomedical Health Sciences LGBTQI Health Working Group and Rutgers School of Nursing Co-sponsored by the Region 2 Public Health Training Center, through the Rutgers School of Public Health Rutgers, The State University of New Jersey 6.5 Nursing Contact Hours *, Continuing Education Credits for CHES **, NJ Public Health CEs *** *Rutgers School of Nursing Center for Professional Development is an approved provider of continuing nursing education by New Jersey State Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission On Accreditation. P#290-6/1417. --**This program has been approved for 6.5 Category I Continuing Education Credits for CHES by the Rutgers School of Public Health. The Rutgers School of Public Health has been designated as a provider of continuing education in health education by the National Commission for Health Education Credentialing, Inc. --*** Participants who complete this educational program will be awarded 6.5 NJ Public Health Continuing Education Contact Hours (CEs). Rutgers School of Public Health has been approved by the New Jersey Department of Health as a provider of NJ Public Health Continuing Education Contact Hours (CEs). Schedule 9:30 Check-In and Continental Breakfast Multipurpose Room 10:00 Welcome & Introduction Wendy Ritch, MA, MTS Auditorium 10:15 PANEL --- US Department of Health and Human Services of Region II – Programmatic Overview and Critical Health Updates Related to LGBTQI Communities Thomas Bane, LMSW and panelists Auditorium 11:45 Experiences of LGBT People in the Healthcare Setting Rubab Qureshi, MD PhD Auditorium 12:15 Healthcare Needs Assessment of LGBT Populations in NJ Peijia Zha, PhD, MA Auditorium 12:45 LGBTQI Inclusion in the Rutgers University DNP HIV Care Specialization John Nelson, PhD, CPNP Auditorium 1:15 Lunch Multipurpose Room 2:00 Sexual, Domestic and Interpersonal Violence in the LGBTQ Community Phil McCabe CSW, CAS Auditorium 3:00 Our Story Too: Sex Therapy with Infertile Lesbian Couples Jennifer Toadvine, Ph.D., LMFT Auditorium 4:00 PANEL--- Religion, Spirituality and Healing in the LGBTQI Community Karen Moosvi, PhD, APN, CNE and panelists Auditorium 5:30 Wrap Up & Evaluations Wendy Ritch, MA, MTS Auditorium Thomas Bane, LMSW Centers for Medicaid and Medicare and his panelists Thomas Bane, LMSW, External Affairs, Centers for Medicare and Medicaid Services, Region II Thomas provides education and training to partners across New Jersey and New York on federal health insurance programs. He works with individuals and communities to ensure that they have the information they need to make decisions about their healthcare needs. Most recently, he has been focused on sharing information about the Affordable Care Act. He is also a member of the Media Team producing monthly episodes of "CMS & You," which is a TV show focused on current health topics. Presenting US Department of Health and Human Services of Region II – Programmatic overview and critical health updates related to LGBTQI communities By the end of this session conference participants will be able to: 1. Learn about federal programs impacting LGBTQI communities in New Jersey 2. Learn about recent changes in federal health policies and regulations 3. Connect with federal resources and assistance The US Department of Health and Human Services of Region II provides funding, oversight, and technical assistance to many health programs in New Jersey. This Federal Health Agency panel will provide an overview of the various programmatic areas and highlights critical updates and hot topics related to LGBTQI communities. Agencies participating on the panel include: the Centers for Medicare & Medicaid Services, the Agency for Community Living, the Substance Abuse and Mental Health Services Administration, the Health Resources Services Administration, and the Social Services Administration. Each agency will provide current information on health programs serving LGTBQI health needs and connect organizations with federal resources and opportunities. To request a copy of this session's materials please contact Thomas Bane at [email protected] Notes ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Phil McCabe CSW, CAS Mr. McCabe works as the LGBT Health Educator for the Rutgers School of Nursing. He serves on the Board of Directors of the Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals and their Allies, and holds the position of President. He contributed to the Center for Substance Abuse Treatment’s, “A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual and Transgender Individuals” as a principal writer on family issues. In 2009, he was selected as a Master Trainer for the SAMSHA/ CSAT Addiction Technology Transfer Center Curriculum on LGBT Clients. Presenting: Sexual, Domestic and Interpersonal Violence in the LGBTQ Community By the end of this session conference participants will be able to: 1. Recognize the prevalence and consequences of interpersonal violence as it pertains to LGBT individuals. 2. Identify three clinical issues impacted by trauma history. 3. List resources and referrals appropriate for the LGBT survivors of interpersonal violence. The workshop will educate on various aspects of interpersonal violence along with awareness of other cultural aspects including, but not limited to race, ethnicity, religion, abilities, socio-economics, sexual orientation, gender expression and gender identity. To request a copy of this session's materials please contact Phil McCabe at [email protected] Notes ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Karen Moosvi, PhD, APN, CNE Dr. Moosvi is a clinician, educator, researcher and compassion-based meditation practitioner. Her clinical work focuses on mind-body practices, particularly mindfulness, in the context of wellness and mental health recovery for both service users and caregivers. Dr. Moosvi is an Assistant Professor at Kean University School of Nursing where she also conducts health outcomes research using large data sets. As Deputy Executive Director of the NJ Board of Nursing, she helped to implement the Alternative to Discipline statute which ensures impaired nurses receive appropriate professional assistance with their wellness and recovery efforts. An ally and member of the LGBTQI Health Working Group, her efforts are directed toward health equity for all persons. Presenting Religion, Spirituality and Healing in the LGBTQI Community By the end of this session conference participants will be able to: 1. Discuss the differences and similarities between a religious and spiritual life. 2. List two examples of how healing may be supported by religion amongst diverse members of the heterosexual and LGBTQI community. 3. List two examples of how healing may be supported by spirituality amongst diverse members of the heterosexual and LGBTQI community. ABSTRACT: Panelists will discuss their spiritual and or religious lives in terms of their sexual identity and healing. A Q&A session will offer conference participants an opportunity to engage in further discussion with the panelists. PANELISTS: Reverend Douglas Brown, a gay man, is pastor of Asbury Park Community Church, a Congregation of the United Church of Christ, ministering to LGBTQI Christians and allies in Asbury Park, NJ. Trained and educated as a fine artist, Reverend Brown uses visual arts in all aspects of his life. Tyler Davies is a transgender male student who was raised Evangelical Christian and now practices Humanism. Ruben Fernandez, RN, and PhD candidate in Nursing, is a gay male with over twenty years of extensive experience in healthcare administration. Currently, Vice President for Patient Care/CNO at Palisades General Hospital he advocates for addressing the spiritual needs of all patients as well as issues relating to LGBTQI health. Strawberry Gallagher, MA identifies as a bisexual female sociologist who despite being baptized a Roman Catholic, receiving First Holy Communion and Confirmation, considers herself reared without religion. Currently she describes herself as “believing in a higher power but feeling lost and confused.” Reverend Janyce L. Jackson Jones, a noted community leader, is founding member and Co-Pastor of Unity Fellowship Church NewArk, Newark, NJ. As Executive Director of the Newark LGBTQ Community Center, Reverend Jackson Jones, a lesbian, oversees community-driven programs and services aimed at creating and sustaining a better quality of life for the Greater Newark LGBTQ community. Karen Moosvi, PhD, APN, CNE, identifies as a heterosexual female raised Roman Catholic and practicing Buddhism. She is an ally member of the Rutgers LGBTQI Health Working Group and advocates for health equity for all persons. Jiselle Madison Parker is a spiritually focused affirmed transgender woman of color. She is an entrepreneur and creative collaborator. The last 8 years she has been dedicated to community, social, and health advocacy for the LGBTQI community, as well as impoverished and marginalized communities throughout New Jersey and Monmouth County. She believes, "Every human has the right to live a peaceful, prosperous, love filled existence; it's up to each of us to claim and affirm our bliss." Bobbi Prato is a retired Trans* person who identifies as a Concerned member of the Human Race. Among her activities and interests she is a member of the Asbury Park Community Church in Asbury Park, NJ and sits on the United Church of Christ Pre-ordination Commission in the New Jersey Association. She has the occasional blog at Believe Out Loud and an active part of GSSN. She also spends a great deal of time educating people on Trans* issues with the thought that the best way to combat transphobia is to educate people and demonstrate that trans folks are just people. To request a copy of this session's materials please contact Karen Moosvi at [email protected] Notes ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ John Nelson, PhD, CPNP Dr. Nelson is the Program Director of the AIDS Education and Training Center (AETC) National Resource Center (NRC), and an instructor with the DNP HIV certification program at Rutgers School of Nursing. John has a BA from Washington University in St. Louis, an MSN (pediatric clinical nurse specialist) from Yale University, a post-master's pediatric nurse practitioner (PNP) certification from Columbia University, and a PhD in Nursing from New York University. John began providing care to HIV-infected adolescents in 1989 at Montefiore Medical Center after completing his MSN. After 24 years of providing direct care to HIV-infected and HIV at-risk adolescents and young adults in hospital-based, school-based, and community-based settings in New York, John began his work at the François-Xavier Bagnoud Center, Rutgers School of Nursing in his current role. John has published journal articles on issues including LGBT adolescents, HIV and adolescents, sexually transmitted infections, cervical dysplasia in adolescent women, and anal dysplasia in YMSM. Presenting: LGBTQI Inclusion in the Rutgers University DNP HIV Primary Care Subspecialty Program By the end of this session conference participants will be able to: 1. Recognize the primary care workforce need for providing care to persons living with HIV (PLWH) and those at-risk in New Jersey 2. Understand Rutgers School of Nursing's approach to HIV-care workforce development 3. Identify pathways for inclusion of LGBTQI specific curriculum in program development Rutgers School of Nursing (SN) was award an AIDS Education and Training Center (AETC) Nurse Practitioner HIV-Training grant from HRSA HIV/AIDS Bureau in July 2013 to prepare Doctor of Nursing Practice (DNP) students to provide primary care to persons living with or at-risk of HIV (of whom LGBTQI persons are disproportionately infected, affected, and at-risk). This certification program is open to students from each of the tracks within the SN DNP program: family practice, adult-geriatric practice, pediatric/adolescent practice, mental health practice, and women’s health or midwifery practice. Three pre-clinical courses were developed: Clinical management of HIV; Social Determinants of HIV; and Historical/Social/Political Responses to the HIV Epidemic. LGBTQI issues are incorporated into each of these courses, as DNP students are prepared to: provide clinical care of the whole person outside of HIV risk/infection (e.g. LGBTQI primary health care); take health histories of different age populations of LGBTQI persons; provide indicators of LGBTQI sensitivity in clinical settings; and, comprehend the history of policies such as HIV criminalization and barriers to health equity among LGBTQI persons in the US and globally. HIV-specific clinical experiences have also been developed for the program, and students complete month-long rotations at each of several sites. These sites include hospital and community-based clinics or health centers providing HIV care, non-clinical community-based organizations working with high-risk populations (urban, African American, street youth, substance users, young men who have sex with men, and transgender persons), and nontraditional clinical sites with support group services and syringe access programs. To request a copy of this session's materials please contact John Nelson at [email protected] Notes ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Rubab Qureshi MD PhD Dr. Qureshi earned her doctorate in Urban Systems (Health track) from UMDNJ, NJIT and Rutgers-Newark. As a scholar of socio-cultural influences she has a keen interest in understanding the relationship between social determinants and health particularly minority status and health including health of immigrants, sexual and racial minorities, and immigrant maternal/child health. She is also interested in cultural competence in health care education and environmental determinants of health. Presenting: Experiences of lesbian, gay, bisexual and transgender people (LGBT) in the healthcare setting. By the end of this session conference participants will be able to: 1. Describe and consider the experiences of lesbians, gays, bisexuals and transgender people (LGBT) with healthcare providers. 2. Assess clinical encounters with LGBT patients. 3. Appraise care environments in relation to the needs of LGBT patients. Purpose: This was a two phase project. The purpose of phase 1 was to explore the experiences of LGBTs with healthcare professionals. This exploration provided the perspectives of informants which will be used in the development of cultural competence teaching modules and assessments around LGBT health needs in phase two. The findings of phase 1 will be presented. Method & Sample: Qualitative. Separate group interviews were conducted with lesbians, gays, bisexuals and transgenders. A sample of convenience of forty participants was drawn by online recruitment and collaborating LGBT community groups from New Jersey and surrounding metropolitan areas. Findings: This paper informs on the health related experiences of lesbians, gays, bisexuals and transgenders with healthcare providers. Data analysis uncovered several themes that were condensed into broad categories. Some themes reflected on the professionalism of care providers and overall office environment and were more universally experienced by members of all groups, while others were more personal and nuanced and experienced at a visceral level and were reflective of the complex intersection of race, gender identity, sexual orientation and socio-economic factors. All groups were concerned about lack of sensitivity and overall numbness of providers, their ‘not wanting to be there’ vibe, the providers’ lack of knowledge about LGBT health issues and always being short on time. Other themes focused on the difficulty in finding compassionate culturally congruent care providers, affordability of their particular healthcare needs, increased vulnerability and feelings of insecurity upon disclosure, concern for privacy and confidentiality and providers who are knowledgeable about their specific healthcare needs. The need for advocates who can champion their concerns was poignant. The experience of transgender participants also included fear of ridicule as a barrier to seeking care. These experiences were also influenced by the perception of discriminatory attitudes of healthcare providers towards and stigmatization of HIV/AIDS and diagnoses of other sexually transmitted diseases. Inter and intra group similarities and differences also emerged. Implications for healthcare providers: The lesbian, gay, bisexual and transgender community are vulnerable populations with a long history of discrimination and victimization by pathologizing of sexual orientation by the medical professions. Findings of this research call for a humanistic and holistic ethos to caring for this population. They also highlight the need for incorporation and understanding of social determinants of LGBT health. To request a copy of this session's materials please contact Rubab Qureshi at [email protected] Notes ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Jennifer Toadvine, Ph.D., LMFT Widener University Jennifer Toadvine, Ph.D., LMFT, is a licensed marriage and family therapist and sexuality educator. Jennifer earned her B.A. from Elon University in psychology, a M.S. from Thomas Jefferson University in couple and family therapy, and a Ph.D. from Widener University in human sexuality. Her dissertation research explored the lived experience of infertility for lesbian couples. Through her research, Jennifer hopes to bring awareness and understanding to this phenomenon. Jennifer chose to examine lesbian couples because of her fascination and interest into human relationships and the importance she places on these relationships. Jennifer continues her work as an educator and couple and family therapist. Presenting Our Story Too: Sex Therapy with Infertile Lesbian Couples By the end of this session conference participants will be able to: 1. Identify two concerns infertile lesbian couples experience 2. Describe two interventions to promote the couple's healing 3. Describe one feeling they may experience when working with infertile lesbian couples. Our Story Too: Sex Therapy with Infertile Lesbian Couples Lesbians are not immune to infertility. For heterosexual couples, infertility has been related to self-esteem, identity, anxiety, shame, relationship satisfaction, and sexual functioning. Few researchers have explored the impact of infertility on lesbian couples and individuals. Infertility for lesbian couples may not look the same as it does for heterosexual couples. In order to provide effective treatment and medical care it is imperative to also understand the unique needs of the infertile lesbian couple. The impact of heteronormativity, ambiguous loss, and disenfranchised grief on the couples' relationships will be explored. By attending this session, participants will have the opportunity to hear and learn about this emerging area of research and clinical work. Participants will also gain knowledge on the clinical presentation of infertile lesbian couples, along with developing skills on how to work effectively with these clients in a sex therapy setting. To request a copy of this session's materials please contact Jennifer Toadvine at [email protected] Notes ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Peijia Zha, PhD, MA Rutgers School of Nursing Dr. Peijia Zha, Assistant Professor, joined the School of Nursing faculty in June 2013. Prior to joining the School of Nursing, she is a Research Associate at the Newark Schools Research Collaborative. Dr. Zha received her Ph.D. in Urban Systems from Rutgers University in 2009 and her MA in Educational Psychology from Louisiana Tech University in 2003. Dr. Zha is a quantitative research methodologist with experience teaching a broad range of statistical courses at both the undergraduate and graduate levels. At the School of Nursing, she teaches epidemiology for PhD programs, she also does statistical consulting for Ph.D. and DNP students. Dr. Zha has been involved in many research projects funded by local, state and national foundation as well as by state and federal agencies, which yielded several publications. She has reviewed grant applications for the U.S. Department of Education. She also served as research consultant for a local foundation to manage their research projects. Dr. Zha’s primary research interests are 1) multivariate statistical modeling; 2) causal modeling; 3) survey design; 4) program evaluation. She is also interested in race & equity in health, immigrant health, and urban community health systems. Presenting: Healthcare Needs Assessment of Lesbian, Gay, Bisexual and Transgender (LGBT) population in New Jersey By the end of this session conference participants will be able to: 1. Understand the demographic and healthcare needs for LGBT community in New Jersey 2. Understand current barriers to seeking health care for LGBT community in New Jersey 3. Understand the importance of cultural competency training for healthcare providers Healthcare Needs Assessment of Lesbian, Gay, Bisexual or Transgender (LGBT) population in New Jersey Background: LGBT community is very diverse and includes people of different ethnic, racial, socio-economic, educational and geographic backgrounds. This population, as sexual and gender minorities, have been a target for discrimination, oppression, violence and exclusion within many spheres of their life. However, they are not well represented in federally collected databases such as the Census and the Centers for Medi- care & Medicaid Services. Consequently, there is very little demographic and health data to inform healthcare providers on the needs of the LGBT community. Objectives: 1) to gather data about demographics and healthcare needs of LGBT community in New Jersey 2) to identify current barriers to seeking health care for LGBT community in New Jersey 3) to utilize this data to promote LGBT healthcare education, prevention, diagnosis, treatment, rehabilitation and terminal care. Method: A survey was constructed from various validated LGBT needs assessment instruments and tailored to the specific New Jersey context. The survey included demographic questions as well as questions on healthcare access, health and human service needs such as mental health, cancer screening and care, chronic disease, infectious diseases, violence, substance abuse, and barriers to care. It was tested for face validity, approved by the Rutgers Institutional Review Board and distributed via social media: craigslist.org, NJgaylife.com, websites of Central Jersey Lesbian Alliance, New Jersey Gay Health and locally at the African American Office of Gay Concerns in Newark, NJ and Hudson Pride in Jersey City, NJ. This study yielded 438 total respondents, these respondents were 18 years of age or older who self-identified as LGBT. Results: Sexual orientation and gender identities were nuanced and descriptions such as lesbian, gay, bisexual and transgender were simplistic and not inclusive of self-identified descriptive categories. Respondents were diverse in age, race, socioeconomic background and residential location. There was high prevalence of: alcoholism; depression; suicide; anxiety; HIV; obesity; smoking; substance abuse within the New Jersey LGBT community. This minority perceived numerous barriers to seeking healthcare which included scarceness of health professionals who were adequately trained and culturally competent about LGBT health, providers who refused to see them, care environments which were not LGBT friendly and health insurance coverage. Conclusions: This study provided a broad view of New Jersey LGBT community health status and made LGBT populations visible and measurable. In addition, this study emphasized the varied barriers to seeking healthcare among this population, which will help inform healthcare professionals and institutions in strengthening education programs around LGBT health issues and also exploring ways to improve LGBT healthcare seeking behaviors. Especially, the cultural competency training for healthcare providers may help alleviate many of the barriers to healthcare for the LGBT. To request a copy of this session's materials please contact Peijia Zha at [email protected]. Notes ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Wendy A. Ritch, MA, MTS Wendy is the Assistant Dean for Administration at the Rutgers School of Nursing. She earned her BA from Mount Holyoke College in Politics and Religion, her MTS from Harvard in Theology and Women’s Studies in Religion, and her MA from the University of Massachusetts at Amherst in Political Theory and American Politics. Wendy is currently pursuing her PhD in the Urban Systems Program at Rutgers and NJIT. She was hired at UMDNJ in 2001 as a faculty member in health systems and policy. Since then she has served as a member of the faculty, staff and administration in three schools at UMDNJ, which is now Rutgers Biomedical and Health Sciences. Wendy's research interests include health policy, population health, health (in)equity, LGBTQI health, and cultural competence education for health professionals. In 2011, with the generous support of the School of Nursing, Wendy founded the interprofessional RBHS LGBTQI Health Working Group, which has grown to nearly 100 members. Wendy enjoys being an agent of change and hopes that her work will help to promote health equity for sexual and gender minorities as well as for all those who experience health disparities. To request a copy of this session's materials please contact Wendy Ritch at [email protected] Notes ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________
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