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美国医疗服务提供者为每天吸烟的有色人种男同性恋者提供戒烟咨询时存在的差距

Gaps in smoking cessation counseling administered by healthcare providers to BIPOC gay men who smoke daily in the U.S.

作者信息

Kelley Natalie, Maglalang Dale Dagar, Suh Riley, Bello Mariel S, de Leon Cora, Moitra Ethan, Ahluwalia Jasjit S

机构信息

Warren Alpert Medical School, Brown University, Providence, RI, USA.

Silver School of Social Work, New York University, New York, USA.

出版信息

J Subst Use Addict Treat. 2025 Feb;169:209590. doi: 10.1016/j.josat.2024.209590. Epub 2024 Nov 30.

Abstract

BACKGROUND

Black, Indigenous, and People of Color (BIPOC) racial/ethnic groups, sexual minorities (SM), and men have higher odds of smoking, less access to smoking cessation education and services, and lower smoking cessation rates than their white, heterosexual, and women counterparts. The purpose of this study is to examine the experiences of BIPOC gay men in accessing smoking cessation counseling from their healthcare providers and understand the facilitators and barriers to smoking cessation.

METHODS

This study analyzed data from BIPOC gay men who smoke daily via social media and organizational listservs throughout the United States and conducted semi-structured individual qualitative interviews. Two trained coders used thematic analysis to analyze the data.

RESULTS

Findings identified three overarching themes: 1) Sources of Information, 2) Facilitators and Barriers, and 3) Areas of Improvement for Smoking Cessation Counseling. Participants reported trusting advice from community members over healthcare providers regarding smoking cessation counseling. They also felt that the smoking cessation advice received from healthcare providers was, at times, confusing and inadequate. Identity concordance between patient and healthcare provider helped participants feel seen by their provider, which motivated them to engage in smoking cessation counseling. Finally, participants suggested improvements for smoking cessation counseling for BIPOC gay men such as integrating mental health support in smoking cessation services, accountability for patients, and providing harm reduction alternatives instead of smoking cessation only.

CONCLUSION

BIPOC gay men who smoke daily value the importance of receiving culturally adaptive and gender-affirming care from healthcare providers who share their identities when receiving smoking cessation and harm reduction counseling.

摘要

背景

黑人、原住民和有色人种(BIPOC)种族/族裔群体、性少数群体(SM)以及男性比他们的白人、异性恋和女性同龄人吸烟几率更高,获得戒烟教育和服务的机会更少,戒烟率更低。本研究的目的是考察BIPOC男同性恋者从医疗服务提供者那里获得戒烟咨询的经历,并了解戒烟的促进因素和障碍。

方法

本研究分析了通过社交媒体和美国各地组织的邮件列表每天吸烟的BIPOC男同性恋者的数据,并进行了半结构化的个人定性访谈。两名经过培训的编码员使用主题分析法对数据进行分析。

结果

研究结果确定了三个总体主题:1)信息来源,2)促进因素和障碍,3)戒烟咨询的改进领域。参与者报告说,在戒烟咨询方面,他们更信任社区成员的建议,而不是医疗服务提供者的建议。他们还觉得从医疗服务提供者那里得到的戒烟建议有时令人困惑且不够充分。患者与医疗服务提供者之间的身份一致性有助于参与者感到被提供者关注,这促使他们参与戒烟咨询。最后,参与者建议为BIPOC男同性恋者改进戒烟咨询,例如在戒烟服务中整合心理健康支持、对患者负责,并提供减少危害的替代方案,而不仅仅是戒烟。

结论

每天吸烟的BIPOC男同性恋者重视在接受戒烟和减少危害咨询时,从与他们身份相同的医疗服务提供者那里获得具有文化适应性和性别肯定性的护理的重要性。

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本文引用的文献

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Tobacco Product Use Among Adults - United States, 2021.成年人烟草制品使用情况 - 美国,2021 年。
MMWR Morb Mortal Wkly Rep. 2023 May 5;72(18):475-483. doi: 10.15585/mmwr.mm7218a1.
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Balancing Consideration of the Risks and Benefits of E-Cigarettes.权衡电子烟的风险和益处。
Am J Public Health. 2021 Sep;111(9):1661-1672. doi: 10.2105/AJPH.2021.306416. Epub 2021 Aug 19.

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