Publications by authors named "Eliot J Lopez"

6 Publications

  • Page 1 of 1

Health Needs and Experiences of a LGBT Population in Georgia and South Carolina.

J Homosex 2019 10;66(7):989-1013. Epub 2018 Aug 10.

a Department of Psychiatry and Health Behavior , Medical College of Georgia, Augusta University , Augusta , Georgia , USA.

The 2016 Municipal Equality Index rated Augusta, the largest city in the Central Savannah River Area (CSRA), as one of the least lesbian, gay, bisexual, and transgender (LGBT) friendly cities in America. To understand the context of our region in relation to LGBT wellness, we conducted the first LGBT health needs assessment of the CSRA, assessing physical and mental health status and health care needs and experiences in the community. Participants (N = 436) were recruited using venue and snowball sampling and completed an anonymous online survey. Overall, the health problems experienced (i.e., obesity, depression) were not uniformly experienced across sexual orientation and gender identity; some groups experienced significantly higher rates of these conditions than others. Similarly, transgender individuals in particular reported higher rates of negative experiences with health care providers. Regional and national dissemination of these findings is critical to reducing health disparities and improving wellness of our local LGBT community.
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http://dx.doi.org/10.1080/00918369.2018.1490573DOI Listing
April 2019

Rationale and design of a pilot study examining Acceptance and Commitment Therapy for persistent pain in an integrated primary care clinic.

Contemp Clin Trials 2018 03 4;66:28-35. Epub 2018 Feb 4.

Department of Psychiatry, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr, Mail Code 7792, San Antonio, TX 78229, USA. Electronic address:

Most of the 100 million Americans with persistent pain are treated in primary care clinics, but evidence-based psychosocial approaches targeting pain-related disability are not usually provided in these settings. This manuscript describes the rationale and methods for a protocol to pilot test the feasibility and effectiveness of Acceptance and Commitment Therapy (ACT), an evidence-based psychological treatment for persistent pain, delivered by a Behavioral Health Consultant in primary care. Eligible patients are identified through electronic health record registries and invited to participate via secure messaging, letters and a follow-up phone call. Participants are also recruited with advertising and clinician referral. Patients agreeing to participate are consented and complete initial assessments, with a target of 60 participants. Randomization is stratified based on pain severity with participants assigned to either ACT or Enhanced Treatment as Usual (E-TAU). ACT participants receive one standardized Behavioral Health Consultation visit followed by three ACT-based group visits and one group booster visit. All patients attend six assessment visits, during which the E-TAU patients are provided with educational pain management handouts based on standard cognitive behavioral treatment of pain. The study aims to determine feasibility and effectiveness of brief ACT for persistent pain delivered by an integrated behavioral health clinician in primary care from pre- to post-treatment, and to examine mechanisms of change in ACT participants. This study, in a "real-world" setting, will lay groundwork for a larger trial. If effective, it could improve treatment methods and quality of life for patients with persistent pain using a scalable approach.
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http://dx.doi.org/10.1016/j.cct.2018.01.004DOI Listing
March 2018

Mental Health Correlates of Cigarette Use in LGBT Individuals in the Southeastern United States.

Subst Use Misuse 2018 05 5;53(6):891-900. Epub 2018 Jan 5.

a Department of Psychiatry and Health Behavior , Augusta University , Augusta , Georgia , USA.

Background: Smoking prevalence for lesbian, gay, bisexual, and transgender (LGBT) individuals is higher than for heterosexual, cisgender individuals. Elevated smoking rates have been linked to psychiatric comorbidities, substance use, poverty, low education levels, and stress.

Objectives: This study examined mental health (MH) correlates of cigarette use in LGBT individuals residing in a metropolitan area in the southeastern United States.

Methods: Participants were 335 individuals from an LGBT health needs assessment (mean age 34.7; SD = 13.5; 63% gay/lesbian; 66% Caucasian; 81% cisgender). Demographics, current/past psychiatric diagnoses, number of poor MH days in the last 30, the Patient Health Questionnaire (PHQ) 2 depression screener, the Three-Item Loneliness Scale, and frequency of cigarette use were included. Analyses included bivariate correlations, analysis of variance (ANOVA), and regression.

Results: Multiple demographic and MH factors were associated with smoker status and frequency of smoking. A logistic regression indicated that lower education and bipolar disorder were most strongly associated with being a smoker. For smokers, a hierarchical regression model including demographic and MH variables accounted for 17.6% of the variance in frequency of cigarette use. Only education, bipolar disorder, and the number of poor MH days were significant contributors in the overall model. Conclusions/Importance: Less education, bipolar disorder, and recurrent poor MH increase LGBT vulnerability to cigarette use. Access to LGBT-competent MH providers who can address culturally specific factors in tobacco cessation is crucial to reducing this health disparities.
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http://dx.doi.org/10.1080/10826084.2017.1418087DOI Listing
May 2018

Contextualizing Competence: Language and LGBT-Based Competency in Health Care.

J Homosex 2017 ;64(10):1330-1349

b Department of Psychiatry , University of Texas Health Science Center San Antonio , San Antonio , Texas , USA.

Changes in the language and terminology used to refer to individuals identifying as lesbian, gay, bisexual, and transgender (LGBT), as well as how best to discuss issues of sexual and gender identity, can prove challenging for health care providers due to (1) lack of training; (2) interdisciplinary issues; and (3) prejudices on personal and institutional levels. Given the importance of language in the relationship between health care provider and patient as well as the myriad ways in which language can reflect knowledge, skills, and attitudes, we contend that language is both a facilitator and inhibitor of competence. In this article, we discuss language as a means of exhibiting cultural competence as well as the barriers to facilitating this degree of competence. Communicative competence, a concept traditionally used in linguistics, is discussed as a framework for contextualizing LGBT-specific cultural competence in health care. Ideally, a professional will be considered competent once they (1) acquire a foundation in issues associated with LGBT individuals, as well as a basic understanding of appropriate vocabulary' (2) reconcile personal beliefs with their professional role; (3) create an inclusive healthcare environment such that the influence of personal biases does not negatively impact care; and (4) use identifiers suggested by the patient.
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http://dx.doi.org/10.1080/00918369.2017.1321361DOI Listing
July 2017

The Changing Face of Treatment: Mental Health Concerns and Integrated Care in an HIV Clinic.

J Health Care Poor Underserved 2017 ;28(1):430-445

Though advances in medical treatment have increased lifespans for those living with HIV, quality of life concerns often remain under-treated by health care providers. The integration of mental health services within the HIV medical setting can provide comprehensive care for patients, including brief screening, intervention, and appropriate follow-up. In this study, investigators examined mental health concerns identified during behavioral health screens at appointments in an Infectious Disease Clinic and compared them with previously published data from the same setting to assess changes in patient-reported problems. Results indicated shifts in identified problems, as well as demographic changes in the patient population from the previous study. Analyses suggested anger and goal-setting problems significantly contribute to reports of psychiatric symptoms, and suggested that adjustment to diagnosis, depression, and sleep concerns significantly contribute to the likelihood of engaging in a mental health consultation. Our findings highlight the importance of behavioral health screening to identify psychosocial concerns in integrated HIV care settings.
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http://dx.doi.org/10.1353/hpu.2017.0032DOI Listing
February 2018

Violence, coping, and consistent medication adherence in HIV-positive couples.

AIDS Educ Prev 2010 Feb;22(1):61-8

Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

The purpose of this study was to investigate the extent to which intimate partner violence (IPV) influences antiretroviral medication adherence. Furthermore, it was hypothesized that adherence would differ for men and women based on degree of violence and coping strategies employed by each gender. A sample of HIV seroconcordant and serodiscordant heterosexual couples was recruited from the Miami area and assessed on rates of medication adherence, conflict resolution tactics, and coping strategies. Of these, 190 individual participants were prescribed antiretroviral medication. Baseline rates of adherence were 90.29% for men and 87.77% for women. Acts of violence were found to have negative effects on adherence for women but not for men. However, negative coping strategies were predictive of poor adherence for men but not women. Violence was found to be related to poor coping styles for both men and women. This study offers support for the inclusion of partners in conducting interventions. Furthermore, it underlines the importance of recognizing IPV as a barrier to medication adherence.
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http://dx.doi.org/10.1521/aeap.2010.22.1.61DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734535PMC
February 2010