Correlates of wanting to seek help for mental health and substance use concerns by sexual and gender minority young adults during the COVID-19 pandemic: A machine learning analysis.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

COVID-19*/epidemiology ; Sexual and Gender Minorities* ; Substance-Related Disorders*/epidemiology; Female ; Young Adult ; Humans ; Mental Health ; Pandemics ; Cross-Sectional Studies ; Machine Learning ; Ontario

The COVID-19 pandemic has worsened the mental health and substance use challenges among many people who are Two Spirit, lesbian, gay, bisexual, transgender, queer, questioning, and intersex (2SLGBTQI+). We aimed to identify the important correlates and their effects on the predicted likelihood of wanting to seek help among 2SLGBTQI+ young adults for mental health or substance use concerns during the pandemic. A cross-sectional survey was conducted in 2020-2021 among 2SLGBTQI+ young adults aged 16-29 living in two Canadian provinces (Ontario and Quebec). Among 1414 participants, 77% (n = 1089) wanted to seek help for their mental health or substance use concerns during the pandemic, out of these, 69.8% (n = 760) reported delay in accessing care. We built a random forest (RF) model to predict the status of wanting to seek help, which achieved moderately high performance with an area under the receiver operating characteristic curve (AUC) of 0.85. The top 10 correlates of wanting to seek help were worsening mental health, age, stigma and discrimination, and adverse childhood experiences. The interactions of adequate housing with certain sexual orientations, gender identities and mental health challenges were found to increase the likelihood of wanting to seek help. We built another RF model for predicting risk of delay in accessing care among participants who wanted to seek help (n = 1089). The model identified a similar set of top 10 correlates of delay in accessing care but lacked adequate performance (AUC 0.61). These findings can direct future research and targeted prevention measures to reduce health disparities for 2SLGBTQI+ young adults.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2022 Kundu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Qual Health Res. 2019 Nov;29(13):1839-1849. (PMID: 30810072)
Psychol Bull. 2003 Sep;129(5):674-697. (PMID: 12956539)
PLoS One. 2021 Sep 21;16(9):e0257693. (PMID: 34547037)
J Affect Disord. 2021 Mar 1;282:407-414. (PMID: 33422816)
PLoS One. 2022 Nov 16;17(11):e0277438. (PMID: 36383536)
Bioinformatics. 2012 Jan 1;28(1):112-8. (PMID: 22039212)
J Clin Nurs. 2021 Aug;30(15-16):2270-2278. (PMID: 33529443)
BMC Psychiatry. 2016 Jul 04;16:209. (PMID: 27377408)
BMC Public Health. 2020 Aug 4;20(1):1123. (PMID: 32746891)
Prev Sci. 2021 Nov;22(8):1173-1184. (PMID: 33974226)
BMJ. 2021 Mar 16;372:m4828. (PMID: 33727244)
JMIR Med Inform. 2021 Nov 11;9(11):e28962. (PMID: 34762059)
JCPP Adv. 2022 May 10;2(2):e12079. (PMID: 37431452)
J Homosex. 2018;65(13):1916-1933. (PMID: 29020574)
Law Hum Behav. 2005 Oct;29(5):615-20. (PMID: 16254746)
Int J Transgend. 2019 Sep 4;20(4):421-433. (PMID: 32999627)
Milbank Q. 2005;83(4):691-729. (PMID: 16279964)
Am J Orthopsychiatry. 2018;88(4):471-482. (PMID: 29355368)
PLoS One. 2015 Feb 13;10(2):e0116198. (PMID: 25679391)
Biomed Inform Insights. 2016 Jan 19;8:1-10. (PMID: 26843812)
Radiology. 2003 Oct;229(1):3-8. (PMID: 14519861)
Tob Control. 2023 Jan;32(1):99-109. (PMID: 34452986)
BMJ Open. 2020 Oct 27;10(10):e037860. (PMID: 33109649)
J Psychiatr Res. 2019 Dec;119:1-6. (PMID: 31518909)
J Ment Health. 2018 Apr;27(2):94-96. (PMID: 29447026)
Psychiatry Res. 2022 Jan;307:114327. (PMID: 34923446)
Health Aff (Millwood). 2022 Apr;41(4):573-580. (PMID: 35377763)
PLoS One. 2021 Jan 22;16(1):e0245268. (PMID: 33481862)
J Psychiatr Res. 2022 Aug;152:269-277. (PMID: 35759979)
Knee Surg Sports Traumatol Arthrosc. 2022 Mar;30(3):753-757. (PMID: 35106604)
Nicotine Tob Res. 2022 Jun 15;24(7):1028-1036. (PMID: 34888698)
Transgend Health. 2017 Dec 01;2(1):207-216. (PMID: 29279875)
J Sex Res. 2012;49(1):36-49. (PMID: 21512945)
J Homosex. 2019;66(8):1148-1177. (PMID: 30052497)
Int J Environ Res Public Health. 2021 Oct 28;18(21):. (PMID: 34769836)
LGBT Health. 2016 Aug;3(4):258-65. (PMID: 27383512)
Brain Sci. 2022 Mar 10;12(3):. (PMID: 35326322)
Am J Public Health. 2014 Feb;104(2):272-8. (PMID: 24328619)
Science. 2015 Jul 17;349(6245):255-60. (PMID: 26185243)
JAMA Otolaryngol Head Neck Surg. 2022 Aug 1;148(8):764-772. (PMID: 35771564)
BMC Med Inform Decis Mak. 2019 Dec 21;19(1):281. (PMID: 31864346)

173073 Canada CIHR

Date Created: 20221116 Date Completed: 20221118 Latest Revision: 20241001

20250114

PMC9668172

10.1371/journal.pone.0277438

36383536