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Applying a Structural‐Competency Framework to the Implementation of Strategies to Reduce Disparities for Sexual and Gender Minority Youth
Author(s) -
Shattuck Daniel G.,
Willging Cathleen E.,
Green Amy E.
Publication year - 2020
Publication title -
journal of school health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.851
H-Index - 86
eISSN - 1746-1561
pISSN - 0022-4391
DOI - 10.1111/josh.12964
Subject(s) - safer , thematic analysis , sexual minority , focus group , population , health equity , public relations , stigma (botany) , psychology , sexual orientation , political science , qualitative research , medicine , sociology , nursing , social psychology , public health , environmental health , computer science , anthropology , social science , computer security , psychiatry
ABSTRACT BACKGROUND Sexual and gender minority youth (SGMY) are at high risk for adverse health outcomes. Safer schools decrease this risk. The US Centers for Disease Control and Prevention has identified 6 practices that can make schools safer for SGMY, yet few US schools implement them all. We apply a structural competency framework to elucidate factors contributing to this implementation gap. METHODS We conducted 75 interviews and 32 focus groups with school professionals in 18 New Mexico high schools to assess factors impacting implementation of the practices over 2 years. We analyzed data using iterative coding, thematic identification techniques, and the sensitizing concept of structural competency. RESULTS Themes included: rendering an invisible population visible; critical thinking about LGBTQ inequalities; building school personnel capacity; intersecting cultural, religious, and political conflicts; and tackling community‐based sources of stigma and discrimination. Conclusions Underlying cultural and structural forces render SGMY invisible and constrain what schools can accomplish. Professional development encouraging critical thinking about structural inequities is foundational, but efforts to close the implementation gap must attend to structural forces producing disparities for SGMY. Structural competency can strengthen the ability of the Whole School, Whole Community, and Whole Child model's cross‐sector coordination of policy and process to meet the needs of every student.