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McKinney-Prupis E, Chiu YCJ, Grov C, Tsui EK, Duke SI. Psychosocial and Health-Related Behavioral Outcomes of a Work Readiness HIV Peer Worker Training Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4322. [PMID: 36901333 PMCID: PMC10001842 DOI: 10.3390/ijerph20054322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Targeted work readiness training is an important approach to help people living with HIV (PLHIV) to overcome their unique barriers to work, while addressing social determinants of health needs. This study assesses the psychosocial impacts of a work readiness training and internship program among HIV peer workers in New York City. From 2014 through 2018, 137 PLHIV completed the training program, and 55 individuals completed both the training and the six-month peer internship. Depression, HIV internalized stigma, self-esteem, HIV medication adherence, patient self-advocacy, and safer sex communication apprehension were used as outcome measures. Paired t-tests were performed to determine if significant score changes occurred at the individual level before and after each training. Our results show that participating in the peer worker training program significantly decreased depression and internalized HIV stigma, and significantly increased self-esteem, medication adherence, and patient self-advocacy. The study underscores that peer worker training programs are important tools to improve not only the work readiness of PLHIV, but also psychosocial and health outcomes. Implications for HIV service providers and stakeholders are discussed.
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Affiliation(s)
| | | | - Christian Grov
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10017, USA
| | - Emma K. Tsui
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10017, USA
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Squires JE, Graham I, Bashir K, Nadalin‐Penno L, Lavis J, Francis J, Curran J, Grimshaw JM, Brehaut J, Ivers N, Michie S, Hillmer M, Noseworthy T, Vine J, Demery Varin M, Aloisio LD, Coughlin M, Hutchinson AM. Understanding context: A concept analysis. J Adv Nurs 2019; 75:3448-3470. [DOI: 10.1111/jan.14165] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/24/2019] [Accepted: 07/03/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Janet E. Squires
- School of Nursing, Faculty of Health Sciences University of Ottawa Ottawa Ontario Canada
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada
| | - Ian Graham
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada
- School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada
| | - Kainat Bashir
- Institute of Health Policy, Management, and Evaluation University of Toronto Toronto Ontario Canada
| | - Letitia Nadalin‐Penno
- School of Nursing, Faculty of Health Sciences University of Ottawa Ottawa Ontario Canada
| | - John Lavis
- Department of Clinical Epidemiology & Biostatistics McMaster University Hamilton Ontario Canada
- McMaster Health Forum Hamilton Ontario Canada
| | - Jill Francis
- School of Health Sciences, City University of London London United Kingdom
| | - Janet Curran
- IWK Health Centre Halifax Nova Scotia Canada
- School of Nursing Dalhousie University Halifax Nova Scotia Canada
| | - Jeremy M. Grimshaw
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada
- Medicine University of Ottawa Ottawa Ontario Canada
| | - Jamie Brehaut
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada
- School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada
| | - Noah Ivers
- Women's College Research Institute Toronto Ontario Canada
- Women's College Hospital Toronto Ontario Canada
- Department of Family and Community Medicine University of Toronto Toronto Ontario Canada
| | - Susan Michie
- Psychology Department University College London London United Kingdom
| | - Michael Hillmer
- Information Management, Data, and Analytics Ontario Ministry of Health and Long‐term Care Toronto Ontario Canada
| | - Thomas Noseworthy
- British Columbia Academic Health Science Network Vancouver British Columbia Canada
| | - Jocelyn Vine
- School of Nursing Dalhousie University Halifax Nova Scotia Canada
- Patient Care IWK Health Centre Halifax Nova Scotia Canada
| | - Melissa Demery Varin
- School of Nursing, Faculty of Health Sciences University of Ottawa Ottawa Ontario Canada
| | - Laura D. Aloisio
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada
| | - Mary Coughlin
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada
| | - Alison M. Hutchinson
- School of Nursing and Midwifery, Faculty of Health Deakin University Melbourne Victoria Australia
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Mullens AB, Duyker J, Brownlow C, Lemoire J, Daken K, Gow J. Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community 'beat' locations. BMC Health Serv Res 2019; 19:93. [PMID: 30711001 PMCID: PMC6359847 DOI: 10.1186/s12913-019-3899-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 01/11/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Innovative health promotion strategies are needed to improve access to HIV testing among regional people in Australia, particularly for men who have sex with men (MSM). This project aimed to establish proof of concept for point-of-care-testing (POCT) via a mobile van clinic at community 'beat' locations. Surveys evaluated client satisfaction, characteristics and testing preferences among 'early adopters'. Sequential mixed-methods approach was used which included secondary qualitative analysis of field notes written by peer-testers (i.e., trained lay providers from the key population being targeted; to extend the contextualise the pilot evaluation), documenting barriers/facilitators and innovations, per action research and to guide recommendations for future health promotion initiatives. METHODS A POCT 'proof of concept' project (2, 3-hourly sessions/week; 20 weeks) was delivered in a regional town by peer-testers using a mobile clinic van, recruited by geosocial 'apps' targeting MSM. Clients completed surveys regarding demographics, and testing satisfaction, frequency and preferences. Peer-testers completed detailed field notes for each session including client characteristics and impressions, salient events, concerns and recommendations. RESULTS The program resulted in 34 online health promotion conversations with MSM and 34 POCT tests (19 HIV, 15 Syphilis; 18 unique client visits; 17 identified as MSM, with 1 heterosexual female. Rates of satisfaction among early adopters of POCT was high. Analysis of field notes revealed three major themes: 1) Practical challenges; 2) Barriers to engagement; and 3) Recruitment method/project promotion. CONCLUSIONS Amongst early adopters satisfaction was high, with 47% of clients reported infrequent testing (over 12 months ago) or having 'never tested'. No tests were reactive. Challenges associated with this health promotion initiative and recommendations for future HIV testing promotion and programs were outlined.
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Affiliation(s)
- Amy B Mullens
- School of Psychology & Counselling, Institute for Resilient Regions, University of Southern Queensland, 11 Salisbury Rd, Ipswich, QLD, 4305, Australia. .,School of Psychology & Counselling, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia.
| | - Josh Duyker
- Queensland Positive People, 21 Manilla St, East Brisbane, QLD, 4169, Australia
| | - Charlotte Brownlow
- School of Psychology & Counselling, Institute for Resilient Regions, University of Southern Queensland, Main St, Toowoomba, QLD, 4350, Australia
| | - Jime Lemoire
- Queensland Positive People, 21 Manilla St, East Brisbane, QLD, 4169, Australia
| | - Kirstie Daken
- School of Psychology & Counselling, Institute for Resilient Regions, University of Southern Queensland, 11 Salisbury Rd, Ipswich, QLD, 4305, Australia
| | - Jeff Gow
- School of Commerce, Institute for Resilient Regions, University of Southern Queensland, Main St, Toowoomba, QLD, 4350, Australia.,School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, 4000, South Africa
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Mutch AJ, Lui CW, Dean J, Mao L, Lemoire J, Debattista J, Howard C, Whittaker A, Fitzgerald L. Increasing HIV testing among hard-to-reach groups: examination of RAPID, a community-based testing service in Queensland, Australia. BMC Health Serv Res 2017; 17:310. [PMID: 28454592 PMCID: PMC5410036 DOI: 10.1186/s12913-017-2249-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 04/19/2017] [Indexed: 01/18/2023] Open
Abstract
Background The success of ‘treatment as prevention’ (TasP) to control HIV relies on the uptake of testing across priority population groups. Innovative strategies including; rapid HIV testing (RHT) in community and outreach settings, engaging peer service providers, and not requiring disclosure of sexual history have been designed to increase access. This paper reports on the implementation of ‘RAPID’, a community-based testing program in Queensland, Australia that employs these strategies to increase access to testing. Methods Service data, including client registration forms and a satisfaction survey from all clients attending RAPID between August 2014 and July 2015 were analysed. Results In 2014/2015 1,199 people attended RAPID to receive a free HIV test. The majority were urban-based gay men. 17.1% were first-time testers and 20.1% of participants were not eligible to access Medicare, Australia’s universal health care scheme. Conclusions RAPID’s evidence-based strategies appear to facilitate access to HIV testing, particularly among those who have never tested before; however the implications for the ongoing treatment and care of people ineligible for Medicare, who test positive to HIV warrants careful consideration. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2249-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Allyson J Mutch
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Chi-Wai Lui
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Judith Dean
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Limin Mao
- Centre for Social Research in Health (CSRH), University of New South Wales, NSW, Australia
| | - Jime Lemoire
- Queensland Positive People, Brisbane, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Queensland Health, Brisbane, Queensland, Australia
| | - Chris Howard
- Queensland Positive People, Brisbane, Queensland, Australia
| | - Andrea Whittaker
- School of Social Sciences, Monash University, Melbourne, Victoria, Australia
| | - Lisa Fitzgerald
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Effectiveness of an Integrated Community- and Clinic-Based Intervention on HIV Testing, HIV Knowledge, and Sexual Risk Behavior of Young Men Who Have Sex With Men in Myanmar. J Adolesc Health 2017; 60:S45-S53. [PMID: 28109340 DOI: 10.1016/j.jadohealth.2016.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/13/2016] [Accepted: 09/14/2016] [Indexed: 01/01/2023]
Abstract
PURPOSE Young men who have sex with men (YMSM) in Myanmar are disproportionately affected by HIV, with prevalence five times that of the general population. The Link Up project implemented an intervention using peer education and outreach providing education and counseling on health seeking around sexually transmitted infections and reproductive health, combined with focused clinic capacity building to improve the sexual and reproductive health of YMSM. This study aimed to evaluate the effectiveness and acceptability of the intervention. METHODS Using a mixed-methods approach, and employing a quasi-experimental design, we conducted two quantitative repeat cross-sectional surveys in purposively selected control (no intervention) and intervention townships, before and after implementation of the Link Up intervention. Respondent-driven sampling was used to recruit YMSM aged 15-24 years, and study participants were administered a structured questionnaire assessing intervention exposure, health service access, knowledge of HIV, and sexual risk behavior. Focus group discussions were held to elicit perspectives on the use and acceptability of the health services and peer outreach. RESULTS At baseline, 314 YMSM were recruited in the intervention townships and 309 YMSM in the control townships. At end line, 267 (intervention) and 318 (control) YMSM were recruited. Coverage of the program was relatively low, with one-third of participants in the intervention townships having heard of the Link Up program by the end line. Comparing changes between baseline and end line, a greater proportion of HIV-negative or unknown status YMSM accessed HIV testing in the past 3 months in intervention townships (from 45.0% to 57.1%) compared with those in control townships (remained at 29.0%); however, this difference in the effect over time was not statistically significant in multivariate modeling (adjusted odds ratio: 1.45; 95% confidence interval: .66-3.17). Qualitative findings showed that the intervention was acceptable to YMSM. CONCLUSIONS Overall, the intervention was perceived as acceptable. Although not statistically significant, results showed some trends toward improvements among YMSM in accessing HIV testing services and HIV-related knowledge. The modest coverage and short time frame of the evaluation likely limits the ability for any significant behavioral improvements.
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Morar NS, Naidoo S, Goolam A, Ramjee G. Research participants' skills development as HIV prevention peer educators in their communities. J Health Psychol 2016; 23:1343-1349. [PMID: 27371447 DOI: 10.1177/1359105316655470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article describes the influence of a peer education programme on skills development among 22 women participating in HIV prevention trials. Interviews were used to collect data on peer educator experiences and their opinions of the trainings. The training enhanced their agency and confidence to engage their family and community on health promotion, including HIV prevention research procedures, thus improving their self-esteem and communication skills. Training and partnering with clinical trial participants as peer educators is an effective and sustainable community-based approach for HIV prevention.
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Affiliation(s)
| | - Sarita Naidoo
- 1 South African Medical Research Council, South Africa
| | | | - Gita Ramjee
- 1 South African Medical Research Council, South Africa.,3 London School of Hygiene & Tropical Medicine, UK
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