ABSTRACT Many of the more than 1 million military veterans who identify as lesbian, gay, bisexual, and/or transgender (LGBT) have encountered “rejecting experiences in the military” and stigma from prior “Don’t Ask Don’t Tell” policies. Associated minority stress and social isolation have been linked to a disproportionate risk for depression and suicide, as well as a reluctance to seek medical care at Veterans Health Administration (VHA) facilities. This paper describes feasibility and preliminary outcomes of the newly developed, Pride in All Who Served Health Education Group created to meet the unique needs of sexual and gender minority veterans. The 10-week, closed, health education group (e.g., continuums of identity, military culture) enables open dialogue, fosters social connectedness, and empowers veterans to be more effective self-advocates within the healthcare system. Feedback from formative evaluations (n = 29 LGBT veterans and n = 25 VHA stakeholders) was incorporated before conducting a small scale, non-randomized pilot. Preliminary pre-post surveys (n = 18) show promise (i.e., Cohen’s d range ± 0.40 to 1.59) on mental health symptoms (depression/anxiety, suicidal ideation), resilience indicators (identity affirmation, community involvement, problem-focused coping), and willingness to access care within the VA system (satisfaction with VA services, perception of staff competence). Results suggest that the 10-week Pride Group may be an effective tool for addressing minority-related stress in LGBT veterans. A full-scale, randomized clinical trial of this intervention is needed to determine short and long-term impacts on clinical and healthcare access-related outcomes.

中文翻译：

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为所有服务者感到自豪：LGBT 退伍军人健康教育小组的发展、可行性和初步效果

摘要 超过 100 万退伍军人中，许多被认定为女同性恋、男同性恋、双性恋和/或跨性别者 (LGBT) 的人都经历过“拒绝在军队中的经历”以及之前“不问不说”政策的耻辱。 。相关的少数族裔压力和社会孤立与抑郁和自杀的高风险以及不愿在退伍军人健康管理局 (VHA) 机构寻求医疗护理有关。本文介绍了新成立的“为所有服务者感到自豪”健康教育小组的可行性和初步成果，该小组旨在满足性和性别少数退伍军人的独特需求。为期 10 周的封闭式健康教育小组（例如，身份连续体、军事文化）能够实现公开对话，促进社会联系，并使退伍军人能够在医疗保健系统中成为更有效的自我倡导者。在进行小规模、非随机试点之前，纳入了形成性评估（n = 29 LGBT 退伍军人和 n = 25 VHA 利益相关者）的反馈。初步的事前事后调查（n = 18）显示出对心理健康症状（抑郁/焦虑、自杀意念）、复原力指标（身份肯定、社区参与、以问题为中心的应对）的希望（即科恩的 d 范围 ± 0.40 至 1.59） ，以及在 VA 系统内获得护理的意愿（对 VA 服务的满意度、对员工能力的看法）。结果表明，为期 10 周的骄傲小组可能是解决 LGBT 退伍军人与少数族裔相关压力的有效工具。需要对该干预措施进行全面的随机临床试验，以确定对临床和医疗保健获取相关结果的短期和长期影响。