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Title of Study: Where are We Now? Rural 2SLGBTQIA+ Individual’s Perspectives on Access to Health Services and Family Supports
1.
Participation Information Sheet
Principal Investigator: Nadine Henriquez - henriquezn@randonu.ca Brandon University Study Co-investigator: Dr. Nora Ahmad - ahmadn@brandonu.ca Brandon University Invitation to Participate: You can participate in this study if you self-identify as 2SLGBTQIA+, are age 16 years or older, and live in rural Manitoba. Aim of the Study: The purpose of this study is to examine the self-rated physical and mental health and supportive service use/healthcare service use and needs, and experiences of discrimination of 2SLGBTQIA+ persons and families living in rural communities in Manitoba. This research will provide an opportunity to create visibility for rural 2SLGBTQIA+ persons. Examining the physical and mental health of 2SLGBTQIA+ persons living rurally and identifying concerns related to wellbeing and supportive service needs are critical to help inform future policy changes and funding for supports and services to ultimately help improve health, well-being, and qual¬ity of life. This study will improve knowledge about the unique needs of 2SLGBTQIA+ rural populations and will assist in the development of services which are affirming and promote diversity and inclusion, to better address the health needs of 2SLGBTQIA+ persons in rural regions. By involving members of the 2SLGBTQIA+ community, the hope is to have a better understanding of the unique needs and experiences of 2SLGBTQIA+ persons in Manitoba and will help to determine recommended changes to healthcare and service providers, policy makers, and service programs to improve equal access, inclusiveness, and cultural sensitivity. Participant: We would be grateful if you could dedicate 20 minutes of your time to participate in an online survey which will consist of questions regarding your physical and mental health, social support and health services you access in your community, your needs regarding supportive services in your community, and experiences of interpersonal discrimination. Responses will only be collected by the online survey. The results will serve for research purposes only. Participation is voluntary and confidential. Benefits and Risks: There are no direct personal benefits or risks associated with participation in the study. By involving members of the 2SLGBTQIA+ community, the hope is to have a better understanding of the unique needs and experiences of 2SLGBTQIA+ persons in Manitoba and will help to determine recommended changes to healthcare and service providers, policy makers, and service programs to improve equal access, inclusiveness, and cultural sensitivity. Confidentiality and Anonymity: The information obtained from the survey is confidential and will be anonymized for research purposes by members of the research team. Data Storage: Surveys will be stored on a password protected computer that belongs to the principal investigator for up to 5 years and then destroyed. Voluntary Participation: Participation is voluntary. You can refuse to answer questions that you do not wish to answer. You may withdraw from the survey at any time. Your responses will not be recorded if you withdraw prior to submitting your survey. I understand that it is impossible to withdraw from the survey once data analysis occurs. Information about the Study Results: The research findings will be included in presentations and a paper that discuss how 2SLGBTQIA+ persons in rural communities rate their quality of life and mental health status, access to social and healthcare services, and experiences with discrimination. The research findings will not be personally shared with the participants; however, participants are welcome to attend knowledge translation and presentation events. Contact Information: If you have any questions or require more information about the study itself, you may contact the primary investigator Nadine Henriquez at henriquezn@brandonu.ca. Ethical Approval: This study has been reviewed by Brandon University Research Ethics Committee (BUREC) at Brandon University. If you have any ethics-elated concerns, you may contact the Research Ethics Office at Brandon University at 204-727-9712 or burec@brandonu.ca. Please keep this form for your records by printing a copy or downloading it onto your computer. Please indicate your consent to participate by clicking the yes or no response option in the survey link. By consenting, you have not waived any right to legal recourse in the event of research-related harm. As a small token of our appreciation for your time and responses, you will be entered into a drawing for a chance to win one of ten $50.00 Visa gift cards. Access the survey by clicking on the link: https://www.surveymonkey.com/r/97TQ2MC
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2.
Online Consent Form
This study is funded by a Brandon University Research Committee. No commercialization of research findings will occur within this study.
Title: Where are We Now? Rural 2SLGBTQIA+ Individual’s Perspectives on Access to Health Services and Family Supports
I agree to take part in this research project.
I have read the Information Sheet provided and have been given information on the purpose of this study, the procedures involved, and of what is expected of me.
I understand that I will be asked to: Participate in an online survey. The survey has demographic questions and four validated scales to examine the self-rated physical and mental health and supportive service use/healthcare service use and needs, and experiences of discrimination of 2SLGBTQIA+ persons and families living in rural communities in Manitoba. There is a possibility that participants may feel a range of different emotions when participating in this research project.
I understand that I may withdraw from completing the survey at any time.
I understand that it is impossible to withdraw from the survey once it has been submitted.
I understand that all information provided by me is treated as confidential and will not be released by the researcher to a third party unless required to do so by law.
I agree that any research data gathered for the study may be published. Identifying information is not disclosed.
By consenting, I understand that I have not waived any right to legal recourse in the event of research related harms.
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3.
I consent to participate in this study
Yes
No
If you are interested in participating in an individual interview that will take approximately one hour, you will be provided with a $20 honorarium. Please leave your email address and phone number. A Research Assistant will contact you for an interview.
Email: ____________________________ Phone number: __________________
Thank you for your interest.
4.
Please specify your age group
16 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 and above
5.
Sex assigned at birth
Male
Female
6.
Education level
High School
College
University
Professional Training
Other (please specify)
7.
Current Occupation
Student
Employed
Unemployed
Retired
8.
Marital Status
Single
Married/Common Law/In relationship
Separated/Divorced
9.
Do you have children/live with children?
Have children/live with children full time
Have children/live with children part-time
Have children/do not live with children
Do not have children
10.
Gender identity
Cisgender
Transgender
Non-binary
Other (please specify)
11.
Gender expression
Masculine
Feminine
Androgynous
Other (please specify)
12.
Sexual orientation
Lesbian
Gay
Bisexual
Asexual
2 Spirit
Other (please specify)
13.
Your primary Health Region where you access services
Prairie Mountain Health
Southern Health/Sante Sud
Winnipeg
North
14.
Have you been diagnosed with a mental illness/challenges. (e.g. PTSD, depression, anxiety)
Yes
No
If yes please specify
15.
Do you identify as someone with a disability.
Yes
No
If yes please specify
16.
Self report of your quality of life?
Very Poor
Poor
Neither poor nor good
Good
Very good
How would you rate your quality of life?
Very Poor
Poor
Neither poor nor good
Good
Very good
How well are you able to get around?
Very Poor
Poor
Neither poor nor good
Good
Very good
17.
How satisfied are you with your quality of life
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with your health?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with your sleep?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with your ability to perform your daily living activities?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with your capacity for work/study?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with yourself?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with your personal relationship?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with your sex life?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with support you get from your friends?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with support you get from your family?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with the conditions of your living place?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with your access to health services?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
How satisfied are you with your transport?
Vey dissatisfied
Dissatified
Neither satisfier nor dissatisfied
Satisfied
Very satisfied
18.
The following questions ask you about how much you have experienced certain things in the last four weeks.
An extreme amount
Very much
A moderate amount
A little
Not at all
To what extent do you feel that physical pain prevents you from doing what you need to do?
An extreme amount
Very much
A moderate amount
A little
Not at all
How much do you need any medical treatment to function in your daily life?
An extreme amount
Very much
A moderate amount
A little
Not at all
19.
The following questions ask about how much you have experienced certain things in the last four weeks
Not at all
A little
A moderate amount
Very much
Extremely
How much do you enjoy life?
Not at all
A little
A moderate amount
Very much
Extremely
To what extent do you feel your life to be meaningful?
Not at all
A little
A moderate amount
Very much
Extremely
How well are you able to concentrate?
Not at all
A little
A moderate amount
Very much
Extremely
How safe do you feel in your daily life?
Not at all
A little
A moderate amount
Very much
Extremely
How healthy is your physical environment
Not at all
A little
A moderate amount
Very much
Extremely
20.
The following questions ask you about how much you were able/complete to do certain things in the last four weeks.
Not at all
A little
A moderate amount
Mostly
Completely
Do you have enough energy for everyday life?
Not at all
A little
A moderate amount
Mostly
Completely
Are you able to accept your body appearance?
Not at all
A little
A moderate amount
Mostly
Completely
Do you have enough money to meet your needs?
Not at all
A little
A moderate amount
Mostly
Completely
How available to you is the information that you need in your day to day life?
Not at all
A little
A moderate amount
Mostly
Completely
To what extent do you have the opportunity for leisure activities?
Not at all
A little
A moderate amount
Mostly
Completely
21.
This question ask you how often you have felt or experienced certain things in the last for weeks
Never
Seldom
Quite often
Very often
Always
How often do you have negative feelings such as blue mood, despair, anxiety, depression
Never
Seldom
Quite often
Very often
Always
22.
Self report of your emotional states of depression, anxiety and stress over the past week.
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I found hard to wind down
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I was aware of dryness of my mouth
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I could not seem to experience any positive feeling at all
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I experienced breathing difficulty (e.g. excessively rapid breathing, breathlessness in the absence of physical exertion)
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I found it difficult to work up the initiative to do things
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I tended to over react to situations
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I experienced trembling (e.g. in the hands)
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I felt that I was using a lot of nervous energy
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I was worried about situations in which I might panic and make a fool of myself
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I felt that I had nothing to look forward to
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I found myself getting agitated
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I found it difficult to relax
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I felt down hearted and blue
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I was intolerant of anything that kept me from getting on with what I was doing
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I felt I was close to panic
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I was unable to become enthusiastic about anything
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I felt I wasn't worth much as a person
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I felt that I was rather touchy
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I was aware of the action of my heart in the absence of physical exertion (e.g. sense of heart rate increase, heart missing a beat)
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I felt scared without any good reason
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
I felt that life was meanigless
Did not apply to me at all
Applied to me to some degree or some of the time
Applied to me to a considerable degree or a good part of the time
Applied to me very much or most of the time
23.
Please think carefully about your life as you answer the questions below. Indicate how much the described events in the past year apply to you.
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you been been rejected by friends because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you been verbally insulted because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you been made fun of, picked on, pushed, shoved, hit or threatened with harm because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you heard Anti-2LGBTQIA+ remarks from family members?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you been rejected by family members because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you been called a heterosexist/cissexist name like dyke, lezzie or other names?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you been treated unfairly by your peers/employer/manager/supervisor because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you been treated unfairly by your family because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times were you denied a raise, a promotion, tenure, a good assignment, a job or other such things at work/school that you deserved because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you been treated unfairly by your teachers or professors because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times you have been treated unfairly by your co-worker, fellow students or colleagues because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times you have been treated unfairly by people in service jobs (by store clerks, waiters, bartender, bank tellers, mechanics) and others because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times you have been treated unfairly by health practitioners (by nurses, physician, psychiatrists, dentists, counselors, and others) because you are 2LGBTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
How many times have you been treated unfairly by strangers because you are 2LBGTQIA+?
If the event has NEVER happened to you
If the event happened ONCE IN A While)
If the event happened SOMETIMES
If the event happened A LOT
If the event happened MOST OF THE TIME
If the event happened ALMOST ALL OF THE TIME
24.
Please indicate how helpful each source is to you
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
My parents
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
My spouse's parents
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
My relatives
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
My spouse
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
My friends
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
My spouse's friends
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
My own children/stepchildren
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
Other parents
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
Church or religious place of worship
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
Social groups/clubs
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
My family physician/physician
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
Professional helpers, social workers, therapies, teacher, specialist
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
School/Day care center
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
Professional agencies (public health, social services, mental health etc)
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
My siblings
Not helpful at all
Sometimes helpful
Generally helpful
Very helpful
Extremely helpful
Other (please specify)
25.
Your contribution to this research is valuable and we appreciate your participation.
THANK YOU