Este metanálisis deja en claro que todavía no se sabe cómo cambiar las actitudes de los heterosexuales antigay, incluso si son levemente homofóbicos. Es útil conocer los caminos tomados por los diversos investigadores. He dejado sin traducir las partes que me parecieron menos útiles del texto.
R.F.
Research on Social Work Practice, Vol. 16 No. 2, March 2006 176-190
El Cambio de Actitudes de los Heterosexuales hacia los Homosexuales: un Reseña Sistemática de la Literatura Empírica
Edmon W. Tucker
Miriam Potocky-Tripodi
Florida International University
Objetivo: Este artículo sistemáticamente reseña la evidencia de intervenciones para cambiar actitudes hacia los homosexuales.
Método: En total, se reseñan 17 estudios empíricos usando muestras de universitarios o alumnos de college e intervenciones destinadas a mejorar las actitudes de los heterosexuales hacia los individuos lesbianas, gays, o bisexuales. Se informan características de los estudios en relación con participantes, intervenciones, metodologías, mediciones de actitud y resultados. Los estudios también fueron puntuados de acuerdo con su nivel de apoyo empírico Finalmente, se discuten los desafíos de la investigación y las aplicaciones a la práctica del trabajo social.
Resultados: Ninguna intervención satisfizo los criterios de un tratamiento bien establecido o probablemente eficaz, y también los estudios tenían limitaciones metodológicas sustanciales.
Conclusión: Estas intervenciones requieren más testeo con experimentos bien diseñados y metodológicamente sólidos para determinar su eficacia. Los investigadores que se dedican a este tópico controversial, sin embargo, pueden experimentar considerable oposición para obtener fondos y / o encontrar foros para diseminar sus resultados.
Keywords: actitudes; homosexual; heterosexual; gay/lesbian/bisexual; reseña sistemática de literatura
Authors’ Note: Correspondence concerning this article may be addressed to Edmon W. Tucker, Community-Based Intervention Research Group, School of Social Work, Florida International University, 11200 SW 8th Street, MARC310, Miami, FL 33199 or via e-mail at etuck001@fiu.edu
Las actitudes antigay bajo forma de heterosexismo y homofobia son omnipresentes (Yang, 1997) y crean Fuentes significativas de estrés y / o dolor para quienes integran la minoría sexual (Herek, 1992). El sistema ideológico de heterosexismo, que “niega, denigra y estigmatiza cualquier forma no heterosexual de conducta, identidad, relación o comunidad” (Herek, 1990, pp. 316-317), ha sido promulgado por las instituciones sociales de este país, tales como las cortes, la religión, la medicina y los medios masivos. Este heterosexismo tiene raíces históricas que sugieren que la homosexualidad se percibe como una amenaza contra la sociedad occidental (Fone, 2000).
Aunque la sociedad norteamericana sigue estando dividida en los temas lésbicos, gays y bisexuales (LGB), incluyendo si deben ser cambiadas las actitudes antigay, la posición oficial de la profesión de trabajo social no da lugar a ambigüedades. A los trabajadores sociales se les prohibe discriminar contra sus clientes o colegas basándose en su orientación sexual (Asociación Nacional de Trabajadores Sociales = National Association of Social Workers, 1999). El código de ética del trabajo social también afirma que los trabajadores sociales deben trabajar para “prevenir y eliminar la dominación de, la explotación de, y la discriminación en contra de cualquier persona . . . basándose en la …orientación sexual” (National Association of Social Workers, 1999). La National Association of Social Workers ha emitido varias declaraciones de políticas públicas relatives a la orientación sexual, incluyendo que “a la orientación sexual mismo género debe concedérsele el mismo respeto y los mismos derechos que a la orientación hacia el otro género” (National Association of Social Workers, 2002). Además, las escuelas de trabajo social deben estar enseñando a sus alumnos a practicar sin discriminación y “con respeto, conocimiento y habilidades relativas a la orientación sexual de los clientes…” (Council on Social Work Education, 2001).
No as sorprendente que las actitudes antigay estén altamente correlacionadas con conductas antigays, incluyendo ataques físicos (Franklin, 2000; Patel, Long, McCammon & Wuensch, 1995; Roderick, McCammon, Long, & Allred, 1998; Whitley, 2001). De hecho, cantidades alarmantes de personas LBC son sometidas a discriminación, hostigamiento y violencia por causa de su orientación sexual (Berrill, 1992; D’Augelli & Grossman, 2001; D’Augelli, Pilkington, & Hershberger, 2002; Herek, Gillis, Cogan, & Glunt, 1997; Rose & Mechanic, 2002; Thurlow, 2001; Waldo, Hesson- McInnis, & D’Augelli, 1998). La extensión exacta de esta victimización no puede saberse con seguridad.
Los informes oficiales de crímenes de odio representan solamente una pequeña fracción de la cantidad real de incidentes motivados por la orientación sexual. Muchos de estos crímenes pasan sin ser informados, y cuando se los informa hay problemas con la recolección y asimilación de los datos (Federal Bureau of Investigation, n.d.; Kuehnle & Sullivan, 2003; Rose & Mechanic, 2002). Además, las víctimas LGB a menudo no notifican a los funcionarios que hacer cumplir la ley, porque esperan una respuesta no comprensiva o incluso hostil de la policía. Esta expectativa puede estar basada o bien en sus propias experiencias anteriores con personal policial y de justicia, o en las experiencias compartidas de otros, o en ambas (Berrill & Herek, 1992; Herek, Gillis, & Cogan, 1999).
Sabemos, sin embargo, que la investigación empírica revela que los homosexuales tienen mucha más probabilidad que los heterosexuales de ser víctimas de crímenes violentos (Berrill, 1992; Bontempo & D’Augelli, 2002; DuRant, Krowchuk, & Sinal, 1998; Herek, Gillis, Cogan, & Glunt, 1997). De modo similar, los individuos LGB soportan mucha más discriminación y hostigamiento que sus pares heterosexuales (Bontempo & D’Augelli, 2002; D’Augelli, 1992; Lewis, Derlega, Berndt, Morris, & Rose, 2001; Thurlow, 2001). Las omnipresentes actitudes antigays también significan que la minoría sexual a menudo de denegado su acceso igual a alojamiento, empleo y / o ascensos, educación y cuidado de salud (Hunter, Joslin, & McGowan, 2004). Además, las parejas del mismo sexo en los Estados Unidos se les rehúsa el derecho fundamental de casarse y, por lo tanto, están privados de todos los beneficios sociales, legales y financieros que el casamiento entrega a las parejas heterosexuales.
Las consecuencias sicológicas y otros efectos acompañantes de esta victimización y discriminación no deben ser pasados por alto. Dada la correlación entre actitudes antigays y conductas, esta reseña sistemática fue conducida para determina qué intervenciones empíricamente validadas existen. si es que hay alguna, para mejorar las actitudes de los heterosexuales hacia los homosexuales, Esta reseña implicó análisis de estudios seleccionados en relación con sus características metodológicas y resultados.
METHOD
Selection Criteria
Studies for inclusion in the analyses were identified through searches of the PsycINFO, Social Services Abstracts, and Sociological Abstracts electronic databases from January 1994 to August 2004. Only studies that included at least one intervention designed to improve the heterosexual participants’ attitudes toward homosexuals and that were published in peer-reviewed journals were included. Search parameters were broad and included wild cards. Specifically, the search terms were attitude* and homosexual* or gay* or lesbian* and experiment* or intervention* or outcome* or change*.
As particular attitudes are often culture bound (Stycos, 1998; Evans, 1997), we limited our inquiry to studies conducted within the United States. Furthermore, a study must have assessed the participants’ personal attitudes toward homosexuals or homosexuality generally to be included. Thus, a study that used participant opinions regarding a specific, politically controversial issue (e.g., gays in the military, gay marriage, etc.) to assess attitudes would not suffice for purposes of this analysis. Only one study was eliminated for this reason.
Rating Criteria
Level of empirical support was assessed using criteria developed by the American Psychological Association’s Division 12 task force for evaluating empirically validated therapies (Chambless et al., 1998; Chambless & Hollon, 1998). None of the studies reviewed herein used single-case designs; therefore, only the criteria for group designs were used. Only interventions that have been demonstrated to be superior (statistically significantly so) to a placebo or another intervention or to be equivalent to an already established treatment in at least two good, between-group design experiments with adequate sample sizes (at least 25 participants per condition) are considered well established (Chambless et al., 1998).
A good between-group design means that participants were randomly assigned to the intervention of interest or to one or more comparison conditions (i.e., randomized, clinical trials; Chambless & Hollon, 1998). Additionally, the experiments must have been conducted with treatment manuals, unless the intervention was relatively simple and adequately specified in the procedure section of the journal article reporting on its efficacy. Furthermore, the characteristics of the participants must have been clearly specified, and the experiments must have been conducted by at least two different investigators or investigating teams. If an intervention met the criteria above, except it was demonstrated to be superior in only one experiment, or it was demonstrated to be superior in two or more experiments conducted by the same investigating team, it was considered probably efficacious. Alternatively, if two or more experiments demonstrated that an intervention was superior to a waiting-list control group, it was considered probably efficacious if the experiments met all of the other criteria.
There are other important elements of establishing efficacy. Demonstrating superiority assumes that the outcome assessment tools have demonstrated reliability and validity (Chambless & Hollon, 1998). Multiple methods of assessment are preferable, although not required, and participant self-reports are suspect. Evaluators are also cautioned to check that researchers have interpreted their outcome data correctly. In other words, assessing outcomes and interpreting data appropriately are critical components of good between-group design experiments (Chambless & Hollon, 1998, p. 8).
A study rating sheet was created in accordance with the criteria outlined above. A random sample of six of the eligible studies was selected to test for interrater reliability between the first and second authors. With a reliability of 83.3% established, the first author rated the remaining studies for empirical soundness.
DESCUBRIMIENTOS
La Tabla 1 reseña los 17 estudios que cumplían con nuestros criterios de selección. Esta sección presenta los descubrimientos pertinentes y resume los puntos comunes a través de los estudios en relación con participantes, intervenciones, intervenciones, metodologías, mediciones de actitud y resultados. Finalmente se evalúan los estudies por su nivel de apoyo empírico.
Summary of the Studies’ Participants
Interventions are often efficacious for only a specific problem or population; therefore, it is important that investigators adequately describe any characteristics of the participants that might affect the generalizability of their findings (Chambless & Hollon, 1998). Specifically, it is the participants who completed all aspects of the experiment and about whom postintervention data are available who should be described rather than some larger prescreening pool. In many cases, only the larger pool of eligible participants is described; therefore, attrition, dropout, and/or missing data information should be explained so the reader can make a judgment about whether the final sample is representative of the described participants. Because more than half (nine) of the studies here under review either did not adequately address attrition (four studies) or experienced so much attrition (attrition rates greater than 10% or five studies), we cannot be confident that the final respondents were adequately described in those articles. All of the reviewed studies used convenience samples comprised of either undergraduate or graduate students in U.S. schools. The remainder of our comments about the participants, however, will focus on the eight studies where the final respondents were adequately described.
All of the studies presently under review reported participants’ gender. Overall, there were wide disparities in gender representation. Of the eight studies where participants were adequately described, four had large (60% or more) majorities of females (Black, Oles, Cramer, & Bennett, 1999; Cotton-Huston & Waite, 2000; Guth, Lopez, Clements, & Rojas, 2001; Probst, 2003). Two of the studies had less than a 10% difference in gender disparity among participants (Corley & Pollack, 1996; Grutzeck & Gidycz, 1997), and two had male majorities (Grack & Richman, 1996; Wallick, Cambre, & Townsend, 1995).
Of the eight participant-described studies, six addressed the ages of the participants by providing either a range, median, or mean. Given that all participants were pursuing either undergraduate or graduate degrees, the age range was limited. With few exceptions, the participants were between the ages of 18 and 35.
Five of the eight participant-described studies addressed participants’ ethnicity. One of these (Guth et al., 2001) reported only the percentage of Caucasians, which, as with all of the studies, was the overwhelming majority. The remaining four studies reported percentages of participants in five ethnic categories that included Caucasian or White, African American or Black, Hispanic, Asian American or Pacific Islander, Native American, and Other (Black et al., 1999; Grutzeck & Gidycz, 1997; Probst, 2003; Wallick et al., 1995).
With regard to other participant characteristics, all of the eight participant-described studies reported the type of undergraduate or graduate courses from which the respondents were recruited. Six of the eight reported participants’ sexual orientation. Two reported marital status. One reported on participants’ contact with homosexuals, and another included whether participants had gay or lesbian friends. Finally, one reported on participants’ income, religion, region, and parental acceptance of lesbians and gay men, and one reported number of participants with a disability.
Sumario de las Intervenciones de los Estudios
La vasta mayoría de los 17 artículos dedicaron atención sustancial a las bases teóricas de sus investigaciones. La mayoría se enfocaron en dos justificaciones principales para sus estudios:
(a) una función cognitiva y / o educacional de la intervención (e.g., disipar mitos y estereotipos atribuidos a los homosexuales), y (b) teoría de contacto — que la exposición a homosexuales y compartir experiencias positivas con ellos ayudará a cambiar los prejuicios de los heterosexuales. De hecho, solamente tres de los estudios no se apoyaron hasta cierto grado en uno o en ambas de estas dos explicaciones racionales. (Pratarelli & Donaldson, 1997; Probst, 2003; Wallick et al., 1995).
Pratarelli y Donaldson (1997) resultaron ser escasos en teoría pero estaban investigando si una explicación biológica de la orientación sexual influiria en las actitudes hacia los homosexuales. Probst (2003) hizo referencia al aumento en los cursos de diversidad en los campus universitarios y a la escasez de estudios empíricos relativos al grado en el que estos cursos en realidad cambian las actitudes y creencias de los alumnos. Wallick et al. (1995) ahorraron su justificación racional para la conclusión, donde simplemente citaron un paper de políticas adoptado por la Asociación Mëdica Norteamericana que exhortaba a los médicos a demostrar una actitud desprovista de juicio hacia los varones gays y las lesbianas y a las escuelas medicas para que aumentaran su concentración en cómo enfocar apropiadamente las necesidades de esta población.
En cuanto a las intervenciones mismas, 11 de los estudies infundieron los contenidos de los cursos con información educativa sobre la homosexualidad o celebraron talleres que la presentaban. Los formatos variaban e incluían comunicaciones verbales, escritas y audiovisuales. Fue típico que se centraran en la estigmatización y discriminación experimentadas por las personas LGB, asi como los mitos y estereotipos comunes. La mayoría de las intervenciones se produjeron en el lapso de una clase.
Cinco de los estudios usaron como intervenciones panelistas gays y/o lesbianas. Tres involucraron el darse a conocer [coming out] (revelación de estatus homosexual) del instructor del aula a los alumnos participantes en combinación con un módulo educacional sobre orientación sexual. Otras intervencions incluyeron una descripción escrita no estereotípica de una pareja lésbica, un ejercicio de resolución de problemas de lógica in el que dos actores participantes se autoidentificaban como homosexuales ante los otros participantes, y una explicación biológica escrita de orientación sexual.
Como se mencionó previamente, con la excepción de intervenciones relativamente simples que han sido adecuadamente explicadas en el artículo de revista que informaba su eficacia, los manuals de tratamiento se han considerado esenciales para las intervenciones empíricamente validadas (Chambless & Hollon, 1998). Sin ellos, otros investigadores no pueden saber con precisión qué tratamiento fue probado, ni puede ser replicada la intervención. Solamente 2 de los 17 artículos reseñados mencionaron el uso de manuales de tratamiento o sus equivalentes (Finkel, Storaasli, Bandele, & Schafer, 2003; Guth et al., 2001).
Resumen de las Metodologías de los Estudios
Solamente 4 de los 17 estudios reseñados fueron diseños verdaderamente experimentales en los que los participantes fueron asignados al azar en la intervención, comparación y / o condiciones de control. Desdichadamente, 3 de los experimentos también usaban pretest. Haciendo más complicado el problema, ninguno de los 3 usó un diseño para dar cuenta de cualquier posible efecto del pretest.
Trece de los 17 estudios fueron diseños cuasiexperimentales que no asignaban al azar a los participantes a grupos de comparación. De hecho, en 6 de los 13, no hubo grupos de control o comparación, lo que excluyó de antemano la posibilidad de comparaciones intergrupales. En 5 de estos estudios de no comparación–no control simplemente hubo un grupo de participantes a los que se les administró uno o más pretests, intervenciones y posttests. El studio que queda simplemente usó un posttest que le pedia a los participantes que evaluaran su nivel de homofobia del momento y tambén que evaluaran retrospectivamente su nivel de homofobia antes de la intervención (Finkel et al., 2003). De los 7 cuasiexperimentos que usaron grupos de comparación y / o control, 6 de ellos administraron pretests, pero solamente 3 de ellos discurrieron sobre el problema de las diferencias de líneas de base entre grupos. De éstos, solamente uno había informado un bajo nivel de deserción (=atrición) que no comprometía la equivalencia de los grupos (Probst, 2003).
Summary of the Studies’ Attitude Measures
It should be noted that many of the 17 reviewed studies were assessing participants on multiple variables. For example, 1 study assessed participants’ masculinity or femininity, attitudes regarding women’s rights and roles, demographics, and attitudes toward homosexuals (Cotton-Huston & Waite, 2000). Our discussion is limited to those instruments that measured participants’ attitudes toward homosexuals.
Six of the 17 studies used measures of heterosexuals’ attitudes toward homosexuals developed by other investigators in previous research. Two used an index developed by Hudson and Ricketts (Cotton-Huston & Waite, 2000; Wallick et al., 1995), and 1 used a scale developed by Herek (Riggle, Ellis, & Crawford, 1996). Both of these measures have established validity and reliability. One investigating team, however, used the Riddle Homophobia Scale developed by Wall (1995; Finkel et al., 2003). This instrument simply asks participants to concurrently (postintervention) rate their current level of homophobia on an 8-point Likert-type scale and rate what their level of homophobia had been prior to the intervention using the same scale. These authors reported that the psychometric properties of the Riddle Homophobia Scale were unknown but that they deemed it to have acceptable face validity.
One of the studies used the Homonegativity Scale developed by Morrison, Parriag, and Morrison (1999; Probst, 2003). This measure contains six items using a 5point Likert-type scale. The investigator reported the test-retest reliability, but we would like to have seen some discussion regarding the instrument’s validity. In this regard, however, a reference for the instrument’s psychometric properties was cited in the study.
Grutzeck and Gidycz (1997) were the only investigators to use multiple measures to assess participants’ attitudes toward homosexuals. They implemented the Heterosexual Attitudes Toward Homosexuality Scale (HATH) developed by Larsen, Reed, and Hoffman (1980) and a modified version of Hudson and Ricketts’ Index of Attitudes Toward Homosexuals (IAH; Hudson & Ricketts, 1980), both of which have previously established validity and reliability. The modifications to the IAH were not specified, but the psychometric properties of the modified version were reported. Grutzeck and Gidycz also used a behavioral measure that they developed for the study to assess tolerance for homosexuals. We have serious doubts about the validity of the behavioral measure, the limitations of which are clearly articulated by the investigators themselves.
Nine studies used modified or adapted versions of previously established measures. These studies varied regarding the extent to which the modifications were specified and whether the psychometric properties of the modified versions were reported. Most, however, were vague about the modifications and did not report on their properties. Of the 14 studies that used either full or modified (or both, i.e., Grutzeck & Gidycz, 1997) versions of preestablished instruments, 6 utilized measures originally developed by Herek and 4 used some version of Hudson and Ricketts’s (1980) IAH. The only other instrument used or adapted by more than one of the studies was Larsen et al.’s (1980) HATH, used by 2 of the studies.
Finally, three of the studies used an instrument developed by the investigators of those studies as the sole measure of attitudes toward homosexuals (Guth et al., 2001; Hood, Muller, & Seitz, 2001; Pratarelli & Donaldson, 1997). Guth et al. (2001) developed an instrument using a thought-listing technique for their pretest and posttest measures. They provided a rationale for this type of measurement, supporting reference citations, and documentation of the interrater reliability. Absent, however, was any discussion of validity for this particular instrument.
Hood et al. (2001) developed their own scale because they were interested in attitudes toward gay men and lesbians specifically with regard to workplace issues. This instrument was composed of five questions on a 5point Likert-type scale. Coefficient alphas for the pretest and posttest scores were provided, but again, there was no discussion of the validity of this scale.
Pratarelli and Donaldson (1997) used “two matched prenormed surveys” (p.1412) previously developed by the first author with another investigator to assess changes in participants’attitudes. Two reference citations presumably regarding the development of this instrument were provided, but one referenced a paper presented at a convention, and the other referenced a manuscript submitted for publication. In the present article, reliability was reported, but there was no discussion of the validity of this instrument.
TABLE 1: Summary of Studies’Characteristics
Authors | Participants | Interventions | Methodologies | Attitude Measures | Outcomes |
Bassett & Day, 2003 | 48 of 65 first-year MSW
students enrolled in three sections of a required course.. Demographics based on the pool of 65. % Female: 87.7 Ethnicity: |
The required human behavior course was infused with con- tent (both written and audiovi- sual) about and regarding gay men. No comparison. No control. | Pre- and posttest given at the beginning and end of the se- mester. Attrition reported and attributed primarily to ab- sences, withdrawals, and con-fusion regarding self-assigned numeric codes used to ensure anonymity. |
Modified version of Attitudes Toward Lesbians and Gay Men (ATLG; Herek, 1988) Modifications were specified. Validity and reliability not reported. | Authors reported that the total group of participants had significantly lowered mean score on the ATLG posttest. |
Black, Oles, Cramer, & Bennett, 1999 | 56 social work students.
% Female: 86 Mean age: 29 Ethnicity: 78.6% White14.3% Black5.4% Hispanic1.8% Asian American |
90-minute speaker panel of 2 gay men and 2 lesbians (a uni-versity administrator, a tenuredprofessor, and 2 social work students), who discussed vari ous issues related to their sex ual orientation and answered questions throughout. No comparison. No control. | Pre- and posttest given 1 week prior to and 1 week following presentation. Attrition reported. | Modified version of ATLG. Modifications were specified. Reliability reported. | Authors reported no significantchange in participants’ scores from pre- to posttest. |
Corley & Pollack, 1996 | 141 heterosexual Introduction to Psychology students.
% Female: 55 Mean age: 19.6 (female) 19.26 (male) Ethnicity: Not reported. Validity reported via citation. Reliability reported. |
E1: Nonstereotypical written description of lesbian couple(feminine-feminine) E2: Stereotypical written descrip- tion of lesbian couple (masculine-feminine)
E3: Somewhat stereotypical writ-ten description of lesbian cou ple (masculine-masculine) No control. Participants per group not reported, but there were 12 groups for analyses (E1, E2, and E3 divided by gender and by traditional vs. nontraditional). |
Random assignment. Posttest immediately following intervention. Follow-up 1 week later. Attrition reported. | Heterosexual Attitudes Toward Homosexuality Scale (HATH; adapted to assess for lesbians only; Larsen et al., 1980). | Traditional and nontraditional fe males who received E1 were significantly more positive to-ward lesbians than those who received E2, but differences were not sustained in follow-up. For traditional males, significant differences existed between all three conditions and were sustained. For nontraditional males, there were no significant differences. Insufficient power to support analyses. |
Cotton-Huston & Waite, 2000 | 150 heterosexual undergraduate business and psychology students.
% Female: 83 Age: 70% were 18-22 Ethnicity: Not reported E1: 53 E2: 50 C1: 47 |
E1: 45-minute video depicting homosexual lifestyles and celebrating gay pride
E2: classroom interaction with a gay panel during one class period C1: No intervention. |
Posttest only. Attrition reported. | Index of Attitudes Toward Homosexuals (IAH;
Hudson & Ricketts, 1980). Reliability reported. |
No significant differences be- tween groups on attitudes reported. |
Cramer, 1997 | 107 MSW students in six foundation practice sessions.
% Female: 82 Median age: 27 Ethnicity: 83% White 15% Black 1% Asian American 1% Hispanic E1: 39 E2: 33 C1: 33 |
E1: Instructor self-disclosed her
lesbian status while conducting educational unit focusingon lesbian identitydevelopment E2: Same educational unit as E1but taught by a self-disclosing heterosexual woman of similar age and race C1: No intervention |
Pre- and posttest. Posttestgiven 6 weeks after intervention. Attrition reported. Baseline comparisons not reported. | Modified version of ATLG.Modifications somewhatspecified. Reliability reportedfor instrument and subscales(Attitudes Toward Lesbians[ATL] and Attitudes TowardGay Men [ATG]) but not formodified versions | Students in E1 had significantlylower mean score (more positive attitudes) than those in C1on the ATG at posttest. |
Cramer, Oles, & Black, 1997 | Started with 110 undergraduate and graduate social work students at four different schools.
% Female: 89 Average age: 26 Ethnicity: 84.5% White 6.4% Black 4.5% Hispanic 4.5% Asian American Participants per group not reported. |
Four different educational interventions, using the information-plus-exposure model and varying disclosure or nondisclosure of instructor sexual orientation, given during the course of one semester. No control. | Pretest given during first 2weeks of classes. Posttestgiven during last 2 weeks ofclasses. Amount of attrition notreported, but missing datawere excluded from analyses. | Modified version of ATLG.Modifications somewhat specified. Reliability reported for instrument and subscales (ATLand ATG) but not for modifiedversion. | There was significant change in all four classes from pretest toposttest on ATLG scores.Comparison between the four educational approaches is problematic, as the instructors varied on several dimensions. No significant differences between groups were found. Sufficiency of power for analyses questionable. |
Finkel, Storaasli, Bandele, & Schafer, 2003 | 48 graduate students at University of Denver’s Graduate School of Professional Psychology
.% Female: 78 Median age: 25 Ethnicity:78% White |
Two 2-hour “Safe Zone” diversity training sessions separated by 6 months. Treatment manuals mentioned. No comparison. No control. | Posttest at end of second session that required participantsto (a) rate current level of homophobia and (b) retrospectively rate level ofpreintervention homophobia.Attrition reported. | Riddle Homophobia Scale(Wall, 1995). Authorsreported that the psychometricproperties of the scale wereunknown. | No significant differences between current and retrospective ratings. |
Grack & Richman, 1996 | 37 undergraduate psychology students who had scored above the 50th percentile on the Gay and Lesbian Attitude Scale (GLAS; Grack &Richman, 1996).
% Female: 40 Age: Not reported Ethnicity: Not reported. Groups ranged from 4 to 6 participants. |
All groups instructed to solveseries of logic problems.
E1: 2 actors self-identifying as homosexual participants and group received extra credit reward E2: 2 actors self-identifying as homosexual participants and group did not receive reward E3: 2 actors self-identifying as heterosexual participants and group rewarded E4: 2 actors self-identifying as heterosexual participants and group did not receive reward. No control. |
Pretest given 8 weeks prior tothe 1-hr intervention. Posttestimmediately following intervention. Attrition not reported.Baseline comparisons not reported. | GLAS, which was reportedlybased on Hudson andRicketts’ (1980) Index of Homophobia Scalea. Reliabilityfor the Index of HomophobiaScale was reported but authors do not explain how theirscale differs from the original,nor is the validity or reliabilityof the GLAS itself reported. | There was a significant difference reported between groupsbased on the sexual orientation of the actors. Insufficientpower to support analyses. |
Grutzeck & Gidycz, 1997 | 200 undergraduate introductory psychology students from a moderately sized midwestern university.
% Female: 54 Age: Not reported Ethnicity: 85% White 11% Black 1% Asian American 1% Native American 2% Other E1: 63 E2: 64 C1: 73 |
E1: 1-hour speaker panel presentation of 4 undergradu- ates (2 gay males, 2 lesbians), who gave brief biographical sketches followed by question and-answer period
E2: Participants were given a handout with basic facts and harmful stereotypes associated with homosexuality C1: Participants were told that more than expected had shown up for the experiment,so it was not necessary for them to participate but that they would still receive credit. |
Random assignment. Pretest given 2 weeks prior to inter- vention. Posttest given 4 weeks after intervention. Attri–tion not reported. | Modified version of the IAH (modifications not specified) and the HATH. Psychometric properties of both instruments and of modified IAH were reported. Behavioral measure
developed by the authors (psychometric properties indeterminate). |
Panel presentation did not have a significant effect on either instrument; however, the entire sample had more tolerant scores on the IAH at posttest. Likely pretest effect. Behavioral measure outcomes indeterminate. |
Guth, Lopez, Clements, & Rojas, 2001 | 47 upper-level undergraduate psychology students at a southeastern university.
% Female: 78.7 Median age: 29.5 Ethnicity:88% White E1: 17 E2: 15 C1: 15 |
Both E1 and E2 were 2-hour workshops that contained myths and facts about homo- sexuality and everyday issues faced by gays and lesbians.
E1: Content was presented“rationally” E2: Content was presented“experientially” C1: Workshop that focused on finding psychology-related material on the Internet. Guidelines for interventions mentioned. |
Random assignment. Pre- and posttest. Posttest given3 weeks after intervention. Attrition reported. | Thought-listing procedure developed by authors that in- volved having participants spontaneously list thoughts elicited by a stimulus (six hy- pothetical scenarios dealing with homosexuals). Three raters (all with doctorates in psychology) judged the pre- and posttests to create categories, then a panel of three graduate students categorized the thoughts. Interrater reliability was reported. Validity not reported. | Thought categories changed significantly at posttest only for E2 group. No between-group comparisons. Insufficient power to support analyses. |
Hood, Muller, & Seitz, 2001 | 150 undergraduate students in five sections of an organizational behavior course
% Female: 49.5 Mean age: 24.8 Ethnicity: 55.7% White 28.1% Hispanic 6.8% Asian American 1% Black 1% Native American 3.5% Other |
Course.content promoting diversity competency. Vague description of intervention. No comparison. No control. | Pretest given at beginning of semester. Posttest given during one of the last two classes. Attrition reported. | A five-item Attitude Toward Gay Men and Lesbians Scale developed by the au-thors. Coefficient alphas for the pre- and postintervention surveys were reported. No other psychometric properties reported. | Change for entire sample was reportedly significant. No sig nificant change by racial group. |
Nelson & Krieger, 1997 | 190 psychology students from six separate classes surveyed across three semesters at a mid-sized southeastern university.
% Female: 72.6 Average age: 21 Ethnicity: “Predominantly Caucasian” |
50-minute panel presentation by2 gay male and 2 lesbian stu- dents attending the same uni- versity, who gave personal narratives followed by question-and-answer period. No comparison. No control. | Pretest given approximately2 weeks prior to intervention. Posttest given 6 weeks after intervention. Attrition not re- ported | Modified version of the Attitudes Toward Homosexuality Scale(ATHS; MacDonald & Games, 1974). Modifications some what specified. Psychometric properties not reported. | Change in sample’s posttest score reported as significant. Females demonstrated more-change in attitude than males. |
Pratarelli & Donaldson, 1997 | 80 heterosexual students at a large midwestern university.
% Female: 50 Age: 18-24 Ethnicity: Not reported. E1: 32 E2: 34 C1: 34 |
E1: Written educational scenario supporting a biological explanation for Homosexuality
E2: A second scenario indirectly supporting an environmental explanation by focusing on the weaknesses of the biological evidence C1: A control scenario containing no information about sexual orientation. |
Random assignment. Baseline survey given 1 week prior to intervention. Posttest immedi- ately following intervention. At- trition not reported. | Two matched, prenormed sur-veys designed to assess changes in participants’ atti- tudes toward homosexuals, developed by first author. Reli ability reported. | No statistically significant differences between groups were reported. |
Probst, 2003 | 57 undergraduate students in a workplace diversity psychology course at Washington State University made up the experimental group
% Female: 62 Mean age: 28.85 Ethnicity: 87% White 7% Asian American 3% Native American 2% Black 2% Hispanic E1: 57 C1: 37 |
E1: A semester long (17 weeks) upper-level undergraduate workplace diversity psychology course that included content on gay, lesbian, and bisexual issues
C1: An elementary statistics course taught by the same in structor during the same semester. |
Pre- and posttest given during the first and last weeks of the semester, respectively. No sig- nificant differences between groups on pretest. Attrition reported. | Homonegativity Scale (six items; Morrison, Parriag, & Morrison, 1999). Reliability reported. | There was a significant improvement in the attitudes of E1 at posttest, whereas C1 attitudes were slightly worse (more negative), suggesting that a between-group comparison would be significant. No between-group comparisons. |
Riggle, Ellis, & Crawford, 1996 | 72 students in introductory psy- chology courses.
% Female: 58 Age: Not reported Ethnicity: Not reported. E1: 44 C1: 28 |
E1: An 88-minute documentary, “The Times of Harvey Milk,” about one of the first openly gay elected officials in the United States
C1: Completed the posttest prior to viewing the documentary |
Pretest 3 weeks prior to intervention. Posttest immedi- ately following. Attrition re- ported and notable (from 314
down to 72). Between-group differences at prescreening re ported (not significant). |
ATHS developed by Herek, 1984.b Citation given for psychometric properties. | E1 had significantly less prejudicial attitudes at posttest. |
Waldo & Kemp, 1997 | 156 undergraduate students in introductory psychology course
% Female: 37.8 Age: Approximately 18-21 Ethnicity: “Predominantly White /European-American.” E1: 40 C1: 116 |
E1: In one section of the course, the instructor came out (self- identified as gay) to the class midway through the semester while presenting educational unit about sexual orientation
C1: Four sections of the same course that were taught by self-identified heterosexual instructors and covered same material regarding sexual orientation. |
Pre- and posttest at the begin- ning and end of the semester, respectively. Attrition not reported. Baselines reported. | Short form of ATLG and imbedded in a 30-question “controversial issues survey.”
Psychometric properties reported. |
E1 scores changed significantly at posttest compared to controls. |
Wallick, Cambre, & Townsend, 1995 | Three consecutive 1st-year classes of medical students at Louisiana State University in New Orleans (exact number of participants provided only for the class entering 1991).
% Female: 34 Mean age: 22.5 Ethnicity: Approximately 78% White 10% Black 7.5% Asian American or Pacific Islander 4% Hispanic 0.5% Native American |
3-hour panel presentation by 3 gay and lesbian physicians, who provided autobiographical sketches, and a faculty member, who shared his son’s coming out story, followed by question-and-answer period; then, students broke into smaller groups for discussion.
No comparison. No control. |
Of the 186 students in the 1991-1992 cohort, 180 completed the IAH at the beginning of their freshman year, 168 at midyear (2 weeks following intervention), 114 at year’s end, and 185 following their required psychology clerkship in their 3rd year. Participation rates were reportedly similar in the two subsequent years, but the IAH was given on entrance and following the intervention only | IAH. Psychometric properties not reported, but citation provided | An overall 6.3% decrease in homophobic attitude within the pooled (all three classes) data was reported (p < .03). On fol-low-up for the ’91 class, there was a rebound effect following the junior clerkship. |
NOTE: E = experimental group condition; C = control group condition.
a.The Index of Homophobia Scale is the same instrument cited by other authors in this study as the IAH.The creators of this instrument suggested the name change to IAH to reduce potential bias in response to the original name (Hudson & Ricketts, 1980).
b. Riggle et al. either incorrectly identified Herek as the developer of the ATHS or correctly cited to Herek but called the scale by the wrong name. The name of the instrument developed by Herek(1984, 1988) is the ATLG. An instrument entitled the ATHS was developed by MacDonald and Games (1974).
Resumen de los Análisis y Resultados de los Estudios
The methodological limitations of the studies summarized above renders a discussion of their analyses and outcomes practically moot. That is, statistical significance is irrelevant when a model has been misspecified or an assumption has been violated. Statistical computer programs are not able to correct for research design and/or methodological shortcomings (Pedhazur & Schmelkin, 1991). There were, however, additional limitations concerning the studies’ analyses that are worth mentioning.
Of the nine studies that analyzed differences between experimental and comparison or control groups, only four used either random assignment without a pretest (one) or nonrandomly assigned groups with baseline comparisons on pretests reported (three). Of these four, only one (Waldo & Kemp, 1997) had enough participants per group to power the analyses. This study, however, did not report the amount of attrition.
None of the reviewed studies discussed effect size or clinical significance. Reports of statistical significance alone are of limited utility (Chambless & Hollon, 1998; Pedhazur & Schmelkin, 1991). We hope that as this area of study expands, there will emerge meaningful units of measures for antigay attitude change. Ultimately, scholars will want to know how much of a change in attitude is required for a measurable change in behavior.
Evaluation of the Level of Empirical Support of the Interventions
None of the interventions qualified as well established, as no single intervention was subjected to two independent experiments (Chambless et al., 1998; Chambless & Hollon, 1998). Nor did any of the interventions meet the criteria for probably efficacious treatments. Most fell short at this level because they were not tested in a between-group design experiment.
Random assignment serves to equate the comparison groups on all variables except for the intended manipulations. Without it, many researchers believe that the comparison groups are inherently and immutably nonequivalent (Chambless & Hollon, 1998; Pedhazur & Schmelkin, 1991). Nevertheless, investigators will employ various methods (e.g., establishing no significant differences between groups on a pretest) in an attempt to accomplish valid comparisons.
As previously mentioned, four of the reviewed studies used random assignment (Corley & Pollack, 1996; Grutzeck & Gidycz, 1997; Guth et al., 2001; Pratarelli & Donaldson, 1997). Two of these used outcome measures that were developed by one or more of the investigators, and the validity of these instruments were not sufficiently established (Guth et al., 2001; Pratarelli & Donaldson, 1997). Additionally, one of these did not conduct between-group comparisons, and there was insufficient power to support such analyses (Guth et al., 2001). The other one did not report participant attrition, nor did it control for possible pretest effects (Pratarelli & Donaldson, 1997).
Of the two randomized studies that used measures with previously established validity and reliability, one did not have sufficient power to conduct its analyses (Corley & Pollack, 1996). The other did not report using treatment manuals for the experimental group that was exposed to a speaker panel presentation. Additionally, this study did not report attrition, nor did it control for possible pretest effects, and the results indicated that such effects were in operation (Grutzeck & Gidycz, 1997).
DISCUSION Y APLICACIONES A LA INVESTIGACIÓN Y PRÁCTICA DE TRABAJO SOCIAL
Esta evaluación de la validación empirica reveló que ninguna de las intervenciones hjabía sido adecuadamente testeada por estos estudios. El diseño óptimo y la metodlogía as una propuesta cara, a veces prohibitivamente cara. Por lo tanto, es difícil culpar a los investigadores por hacer lo que pudieron con sus limitados recursos.
Dicho esto, algunos de los problemas informados en nuestros resultados merecen discusión más profunda. En relación con las características de los participantes, los investigadores adecuadamente informaron que todos los respondientes eran alumnos de univerdad o de los primeros años de Universidad..
Como mínimo, pensamos que los investigadores deberían también informar sobre el género, la edad, la etnicidad y la religiosidad y/ o religión de los participantes.
La investigación anterior ha demostrado que hay diferencias significativas en actitudes y conductas hacia los homosexuales a través del género (Franklin, 2000; Whitley, 2001; Yang, 1997). La lógica dicta que los resultados de las intervenciones diseñadas para cambiar las actitudes también podrían diferir por género. Por lo tanto, es imperativo que los investigadores que conduzcan tales estudios informen sobre la estructura de género de sus muestras y cualesquiera diferencias significativas en resultados entre participantes varones y mujeres male and female participants.
Como el género, la edad puede ser una característica distinguidora del participante. Desde una perspectiva de desarrollo, sabemos que las actitudes pueden evolucionar a través del tiempo de vida (Pillari, 1998). Específicamente, las encuestas han demostrado que hay disparidades generacionales en relación con las actitudes hacia los homosexuales (Ricci & Biederman, 2004). Por lo tanto, no sería sorprendente si los efectos de las intervenciones variaran por grupos etarios.
Hay poca evidencia empirica en un sentido o en el otro relative al efecto de la etnicidad en las actitudes hacia los homosexuales. Sin embargo, la etnicidad ha tenido un efecto demostrado en los resultados de las intervenciones terapéuticas (Arroyo, Miller, & Tonigan, 2003; Markowitz, Spielman, Sullivan, & Fishman, 2000). Por lo tanto, incluso si no hubiera suficientes participantes de diversas etnicidades en los estudios aquí presentados para demostrar efectos entre grupos, todavía querríamos saber su constitución étnica para poder emitir un juicio sobre la generalizabilidad de los resultados.
Las actitudes antigays han sido consistentemente correlacionadas con religión y religiosidad (e.g., Hinrichs & Rosenberg, 2002; Laythe, Finkel, Bringle, & Kirkpatrick, 2002; Snively, Kreuger, Stretch, Watt, & Chadha, 2004). Específicamente, los estudios han encontrado que los participantes que tienen altos puntajes en mediciones de actitudes antigays también tienden a ser los más religiosos de todos. De modo similar, los que pertenecen a las Iglesias fundamentalistas tienen puntajes más altos, en general, en la mediciones de homofobia y/o heterosexismo. Por lo tanto es importante saber cómo varían los efectos de las intervenciones por religión y religiosidad. Es notable aque solamente cuatro de los diecisiete estudios reseñados intentaron investigar estos efectos (Black et al., 1999; Cotton-Huston & Waite, 2000; Cramer, 1997; Cramer, Oles, & Black, 1997).
Los investigadores de al menos un estudio (Waldo & Kemp, 1997) a propósito no pidieron información demográfica que no fuera el género de los participantes, en un esfuerzo para aseguurar la anonimidad y reducir los efectos de demanda. Sin embargo, la anonimidad puede ser asegurada a través de elementos de diseño de estudio a la vez que se sigue reuniendo valiosa información demográfica. A los participantes debería instruirselos en que las eencuestas están diseñadas para ser anónimas y para evitar escribir sus nombres u otra información identificadoria en sus hojas de respuestas. Adicionalmente, asistentes de investigación desconocidos para los participantes podrían administrar las encuestas e instruir a los respondientes sobre que el asistente no estará analizado los datos en persona. Se podría c olocar una caja cerrada y con una hendija en la habitación donde los participantes depositaran sus encuestas una vez que las hubieran completado. Además, as major si los investigadores pueden conseguir participantes con los que no tengan otro contacto (e.g., como ayudante de cátedra).
Hubo multiples limitaciones metodológicas informadas en nuestros resultados, pero el tema de los pretests debe ser explicado en profunidad. Aunque los pretests son integrales en muchos diseños cuasiexperimentales, los investigadores que conducen experimentos con asignación al azar en general deben evitarlos (Pedhazur & Schmelkin, 1991). A no ser que se tomen medidas para hacer control por los posibles efectos del pretest (sensibilización de los participantes a la intervención o interacción con ella) , as una amenaza innecesaria contra la validez.
También tuvimos muchos recelos sobre la información de los instrumentos usados por los investigadores para medir actitudes antigays. En particular nos sentíamos escépticos sobre la Escala de Homofobia de Acertijo [Riddle Homophobia Scale] usada por Finkel et al. (2003). En general, sin embargo, los invesstigadores de los estudios reseñados no informaron adecuadamente sobre la validez y confiabilidad de los instrumentos que usaron.
En general, aplaudimos a los investigadores de los estudios reseñados por su trabajo pionero en esta área subestudiada. Al atraer atención hacia la victimización que surge de la homophobia y el heterosexismo ampliamente difundidos, quizás las fuentes de financiación reconocerán la necesidad de dedicar recursos adecuados al estudio continuo de este problema omnipresente. El resto de esta sección examina los desafíos politicos e ideologicos a los que se enfrentan los investigadores que buscan desarrollar intervenciones que se enfoquen en actitudes antigau y concluye con aplicaciones a la práctica del trabajo social.
Hasta este punto nos hemos concentrado en los temas metodológicos y de diseño involucrados en los estudios de intervención que reseñamos. Nuestra reseña estaría incomplete, sin embargo, si no enfrentásemos el contexto politico e ideológico dentro del que se produjo la investigación y cómo probablemente afectará las investigaciones futures consistentes con los estudios reseñados. De modo específico debe advertirse que la omnipresencia de actitudes antigay en nuestra sociedd, indcluyendo el heterosexismo y la homophobia, puede tener un efecto de enfriamiento en la investigación sobre estos mismos temas. Aunque tenemos la esperanza de que los investigadores podrán asegurar los fondos y recursos necesarios para conducir experimentos bien diseñados y metodológicamente sólidos para hacer avanzar esta línea de investigación, sospechamos que habrá muchos obstáculos..
No todos están de acuerdo en cómo enfrentar la homophobia y el heterosexismo. Una proporción sustancial y evidentemente políticamente ponderosa de la población cree que la homofobia y / o el heterosexismo deben ser sostenidos y no enfrentados. Hay numerosos informes recientes que testimonian que hay en curso una guerra cultural en cuanto a temas gays y lésbicos. Por ejemplo, un legislador de Alabama recientemente presentó un proyecto de ley en la Cámara de Diputados de ese estado que prohibiría gastar fondos públicos en cualquier material escrito que retrate a la homosexualidad como un estilo de vida aceptable y prohibiría que los educadores trajeran oradores o cualquier material escrito al aula que incluyese contenidos referidos a temas LGB (Snorton, 2004).
En el nivel nacional, el clima politico de la actual administración parece particularmente hostil hacia la población LGB en general y especificamente hacia la investigación diseñada para estudiar a esta población. Un estudio que examinaba el riesgo sexual y de salud de los americanos nativos LGB fue uno de los cinco subsidios reseñados por pares de los Institutos Nacionales de Salud que el diputado Pat Toomey eligió como blancos para quitarles los fondos en el 2003 (Winerman, 2004). El investigador principal de ese studio afirmó que había sido informada por personas del ámbito interno de la política [political insiders[] de que las acciones de Toomey eran representativas de las muchas tácticas, incluyendo el ataque contra el casamiento gay, adoptadas por los republicanos para usar a la población LGB en la creación de temas de divergencia [wedge issues] en la campaña presidencial del 2004 (LaSala et al., 2005).
Más recientemente, funcionarios de la Administración de Abuso de Sustancias y Salud Mental [ Substance Abuse and Mental Health Services Administration] (SAMHSA) informaron que Centro de Recursos de Prevención del Suicidio [Suicide Prevention Resource Center] (SPRC) de que el administrador de SAMHSA no estaría presente en la conferencia de SPRC sobre prevención del suicidio a no ser que los organizadores quitaran las palabras gay, lesbiana, bisexual y transgénero del título y del texto descriptivo de un taller planeado (R. Bloodworth, J. Liljeholm, & R. Vanderburgh, personal communication, February 15, 2005). Los presentadores del taller tuvieron que cambiar el título de Prevención del Suicidio entre Individuos Gays, Lésbicos, Bisexuales y Transgéneros [Suicide Prevention Among Gays, Lesbians, Bisexuals, and Transgender Individuals] a Prevención del Suicidio en Poblaciones Vulnerables [“Suicide Prevention in Vulnerable Populations”] para que el taller fuera ofrecido. Adicionalmente, las palabras ofensoras del texto descriptivo debieron ser reemplazadas con una referencia general a la orientación sexual, pero cualquier referencia a la identidad de género no fue permitida.
Las ideas de la sociedad sobre los grupos marginalizados generalmente son lentas para evolucionar; sin embargo, los estudios aquí reseñados prepresentan intentos de acelerar ese proceso. Primero, sin embargo, las ideas de la sociedad debieron progresar lo suficiente para permitir que se produjesen estos estudios. Hace tan poco como veinte años atrás estudios de este tipo no hubieran sido permitidos en muchos campus universitarios. A decir verdad, no hace mucho tiempo que los profesores arriesgaban su empleo en la mayoría de las universidades si se daban a conocer [if they came out] (Taylor & Raeburn, 1995). Desde esta perspectiva histórica, los estudios reseñados también representan investigación pionera. Sin embargo, esperamos que los que abrazan una mayor aceptación de la población LGB continuarán encontrando resistencia significativa, particularmente de la derecha religiosa.
Aunque la política official hacia la población LGB en el campo del trabajo social decididamente as progresista y los apoya, hay otros indicadores que sugieren que estas políticas no son puestas en práctica de modo eficaz. UUUn studio del contenido gay lésbico en los libros de texto de trabajo social sugiere que los programas de educacion en trabajo social continúan perpetuando el sesgo heterosexista y la discriminación (Morrow, 1996). Otros estudios han informado niveles de homophobia de moderados a altos y actitudes heterosexistas entre los alumnos de trabajo social y poca o ninguna atención a la práctica con poblaciones LLLGB provistas en su capacitación de trabajo sooocial (Krieglstein, 2003; Snively et al., 2004).
Hay solamente unos pocos estudios rudimentarios que examinan los efectos de la homofobia en la práctica del trabajo social. Por ejemplo,. La homofobia entre los trabajadores y consejeros sociales ha sido correlacionada con la incomodidad en trabajar con clientes GLB (Hayes & Gelso, 1993; Weiner & Siegel, 1990). Sin embargo, faltan estudios que examinen el impacto de la homofobia y el heterosexismo en los resultados de tratamiento de los clients de las minorías sexuales. También hay una necesidad de investigación en mejores prácticas con individuos LGB y en cómo preparar a los trabajadores sociales para implementar intervenciones efectivas con esta población (Snively et al., 2004).
Finalmente, una reseña de la literature de trabajo social indica pobreza de información erelativa a temas GLB en general (Van Voorhis & Wagner, 2002). Se condujo un análisis de contenido de las revistas journals Social Work, Child Welfare, Social Service Review, y Families in Society de los 10 que se entienden entre 1988 a 1997. Estos journals en particular se seleccionaron explícitamente porque tienen audiencia nacional y no están limitados a un area única del trabajo social.
Solamente el 3.92% de los artículos (77 of 1,964) tocaban de algun modo la Homosexualidad, y la vasta mayoría de ellos (más del 65%) enfocaban el VIH o el SIDA. Esto es, menos de 1.37% de los artículos enfocaban aspectos de la práctica con clientes LGB que no fueran VIH o SIDA. El resultado más asombroso para los investigadores, sin embargo, fue que solamente cuatro de los 77 articulos tenían un foco macro, y ninguno de los artículos no VIH o SIDA se enfocaban en temas macro. Los investigadores sacaron la conclusion de que la escasa cobertura en estas revistas de temas que se enfocaran a la población LGB contribuía a la opresión de este grupo, y cuestionaban el compromiso de la profesión con sus principios adoptados de la perspectiva ecológica y el abordaje de persona-en-ambiente (Van Voorhis & Wagner, 2002).
En conclusion queda por verse si alguna de las intervenciones de corto plazo puede crear cambios en actitudes duraderos que se trasudzcan en cambios comportamentales hacia los individuos LGC. Parece probable que el cambio de actitud sea un proceso acumulativo que resulte de exposición repetida a información consistente que se considere creíble. Las intervenciones discutidas aquí pueden contribuir a ese proceso, pero deben ser todavía testeadas en profundidad con experimentos bien diseñados y metodológicamente sólidos. Esta area de investigación también debe ser expandida más allá de la Universidad o del contexto del aula. Querríamos ver tests de investigación future para cambiar actitudes antigay en otros contextos con otras poblaciones (lugares de trabajo, centros comunitarios, iglesias, etcétera). Sin embargo, lo que m+ás desearíamos sería ver una expansion general de la investigación diseñada para enfrentar la omnipresente victiminzación, discriminación y marginalización experimentada por la población LGB en este país.
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