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OSGM status, healthcare delays, and frailty were assessed using survey data. Electronic health record (EHR) data was used to measure the number of medical visits or mental health (MH) visit days, following 12 months from the calculated All of Us Frailty Index. Analyses adjusted for age, race and ethnicity, income, HIV, marital status \u00b1 general MH (only MH analyses).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared to non-OSGM, OSGM adults have higher rates of medical visits (adjusted rate ratio [aRR]: 1.14; 95% CI: 1.03, 1.24) and MH visits (aRR: 1.85; 95% CI: 1.07, 2.91). Frailty mediated the association between OSGM status medical visits (Controlled direct effect [Rcde] aRR: 1.03, 95% CI [0.87, 1.22]), but not MH visits (Rcde aRR: 0.37 [95% CI: 0.06, 1.47]). Delays mediated the association between OSGM status and MH visit days (Rcde aRR: 2.27, 95% CI [1.15, 3.76]), but not medical visits (Rcde aRR: 1.06 [95% CI: 0.97, 1.17]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Frailty represents a need for medical care among OSGM adults, highlighting the importance of addressing it to improve health and healthcare utilization disparities. In contrast, healthcare delays are a barrier to MH care, underscoring the necessity of targeted strategies to ensure timely MH care for OSGM adults.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocae205","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:01:50Z","timestamp":1722384110000},"page":"2916-2923","source":"Crossref","is-referenced-by-count":3,"title":["Assessing how frailty and healthcare delays mediate the association between sexual and gender minority status and healthcare utilization in the <i>All of Us<\/i> Research Program"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4315-3923","authenticated-orcid":false,"given":"Chelsea N","family":"Wong","sequence":"first","affiliation":[{"name":"Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA 02445,","place":["United States"]},{"name":"Department of Medicine, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife , Boston, MA 02131,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9029-4644","authenticated-orcid":false,"given":"Louisa H","family":"Smith","sequence":"additional","affiliation":[{"name":"Roux Institute, Northeastern University , Portland, ME 04101,","place":["United States"]},{"name":"Department of Health Sciences, Bouv\u00e9 College of Health Sciences, Northeastern University , Boston, MA 02115,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Cavanaugh","sequence":"additional","affiliation":[{"name":"Roux Institute, Northeastern University , Portland, ME 04101,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae H","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA 02445,","place":["United States"]},{"name":"Department of Medicine, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife , Boston, MA 02131,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Carl G","family":"Streed","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine , Boston, MA 02118,","place":["United States"]},{"name":"GenderCare Center, Boston Medical Center , Boston, MA 02118,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farzana","family":"Kapadia","sequence":"additional","affiliation":[{"name":"D , New York, NY 10003,","place":["United States"]},{"name":"epartment of Epidemiology, New York University School of Global Public Health , New York, NY 10003,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brianne","family":"Olivieri-Mui","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife , Boston, MA 02131,","place":["United States"]},{"name":"Roux Institute, Northeastern University , Portland, ME 04101,","place":["United States"]},{"name":"Department of Health Sciences, Bouv\u00e9 College of Health Sciences, Northeastern University , Boston, MA 02115,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"issue":"1","key":"2024121023405861800_ocae205-B1","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1093\/geront\/gnu081","article-title":"Successful aging among LGBT older adults: physical and mental health-related quality of life by age group","volume":"55","author":"Fredriksen-Goldsen","year":"2015","journal-title":"Gerontologist"},{"issue":"5","key":"2024121023405861800_ocae205-B2","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1503\/cmaj.050051","article-title":"A global clinical measure of fitness and frailty in elderly people","volume":"173","author":"Rockwood","year":"2005","journal-title":"CMAJ"},{"issue":"11","key":"2024121023405861800_ocae205-B3","doi-asserted-by":"publisher","first-page":"2111","DOI":"10.1093\/gerona\/glad149","article-title":"Frailty among sexual and gender minority older adults: the All of Us database","volume":"78","author":"Wong","year":"2023","journal-title":"J Gerontol Ser A"},{"key":"2024121023405861800_ocae205-B4","author":"Harvard T.H. 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