Financial hardship differences by LGBTQ+ status among assigned female at birth adolescent and young adult cancer survivors: a mixed methods analysis.
Financial hardship differences by LGBTQ+ status among assigned female at birth adolescent and young adult cancer survivors: a mixed methods analysis.
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按 LGBTQ 身份划分的出生时女性青少年和年轻成年癌症幸存者的经济困难差异：混合方法分析。
DOI：
10.1007/s10552-023-01740-9
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Nichols,HazelB
中科院分区：
文献类型：
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作者：
Waters,AustinR;Kent,ErinE;Meernik,Clare;Getahun,Darios;Laurent,CecileA;Xu,Lanfang;Mitra,Sara;Kushi,LawrenceH;Chao,Chun;Nichols,HazelB
青少年和年轻成人（AYA）癌症幸存者面临经济困难的风险增加。然而，LGBTQ+ AYAs的经济困难尚未得到广泛探讨。因此，我们使用定性和定量的调查数据从地平线研究队列来评估经济困难的AYAs LGBTQ+ status.MethodsMultivariable logit模型，预测概率，平均边际效应或预测概率（AME）和95%置信区间（CI）的差异被用来评估LGBTQ+状态和经济困难的两个组成部分：物质和心理的关联。定性内容分析的一个开放式的调查问题的经济牺牲被用来描述的第三个组成部分的经济困难，behavioral.ResultsAmong 1,635名参与者，4.3%的自我认定为LGBTQ+。控制人口因素的多变量logit模型显示，LGBTQ+ AYAs经历物质经济困难的概率高出18个百分点（95%CI 6-30%），经历心理经济困难的概率高出14个百分点（95%CI 2-26%）。控制经济因素减弱了LGBTQ+状态与心理经济困难的关联（AME = 11%; 95%CI - 1-23%），而物质经济困难的关联仍然具有统计学意义（AME = 14%; 95%CI 3-25%）。在定性分析中，LGBTQ+ AYA经常报告教育变化和成本（例如，退学），未付账单和债务（例如，医疗债务，承担信用卡债务），以及住房变化和住房条件差（例如，搬进不太昂贵的房子）。结论LGBTQ+有针对性和量身定制的干预措施是必要的，以走向LGBTQ+ AYA-一个被忽视的少数群体的公平。
BackgroundAdolescent and young adult (AYA) cancer survivors are at an elevated risk of financial hardship. However, financial hardship among LGBTQ+ AYAs has not been widely explored. Thus, we used qualitative and quantitative survey data from the Horizon Study cohort to assess financial hardship of AYAs by LGBTQ+ status.MethodsMultivariable logit models, predicted probabilities, average marginal effects or differences in predicted probabilities (AME) and 95% confidence intervals (CI) were used to assess the association of LGBTQ+ status and two components of financial hardship: material and psychological. Qualitative content analysis of an open-ended survey question about financial sacrifices was used to describe the third component of financial hardship, behavioral.ResultsAmong 1,635 participants, 4.3% self-identified as LGBTQ+. Multivariable logit models controlling for demographic factors revealed that LGBTQ+ AYAs had an 18-percentage point higher probability of experiencing material financial hardship (95%CI 6–30%) and a 14-percentage point higher probability of experiencing psychological financial hardship (95%CI 2–26%) than non-LGBTQ+ AYAs. Controlling for economic factors attenuated the association of LGBTQ+ status with psychological financial hardship (AME = 11%; 95%CI – 1–23%), while the material financial hardship association remained statistically significant (AME = 14%; 95%CI 3–25%). In the qualitative analysis, LGBTQ+ AYAs frequently reported educational changes and costs (e.g., quitting school), unpaid bills and debt (e.g., medical debt, taking on credit card debt), as well as changes in housing and poor housing conditions (e.g., moving into less expensive house).ConclusionsLGBTQ + targeted and tailored interventions are needed to move toward equity for LGBTQ+ AYAs—an overlooked minority population.