The Contribution of Personal and Social Resources to Health Promoting Behaviors among LGBT in Israel

The LGBT population (lesbians, gays, transgenders, and bisexuals) is a sexual or gender minority. Although its actual proportion is unknown, it is estimated that it includes approximately 10% of the population (Coffman et al., 2017). There are unique psychosocial and health characteristics that are associated with LGBT which are related to their sexual/gender identity (Fredriksen-Goldsen et al., 2013), to the way general society accepts and responds to their identity, and how connected and involved they are with each other and within the LGBT community (Horvath et al. 2008; Wong et al., 2010). In recent years, there has been an improvement in the acceptance, recognition, and promotion of the rights of LGBT people in various fields (Witeck, 2014), but data on their physiological and mental health still indicates a high rate of health problems compared to heterosexuals, and the lack of willingness to turn to professional mental or medical care, even in cases of health distress (Centers for Disease Control and Prevention, 2019; Conron et al., 2010; Elliott et al., 2014). Despite the risk of poor physical and mental health, and even though it has been found that the quality of life and health data of LGBT people can be improved through health promoting behaviors (Mustanski et al., 2015; Smalley et al., 2016), even today there is still a lack of research knowledge about health behavior among this population.

The current study is based on a combination of two theoretical approaches - Hobfoll's "resource conservation theory" (Hobfoll, 2018, 2001, 1989), which provided a theoretical source for the selection of variables for the study, and "general systems theory" (von Bertalanffy, 1973), which helped to understand the system of interrelationships between the resources. Both theories emphasize the relationship between personal and social resources and interactions between the individual and the environment, an essential perspective for understanding the LGBTQ data and social pressures that link to poor health data and the adoption of risky health behavior patterns.

The objective of the present study is to examine the relationship between the personal resource "self-efficacy", the social resources "perceived social support" and "sense of community belonging", and the unique variable "risky sexual behavior", with "health behaviors" represented by two outcome variables- "Physical activity" & ""Health promoting Nutrition", among LGBT people. The health behaviors were measured using the variables " Physical activity " and " Health promoting Nutrition".

Methods: The study is a quantitative-correlational study and was conducted at one point in time as a cross-sectional survey. In the study, 342 participants who identify as lesbian, gay, or bisexual, aged 18 and over, were sampled. The data was collected through online questionnaires and the sampling of the participants in the study was done using the "convenience sample" method. The research hypotheses estimated that significant relationships would be found between the independent research variables and the health behavior variables.

Results: Contrary to some of the research's hypotheses, no significant direct relationships were found between the social resources and the outcome variables of "Health Behaviors". However, a correlation was found through full mediation relationships of the personal resource "self-efficacy". The variable "risky sexual behavior" was found to be associated with a direct negative relationship with "physical activity", and with a partial mediating relationship through "self-efficacy". The outcome variable "health promoting nutrition" was not found to be related to any social or personal resources. rather only with the other outcome variable "physical activity". The personal resource "self-efficacy" is in a distinct and positive relationship with most of the research variables - "perceived social support", "sense of community belonging", "risky sexual behavior" and "physical activity".

In the research, a path analysis was used that allows for a series of simultaneous regressions, and through it the three mediation models were located through "self-efficacy" with the outcome variable "physical activity" - "perceived social support", "sense of community belonging" and "risky sexual behavior".

The study is unique among the LGBT community in Israel, which is faced with poor health data, and thus far has not been researched on the topic of health behaviors. The importance of the study is in its adaptation to the unique population; therefore, it includes, among other things, the designated variable "risky sexual behavior". The novelty and unique contribution of the study is important Both at the theoretical level and at the applied level - theoretically, the study examines for the first time the personal and environmental factors related to health behavior among LGBT people in Israel, based on the combination of two theoretical models; From an applied point of view, the research findings shed light on the personal, social and behavioral factors that promote or endanger the health of the LGBT population, and on the health behavior patterns, and not only on the health indicators themselves.

Importance and implications of the research: This study may lead to an improvement in health indicators and the promotion of health services for LGBT people, its findings allow for medical attention to the emotional and social needs of this population and create a platform for the development of unique intervention programs to prevent diseases and improve quality indicators in treatment among the LGBT population.