Abstract Objectives Existing research suggests young people with visible differences can experience a range of psychosocial challenges, such as low self‐esteem and increased anxiety and depression. However, young people from minoritised groups are not well represented in visible difference research. This includes LGBTQIA+ young people, who experience both mental and physical health inequalities and may be at greater risk of negative body image than their cisgender/heterosexual peers. While it can be argued that LGBTQIA+ young people with visible differences may be at greater risk of negative psychosocial outcomes compared to their cisgender/heterosexual counterparts, little research explores the unique experiences of this population. Therefore, this study aimed to explore the lived experiences of LGBTQIA+ young people (aged 15–28 years) with visible differences. Design This study used an inductive, qualitative design. The research was underpinned by a critical realist/contextualist perspective. Methods Data were generated using online qualitative surveys and 75 young people with a range of gender identities, sexualities, and visible differences took part. Reflexive thematic analysis was used to analyse the data. Results One overarching theme, The weight of multiple marginalisation , was generated that encompassed two themes: (1) Dual identities , dual stigma and (2) Hiding to prevent hurting . Conclusions Analysis suggested that LGBTQIA+ young people with visible differences face unique challenges not accounted for by generic support. However, some experienced personal growth and described feeling accepted by LGBTQIA+ people. Tailored, co‐produced interventions are needed to effectively support this population and reduce the health and social inequalities they face.
Abstract Background Weight stigma refers to prejudice and discrimination based on body weight. Healthcare professionals often hold negative attitudes towards patients with overweight, which can negatively affect patient care and health outcomes. However, weight stigma is yet to be explored in midwifery and dental students. Methods Two online experimental studies using hypothetical patient vignettes were conducted in midwifery ( n = 281; Study 1) and dental and non‐dental students ( n = 528; Study 2). Participants were randomly assigned to view a healthy‐weight, overweight or obese patient vignette and then reported their attitudes, predicted time, advice they would provide and beliefs about obesity. Data were analysed using ANOVA and logistic regression. Results In Study 1, midwifery students held significantly more stigmatizing attitudes towards patients who were overweight than healthy‐weight patients; however, there was no significant difference in attitudes towards patients with obesity. Predicted time spent with patients did not significantly differ as a function of patient weight status. In Study 2, dental and non‐dental students reported more stigmatizing attitudes towards overweight and obese patients compared to healthy‐weight patients. Predicted time spent with patients did not differ significantly. Dental and non‐dental students were more likely to offer lifestyle‐related advice to overweight and obese patients. There was no significant relationship between beliefs about obesity and attitudes towards treating patients. Conclusions Weight stigma is evident among healthcare students and can affect healthcare advice. Increased awareness of potential biases in midwives and dental students is needed and should form formal training to improve equitable healthcare delivery.
Abstract Objectives Despite being the gold standard for assessing physical activity (PA) under free‐living conditions, accelerometer‐based assessments are prone to measurement reactivity, that is, changes in people's cognitions, emotions or behaviour due to being measured. Little is known about whether participants are aware of these changes. This preregistered secondary analysis assesses objective and subjective reactivity to the sensor‐based measurement of PA (steps, light PA [LPA], moderate‐to‐vigorous PA [MVPA]) and sedentary behaviour (SB) in adults with and without attention‐deficit/hyperactivity disorder (ADHD), depression and insulin resistance. Design Intensive longitudinal design. Methods Two existing datasets were used, comprising 354 adults (64% female; M age = 35.63, SD age = 13.98; M BMI = 26.27, SD BMI = 5.85) who wore an accelerometer for 7 days and self‐reported whether they changed their PA due to the activity tracker (i.e. subjective measurement reactivity). Objective measurement reactivity was defined as decreases in PA and increases in SB. Results Multilevel models found small, but significant decreases of PA over the study period and from the first study day(s) to the remaining study days. Yet, over 90% of participants indicated to have (rather) not changed their PA. SB did not systematically change. Subjective measurement reactivity and clinical diagnoses were not related to measurement reactivity. Conclusions Steps, LPA and MVPA, but not SB, systematically changed in line with common definitions of measurement reactivity. Yet, most participants were unaware of these changes, potentially because changes were small. Measurement reactivity may be predominantly driven by unconscious mechanisms and appears universal, with no differences found by diagnoses.
Abstract Purpose Previous research demonstrates that body image concerns are highly prevalent in stoma patients and can significantly limit quality of life, yet the psychological processes underlying these changes remain under‐theorized in the literature. This review aims to develop an understanding of the psychological experience of body image change in adult stoma patients. Methods A systematic review and meta‐ethnography was undertaken of primary, qualitative, English‐language research focusing on the psychological experience of body image change in adult stoma patients. Eight hundred and forty‐three studies were initially obtained from backwards citation chaining and three databases: Medline, CINAHL and PsychINFO. Methodological quality and risk of bias were evaluated using the Joanna Briggs Institute Qualitative Checklist. Results After screening, 18 studies ( n = 602) were included in the synthesis. Three third‐order constructs were found across two time phases (immediately after surgery, and living with the stoma): all‐consuming shock, visible ‘otherness’ and fluctuating acceptance. Findings map the trajectory of body image change following stoma formation and identify psychological, social and relational processes associated with continuing distress and adaptation. Conclusions This review moves beyond documenting body image distress in stoma patients to explain the psychological mechanisms through which it develops and fluctuates over time. Stoma formation can disrupt bodily integrity and identity, with distress maintained through self‐scrutiny, shame and perceived social exposure. The mechanisms identified provide clear targets for tailored psychosocial support beginning pre‐surgery and continuing through recovery to reduce long‐term body image distress and improve health‐related quality of life.
Abstract Objective Regular exercise is vital for preventing cardiovascular disease, maintaining a healthy body weight and supporting mental well‐being, yet most people exercise insufficiently often due to motivational barriers. Design This study examined two types of exercise motive—functional (divided into health/fitness and enjoyment) and appearance—and their interplay with mood and exercise engagement in daily life. Two hypotheses were tested: (H1) functional motives, compared to appearance motive, predict greater exercise engagement, and (H2) higher (more positive) mood, in interaction with exercise motives, predicts greater exercise engagement. Method Ninety‐eight healthy BMI women completed a 2‐week smartphone Ecological Momentary Assessment (EMA) protocol reporting exercise motive (baseline), exercise engagement (frequency, intensity, duration) and mood several times/day. Results Partially supporting H1, enjoyment motive predicted greater exercise frequency and duration, whereas—contrary to H1— health/fitness motive predicted shorter duration and appearance was unrelated to engagement. H2 was not supported: mood did not predict engagement and functional motives did not strengthen the mood–engagement link. Contrary to H2, the appearance motive strengthened the (same‐moment) within‐person association between mood and exercise intensity, such that women higher in appearance motive showed a stronger positive mood–intensity link. Multilevel temporal networks revealed that higher (more positive) mood at one assessment weakly predicted greater exercise intensity and duration at the next assessment. Conclusions Together, enjoyment emerges as central to exercise engagement, while positive mood temporally precedes exercise, informing future lifestyle interventions. Further research on the temporal dynamics linking mood and exercise is warranted.
