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Fu Y, Yu B, Yu W, Yang S. Network Analysis of Sexual Sensation Seeking, Internalized Homophobia, and Social Norms Among Men Who Have Sex with Men with Different Sexual Partner Types. AIDS Behav 2023; 27:3548-3558. [PMID: 37079209 DOI: 10.1007/s10461-023-04069-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 04/21/2023]
Abstract
Men who have sex with men (MSM) are at disproportionate risk for developing sexually transmitted infections (STIs) such as HIV. Understanding the relationships among factors related to risky sexual behaviors, such as internalized homophobia, sexual sensation seeking, and individual and community norms, among MSM with different sexual partner types may contribute to designing targeted interventions for reducing risky sexual behaviors and STI transmission. We conducted a cross-sectional study recruiting 781 MSM in Sichuan Province, China. All participants were divided into groups with and without sexual partners, groups with regular and casual sexual partners, and groups with only male and both male and female partners in the past 6 months. Network analysis was used to analyze the relationships among dimensions of self-reported sexual sensation seeking, internalized homophobia, and social norms in different groups. Of 781 MSM, 606 (77.6%) had sexual partners in the past 6 months, and among these participants, 429 (70.8%) had casual sexual partners, and 103 (17.0%) had both male and female sexual partners. The complex and intensive relationships between dimensions were mainly observed in networks of MSM with any type of sexual partners, with individual norms (dimension of social norms) presenting strongly negative relationships with fresh feeling (dimension of sexual sensation seeking) and homosexuality morality (dimension of internalized homophobia). One dimension of sexual sensation seeking (i.e., fresh feeling) and two dimensions of internalized homophobia (i.e., homosexuality morality and self-identification) were relatively central variables in most groups, especially for those with casual sexual partners. Our study highlights the role of individual norms in restraining sensation seeking, internalized homophobia, especially among MSM with sexual partners. Intervention targeting these central variables may contribute to reduced risky sexual behaviors and further slow the spread of STIs in MSM.
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Affiliation(s)
- Yao Fu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bin Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
| | - Wanqi Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan, China.
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Dudley MZ, Squires GK, Petroske TM, Dawson S, Brewer J. The Use of Narrative in Science and Health Communication: A Scoping Review. PATIENT EDUCATION AND COUNSELING 2023; 112:107752. [PMID: 37068426 DOI: 10.1016/j.pec.2023.107752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Many people deny science and reject health recommendations despite widely distributed facts and statistics. Didactic science and health communication is often dry, and relies on the false assumption that people make purely evidence-based decisions. Stories can be a powerful teaching tool by capturing attention and evoking emotion. OBJECTIVE We explore the impact and appeal of, and describe best practices for, using narrative (storytelling) versus didactic methods in science and health communication. PATIENT INVOLVEMENT No patients were involved in the review process. METHODS We searched PubMed and Web of Science for articles either: assessing effectiveness of narrative science/health communication; assessing acceptability of (or preference for) narrative science/health communication; giving advice on how best to use narrative; and/or providing science-based explanations for how/why narrative succeeds. RESULTS Narrative science/health communication is effective and appealing for audiences across a variety of topics and mediums, with supporting evidence across fields such as epidemiology, neuroscience, and psychology. Whether narrative or didactic messaging is most effective depends on the topic, audience, and objective, as well as message quality. However, combining narrative with didactic methods is likely to be more effective than using either strategy alone. DISCUSSION Narrative science/health communication merits wider implementation and further research. Narrative communication creates openness to information by delaying the formulation of counterarguments. PRACTICAL VALUE Science and health communicators should collaborate with cultural and storytelling experts, work directly with their target audiences throughout the message development and testing processes, and rely on popular story elements (e.g., first-person point of view, relatable protagonists) to improve the comprehension, engagement, and thoughtful consideration of their intended audience. FUNDING This work was funded by Thirty Meter Telescope, with which two authors (GKS and SD) were affiliated. Otherwise, the funding organization had no role in the study and/or submission.
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA.
| | - Gordon K Squires
- California Institute of Technology / IPAC, 1200 E California Blvd, 315 Keith Spalding, Pasadena, CA 91125, USA
| | | | - Sandra Dawson
- Thirty Meter Telescope International Observatory, Pasadena, CA, USA
| | - Janesse Brewer
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA
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Kruse CS, Pacheco GJ, Rosenthal N, Kopp CJ, Omorotionmwan O, Cruz JE. Leveraging mHealth for the Treatment and Management of PLHIV. Risk Manag Healthc Policy 2023; 16:677-697. [PMID: 37077534 PMCID: PMC10106311 DOI: 10.2147/rmhp.s403946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/25/2023] [Indexed: 04/21/2023] Open
Abstract
Objective The objective of this systematic review was to analyze published literature from the last five years to assess facilitators and barriers to the adoption of mHealth as interventions to treat and manage HIV for PLHIV (people living with HIV). The primary outcomes were physical and mental conditions. The secondary outcomes were behavior based (substance use, care engagement, and healthy habits). Methods Four databases (PubMed, CINAHL, Web of Science, and ScienceDirect) were queried on 9/2/2022 for peer-reviewed studies on the treatment and management of PLHIV with mHealth as the intervention. The review was conducted in accordance with the Kruse Protocol and reported in accordance with PRISMA 2020. Results Five mHealth interventions were identified across 32 studies that resulted in improvements in physical health, mental health, care engagement, and behavior change. mHealth interventions offer both convenience and privacy, meet a digital preference, increase health knowledge, decrease healthcare utilization, and increase quality of life. Barriers are cost of technology and incentives, training of staff, security concerns, digital literacy gap, distribution of technology, technical issues, usability, and visual cues are not available over the phone. Conclusion mHealth offers interventions to improve physical health, mental health, care engagement, and behavior for PLHIV. There are many advantages to this intervention and very few barriers to its adoption. The barriers are strong, however, and should be addressed through policy. Further research should focus on specific apps for younger versus older PLHIV, based on preferences and the digital literacy gap.
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Affiliation(s)
- Clemens Scott Kruse
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
- Correspondence: Clemens Scott Kruse, Email
| | - Gerardo J Pacheco
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - Noah Rosenthal
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - Caris J Kopp
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - Omosigho Omorotionmwan
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - John E Cruz
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
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Wirtz AL, Logie CH, Mbuagbaw L. Addressing Health Inequities in Digital Clinical Trials: A Review of Challenges and Solutions From the Field of HIV Research. Epidemiol Rev 2022; 44:87-109. [PMID: 36124659 PMCID: PMC10362940 DOI: 10.1093/epirev/mxac008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/10/2022] [Accepted: 09/12/2022] [Indexed: 12/29/2022] Open
Abstract
Clinical trials are considered the gold standard for establishing efficacy of health interventions, thus determining which interventions are brought to scale in health care and public health programs. Digital clinical trials, broadly defined as trials that have partial to full integration of technology across implementation, interventions, and/or data collection, are valued for increased efficiencies as well as testing of digitally delivered interventions. Although recent reviews have described the advantages and disadvantages of and provided recommendations for improving scientific rigor in the conduct of digital clinical trials, few to none have investigated how digital clinical trials address the digital divide, whether they are equitably accessible, and if trial outcomes are potentially beneficial only to those with optimal and consistent access to technology. Human immunodeficiency virus (HIV), among other health conditions, disproportionately affects socially and economically marginalized populations, raising questions of whether interventions found to be efficacious in digital clinical trials and subsequently brought to scale will sufficiently and consistently reach and provide benefit to these populations. We reviewed examples from HIV research from across geographic settings to describe how digital clinical trials can either reproduce or mitigate health inequities via the design and implementation of the digital clinical trials and, ultimately, the programs that result. We discuss how digital clinical trials can be intentionally designed to prevent inequities, monitor ongoing access and utilization, and assess for differential impacts among subgroups with diverse technology access and use. These findings can be generalized to many other health fields and are practical considerations for donors, investigators, reviewers, and ethics committees engaged in digital clinical trials.
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Affiliation(s)
- Andrea L Wirtz
- Correspondence to Dr. Andrea L. Wirtz, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 (e-mail: )
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Meanley S, Sexton Topper P, Listerud L, Bonett SK, Watson D, Choi SK, Teixeira Da Silva D, Flores DD, James R, Bauermeister JA. Leveraging Resilience-supportive Strategies to Enhance Protective Factors in Young Sexual Minority Men: A Scoping Review of HIV Behavioral Interventions Implemented in High-income Countries. JOURNAL OF SEX RESEARCH 2022; 59:957-983. [PMID: 35080999 DOI: 10.1080/00224499.2021.2024789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Behavioral HIV interventions focused on strengthening young sexual minority men's (SMM) internal (assets) and external (resources) protective factors are promising, yet their evaluation as resilience-supportive strategies to minimize or negate HIV-related risks remain understudied. The objective of this scoping review was to describe resilience-supportive intervention strategies that have been used to achieve desired HIV behavioral outcomes and to identify how these strategies have been evaluated using a resilience analytic framework. Our scoping review uncovered 271 peer-reviewed articles, of which 38 were eligible for inclusion based on our review criteria. The majority of interventions relied on social support strategies as their primary resilience-supportive strategy. A third of interventions reviewed analyzed their findings from a deficits-focused model, another third used compensatory resilience models, and the remaining interventions employed a hybrid (i.e., deficit and compensatory model) strategy. None of the interventions evaluated their intervention effects using a risk-protective model. From our synthesis regarding the current state of research around resilience-informed interventions, we propose strategies to inform the design of resilience-supportive approaches and make recommendations to move the field forward on how to develop, implement, and measure young SMM's resiliency processes.
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Affiliation(s)
- Steven Meanley
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Patrina Sexton Topper
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Louis Listerud
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Stephen K Bonett
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- University of Pennsylvania Leonard Davis Institute of Health Economics
| | - Dovie Watson
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- School of Medicine, Division of Infectious Diseases, University of Pennsylvania Perelman
| | - Seul Ki Choi
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Daniel Teixeira Da Silva
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- University of Pennsylvania Leonard Davis Institute of Health Economics
- School of Medicine National Clinician Scholar, University of Pennsylvania Perelman
| | - Dalmacio D Flores
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | | | - José A Bauermeister
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
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