Doctoral Dissertation Research: Minority Population Experiences of Healthcare

本项目将分析两个不同医疗机构中不同种族的性和性别认同少数群体（SGM）患者的医疗保健经历和需求，以揭示影响SGM决定寻求或推迟获得医疗保健的因素。通过这样做，本项目将弥合我们关于社会力量如何影响SGM获得医疗保健的知识的紧迫差距，并提供一个理论模型，以帮助未来的学者了解组织如何影响医疗保健使用。该项目产生的见解将通过帮助减少对利用不足和健康状况不佳的高风险少数民族人口的护理障碍，解决医疗保健中歧视和不平等的重要社会问题。与异性恋者相比，各种各样的措施表明，在生命历程的每个阶段，同性恋者的健康状况都较差。然而，sgm获得医疗保健的可能性要低得多。尽管在美国解决SGM未充分利用的一个主要策略是创建SGM医疗保健组织，但不同的组织背景如何影响SGM医疗保健体验和使用尚未经过实证检验。该项目在纽约市的两个医疗保健组织中对患者和提供者进行访谈，并进行人种学观察：一个专门为sgm服务，另一个为普通人群设计。推动该项目的问题包括：为什么不同的SGMs会延迟就医？他们如何做出关于护理的决定？在不同的卫生环境中，不同的sgm对其具体需求的理解是什么？组织因素和环境如何塑造不同的SGM患者的经历和医疗保健决策？收集和分析三个数据来源：患者观点、提供者观点和直接观察，将允许在分析过程中进行三角测量，这将有助于确保强有力的发现，即个人和组织因素如何共同影响少数群体的护理经验和决定。

Title: Minority Population Experiences of HealthcareThis project will analyze the healthcare experiences and needs of racially diverse sexual and gender identity minorities (SGMs) patients within two different healthcare organizations to reveal factors that shape SGM decisions about seeking or delaying access to healthcare. By doing so, this project will bridge urgent gaps in our knowledge about how social forces influence SGM access to healthcare, as well as contribute a theoretical model to help future scholars understand how organizations impact healthcare use. Insight generated by this project will address the important social problems of discrimination and inequality within healthcare by helping to decrease barriers to care for minority populations at high risk of underutilization and poor health. Compared to heterosexuals, SGMs are in poorer health as indicated by a wide variety of measures and at every stage of the lifecourse?yet SGMs are significantly less likely to access healthcare. Although one primary strategy for addressing SGMs' underutilization in the U.S. has been the creation of SGM healthcare organizations, how different organizational contexts influence SGM healthcare experiences and use has yet to be empirically examined. This project uses interviews with patients and providers as well as ethnographic observation at two healthcare organizations in New York City: one specialized for SGMs and one designed for the general population. Questions driving the project include: why do diverse SGMs delay seeking healthcare? How do they make decisions about care? What do diverse SGMs understand to be their specific needs within different health settings? And (how) do organizational factors and contexts shape diverse SGM patients' experiences and healthcare decisions? Gathering and analyzing three data sources: patient perspectives, provider perspectives, and direct observation will allow for triangulation during analysis, which will help ensure robust findings about how individual and organizational factors come together to influence minority experiences of and decisions about care.