Institute for Social Science Research, The University of Queensland, Brisbane, Australia.
LGBT Health. 2020 Apr;7(3):146-154. doi: 10.1089/lgbt.2019.0285. Epub 2020 Mar 5.
An emerging literature documents that sexual minority youth experience significantly and substantially worse health than their heterosexual peers, but few studies have examined the intervening mechanisms linking adolescents' sexual orientation to their health outcomes. This study hypothesized that social support from parents and friends and school belonging would act as important mediators of this relationship and is among the first to test this proposition empirically. The analyses used rich data from an Australian national probability sample of 14-15-year olds (Longitudinal Study of Australian Children, = 3204) and regression models to estimate the associations between sexual attraction and four high-quality indicators of adolescent health/well-being capturing health-related quality of life, socio-emotional functioning, depressive symptoms, and life satisfaction. Mediation tests were subsequently performed to quantify the extent to which three scales capturing social support from parents and friends and school belonging mediated the relationships identified. Sexual minority status, social support from parents and friends, and school belonging were significantly related to all health/well-being outcomes. Sexual minority adolescents reported significantly lower levels of support and belonging. Collectively, the support and belonging variables were responsible for 49%-70% of the associations between sexual minority status and the health/well-being outcomes, with school belonging being the most important mediator. These findings have important implications for health equity policy and practice. They suggest that interventions designed to improve the health/well-being of sexual minority adolescents should be directed at eliciting enhanced social support from families and peers and fostering integration at school. School-based interventions may be particularly fruitful.
越来越多的文献表明，性少数群体青少年的健康状况明显且严重劣于异性恋同龄人，但很少有研究探讨将青少年的性取向与其健康结果联系起来的中介机制。本研究假设，来自父母和朋友的社会支持以及学校归属感将作为这种关系的重要中介因素，这也是首次对此命题进行实证检验。该分析使用了来自澳大利亚全国青少年概率样本（澳大利亚儿童纵向研究，n=3204）的丰富数据和回归模型，来估计性吸引力与四个高质量的青少年健康/幸福感指标之间的关联，这四个指标分别是与健康相关的生活质量、社会情感功能、抑郁症状和生活满意度。随后进行了中介检验，以量化三个捕捉来自父母和朋友的社会支持以及学校归属感的量表在识别出的关系中所起的中介作用的程度。性少数群体身份、来自父母和朋友的社会支持以及学校归属感与所有健康/幸福感结果均显著相关。性少数群体青少年报告的支持和归属感水平明显较低。总的来说，支持和归属感变量解释了性少数群体身份与健康/幸福感结果之间 49%-70%的关联，其中学校归属感是最重要的中介因素。这些发现对健康公平政策和实践具有重要意义。它们表明，旨在改善性少数群体青少年健康/幸福感的干预措施应针对家庭和同伴中增强社会支持，并促进学校的融合。基于学校的干预措施可能特别有效。
