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Medeiros P, Gupta M, Wong H, Kazemi M, Ndung'u M, Smith S, Kishibe T, Loutfy M. Women-centred HIV care: a scoping review to understand the current state of service delivery for women living with HIV globally. AIDS Care 2022; 34:1083-1093. [PMID: 34260327 DOI: 10.1080/09540121.2021.1948498] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Women living with HIV (WLWH) face unique barriers and require specialized, integrated care that focuses on women's specific needs. We conducted a scoping review to examine factors important for a women-centred HIV care (WCHC) approach. We included published peer-reviewed articles which featured WCHC services as their central focus; included study populations of girls and WLWH aged 14 years of age or older; and contributed to the understanding of WCHC for WLWH. Seven databases were reviewed and yielded 15,332 references, of which 21 fit our inclusion criteria for the scoping review. Research findings were categorized into characteristics of the study, recommendations, and target audiences. Findings revealed WCHC as care which includes the involvement of WLWH in decisions; person-centred integrated care; integrated services including mental health; sexual and reproductive health services; trauma-informed and safe space practices; healthcare provider training; and women's care self-management. In general, current systems of care do not meet the unique needs of WLWH.
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Affiliation(s)
- Priscilla Medeiros
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.,CIHR Canadian HIV Trials Network, Vancouver, Canada
| | - Meenakshi Gupta
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Heather Wong
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Mina Kazemi
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Mary Ndung'u
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Stephanie Smith
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | | | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.,Library Services, Unity Health Toronto, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
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Waldron EM, Burnett-Zeigler I, Wee V, Ng YW, Koenig LJ, Pederson AB, Tomaszewski E, Miller ES. Mental Health in Women Living With HIV: The Unique and Unmet Needs. J Int Assoc Provid AIDS Care 2021; 20:2325958220985665. [PMID: 33472517 PMCID: PMC7829520 DOI: 10.1177/2325958220985665] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Women living with HIV (WLWH) experience depression, anxiety, and posttraumatic
stress symptoms at higher rates than their male counterparts and more often than
HIV-unaffected women. These mental health issues affect not only the well-being
and quality of life of WLWH, but have implications for HIV management and
transmission prevention. Despite these ramifications, WLWH are under-treated for
mental health concerns and they are underrepresented in the mental health
treatment literature. In this review, we illustrate the unique mental health
issues faced by WLWH such as a high prevalence of physical and sexual abuse
histories, caregiving stress, and elevated internalized stigma as well as myriad
barriers to care. We examine the feasibility and outcomes of mental health
interventions that have been tested in WLWH including cognitive behavioral
therapy, mindfulness-based interventions, and supportive counseling. Future
research is required to address individual and systemic barriers to mental
health care for WLWH.
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Affiliation(s)
- Elizabeth M Waldron
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
| | - Inger Burnett-Zeigler
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
| | - Victoria Wee
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
| | - Yiukee Warren Ng
- Department of Psychiatry, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - Linda J Koenig
- Division of HIV/AIDS Prevention, 1242Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Aderonke Bamgbose Pederson
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
| | - Evelyn Tomaszewski
- Department of Social Work, College of Health and Human Services, 49340George Mason University, Fairfax, VA, USA
| | - Emily S Miller
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA.,Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, 12244Northwestern University, Chicago, IL, USA
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Han S, Hu Y, Relf MV, Mulawa MI, Lu H, Zhang L, Zhu Z, Luo J, Pei Y, Wu B. Effects of Nurse-Delivered Cognitive Behavioral Intervention on Depression and Anxiety for Persons Living With HIV in China: A Clinical Controlled Trial. J Assoc Nurses AIDS Care 2021; 32:79-93. [PMID: 33177434 DOI: 10.1097/jnc.0000000000000213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Depression and anxiety, which may influence antiretroviral therapy (ART) medication adherence, are prevalent among persons living with HIV (PLWH) in China. This parallel two-arm clinical controlled trial aimed to examine the effects of a nurse-delivered cognitive behavioral intervention (CBI) on depression, anxiety, and ART medication adherence in Chinese PLWH. Using in-person and online recruitment, 140 PLWH ages 18 years and older who were undergoing ART and had a Patient Health Questionnaire-4 score of ≥2 were assigned to the 10-week-long CBI group or the routine follow-up group according to their preference. Outcomes were measured at baseline, postintervention, and 6-month follow-up. Results showed significant intervention effects on depression maintained until the 6-month follow-up. Although anxiety and ART medication adherence did not show robust effects between conditions, amelioration trends for these outcomes were also found. Our study demonstrated that the nurse-delivered CBI could help Chinese PLWH ameliorate depression.
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Affiliation(s)
- Shuyu Han
- Shuyu Han, MSN, RN, is a Doctoral Candidate, School of Nursing, Fudan University, Shanghai, China. Yan Hu, PhD, RN, FAAN, is a Professor and Dean, School of Nursing, Fudan University, Shanghai, China, and is the Director of Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China. Michael V. Relf, PhD, RN, AACRN, ANEF, FAAN, is the Editor-in-Chief of JANAC and Associate Dean for Global and Community Health Affairs, Duke University, School of Nursing, Durham, North Carolina, USA. Marta I. Mulawa, PhD, MHS, is the Assistant Professor of Nursing and Global Health, Duke University, School of Nursing, Durham, North Carolina, USA. Hongzhou Lu, PhD, is the President, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. Lin Zhang, BSN, RN, is a Vice Director of Nursing, Shanghai Public Health Clinical Nursing, Fudan University, Shanghai, China. Zheng Zhu, PhD, RN, is a Faculty Member, School of Nursing, Fudan University, Shanghai, China, and is a Core Researcher of Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China. Jianfeng Luo, PhD, is a Professor, School of Public Health, Fudan University, Shanghai, China. Yaolin Pei, PhD, is a Post-doctoral Fellow, Rory Meyers College of Nursing, New York University, New York, New York, USA. Bei Wu, PhD, is the Dean's Professor in Global Health, the Director for Global Health and Aging Research, and the Director for Research, Hartford Institute for Geriatric Nursing, Rory Meyers College of Nursing, New York University, New York, New York, USA
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4
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Han S, Hu Y, Lu H, Zhang L, Zhu Z, Luo J, Relf MV, Mulawa MI, Pei Y, Wu B. Cognitive behavioral therapy for persons living with HIV in China: A randomized pilot trial. J Affect Disord 2020; 277:640-648. [PMID: 32911214 DOI: 10.1016/j.jad.2020.08.085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/09/2020] [Accepted: 08/25/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Chinese persons living with HIV (PLWH) suffer from prevalent mental health issues. We aimed to develop a tailored cognitive behavioral therapy (CBT), test its feasibility, acceptability, and preliminary effects (depression, anxiety, and medication adherence) for Chinese PLWH. METHODS Twenty PLWH were assigned randomly. Intervention participants learned skills in CBT and relaxation training in a tailored group-based weekly 10-session project. Each session lasted for two hours and was delivered by nurses and volunteers. Control participants only received laboratory tests and free antiretroviral therapy (ART) medication. Feasibility and acceptability were descriptively summarized. Depression, anxiety, and ART medication adherence data were collected at the baseline (T0), after the intervention (T1) and after 6 months of follow-up (T2). RESULTS The average CBT attendance rate for all sessions was 60%. No participants in the intervention group dropped out of the study. All participants in the intervention group agreed that they could benefit from the CBT. Participants in the intervention group showed a greater improvement in anxiety and self-reported ART medication adherence than those in the control group at T1. However, no preliminary intervention effect was found at T2. LIMITATIONS The small sample size leads to a lack of representativeness in the study sample. We excluded participants with severe comorbidities, which may lead to an underestimate of the intervention effect of CBT among Chinese PLWH. CONCLUSIONS CBT is feasible and acceptable, demonstrating promising preliminary effects on anxiety and ART medication adherence among Chinese PLWH. Additional research is needed to test the effectiveness of this approach.
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Affiliation(s)
- Shuyu Han
- School of Nursing, Fudan University, Shanghai 200032, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai 200032, China.
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center Affiliated with Fudan University, Shanghai 201508, China.
| | - Lin Zhang
- Shanghai Public Health Clinical Center Affiliated with Fudan University, Shanghai 201508, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai 200032, China
| | - Jianfeng Luo
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Michael V Relf
- Duke Global Health Institute, Duke University, Durham, USA
| | - Marta I Mulawa
- Duke Global Health Institute, Duke University, Durham, USA
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, USA
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Ramirez-Garcia MP, Gagnon MP, Colson S, Côté J, Flores-Aranda J, Dupont M. Mind-body practices for people living with HIV: a systematic scoping review. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:125. [PMID: 31185970 PMCID: PMC6560810 DOI: 10.1186/s12906-019-2502-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/15/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Mind-body practices are frequently used by people living with HIV to reduce symptoms and improve wellbeing. These include Tai Chi, Qigong, yoga, meditation, and all types of relaxation. Although there is substantial research on the efficacy of mind-body practices in people living with HIV, there is no summary of the available evidence on these practices. The aim of this scoping review is to map available evidence of mind-body practices in people living with HIV. METHODS The Arksey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005) methodological framework was used. A search of 16 peer-review and grey literature databases, websites, and relevant journals (1983-2015) was conducted. To identify relevant studies, two reviewers independently applied the inclusion criteria to all abstracts or full articles. Inclusion criteria were: participants were people living with HIV; the intervention was any mind-body practice; and the study design was any research study evaluating one or several of these practices. Data extraction and risk of bias assessment were performed by one reviewer and checked by a second, as needed, using the criteria that Cochrane Collaboration recommends for systematic reviews of interventions (Higgins and Green, Cochrane handbook for systematic reviews of intervention. 2011). A tabular and narrative synthesis was carried out for each mind-body practice. RESULTS One hundred thirty-six documents drawing on 84 studies met the inclusion criteria. The most widely studied mind-body practice was a combination of least three relaxation techniques (n = 20), followed in declining order by meditation (n = 17), progressive muscle relaxation (n = 10), yoga (n = 9) and hypnosis (n = 8). Slightly over half (47/84) of studies used a RCT design. The interventions were mainly (46/84) conducted in groups and most (51/84) included daily individual home practice. All but two studies were unblinded to participants. CONCLUSION The amount of available research on mind-body practices varies by practice. Almost half of the studies in this review were at high risk of bias. However, mindfulness, a combination of least three relaxation techniques and cognitive behavioral strategies, and yoga show encouraging results in decreasing physical and psychological symptoms and improving quality of life and health in people living with HIV. More rigorous studies are necessary to confirm the results of Tai Chi, Qigong, and some relaxation techniques.
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Affiliation(s)
- Maria Pilar Ramirez-Garcia
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Marie-Pier Gagnon
- Faculty of Nursing, Université Laval, Québec, Canada
- Research Center of the Centre Hospitalier Universitaire, Québec, Canada
| | - Sébastien Colson
- Faculty of Medicine, Aix Marseille Université, Marseille, France
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Jorge Flores-Aranda
- University Institute on Addiction, Montreal-Island-South-Center Integrated University Health and Social Services Centre, Montréal, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada
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Palinkas LA, Um MY, Aarons GA, Rafful C, Chavarin CV, Mendoza DV, Staines H, Patterson TL. Implementing Evidence-Based HIV Prevention for Female Sex Workers in Mexico: Provider Assessments of Feasibility and Acceptability. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2019; 6:57-68. [PMID: 31632894 PMCID: PMC6800729 DOI: 10.1007/s40609-018-0113-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study examined service provider perceptions of feasibility and acceptability of implementing evidence-based practices for preventing HIV/AIDS and STIs in female sex workers (FSWs) in Mexico. Semi-structured interviews were conducted with 124 directors, supervisors and counselors from 12 reproductive health clinics located throughout Mexico participating in a large randomized controlled trial to scale-up the use of a psychoeducational intervention designed to promote FSW condom use and enhance safer sex negotiation skills. Feasibility was based on assessment of personal, organizational and social costs, benefits, and capacity. Costs included anxiety over intervention competency, purchase of condoms and other supplies, expenses of laboratory tests for HIV/STIs, and stigma associated with FSWs. Benefits included increase in personal knowledge and experience, enhanced clinic reputation and service delivery capacity, and increased public health. Capacity was expressed in terms of provider skills to deliver the intervention and additional workload. Acceptability was expressed in terms of provider enthusiasm in delivering these services and FSWs willingness to receive the services. Service provider evaluations of feasibility and acceptability of implementing evidence-based prevention interventions are grounded in local contexts that define costs and benefits of and capacity for implementation and determine features of the intervention and its implementation that are acceptable.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA USA
| | - Mee Young Um
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA USA
| | - Gregory A. Aarons
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Claudia Rafful
- Division of Global Public Health, School of Medicine, University of California, San Diego, La Jolla, CA USA
- School of Public Health, San Diego State University, San Diego, CA USA
| | - Claudia V. Chavarin
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Doroteo V. Mendoza
- Research and Evaluation Unit, Mexican Foundation for Family Planning (MexFam), Mexico City, Mexico
| | - Hugo Staines
- Faculty of Biomedical Sciences, Autonomous University of Ciudad Juarez, Ciudad Juárez, Chihuahua, Mexico
| | - Thomas L. Patterson
- Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
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Maru S, Nirola I, Thapa A, Thapa P, Kunwar L, Wu WJ, Halliday S, Citrin D, Schwarz R, Basnett I, Kc N, Karki K, Chaudhari P, Maru D. An integrated community health worker intervention in rural Nepal: a type 2 hybrid effectiveness-implementation study protocol. Implement Sci 2018; 13:53. [PMID: 29598824 PMCID: PMC5875011 DOI: 10.1186/s13012-018-0741-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/13/2018] [Indexed: 11/13/2022] Open
Abstract
Background Evidence-based medicines, technologies, and protocols exist to prevent many of the annual 300,000 maternal, 2.7 million neonatal, and 9 million child deaths, but they are not being effectively implemented and utilized in rural areas. Nepal, one of South Asia’s poorest countries with over 80% of its population living in rural areas, exemplifies this challenge. Community health workers are an important cadre in low-income countries where human resources for health and health care infrastructure are limited. As local women, they are uniquely positioned to understand and successfully navigate barriers to health care access. Recent case studies of large community health worker programs have highlighted the importance of training, both initial and ongoing, and accountability through structured management, salaries, and ongoing monitoring and evaluation. A gap in the evidence regarding whether such community health worker systems can change health outcomes, as well as be sustainably adopted at scale, remains. In this study, we plan to evaluate a community health worker system delivering an evidence-based integrated reproductive, maternal, newborn, and child health intervention as it is scaled up in rural Nepal. Methods We will conduct a type 2 hybrid effectiveness-implementation study to test both the effect of an integrated reproductive, maternal, newborn, and child health intervention and the implementation process via a professional community health worker system. The intervention integrates five evidence-based approaches: (1) home-based antenatal care and post-natal care counseling and care coordination; (2) continuous surveillance of all reproductive age women, pregnancies, and children under age 2 years via a mobile application; (3) Community-Based Integrated Management of Newborn and Childhood Illness; (4) group antenatal and postnatal care; and 5) the Balanced Counseling Strategy to post-partum contraception. We will evaluate effectiveness using a pre-post quasi-experimental design with stepped implementation and implementation using the RE-AIM framework. Discussion This is the first hybrid effectiveness-implementation study of an integrated reproductive, maternal, newborn, and child health intervention in rural Nepal that we are aware of. As Nepal takes steps towards achieving the Sustainable Development Goals, the data from this three-year study will be useful in the detailed planning of a professionalized community health worker cadre delivering evidence-based reproductive, maternal, newborn, and child health interventions to the country’s rural population. Trial registration ClinicalTrials.gov Identifier: NCT03371186, registered 04 December 2017, retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s13012-018-0741-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sheela Maru
- Possible, Kathmandu, Nepal.,Department of Obstetrics and Gynecology, Boston Medical Center, Boston, MA, USA.,Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA
| | - Isha Nirola
- Possible, Kathmandu, Nepal.,Department Medicine, Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | - Wan-Ju Wu
- Possible, Kathmandu, Nepal.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Scott Halliday
- Possible, Kathmandu, Nepal.,Henry M. Jackson School of International Studies, University of Washington, Seattle, WA, USA
| | - David Citrin
- Possible, Kathmandu, Nepal.,Henry M. Jackson School of International Studies, University of Washington, Seattle, WA, USA.,Department of Anthropology, University of Washington, Seattle, WA, USA.,Department of Global Health, University of Washington, Seattle, WA, USA
| | - Ryan Schwarz
- Possible, Kathmandu, Nepal.,Department of Medicine, Division of Global Health Equity, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.,Department of Medicine, Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Indira Basnett
- Department of Health Services, Nepal Health Sector Programme, Ministry of Health, Kathmandu, Nepal
| | - Naresh Kc
- Department of Health Services, Family Health Division, Ministry of Health, Kathmandu, Nepal
| | - Khem Karki
- Department of Community Medicine, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal
| | - Pushpa Chaudhari
- Department of Health Services, Ministry of Health, Kathmandu, Nepal
| | - Duncan Maru
- Possible, Kathmandu, Nepal. .,Department of Medicine, Division of Global Health Equity, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. .,Department of Medicine, Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA. .,Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
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8
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Adam GP, Di M, Cu-Uvin S, Halladay C, Smith BT, Iyer S, Trikalinos TA. Strategies for improving the lives of US women aged 40 and above living with HIV/AIDS: an evidence map. Syst Rev 2018; 7:25. [PMID: 29391059 PMCID: PMC5796491 DOI: 10.1186/s13643-018-0684-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/12/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND While in its early years the HIV epidemic affected primarily the male and the young, nowadays, the population living with HIV/AIDS is approximately 24% women, and its age composition has shifted towards older ages. Many of the older women who live with HIV/AIDS also live with the medical and social conditions that accompany aging. This work aims to identify and characterize empirical studies of strategies for the comprehensive management of women over 40, including transgender women, who live with HIV/AIDS. Forty was chosen as an operational age cutoff to identify premenopausal women who are less likely to bear children, as well as peri- and postmenopausal women. METHODS We conducted a literature search after discussions with a diverse panel of content experts and other stakeholders and developed an evidence map that identified 890 citations that address questions having to do with programs and barriers to engaging with programs, as well as the role of insurance and comorbidities, and have enrolled older women who live with HIV/AIDS. RESULTS Of these, only 37 (4%) reported results of interest for women over 40 who live with HIV/AIDS, or examined interactions between gender and older age that would allow predictions in this subgroup. Few of the 37 eligible studies focused on women facing obvious challenges, such as immigrants, transgender, physically abused, or those recently released from prison. No studies focused on women caring for dependents, including children and grandchildren, or those diagnosed after age 40. CONCLUSION The evidence base that is directly applicable to women over 40 who live with HIV/AIDS in the USA is limited, and the research need is broad. We propose research prioritization strategies for this population.
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Affiliation(s)
- Gaelen P Adam
- Brown Evidence-based Practice Center, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA.
| | - Mengyang Di
- Brown Evidence-based Practice Center, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA
| | - Susan Cu-Uvin
- Brown Evidence-based Practice Center, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA.,Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, USA.,Department of Ob-Gyn and Medicine, Warren Alpert School of Medicine, Brown University, Providence, USA
| | - Christopher Halladay
- Brown Evidence-based Practice Center, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA
| | - Bryant T Smith
- Brown Evidence-based Practice Center, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA
| | - Suchitra Iyer
- Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, Rockville, MD, USA
| | - Thomas A Trikalinos
- Brown Evidence-based Practice Center, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA.,Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, USA
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9
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Chan CKY, Oldenburg B, Viswanath K. Advancing the science of dissemination and implementation in behavioral medicine: evidence and progress. Int J Behav Med 2015; 22:277-82. [PMID: 26001382 DOI: 10.1007/s12529-015-9490-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The enormous time lag between the discovery of new knowledge and its implementation poses a significant challenge to improving public health because of the very slow uptake into policy and practice. The field of dissemination and implementation research in behavioral medicine is receiving increased attention because of the keen interest in accelerating knowledge transfer from relevant research to improve the health and wellbeing of populations in many different settings, contexts, and countries around the world. This is particularly important in high-risk populations, resource-poor and developing regions of the world where the difference in health systems, languages, and cultures very significantly influences the translation of evidence into policy and practice. Moreover, demonstrating the broader societal and economic value of behavioral interventions in settings where they are implemented can further support the sustainability, uptake, and implementation of these findings in other settings and contexts. This special issue presents a series of empirical studies, reviews, and case studies that address dissemination, implementation, and translation issues in both developed and developing countries. Specifically, the learnings from the application of many and varied theories and research methodologies are very relevant for bridging the current division between research findings and their translation and uptake into policy and practice.
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Affiliation(s)
- Carina K Y Chan
- School of Psychology, Australian Catholic University, 1100 Nudgee Road, Banyo, QLD, 4014, Australia,
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10
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Palinkas LA, Chavarin CV, Rafful CM, Um MY, Mendoza DV, Staines H, Aarons GA, Patterson TL. Sustainability of Evidence-Based Practices for HIV Prevention among Female Sex Workers in Mexico. PLoS One 2015; 10:e0141508. [PMID: 26517265 PMCID: PMC4627751 DOI: 10.1371/journal.pone.0141508] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/08/2015] [Indexed: 02/03/2023] Open
Abstract
Objective This study examined service provider perceptions of requirements for successful sustainment of an efficacious intervention for preventing HIV/AIDS and STIs in female sex workers (FSWs) in Mexico. Methods Semi-structured interviews were conducted with 77 leaders and counselors from 12 community-based reproductive health clinics located throughout Mexico participating in a large hybrid effectiveness-implementation randomized controlled trial to scale-up the use of Mujer Segura, a psychoeducational intervention designed to promote condom use and enhance safer sex negotiation skills among FSWs. Results Five sets of requirements for sustainment were identified: 1) characteristics of the provider, including competence in delivering the intervention, need for continued technical support and assistance from outside experts, and satisfaction with addressing the needs of this population; 2) characteristics of the clients (i.e., FSWs), including client need and demand for services and incentives for participation; 3) characteristics of the organization, including its mission, benefits, and operations; 4) characteristics of the outer setting, including financial support and relationship with the community-based organization’s central offices, and transportation and security in areas where FSWs live and work; and 5) outcomes associated with the intervention itself, including a reduction of risk through education and increased outreach through referrals from FSWs who received the intervention. Conclusions Although the requirements for successful sustainment of interventions like Mujer Segura are consistent with the factors identified in many models of implementation, the results illustrate the importance of local context in assigning priority to these model elements and suggest that the five categories are not discrete entities but interconnected.
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Affiliation(s)
- Lawrence A. Palinkas
- School of Social Work, University of Southern California, Los Angeles, CA, United States of America
- * E-mail:
| | - Claudia V. Chavarin
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States of America
| | - Claudia M. Rafful
- Division of Global Public Health, School of Medicine, University of California San Diego, La Jolla, CA, United States of America
- School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Mee Young Um
- School of Social Work, University of Southern California, Los Angeles, CA, United States of America
| | - Doroteo V. Mendoza
- Research and Evaluation Unit, Mexican Foundation for Family Planning (Mexfam), Mexico City, Mexico
| | - Hugo Staines
- Faculty of Biomedical Sciences, Autonomous University of Ciudad Juarez, Ciudad Juárez, Chihuahua, Mexico
| | - Gregory A. Aarons
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States of America
| | - Thomas L. Patterson
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States of America
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Translating evidence-based interventions from research to practice: challenges and lessons learned. Transl Behav Med 2015; 5:233-41. [PMID: 26029285 DOI: 10.1007/s13142-015-0307-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Despite the increasing popularity of translation research, few studies have described the process and challenges involved in implementing a translation study. The main objective was to determine whether a multi-component group behavioral intervention could be successfully translated from an academic setting into the community health system of federally qualified health centers (FQHCs) funded by the Health Resources and Services Administration (HRSA) in Miami, NY, and NJ. Key challenges and "lessons learned" from the dissemination and implementation process for the SMART/EST (Stress Management And Relaxation Training/Emotional Supportive Therapy) Women's Project (SWP) III in low-resource primary care settings are described. The Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) model served as the theoretical framework for the translation of the study. This study outlines several essential factors related to Glasgow's RE-AIM model that need to be considered in order to accomplish successful translation of evidence-based interventions from traditional academia to "real-world" community health center settings.
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