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Review of Article: "Understanding and Measuring LGBTQ Pathways to Health: A Scoping Review of Strengths-Based Health Promotion Approaches in LGBTQ Health Research"

Updated: Mar 9

The article titled "Understanding and Measuring LGBTQ Pathways to Health: A Scoping Review of Strengths-Based Health Promotion Approaches in LGBTQ Health Research" published in the Journal of Homosexuality presents a comprehensive analysis of LGBTQ health research, focusing on strengths-based approaches to understanding and measuring LGBTQ health. The authors, Jacqueline Gahagan and Emily Colpitts, emphasize the need to move away from a deficit-focused approach and shift towards a strengths-based health promotion perspective. The scoping review explored existing methodological frameworks for studying LGBTQ health, as well as suggestions for future methodological approaches from a strengths-based health promotion perspective. The study highlighted the importance of recognizing the determinants that promote health across the life course and informing appropriate and engaging health policies, services, and systems for LGBTQ populations.


The traditional biomedical framework of LGBTQ health research has historically focused on health risks and deficits, obscuring the impact of social and structural factors such as stigma and discrimination. This approach has often led to an incomplete understanding of LGBTQ health, particularly through a heteronormative and cisnormative lens. The scoping review identified various methodological frameworks and conceptual models used in LGBTQ health research, including resilience, community-based participatory research (CBPR), grounded theory, social determinants of health (SDOH), social ecological approaches, intersectionality, and life course approaches. These frameworks provide a more comprehensive understanding of LGBTQ health and emphasize the importance of recognizing the strengths and resilience of LGBTQ populations.


The review also highlighted the diverse experiences of LGBTQ populations, various protective factors, and the importance of employing an intersectional analysis in LGBTQ health research. The findings underscore the need for LGBTQ-specific and contextually situated methods and approaches for researching LGBTQ health. The scoping review identified a range of methodologies and conceptual models that may be useful for future strengths-based health promotion research on LGBTQ health, ultimately informing the development of appropriate health services and interventions for LGBTQ populations. The study's limitations include its focus on peer-reviewed published academic articles available in English, potentially excluding non-peer-reviewed gray literature and research published in other languages. Despite these limitations, the scoping review provides valuable insights into the importance of adopting strengths-based approaches to LGBTQ health research.





What are the key findings of the scoping review on strengths-based health promotion approaches to understanding and measuring LGBTQ health?


The key findings of the scoping review on strengths-based health promotion approaches to understanding and measuring LGBTQ health are as follows:


1. The review emphasizes the importance of adopting strengths-based research approaches to identify the strengths that LGBTQ populations already possess and shift away from focusing solely on risks, deficits, and marginalization.


2. Strengths-based health promotion research has the potential to inform appropriate interventions aimed at focusing on the intersecting determinants of health that keep LGBTQ populations well across the life course.


3. The review highlights the need to develop LGBTQ-specific and contextually situated methods and approaches for researching LGBTQ health, challenging the heteronormative and cisnormative lens through which LGBTQ health is generally situated.


4. The scoping review identified a range of methodological and conceptual frameworks used in LGBTQ health research, including resilience, community-based participatory research, and grounded theory, which provide a more comprehensive understanding of LGBTQ health.


5. The review also emphasizes the importance of employing an intersectional analysis in LGBTQ health research and the need for a social-ecological approach that considers personal risk and resilience factors, as well as structural and relational factors.


6. The scoping review identified the importance of recognizing, appropriately measuring, and rendering visible the determinants of health that promote positive health outcomes across the life course among LGBTQ populations.




These findings underscore the need for a substantive and sustainable shift in health research approaches, away from a focus on deficits to strengths-based health promotion approaches, to meaningfully engage and promote the health of LGBTQ populations across the life course.


What methodological and conceptual frameworks were identified in the scoping review for studying LGBTQ health from a strengths-based health promotion approach?


The scoping review identified several methodological and conceptual frameworks for studying LGBTQ health from a strengths-based health promotion approach. These frameworks include resilience, community-based participatory research (CBPR), grounded theory, social determinants of health (SDOH), social ecological approaches, and intersectionality. Resilience was a prevalent framework, focusing on the capacity for successful adaptation despite challenging circumstances. CBPR involves including individuals and communities affected by the research in all aspects of the research process. Grounded theory allows critical issues to be identified through the conduct of the research rather than being predetermined. Social determinants of health and social ecological approaches emphasize the importance of social and structural factors in health outcomes. Intersectionality was also highlighted, recognizing the diverse experiences of LGBTQ populations and the importance of considering multiple intersecting identities and social factors in health research.


These frameworks provide a more comprehensive understanding of LGBTQ health and emphasize the importance of recognizing the strengths and resilience of LGBTQ populations. They also challenge the heteronormative, cisnormative, and biomedical framework through which LGBTQ health has traditionally been understood. The scoping review suggests that efforts to develop appropriate health services and health promotion interventions for LGBTQ populations must be grounded in strengths-based health promotion approaches to understanding and measuring LGBTQ health.


How did the scoping review address the invisibility and understudied nature of certain LGBTQ populations?


The scoping review addressed the invisibility and understudied nature of certain LGBTQ populations by highlighting the importance of recognizing and rendering visible the diverse experiences of LGBTQ populations. The review emphasized the need to develop LGBTQ-specific and contextually situated methods and approaches for researching LGBTQ health, particularly focusing on the experiences of marginalized and hidden populations within the LGBTQ community. For example, the review identified the use of respondent-driven sampling as a useful technique for recruiting particularly marginalized or hidden populations such as transgender individuals and LGBTQ immigrants. Additionally, the review emphasized the importance of community-based participatory research approaches, which engage LGBTQ populations in identifying salient health issues and contribute to informing appropriate health services and programs. By recognizing the complex interactions between social, structural, and individual-level determinants of health and challenging the heteronormative and cisnormative lens through which LGBTQ health is generally understood, the scoping review aimed to shed light on the experiences and health needs of often overlooked LGBTQ populations.


What are the limitations of the scoping review, and how might future research address these limitations?


The limitations of the scoping review on strengths-based health promotion approaches to understanding and measuring LGBTQ health include the focus on peer-reviewed published academic articles available in English, potentially excluding non-peer-reviewed gray literature and research published in languages other than English. Additionally, the scoping review did not assess the overall quality of evidence, as scoping reviews do not evaluate the quality of the included studies. Furthermore, the review could not make definitive statements regarding the conceptual and methodological models used in the included studies if they were not explicitly stated or discussed by the authors.


To address these limitations, future research in this area should consider conducting systematic reviews to better understand the synergies between the methodological approaches used in strengths-based approaches to LGBTQ health promotion. Additionally, efforts should be made to include non-peer-reviewed gray literature and research published in languages other than English to ensure a more comprehensive understanding of LGBTQ health. Future research should also aim to develop LGBTQ-specific measures and models of resilience, as well as explore external social and contextual factors in addition to individual characteristics when examining resilience among LGBTQ populations. Moreover, there is a need for more LGBTQ-specific and contextually situated methods and approaches for researching LGBTQ health, as well as the inclusion of community-based participatory research approaches to engage LGBTQ populations in identifying salient health issues and informing appropriate health services and programs. These approaches can help address the limitations of the scoping review and contribute to a more comprehensive understanding of LGBTQ health.


Citation:

Gahagan J, Colpitts E. Understanding and Measuring LGBTQ Pathways to Health: A Scoping Review of Strengths-Based Health Promotion Approaches in LGBTQ Health Research. J Homosex. 2017;64(1):95-121. doi: 10.1080/00918369.2016.1172893. Epub 2016 Apr 4. PMID: 27043161.

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