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Article ; Online: Bias and Discrimination Against Lesbian, Gay, Bisexual, Transgender, and Queer Parents Accessing Care for Their Children: A Literature Review.

Coulter-Thompson, Emilee I

Health education & behavior : the official publication of the Society for Public Health Education

2023 Volume 50, Issue 2, Page(s) 181–192

Abstract: Background: The experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents of children with developmental disabilities (DDs) in health and early learning systems are largely understudied. Inclusive, affirming services are critical to ... ...

Abstract	Background: The experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents of children with developmental disabilities (DDs) in health and early learning systems are largely understudied. Inclusive, affirming services are critical to timely identification and intervention for DDs. This literature review aimed to establish whether LGBTQ parents experience structural bias and discrimination when accessing care for their children in health and early learning systems. Methods: PubMed, ERIC, and Scopus were searched for empirical research from 1990 to 2020 on: LGBTQ; parents, children, families; bias, disparities, discrimination; and health and early learning services. Themes were analyzed by conceptual model bias levels, participant type, and setting. Results: The search yielded 1,872 unduplicated records (three through hand search). Twenty-nine articles representing 26 studies in health and early learning in eight countries met the inclusion criteria. Biases common across sectors included challenges surrounding LGBTQ status disclosures; lack of acknowledgment of non-biological parents; and heterosexist forms. Knowledge gaps and negative attitudes about LGBTQ families were found among some professionals and students. Conclusion: Some LGBTQ parents experienced bias and discrimination while accessing care for their children in health and early learning systems. Policies and programs to implement and monitor LGBTQ-inclusive health education and evaluate practice changes are recommended to improve professionals' knowledge, attitudes, and behavior. Multilevel workforce development (e.g., accreditation standards, organizational audits, and training) is needed to create and sustain LGBTQ-affirming health and education environments. Honoring LGBTQ family diversity and reducing health and early learning inequities are critical for improving children's health and education outcomes.
MeSH term(s)	Female ; Humans ; Child ; Transgender Persons ; Sexual and Gender Minorities ; Sexual Behavior ; Gender Identity ; Parents
Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1362906-2
ISSN	1552-6127 ; 1090-1981
ISSN (online)	1552-6127
ISSN	1090-1981
DOI	10.1177/10901981221148959
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Article ; Online: Survey of Lesbian, Gay, Bisexual, Transgender, and Queer Parents' Experiences Accessing Health Care for their Children With Developmental Disabilities.

Coulter-Thompson, Emilee I / Matthews, Derrick D / Applegate, Julia / Broder-Fingert, Sarabeth / Dubé, Karine

Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners

2023 Volume 37, Issue 3, Page(s) 291–301

Abstract: Introduction: This study explored the impact of health care (HC) bias and discrimination on lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents and their children with developmental disabilities.: Method: We conducted a national online ... ...

Abstract	Introduction: This study explored the impact of health care (HC) bias and discrimination on lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents and their children with developmental disabilities. Method: We conducted a national online survey of LGBTQ parents of children with developmental disabilities using social media and professional networks. Descriptive statistics were compiled. Open-ended responses were coded using inductive and deductive approaches. Results: Thirty-seven parents completed the survey. Most participants identified as highly educated, White, lesbian or queer, cisgender women and reported positive experiences. Some reported bias and discrimination, including heterosexist forms, LGBTQ disclosure challenges, and, because of their LGBTQ identity, feeling mistreated by their children's providers or being refused needed HC for their child. Discussion: This study advances knowledge around LGBTQ parents' experiences of bias and discrimination while accessing children's HC. Findings highlight the need for additional research, policy change, and workforce development to improve HC for LGBTQ families.
MeSH term(s)	Child ; Humans ; Female ; Transgender Persons ; Developmental Disabilities/epidemiology ; Developmental Disabilities/therapy ; Sexual and Gender Minorities ; Health Services Accessibility ; Parents
Language	English
Publishing date	2023-03-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	1036356-7
ISSN	1532-656X ; 0891-5245
ISSN (online)	1532-656X
ISSN	0891-5245
DOI	10.1016/j.pedhc.2022.11.008
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Article ; Online: Health Care Bias and Discrimination Experienced by Lesbian, Gay, Bisexual, Transgender, and Queer Parents of Children With Developmental Disabilities: A Qualitative Inquiry in the United States.

Coulter-Thompson, Emilee I / Matthews, Derrick D / Applegate, Julia / Broder-Fingert, Sarabeth / Dubé, Karine

Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners

2022 Volume 37, Issue 1, Page(s) 5–16

Abstract: Introduction: This study explored the impact of health care (HC) bias and discrimination on lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents and their children with disabilities in the United States, including the timing of developmental ... ...

Abstract	Introduction: This study explored the impact of health care (HC) bias and discrimination on lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents and their children with disabilities in the United States, including the timing of developmental screening and diagnosis. Method: We conducted semistructured interviews with 16 LGBTQ parents of children with developmental concerns or disabilities recruited through a prior national survey. Interviews were transcribed and analyzed using a combined inductive and deductive approach. Results: Discrimination types reported included noninclusive forms, disclosure challenges, and providers dismissing nongestational parents and diverse families. Few parents reported screening and diagnosis delays. Parents' recommendations included: avoiding assumptions, honoring family diversity, increasing LGBTQ family support, improving HC forms, increasing antibias training, and convening a learning community. Discussion: Our study advances the knowledge around HC bias and discrimination among LGBTQ parents of children with disabilities. Findings highlight the need for increased LGBTQ-affirming family support and research representing LGBTQ family diversity in U.S. health care.
MeSH term(s)	Female ; Child ; United States/epidemiology ; Humans ; Transgender Persons ; Developmental Disabilities/epidemiology ; Sexual and Gender Minorities ; Parents ; Healthcare Disparities
Language	English
Publishing date	2022-09-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	1036356-7
ISSN	1532-656X ; 0891-5245
ISSN (online)	1532-656X
ISSN	0891-5245
DOI	10.1016/j.pedhc.2022.09.004
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Zs.A 2641: Show issues

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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Factors Impacting Treatment of Out-of-Hospital Cardiac Arrest: A Qualitative Study of Emergency Responders.

Missel, Amanda L / Dowker, Stephen R / Dzierwa, Drake / Krein, Sarah L / Coulter-Thompson, Emilee I / Williams, Michelle / Trumpower, Brad / Swor, Robert / Hunt, Nathaniel / Friedman, Charles P

Journal of the American Heart Association

2023 Volume 12, Issue 10, Page(s) e027756

Abstract: Background Of the more than 250 000 emergency medical services-treated out-of-hospital cardiac arrests that occur each year in the United States, only about 8% survive to hospital discharge with good neurologic function. Treatment for out-of-hospital ... ...

Abstract	Background Of the more than 250 000 emergency medical services-treated out-of-hospital cardiac arrests that occur each year in the United States, only about 8% survive to hospital discharge with good neurologic function. Treatment for out-of-hospital cardiac arrest involves a system of care that includes complex interactions among multiple stakeholders. Understanding the factors inhibiting optimal care is fundamental to improving outcomes. Methods and Results We conducted group interviews with emergency responders including 911 telecommunicators, law enforcement officers, firefighters, and transporting emergency medical services personnel (ie, emergency medical technicians and paramedics) who responded to the same out-of-hospital cardiac arrest incident. We used the American Heart Association System of Care as the framework for our analysis to identify themes and their contributory factors from these interviews. We identified 5 themes under the structure domain, which included workload, equipment, prehospital communication structure, education and competency, and patient attitudes. In the process domain, 5 themes were identified focusing on preparedness, field response and access to patient, on-scene logistics, background information acquisition, and clinical interventions. We identified 3 system themes including emergency responder culture; community support, education, and engagement; and stakeholder relationships. Three continuous quality improvement themes were identified, which included feedback provision, change management, and documentation. Conclusions We identified structure, process, system, and continuous quality improvement themes that may be leveraged to improve outcomes for out-of-hospital cardiac arrest. Interventions or programs amenable to rapid implementation include improving prearrival communication between agencies, appointing patient care and logistical leadership on-scene, interstakeholder team training, and providing more standardized feedback to all responder groups.
MeSH term(s)	Humans ; United States ; Out-of-Hospital Cardiac Arrest/diagnosis ; Out-of-Hospital Cardiac Arrest/therapy ; Electric Countershock ; Cardiopulmonary Resuscitation/methods ; Emergency Responders ; Emergency Medical Services
Language	English
Publishing date	2023-05-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.122.027756
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Early intranasal medication administration in out-of-hospital cardiac arrest: Two randomized simulation trials.

Dowker, Stephen R / Downey, Madison L / Majhail, Noor K / Scott, Isabella G / Mathisson, Jonah / Rizk, Daniel / Trumpower, Brad / Yake, Debra / Williams, Michelle / Coulter-Thompson, Emilee I / Brent, Christine M / Smith, Graham C / Swor, Robert / Berger, David A / Rooney, Deborah M / Neumar, Robert W / Friedman, Charles P / Cooke, James M / Missel, Amanda L

Journal of the American College of Emergency Physicians open

2024 Volume 5, Issue 1, Page(s) e13100

Abstract: Objective: Intranasal medications have been proposed as adjuncts to out-of-hospital cardiac arrest (OHCA) care. We sought to quantify the effects of intranasal medication administration (INMA) in OHCA workflows.: Methods: We conducted separate ... ...

Abstract	Objective: Intranasal medications have been proposed as adjuncts to out-of-hospital cardiac arrest (OHCA) care. We sought to quantify the effects of intranasal medication administration (INMA) in OHCA workflows. Methods: We conducted separate randomized OHCA simulation trials with lay rescuers (LRs) and first responders (FRs). Participants were randomized to groups performing hands-only cardiopulmonary resuscitation (CPR)/automated external defibrillator with or without INMA during the second analysis phase. Time to compression following the second shock (CPR2) was the primary outcome and compression quality (chest compression rate (CCR) and fraction (CCF)) was the secondary outcome. We fit linear regression models adjusted for CPR training in the LR group and service years in the FR group. Results: Among LRs, INMA was associated with a significant increase in CPR2 (mean diff. 44.1 s, 95% CI: 14.9, 73.3), which persisted after adjustment ( Conclusions: INMA in LR resuscitation was associated with diminished resuscitation performance. INMA by FR did not impede key times or quality.
Language	English
Publishing date	2024-01-21
Publishing country	United States
Document type	Journal Article
ISSN	2688-1152
ISSN (online)	2688-1152
DOI	10.1002/emp2.13100
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Article ; Online: Barriers to the Initiation of Telecommunicator-CPR during 9-1-1 Out-of-Hospital Cardiac Arrest Calls: A Qualitative Study.

Missel, Amanda L / Dowker, Stephen R / Chiola, Madeline / Platt, Jodyn / Tsutsui, Julia / Kasten, Kristin / Swor, Robert / Neumar, Robert W / Hunt, Nathaniel / Herbert, Logan / Sams, Woodrow / Nallamothu, Brahmajee K / Shields, Theresa / Coulter-Thompson, Emilee I / Friedman, Charles P

Prehospital emergency care

2023 Volume 28, Issue 1, Page(s) 118–125

Abstract: Introduction: Fewer than 10% of individuals who suffer out-of-hospital cardiac arrest (OHCA) survive with good neurologic function. Bystander CPR more than doubles the chance of survival, and telecommunicator-CPR (T-CPR) during a 9-1-1 call ... ...

Abstract	Introduction: Fewer than 10% of individuals who suffer out-of-hospital cardiac arrest (OHCA) survive with good neurologic function. Bystander CPR more than doubles the chance of survival, and telecommunicator-CPR (T-CPR) during a 9-1-1 call substantially improves the frequency of bystander CPR. Objective: We examined the barriers to initiation of T-CPR. Methods: We analyzed the 9-1-1 call audio from 65 EMS-treated OHCAs from a single US 9-1-1 dispatch center. We initially conducted a thematic analysis aimed at identifying barriers to the initiation of T-CPR. We then conducted a conversation analysis that examined the interactions between telecommunicators and bystanders during the recognition phase (i.e., consciousness and normal breathing). Results: We identified six process themes related to barriers, including incomplete or delayed recognition assessment, delayed repositioning, communication gaps, caller emotional distress, nonessential questions and assessments, and caller refusal, hesitation, or inability to act. We identified three suboptimal outcomes related to arrest recognition and delivery of chest compressions, which are missed OHCA identification, delayed OHCA identification and treatment, and compression instructions not provided following OHCA identification. A primary theme observed during missed OHCA calls was incomplete or delayed recognition assessment and included failure to recognize descriptors indicative of agonal breathing (e.g., "snoring", "slow") or to confirm that breathing was effective in an unconscious victim. Conclusions: We observed that modifiable barriers identified during 9-1-1 calls where OHCA was missed, or treatment was delayed, were often related to incomplete or delayed recognition assessment. Repositioning delays were a common barrier to the initiation of chest compressions.
MeSH term(s)	Humans ; Out-of-Hospital Cardiac Arrest/therapy ; Cardiopulmonary Resuscitation ; Emergency Medical Services ; Emergency Medical Service Communication Systems ; Emergency Medical Dispatch
Language	English
Publishing date	2023-03-13
Publishing country	England
Document type	Journal Article
ZDB-ID	1461751-1
ISSN	1545-0066 ; 1090-3127
ISSN (online)	1545-0066
ISSN	1090-3127
DOI	10.1080/10903127.2023.2183533
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Zs.A 4762: Show issues

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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Assessment of telecommunicator cardiopulmonary resuscitation performance during out-of-hospital cardiac arrest using a standardized tool for audio review.

Dowker, Stephen R / Smith, Graham / O'Leary, Michael / Missel, Amanda L / Trumpower, Brad / Hunt, Nathaniel / Herbert, Logan / Sams, Woodrow / Kamdar, Neil / Coulter-Thompson, Emilee I / Shields, Theresa / Swor, Robert / Domeier, Robert / Abir, Mahshid / Friedman, Charles P / Neumar, Robert W / Nallamothu, Brahmajee K

Resuscitation

2022 Volume 178, Page(s) 102–108

Abstract: Objective: Telecommunicator cardiopulmonary resuscitation (T-CPR) is a critical component of optimized out-of-hospital cardiac arrest (OHCA) care. We assessed a pilot tool to capture American Heart Association (AHA) T-CPR measures and T-CPR coaching by ... ...

Abstract	Objective: Telecommunicator cardiopulmonary resuscitation (T-CPR) is a critical component of optimized out-of-hospital cardiac arrest (OHCA) care. We assessed a pilot tool to capture American Heart Association (AHA) T-CPR measures and T-CPR coaching by telecommunicators using audio review. Methods: Using a pilot tool, we conducted a retrospective review of 911 call audio from 65 emergency medical services-treated out-of-hospital cardiac arrest (OHCA) patients. Data collection included events (e.g., OHCA recognition), time intervals, and coaching quality measures. We calculated summary statistics for all performance and quality measures. Results: Among 65 cases, the patients' mean age was 64.7 years (SD: 14.6) and 17 (26.2%) were women. Telecommunicator recognition occurred in 72% of cases (47/65). Among 18 non-recognized cases, reviewers determined 12 (66%) were not recognizable based on characteristics of the call. Median time-to-recognition was 76 seconds (n = 40; IQR:39-138), while median time-to-first-instructed-compression was 198 seconds (n = 26; IQR:149-233). In 36 cases where coaching was needed, coaching on compression-depth occurred in 27 (75%); -rate in 28 (78%); and chest recoil in 10 (28%) instances. In 30 cases where repositioning was needed, instruction to position the patient's body flat occurred in 18 (60%) instances, on-back in 22 (73%) instances, and on-ground in 22 (73%) instances. Conclusions: Successful collection of data to calculate AHA T-CPR measures using a pilot tool for audio review revealed performance near AHA benchmarks, although coaching instructions did not occur in many instances. Application of this standardized tool may aid in T-CPR quality review.
MeSH term(s)	American Heart Association ; Cardiopulmonary Resuscitation ; Emergency Medical Services ; Female ; Humans ; Male ; Middle Aged ; Out-of-Hospital Cardiac Arrest/therapy ; Retrospective Studies
Language	English
Publishing date	2022-04-26
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2022.04.015
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Article ; Online: Bias and Discrimination Against Lesbian, Gay, Bisexual, Transgender, and Queer Parents Accessing Care for Their Children: A Literature Review.

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Article ; Online: Survey of Lesbian, Gay, Bisexual, Transgender, and Queer Parents' Experiences Accessing Health Care for their Children With Developmental Disabilities.

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Article ; Online: Health Care Bias and Discrimination Experienced by Lesbian, Gay, Bisexual, Transgender, and Queer Parents of Children With Developmental Disabilities: A Qualitative Inquiry in the United States.

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Article ; Online: Factors Impacting Treatment of Out-of-Hospital Cardiac Arrest: A Qualitative Study of Emergency Responders.

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Article ; Online: Early intranasal medication administration in out-of-hospital cardiac arrest: Two randomized simulation trials.

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Article ; Online: Barriers to the Initiation of Telecommunicator-CPR during 9-1-1 Out-of-Hospital Cardiac Arrest Calls: A Qualitative Study.

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Article ; Online: Assessment of telecommunicator cardiopulmonary resuscitation performance during out-of-hospital cardiac arrest using a standardized tool for audio review.

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