Objectives: This multi-method, three-year qualitative study addresses the following research questions: (1) How does socio-cultural context shape the information creation, seeking, sharing, and use of health information among LGBTQ+ communities? (2) How can these findings inform medical librarian services to LGBTQ+ communities for health promotion?
Methods: Data collection consists of 30 individual semi-structured interviews with LGBTQ+ community leaders from STATE (completed), 6-8 focus groups with leaders' communities (in progress), and a community forum informed by the World Café methodology between 30-40 leaders and librarians (in progress). Individual and focus group interview participants also engaged in information worlds mapping, a visual arts-based elicitation method. Data for analysis are verbatim transcripts, analytical memos of information worlds maps, community forum notes, and researcher field notes and reflexivity journals. Data analysis follows qualitative open coding and constant comparison methods. Line-by-line first-cycle process coding identifies initial codes, which the researchers compare, combine, and refine via subsequent data collection and analysis. Second-cycle axial and theoretical coding informs development of a conceptual model that describes key coding categories and the relationships between them. Peer debriefing and participant member-checking serve as validity checks.
Results: Preliminary interview findings invert deficit models of LGBTQ+ health and information practices. These models position communities as lacking resources and knowledge to improve their social conditions and envision experts as able to “correct” this deficit. Participants challenged these presumptions by identifying social and structural factors, including experts, as hindrances to achieving positive health outcomes, and tactically responding to these constraints. For example, several communities stated that being misgendered at the doctor’s office took a significant toll on their mental health. They responded to this lack of expert competency by developing lists of community-approved medical professionals based on collective information assessment.
Conclusions: Inverting the deficit model to view experts rather than LGBTQ+ communities, as lacking has implications for social and structural change. From the position of medical librarianship, this change can occur via a shift from outreach, which focuses on information and resource provision, to engagement, which centers community expertise as the driver for information and resource development. Three specific implications informed by this shift and emergent research findings are establishing partnerships with community health workers, facilitating cultural competency training for medical professionals, and offering harm reduction workshops.
