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Rhodes SD, Tanner AE, Mann-Jackson L, Alonzo J, Hall MA, Bertoni AG, McCoy TP, Aguilar-Palma SK, Garcia M, Miranda D, Turner MJ. Increasing COVID-19 testing and vaccination among Spanish speakers in the USA: protocol for the development and evaluation of the Nuestra Comunidad Saludable intervention using a group-randomised trial design. BMJ Open 2022; 12:e066585. [PMID: 36385019 PMCID: PMC9670094 DOI: 10.1136/bmjopen-2022-066585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Our community-based participatory research partnership aims to expand understanding of the social, ethical and behavioural implications of COVID-19 testing and vaccination to inform the development of an integrated intervention that harnesses community-based peer navigation and mHealth strategies to improve COVID-19 testing and vaccination; test the intervention; and develop and disseminate practice, research and policy recommendations to further increase COVID-19 testing and vaccination among Spanish-speaking Latine communities in the USA. METHODS AND ANALYSIS We will conduct 50 individual in-depth interviews with health providers, who have conducted COVID-19 testing and/or vaccination activities within Spanish-speaking communities, and with representatives from Latine-serving community-based organisations. We will also conduct six focus groups with 8-12 Spanish-speaking Latine community member participants each for a total number of about 60 focus group participants. Next, we will develop the Nuestra Comunidad Saludable intervention based on findings from interviews and focus groups and use a longitudinal group-randomised trial design with two arms (intervention and delayed intervention) to evaluate the impact of the intervention. We will recruit, enrol and collect baseline data from 20 community-based peer navigators (Navegantes) and their social network members (n=8 unique social network members per Navegante). Navegantes (coupled with their social networks) will be randomised to intervention or delayed intervention groups (10 Navegantes and 80 social network members per group). ETHICS AND DISSEMINATION Ethical approval for data collection was granted by the Wake Forest University School of Medicine Institutional Review Board. Following the description of study procedures, we will obtain consent from all study participants. Study findings will be disseminated through an empowerment theory-based community forum, peer-reviewed publications and presentations at scientific meetings, and reports and briefs for lay, community and practitioner audiences. TRIAL REGISTRATION NUMBER NCT05302908.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Amanda E Tanner
- Department of Public Health Education, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark A Hall
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Wake Forest University School of Law, Winston-Salem, North Carolina, USA
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Thomas P McCoy
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | | | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Majewska AA, Stuart JD, Gray KM, Ryder PV, Vereen E. Development of a Men's Health course for first-year undergraduates using culturally responsive teaching strategies. HEALTH EDUCATION 2022. [DOI: 10.1108/he-07-2021-0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose A novel first-year experience course was developed using culturally responsive teaching strategies at an undergraduate liberal arts college in the southeastern USA to promote health advocacy and to provide students with an overview of male health. The course focuses on the biological, sociocultural, economic and gender influences that shape men's health beliefs and practices. It also emphasizes health disparities in the USA among Black/African American men compared to other racial groups and intervention strategies to improve health outcomes.Design/methodology/approach The lecture and laboratory components of the course were designed as a blended learning environment with a modified flipped class model. Culturally relevant strategies guided the course design with three focus domains: academic success, cultural competence and sociopolitical consciousness. A community engagement model and service-learning activities were also incorporated in the design. The authors used course grades to gauge learning and implemented a survey to assess students' perception of the knowledge gained in three realms: men's health, health sciences and physical sciences.Findings This report describes the course design, highlights the value of using culturally responsive teaching strategies and service-learning projects to encourage students' active learning. Course activity examples are discussed with student responses. The authors found that students' perception of their knowledge in men's health, health sciences and physical sciences increased and the students performed well in the course.Originality/value This is one of few biology courses in the nation that intentionally focuses on the unique health challenges of Black men, while empowering college students to develop culturally competent strategies to improve their health outcomes. The findings suggest that the students learned the material and that their perceived knowledge on men's health increased. The authors urge other academic institutions and healthcare providers to consider implementation of similar courses in an effort to enhance male health equity.
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Abubakari GM, Nelson LE, Ogunbajo A, Boakye F, Appiah P, Odhiambo A, Sa T, Zhang N, Ngozi I, Scott A, Maina G, Manu A, Torpey K. Implementation and evaluation of a culturally grounded group-based HIV prevention programme for men who have sex with men in Ghana. Glob Public Health 2021; 16:1028-1045. [PMID: 33050773 PMCID: PMC8728790 DOI: 10.1080/17441692.2020.1832555] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
This study examined the feasibility and acceptability of an evidence-based HIV prevention programme for men who have sex with men (MSM) in Ghana through a participatory approach. The programme involved 57 self-identified adult cisgender MSM and led by a community-based organisation in collaboration with local nurses. We used an explanatory mixed-method design to evaluate the programme. We computed descriptive statistics, relative frequency, and paired proportionate analysis for the survey data and subjected the focus groups data to summative content analysis. Five key themes from the qualitative data indicated strong evidence of the acceptability and efficacy of the programme among MSM. The programme contributed to building social support networks, a sense of social justice among MSM, and facilitated the development of personalised HIV prevention menus by the participants. We observed increases in HIV testing (from 4% to 17%) and increases in the relative frequency of condom use for anal, oral, and vaginal sex. The programme served as an example of a successfully implemented culturally grounded intervention that has the potential to increase HIV and STI awareness and prevention among MSM in Ghana and other highly stigmatised environments.
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Affiliation(s)
- Gamji M’Rabiu Abubakari
- Yale AIDS Prevention Program (Y-APT), Center for Interdisciplinary Research on AIDS, School of Public Health/Medicine, Yale University, New Haven, CT
| | - LaRon E. Nelson
- School of Nursing, Yale University, New Haven CT, USA
- Centre for Interdisciplinary Research on AIDS, Yale University, New Haven CT, USA
- Yale Institute of Global Health, Yale University, New Haven CT, USA
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto ON, Canada
| | | | | | | | - Apondi Odhiambo
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Ting Sa
- Department of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Centre, Cincinnati OH, USA
| | - Nanhua Zhang
- Faculty of Health Sciences, York University, Toronto ON, Canada
| | - Ironyah Ngozi
- Faculty of Nursing, University of Saskatchewan, Prince Albert SK, Canada
| | - Adjei Scott
- Faculty of Nursing, University of Saskatchewan, Prince Albert SK, Canada
| | - Geoffrey Maina
- Faculty of Nursing, University of Saskatchewan, Prince Albert SK, Canada
| | - Adom Manu
- School of Public Health, University of Ghana, Legon, Ghana
| | - Kwasi Torpey
- School of Public Health, University of Ghana, Legon, Ghana
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Rhodes SD, Mann-Jackson L, Alonzo J, Nall J, Simán FM, Song EY, Garcia M, Tanner AE, Eng E. Harnessing "Scale-Up and Spread" to Support Community Uptake of the HoMBReS por un Cambio Intervention for Spanish-Speaking Men: Implementation Science Lessons Learned by a CBPR Partnership. Am J Mens Health 2021; 14:1557988320938939. [PMID: 32659149 PMCID: PMC7359643 DOI: 10.1177/1557988320938939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Latinx men in the southern United States are affected disproportionately by HIV and other sexually transmitted infections (STIs). However, few evidence-based prevention interventions exist to promote health equity within this population. Developed by a well-established community-based participatory research partnership, the HoMBReS por un Cambio intervention decreases sexual risk among Spanish-speaking, predominately heterosexual Latinx men who are members of recreational soccer teams in the United States. Scale-up and spread, an implementation science framework, was used to study the implementation of this evidence-based community-level intervention within three community organizations that represent typical community-based providers of HIV and STI prevention interventions (i.e., an AIDS service organization, a Latinx-serving organization, and a county public health department). Archival and interview data were analyzed, and 24 themes emerged that mapped onto the 12 scale-up and spread constructs. Themes included the importance of strong and attentive leadership, problem-solving challenges early, an established relationship between innovation developers and implementers, organizational capacity able to effectively work with men, trust building, timelines and incremental deadlines, clear and simple guidance regarding all aspects of implementation, appreciating the context (e.g., immigration-related rhetoric, policies, and actions), recognizing men’s competing priorities, and delineated supervision responsibilities. Scale-up and spread was a useful framework to understand multisite implementation of a sexual risk reduction intervention for Spanish-speaking, predominately heterosexual Latinx men. Further research is needed to identify how constructs, like those within scale-up and spread, affect the process across the implementation continuum, given that the uptake and implementation of an innovation is a process, not an event.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Program in Community Engagement, Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Program in Community Engagement, Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Program in Community Engagement, Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jennifer Nall
- Carolina Family Health Centers, Inc, Wilson, NC, USA
| | | | - Eunyoung Y Song
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Program in Community Engagement, Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Amanda E Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Eugenia Eng
- Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
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Bammann K, Recke C, Albrecht BM, Stalling I, Doerwald F. Promoting Physical Activity Among Older Adults Using Community-Based Participatory Research With an Adapted PRECEDE-PROCEED Model Approach: The AEQUIPA/OUTDOOR ACTIVE Project. Am J Health Promot 2020; 35:409-420. [PMID: 33267636 PMCID: PMC8010898 DOI: 10.1177/0890117120974876] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The PRECEDE-PROCEED model (PPM) is a community-based participatory research (CBPR) framework for health promotion, yet the direct application of the PPM into practice is unclear. This paper describes how the PPM was adapted for the development and application of a pilot intervention study to promote outdoor physical activity (PA) in older adults (OUTDOOR ACTIVE). We illustrate the steps and adaptations we applied to put the PPM into practice and present the developed interventions. DESIGN The PPM was adapted by incorporating a socio-ecological model. This ensured the design of any resultant intervention would explicitly address multi-level determinants of physical activity. The list of possible program components to select from for the design of an intervention was also extended. SETTING Bremen, Germany. PARTICIPANTS Participants in the intervention development were 924 noninstitutionalized older adults, aged 65-75 years (response: 25.2%), living in Bremen-Hemelingen, Germany. For implementation of the intervention and to ensure sustainability, several groups of stakeholders were involved throughout the process. METHODS A mixed method design was employed (e.g., focus groups, quantitative survey) to identify determinants. A round table and participatory workshops were held to involve the target group and community stakeholders in the design of an intervention using the adapted PPM model. RESULTS A conceptual model was developed illustrating the integration of a socio-ecological model into the PPM. The model received ecological validity, as it was affirmed by community stakeholders as an appropriate method for designing a community-level PA intervention. Target goals to address PA determinants were selected by target group members. An intervention to meet the goals was developed and implemented with target group input. CONCLUSION The adapted PPM is a promising starting point for developing multi-level interventions. Steps should be taken to ensure all social groups are participating in the process and all levels of determinants are addressed.
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Affiliation(s)
- Karin Bammann
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Carina Recke
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Birte Marie Albrecht
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Imke Stalling
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Friederike Doerwald
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
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Sexual Health, HIV Care and Pre-exposure Prophylaxis in the African Immigrant Population: A Needs Assessment. J Immigr Minor Health 2020; 22:134-144. [PMID: 30859481 DOI: 10.1007/s10903-019-00873-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objective was to gain insight, from the perspective of healthcare professionals, non-medical service providers and community-based organizations working with a large majority of African immigrant patients or clients, regarding sexual health and the potential for the use of HIV PrEP in this priority population. Thirty key informants participated in a needs assessment. A questionnaire was used to obtain information through focus groups, structured interviews and by self-administration. There are cultural and linguistic barriers to engaging Africans in discussing sexual health issues. Key challenges to uptake of PrEP are multi-dimensional: socioeconomic [immigration status, housing]; cultural [talking about sex 'taboo', HIV related stigma, no concept of preventive care]; provider-related (cultural competency, inadequate PrEP education, language barrier); and individual (lack of awareness, perception of HIV risk). Meeting basic needs like housing, assuring access to care (including PrEP), community-based education, relevant training of providers, and tailored messaging are strongly recommended. Effectively addressing HIV incidence in the African-born immigrant population redonequires a multi-pronged approach.
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Cunningham-Erves J, Barajas C, Mayo-Gamble TL, McAfee CR, Hull PC, Sanderson M, Canedo J, Beard K, Wilkins CH. Formative research to design a culturally-appropriate cancer clinical trial education program to increase participation of African American and Latino communities. BMC Public Health 2020; 20:840. [PMID: 32493245 PMCID: PMC7268329 DOI: 10.1186/s12889-020-08939-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/17/2020] [Indexed: 01/24/2023] Open
Abstract
Background Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program. Methods We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An iterative-deductive approach was used to analyze focus group data. Qualitative data from advisory groups and community members were compiled and used to finalize the program. Results Focus group themes were: 1) Community Perspectives on Overall Presentation; 2) Community Opinions and Questions on the Content of the Presentation; 3) Culturally Specific Issues to Participation in Cancer Clinical Trials; 4) Barriers to Clinical Trial Participation; and 5) Perspectives of Community Health Educators. Feedback was documented during reviews by scientific experts and community members with suggestions to ensure cultural appropriateness using peripheral, evidential, linguistic, sociocultural strategies, and constituent-involving. The final program consisted of two versions (English and Spanish) of a culturally-appropriate slide presentation with speaker notes and videos representing community member and researcher testimonials. Conclusions Incorporating multiple community engagement approaches into formative research processes can facilitate the inclusion of multiple community perspectives and enhance the cultural-appropriateness of the programs designed to promote cancer clinical trial participation among African Americans and Latinos.
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Affiliation(s)
- Jennifer Cunningham-Erves
- Department of Internal Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Blvd, Nashville, TN, 37208, USA.
| | - Claudia Barajas
- Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tilicia L Mayo-Gamble
- Department of Health Policy and Community Health, Georgia Southern University, Statesboro, GA, USA
| | - Caree R McAfee
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pamela C Hull
- Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maureen Sanderson
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA
| | - Juan Canedo
- Progreso Community Center, Nashville, TN, USA.,School of Graduate Research Studies, Meharry Medical College, Nashville, TN, USA
| | - Katina Beard
- Matthew Walker Community Health Center, Nashville, TN, USA
| | - Consuelo H Wilkins
- Department of Internal Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Blvd, Nashville, TN, 37208, USA.,Meharry Vanderbilt Alliance, Nashville, TN, USA.,VUMC Office of Health Equity, Vanderbilt University Medical Center, Nashville, TN, USA
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Ornelas IJ, Yamanis TJ, Ruiz RA. The Health of Undocumented Latinx Immigrants: What We Know and Future Directions. Annu Rev Public Health 2020; 41:289-308. [PMID: 32237989 PMCID: PMC9246400 DOI: 10.1146/annurev-publhealth-040119-094211] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Undocumented Latinx immigrants experience unique factors prior to migration, during migration, and after migration that shape their health. Our review summarizes the limited but growing literature highlighting how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect the mental and physical health of undocumented Latinx immigrants. We also discuss how policies and social ties can promote their health. We focus on areas of particular concern, including health care, mental health, and HIV. Future research should use interdisciplinary approaches and intersectional frameworks to understand and address health inequities. Conducting research with undocumented Latinx immigrant communities requires community engagement, assurance of confidentiality, and creative recruitment and retention strategies. Recommendations for public health practice include investing in community health centers and organizations to ensure access to health and social services; presenting results with sufficient contextualization to interpret their generalizability; and advocating for federal-, state-, and local-level policy changes that reduce the negative health consequences associated with being undocumented.
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Affiliation(s)
- India J Ornelas
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
| | - Thespina J Yamanis
- School of International Service, American University, Washington, DC 20016-8071, USA;
| | - Raymond A Ruiz
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
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Adams C. Toward an institutional perspective on social capital health interventions: lay community health workers as social capital builders. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:95-110. [PMID: 31674684 DOI: 10.1111/1467-9566.12992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This article argues that social capital health research should move beyond a mere focus on social cohesion and network perspectives to integrate an institutional approach into the development of social capital health interventions. An institutional perspective, which is unique in its emphasis on linking social capital in addition to the bonding and bridging forms, contextualises social capital, allowing researchers to confront the complexity of social relationships. This perspective allows for the construction of interventions that draw on the resources of diverse actors, particularly the state. One intervention strategy with the potential to create community linkages involves lay community health workers (LCHWs), individuals who are trained to perform a variety of health-related functions but lack a formal professional health education. This article begins with a review of the institutional social capital-building literature. It then goes on to briefly review the social capital and health literature and discuss the state of intervention research. Thereafter, it describes LCHWs and discusses studies that have utilised LCHWs to tackle community health problems. In doing so, this article presents an institutional-based systematic framework for how LCHWs can build social capital, including a discussion of the ways in which LCHWs can successfully promote bonding, bridging and linking social capital.
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Affiliation(s)
- Crystal Adams
- Department of Sociology and Anthropology, Muhlenberg College, Allentown, Pennsylvania, USA
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Kim MH, Ahmed S, Tembo T, Sabelli R, Flick R, Yu X, Mazenga A, Le Blond H, Simon K, Hartig M, Wetzel E, Nyirenda R, Kazembe PN, Mphande M, Mkandawire A, Chitani MJ, Abrams EJ. VITAL Start: Video-Based Intervention to Inspire Treatment Adherence for Life-Pilot of a Novel Video-Based Approach to HIV Counseling for Pregnant Women Living with HIV. AIDS Behav 2019; 23:3140-3151. [PMID: 31410618 PMCID: PMC6803103 DOI: 10.1007/s10461-019-02634-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We developed and piloted a video-based intervention targeting HIV-positive pregnant women to optimize antiretroviral therapy (ART) retention and adherence by providing a VITAL Start (Video-intervention to Inspire Treatment Adherence for Life) before ART. VITAL Start (VS) was grounded in behavior-determinant models and developed through an iterative multi-stakeholder process. Of 306 pregnant women eligible for ART, 160 were randomized to standard of care (SOC), 146 to VS and followed for one-month. Of those assigned to VS, 100% completed video-viewing; 96.5% reported they would recommend VS. Of 11 health workers interviewed, 82% preferred VS over SOC; 91% found VS more time-efficient. Compared to SOC, VS group had greater change in HIV/ART knowledge (p < 0.01), trend towards being more likely to start ART (p = 0.07), and better self-reported adherence (p = 0.02). There were no significant group differences in 1-month retention and pharmacy pill count. VITAL Start was highly acceptable, feasible, with promising benefits to ART adherence.
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Affiliation(s)
- Maria H Kim
- Baylor College of Medicine International Paediatric AIDS Initiative, Texas Children's Hospital, Houston, USA.
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi.
| | - Saeed Ahmed
- Baylor College of Medicine International Paediatric AIDS Initiative, Texas Children's Hospital, Houston, USA
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Tapiwa Tembo
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Rachael Sabelli
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Robert Flick
- Baylor College of Medicine International Paediatric AIDS Initiative, Texas Children's Hospital, Houston, USA
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Xiaoying Yu
- University of Texas Medical Branch at Galveston, Galveston, USA
| | - Alick Mazenga
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | | | - Katie Simon
- Baylor College of Medicine International Paediatric AIDS Initiative, Texas Children's Hospital, Houston, USA
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Miriam Hartig
- Baylor College of Medicine International Paediatric AIDS Initiative, Texas Children's Hospital, Houston, USA
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Elizabeth Wetzel
- Baylor College of Medicine International Paediatric AIDS Initiative, Texas Children's Hospital, Houston, USA
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Rose Nyirenda
- HIV Unit, Malawi Ministry of Health, Lilongwe, Malawi
| | - Peter N Kazembe
- Baylor College of Medicine International Paediatric AIDS Initiative, Texas Children's Hospital, Houston, USA
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Mtisunge Mphande
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Angella Mkandawire
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Mike J Chitani
- Baylor College of Medicine - Abbott Fund Children's Clinical Centre of Excellence, Private bag B-397, Lilongwe 3, Malawi
| | - Elaine J Abrams
- ICAP at Columbia, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York, USA
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11
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Fernandez SB, Howard M, Hospital M, Morris SL, Wagner EF. Hispanic Students' Perceptions About HIV/STI Testing and Prevention: A Mixed-Methods Study in a Hispanic-Serving University. Health Promot Pract 2018; 20:742-750. [PMID: 30253668 DOI: 10.1177/1524839918801590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hispanic young adults in the United States are disproportionately affected by HIV and should be considered a priority for prevention efforts. The purpose of this study was to explore perceptions and beliefs of English-speaking students (aged 18-24 years) at a Hispanic-serving university about HIV/sexually transmitted infection (STI) testing and prevention to increase acceptance and adoption of services. Four major themes emerged from four qualitative focus groups (n = 30 students) and were corroborated by an optional anonymous survey (n = 24 surveys): (a) preferences for HIV/STI testing services, (b) essential HIV/STI testing information, (c) preferred delivery method of HIV/STI testing information, and (d) culturally appropriate message design with Hispanic young adults. Findings suggest that Hispanic young adults perceive accessible testing to be important to their community and view normalization of these services as a necessary component of successful adoption and adherence. Although flyers were reported as a practical means for distributing on-campus testing and service information, social media was endorsed as one of the most effective ways to reach young adults. Among participants, there was less consensus regarding the need for cultural tailoring. Results provide practical insights into the development and application of health promotion strategies with an ethnic minority group and demonstrate how a mixed-methods approach can be employed to inform health promotional efforts.
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Affiliation(s)
- Sofia B Fernandez
- 1 Community Based Research Institute, Florida International University, Miami, FL, USA
| | - Melissa Howard
- 1 Community Based Research Institute, Florida International University, Miami, FL, USA
| | - Michelle Hospital
- 1 Community Based Research Institute, Florida International University, Miami, FL, USA
| | - Staci Leon Morris
- 1 Community Based Research Institute, Florida International University, Miami, FL, USA
| | - Eric F Wagner
- 1 Community Based Research Institute, Florida International University, Miami, FL, USA
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Patel VV, Ginsburg Z, Golub SA, Horvath KJ, Rios N, Mayer KH, Kim RS, Arnsten JH. Empowering With PrEP (E-PrEP), a Peer-Led Social Media-Based Intervention to Facilitate HIV Preexposure Prophylaxis Adoption Among Young Black and Latinx Gay and Bisexual Men: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e11375. [PMID: 30154071 PMCID: PMC6134229 DOI: 10.2196/11375] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 11/15/2022] Open
Abstract
Background Young black and Latinx, gay, bisexual, and other men who have sex with men (YBLGBM, aged 18-29 years) have among the highest rates of new HIV infections in the United States and are not consistently reached by existing prevention interventions. Preexposure prophylaxis (PrEP), an oral antiretroviral regimen taken daily by HIV-uninfected individuals to prevent HIV acquisition, is highly efficacious in reducing HIV acquisition and could help stop the HIV epidemic in YBLGBM. Use of social media (eg, Facebook, Twitter, online dating sites) is ubiquitous among young people, providing an efficient avenue to engage YBLGBM to facilitate PrEP adoption. Objective Our overall goal was to develop and pilot test a theoretically grounded, social media–based, peer-led intervention to increase PrEP uptake in YBLGBM. We used diffusion of innovation and information-motivation-behavioral skills frameworks to (1) identify potential factors associated with interest in and adoption of PrEP among YBLGBM; (2) develop Empowering with PrEP (E-PrEP), a social media–based, peer-led intervention to increase PrEP uptake in YBLGBM; and (3) pilot test the feasibility and acceptability of E-PrEP, and determine its preliminary efficacy for increasing adoption of PrEP by YBLGBM. We describe the development and protocol for E-PrEP. Methods Using a participatory research approach, we partnered with YBLGBM intervention development partners to develop a social media–based behavioral intervention to facilitate PrEP uptake, which involved an online messaging campaign disseminated by YBLGBM peer leaders to their existing online networks. We designed the 6-week campaign to provide education about PrEP, increase motivation to use PrEP, and facilitate access to PrEP. We then conducted a cluster-randomized trial of E-PrEP compared with an attention-matched general health control condition (E-Health) among YBLGBM aged 18 to 29 years to assess E-PrEP’s feasibility, acceptability, preliminary efficacy for increasing self-reported intention to use PrEP, PrEP uptake, and impact on knowledge and attitudes about PrEP at 12-week follow-up (6 weeks after the end of the online campaign). Results From October 2016 to March 2017, we developed, pretested, and refined E-PrEP with 6 YBLGBM intervention development partners. From May to June 2017, we recruited, enrolled, and randomly assigned 10 peer leaders (n=5 for each condition). The 10 peer leaders then recruited and enrolled 152 participants from their existing online networks (range 3-33 per peer leader), during June and July 2017. Intervention follow-up was completed after 12 weeks, in November 2017, with analyses underway. Conclusions We hypothesize that, compared with E-Health, participants randomly assigned to E-PrEP will be more likely to express intention to use PrEP and greater PrEP uptake, and will also show changes in potential mediators of PrEP uptake (knowledge, attitudes, stigma, and access). A Web-based biobehavioral intervention model such as E-PrEP could be rapidly scaled even with limited resources and have significant population-level impact. Trial Registration ClinicalTrials.gov NCT03213366; https://clinicaltrials.gov/ct2/show/NCT03213366 (Archived by WebCite at http://www.webcitation.org/71onSdcXY) Registered Report Identifier RR1-10.2196/11375
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Affiliation(s)
- Viraj V Patel
- Division of General Internal Medicine, Department of Medicine, Montefiore Health System / Albert Einstein College of Medicine, Bronx, NY, United States
| | - Zoë Ginsburg
- Department of Family Medicine, Swedish Cherry Hill Campus, Swedish Medical Center, Seattle, WA, United States
| | - Sarit A Golub
- Hunter HIV/AIDS Research Team, Department of Psychology, Hunter College, City University of New York, New York, NY, United States
| | - Keith J Horvath
- Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Nataly Rios
- Division of General Internal Medicine, Department of Medicine, Montefiore Health System / Albert Einstein College of Medicine, Bronx, NY, United States
| | - Kenneth H Mayer
- The Fenway Institute, Boston, MA, United States.,Infectious Disease Fellowship, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Ryung S Kim
- Division of General Internal Medicine, Department of Medicine, Montefiore Health System / Albert Einstein College of Medicine, Bronx, NY, United States
| | - Julia H Arnsten
- Division of General Internal Medicine, Department of Medicine, Montefiore Health System / Albert Einstein College of Medicine, Bronx, NY, United States
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From Structural Analysis to Pragmatic Action: The Meso-level Modifiable Social Determinants of HIV Vulnerability for Labor Migrants. SOCIAL ASPECTS OF HIV 2018. [DOI: 10.1007/978-3-319-63522-4_2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Rhodes SD, Mann-Jackson L, Alonzo J, Simán FM, Vissman AT, Nall J, Abraham C, Aronson RE, Tanner AE. Engaged for Change: A Community-Engaged Process for Developing Interventions to Reduce Health Disparities. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2017; 29:491-502. [PMID: 29283276 PMCID: PMC5798238 DOI: 10.1521/aeap.2017.29.6.491] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The science underlying the development of individual, community, system, and policy interventions designed to reduce health disparities has lagged behind other innovations. Few models, theoretical frameworks, or processes exist to guide intervention development. Our community-engaged research partnership has been developing, implementing, and evaluating efficacious interventions to reduce HIV disparities for over 15 years. Based on our intervention research experiences, we propose a novel 13-step process designed to demystify and guide intervention development. Our intervention development process includes steps such as establishing an intervention team to manage the details of intervention development; assessing community needs, priorities, and assets; generating intervention priorities; evaluating and incorporating theory; developing a conceptual or logic model; crafting activities; honing materials; administering a pilot, noting its process, and gathering feedback from all those involved; and editing the intervention based on what was learned. Here, we outline and describe each of these 13 steps.
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Affiliation(s)
- Scott D. Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Aaron T. Vissman
- Center for Health and Human Services Research, Talbert House, Cincinnati, OH
| | - Jennifer Nall
- Forsyth County Department of Public Health, Winston-Salem, NC
| | | | | | - Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC
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Murray A, Gaul Z, Sutton MY, Nanin J. "We hide…": Perceptions of HIV Risk Among Black and Latino MSM in New York City. Am J Mens Health 2017; 12:180-188. [PMID: 29161954 PMCID: PMC5818124 DOI: 10.1177/1557988317742231] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Black and Latino men who have sex with men (BLMSM) are disproportionately infected with HIV; they comprised 66% of HIV diagnoses among men who have sex with men (MSM) in the United States in 2015. Risk factors for HIV infection among BLMSM include a high community prevalence of diagnosed and undiagnosed HIV/STDs, and dense sex partner networks. Perceptions of HIV risk among BLMSM were explored to inform HIV prevention efforts. During 2011-2012, semistructured interviews were conducted with BLMSM in New York City. Using computer-assisted thematic analyses (NVivo), transcribed interview responses to questions regarding HIV risk for main themes were examined. Interview data were available for 108 BLMSM: 86% Black, 13% Latino, 26% aged 18-24 years, 59% self-identified as "gay," and 33% self-identified as "bisexual." The main emergent theme was stigma. Subthemes related to stigma included: (a) homophobia in the Black and Latino community, (b) fear of losing support from family and friends, and (c) lack of support leading to low self-esteem. Addressing the stigma felt by BLMSM may be an important strategy to facilitate improved HIV prevention efforts, HIV care and treatment, and to decrease HIV-related disparities.
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Affiliation(s)
- Ashley Murray
- 1 Division of HIV/AIDS Prevention, NCHHSTP, CDC, Atlanta, GA, USA
| | - Zaneta Gaul
- 1 Division of HIV/AIDS Prevention, NCHHSTP, CDC, Atlanta, GA, USA.,2 ICF, Atlanta, GA, USA
| | | | - Jose Nanin
- 3 Kingsborough Community College, CUNY, New York, NY, USA
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16
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Daniel-Ulloa J, Sun C, Rhodes SD. The intersection between masculinity and health among rural immigrant Latino men. INTERNATIONAL JOURNAL OF MEN'S HEALTH 2017; 16:84-95. [PMID: 29422781 PMCID: PMC5798237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Latino men experience health disparities in STI/HIV, diabetes, hypertension, and cancer. Gender roles likely play a role in risk behaviors and outcomes; however, there has been little focus on masculinity in Latino men. We conducted 20 semi-structured interviews with Latino men living in North Carolina. The interviews, conducted by a trained bilingual/bicultural Latino male, prompted discussion around work, family, and stress. Four themes were identified: masculine roles of being a family provider and protector, sources of stress, family responsibility and interconnectedness to health, and coping mechanism. For Latino men, masculinity may have both positive and negative influences on health. For example, the role of family provider may contribute to coping and be a stressor simultaneously. Future research should examine masculinity as a positive and a negative health influence and the additional impacts of gender roles on mens' health.
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Affiliation(s)
- Jason Daniel-Ulloa
- Department of Community and Behavioral Health, University of Iowa and the University of Iowa Prevention Research Center, Iowa City, IA
| | - Christina Sun
- School of Community Health. Portland State University, Portland, OR
| | - Scott D Rhodes
- Department of Social Sciences and Health Policy and Clinical and Translational Science Institutes Program in Community Engagement, Wake Forest University, Winston-Salem, NC
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17
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Alonzo J, Mann L, Tanner AE, Sun CJ, Painter TM, Freeman A, Reboussin BA, Song E, Rhodes SD. Reducing HIV risk among Hispanic/Latino men who have sex with men: Qualitative analysis of behavior change intentions by participants in a small-group intervention. ACTA ACUST UNITED AC 2016; 7. [PMID: 27468361 DOI: 10.4172/2155-6113.1000572] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The southeastern United States has the fastest-growing Hispanic/Latino population in the country and carries a disproportionate HIV burden. Among Hispanics/Latinos, men, and men who have sex with men (MSM) in particular, are at elevated risk of HIV infection; however, very few efficacious behavioral HIV prevention interventions are available for use with this vulnerable population. To address this shortage of prevention resources, our community-based participatory research (CBPR) partnership developed and is currently evaluating the efficacy of the HOLA en Grupos intervention to increase condom use and HIV testing among Hispanic/Latino MSM. METHODS We recruited 304 Hispanic/Latino MSM who were randomized to receive the small group HOLA en Grupos intervention that was implemented during four 4-hour long sessions over four consecutive Sundays, or a 4-session small group general health education comparison intervention. At the end of the fourth session of the HOLA en Grupos intervention, the intervention facilitators asked participants to write down the sexual health-related behaviors they intended to change as a result of their participation. RESULTS Qualitative analysis of the participants' responses identified six types of intended behavior changes: increasing and maintaining condom use; identifying strategies to support correct and consistent condom use; increasing communication and negotiation with sexual partners about condom use; getting tested for HIV and other sexually transmitted infections; applying other sexual health promotion strategies; and sharing newly learned sexual health information with their peers. CONCLUSION Most risk-reduction intentions aligned with the intervention's key messages of using condoms consistently and getting tested for HIV. However, participants' stated intentions may have also depended on which behavior changes they perceived as most salient after participating in the intervention. Participants' intentions to share information with their peers may result in elements of the intervention content reaching others within their social networks, and potentially contributing to a broader community-level impact.
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Affiliation(s)
- Jorge Alonzo
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-713-5048
| | - Lilli Mann
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-716-7441
| | - Amanda E Tanner
- University of North Carolina at Greensboro, Department of Public Health Education, Greensboro, NC, USA; ; Tel: 336-334-5389
| | - Christina J Sun
- Portland State University, School of Community Health, OR, USA; ; Tel: 503-725-3616
| | - Thomas M Painter
- Prevention Research Branch Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA, USA; ; Tel: 404-639-6113
| | - Arin Freeman
- Prevention Research Branch Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta GA, USA; ; Tel: 404-639-8432
| | - Beth A Reboussin
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-713-5213
| | - Eunyoung Song
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA; ; Tel: 336-716-9280
| | - Scott D Rhodes
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Winston-Salem, NC, USA 27157; ; Tel: 336-713-5080
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18
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Evans JMM, Ryde G, Jepson R, Gray C, Shepherd A, Mackison D, Ireland AV, McMurdo MET, Williams B. Accessing and engaging women from socio-economically disadvantaged areas: a participatory approach to the design of a public health intervention for delivery in a Bingo club. BMC Public Health 2016; 16:345. [PMID: 27090081 PMCID: PMC4836085 DOI: 10.1186/s12889-016-3013-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/08/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Our aim was to use participatory methods to investigate the feasibility and acceptability of using Bingo clubs for the design and delivery of an evidence-based physical activity and/or healthy eating intervention to socio-economically disadvantaged women. This paper describes the participatory process that has resulted in a physical activity intervention for women aged >55 years, ready for pilot-testing in a Bingo club setting. METHODS Studies using different quantitative and qualitative approaches were conducted among customers and staff of a Bingo club in a city of 85,000 inhabitants in central Scotland. These were designed to take the views of different stakeholders into account, with a view to enhancing uptake, engagement and effectiveness with any proposed intervention. RESULTS Sixteen relevant studies were identified in a literature review that generated ideas for intervention components. A questionnaire completed by 151 women in the Bingo club showed that almost half (47 %) aged >55 years were not meeting physical activity guidelines; evidence backed up by accelerometer data from 29 women. Discussions in six focus groups attended by 27 club members revealed different but overlapping motivations for attending the Bingo club (social benefits) and playing Bingo (cognitive benefits). There was some scepticism as to whether the Bingo club was an appropriate setting for an intervention, and a dietary intervention was not favoured. It was clear that any planned intervention needed to utilise the social motivation and habitual nature of attendance at the Bingo club, without taking women away from Bingo games. These results were taken forward to a 5-h long participative workshop with 27 stakeholders (including 19 Bingo players). Intervention design (form and content) was then finalised during two round table research team meetings. CONCLUSIONS It was possible to access and engage with women living in areas of socio-economic disadvantage through a Bingo club setting. A physical activity intervention for women >55 years is realistic for recruitment, will address the needs of potential recipients in the Bingo club, appears to be feasible and acceptable to club members and staff, and has been designed with their input. A pilot study is underway, investigating recruitment, retention and feasibility of delivery.
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Affiliation(s)
- Josie M. M. Evans
- />School of Health Sciences, University of Stirling, Stirling, FK9 4LA Scotland, UK
| | - Gemma Ryde
- />School of Health Sciences, University of Stirling, Stirling, FK9 4LA Scotland, UK
| | - Ruth Jepson
- />Scottish Collaboration for Public Health Research and Policy, 20 West Richmond St, EH8 9DX Edinburgh, UK
| | - Cindy Gray
- />Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS UK
| | - Ashley Shepherd
- />School of Health Sciences, University of Stirling, Stirling, FK9 4LA Scotland, UK
| | | | - Aileen V. Ireland
- />School of Health Sciences, University of Stirling, Stirling, FK9 4LA Scotland, UK
| | - Marion E. T. McMurdo
- />Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY UK
| | - Brian Williams
- />School of Health Sciences, University of Stirling, Stirling, FK9 4LA Scotland, UK
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Martinez O, Wu E, Levine EC, Muñoz-Laboy M, Fernandez MI, Bass SB, Moya EM, Frasca T, Chavez-Baray S, Icard LD, Ovejero H, Carballo-Diéguez A, Rhodes SD. Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples. PLoS One 2016; 11:e0152361. [PMID: 27028873 PMCID: PMC4814093 DOI: 10.1371/journal.pone.0152361] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/14/2016] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM), who face a disproportionately high risk of HIV acquisition. MATERIALS AND METHODS We collaborated with Latino male couples and providers to adapt Connect 'n Unite, an evidence-based intervention for Black male couples, for Latino male couples. We conducted a series of three focus groups, each with two cohorts of couples, and one focus group with providers. A purposive stratified sample of 20 couples (N = 40, divided into two cohorts) and 10 providers provided insights into how to adapt and integrate social, cultural, and biomedical approaches in a couples-based HIV/AIDS behavioral intervention. RESULTS The majority (N = 37) of the couple participants had no prior knowledge of the following new biomedical strategies: non-occupational post-exposure prophylaxis (nPEP); pre-exposure prophylaxis (PrEP); and HIV self-testing kits. After they were introduced to these biomedical interventions, all participants expressed a need for information and empowerment through knowledge and awareness of these interventions. In particular, participants suggested that we provide PrEP and HIV self-testing kits by the middle or end of the intervention. Providers suggested a need to address behavioral, social and structural issues, such as language barriers; and the promotion of client-centered approaches to increase access to, adaptation of, and adherence to biomedical strategies. Corroborating what couple participants suggested, providers agreed that biomedical strategies should be offered after providing information about these tools. Regarding culturally sensitive and responsive approaches, participants identified stigma and discrimination associated with HIV and sexual identity as barriers to care, language barriers and documentation status as further barriers to care, the couple-based approach as ideal to health promotion, and the need to include family topics in the intervention. DISCUSSION We successfully adapted an evidence-based behavioral HIV prevention intervention for Latino male couples. The adapted intervention, called Conectando Latinos en Pareja, integrates social, cultural, behavioral and biomedical strategies to address the HIV epidemic among Latino MSM. The study highlights the promise regarding the feasibility of implementing a combination approach to HIV prevention in this population.
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Affiliation(s)
- Omar Martinez
- School of Social Work, College of Public Health, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Elwin Wu
- School of Social Work, Columbia University, New York, New York, United States of America
| | - Ethan C. Levine
- College of Liberal Arts, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Miguel Muñoz-Laboy
- School of Social Work, College of Public Health, Temple University, Philadelphia, Pennsylvania, United States of America
| | - M. Isabel Fernandez
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, United States of America
| | - Sarah Bauerle Bass
- School of Public Health, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Eva M. Moya
- School of Social Work, University of Texas at El Paso, El Paso, Texas, United States of America
| | - Timothy Frasca
- HIV Center for Clinical and Behavioral Studies, Columbia University, New York, New York, United States of America
| | - Silvia Chavez-Baray
- School of Social Work, University of Texas at El Paso, El Paso, Texas, United States of America
| | - Larry D. Icard
- School of Social Work, College of Public Health, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Hugo Ovejero
- Lutheran Family Health Centers, New York, New York, United States of America
| | - Alex Carballo-Diéguez
- HIV Center for Clinical and Behavioral Studies, Columbia University, New York, New York, United States of America
| | - Scott D. Rhodes
- Wake Forest University Medical Center, Winston-Salem, North Carolina, United States of America
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McDavitt B, Bogart LM, Mutchler MG, Wagner GJ, Green HD, Lawrence SJ, Mutepfa KD, Nogg KA. Dissemination as Dialogue: Building Trust and Sharing Research Findings Through Community Engagement. Prev Chronic Dis 2016; 13:E38. [PMID: 26986541 PMCID: PMC4797478 DOI: 10.5888/pcd13.150473] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A fundamental feature of community-based participatory research (CBPR) is sharing findings with community members and engaging community partners in the dissemination process. To be truly collaborative, dissemination should involve community members in a two-way dialogue about new research findings. Yet little literature describes how to engage communities in dialogue about research findings, especially with historically marginalized communities where mistrust of researchers may exist because of past or present social injustices. Through a series of interactive community presentations on findings from a longitudinal study, we developed a process for community dissemination that involved several overlapping phases: planning, outreach, content development, interactive presentations, and follow-up. Through this process, we built on existing and new community relationships. Following each interactive presentation, the research team debriefed and reviewed notes to identify lessons learned from the process. Key themes included the importance of creating a flexible dissemination plan, tailoring presentations to each community group, establishing a point person to serve as a community liaison, and continuing dialogue with community members after the presentations. Core strategies for developing trust during dissemination included engaging community members at every step, reserving ample time for discussion during presentations, building rapport by sharing personal experiences, being receptive to and learning from criticism, and implementing input from community members. This process led to a deeper understanding of research findings and ensured that results reached community members who were invested in them.
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Affiliation(s)
- Bryce McDavitt
- AIDS Project Los Angeles, 611 South Kingsley Dr, Los Angeles, CA 90005. . Dr McDavitt is also affiliated with University of Southern California, Los Angeles, California and Pacifica Graduate Institute, Carpinteria, California
| | - Laura M Bogart
- Boston Children's Hospital, Boston, Massachusetts, Harvard Medical School, Boston, Massachusetts, RAND Corporation, Santa Monica, California
| | - Matt G Mutchler
- AIDS Project Los Angeles, Los Angeles, California, California State University, Dominguez Hills, Carson, California
| | | | | | - Sean Jamar Lawrence
- AIDS Project Los Angeles, Los Angeles, California; Kieta D. Mutepfa, UCLA CARE Center, Los Angeles, California
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Palazzolo SL, Yamanis TJ, De Jesus M, Maguire-Marshall M, Barker SL. Documentation Status as a Contextual Determinant of HIV Risk Among Young Transgender Latinas. LGBT Health 2015; 3:132-8. [PMID: 26669583 DOI: 10.1089/lgbt.2015.0133] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The purpose of this study was to explore the contextual factors that determine or mitigate vulnerability to HIV among Latina transgender women. Documentation status (legal authorization to live in the United States) has been cited by other studies as a barrier to recruitment or engagement in HIV-related care among immigrant Latinos, but not explored as a determinant of HIV risk for transgender immigrant Latinas. METHODS We collaborated with a community-based organization to explore these contextual, including social and structural, factors. In-depth interviews in Spanish captured life histories of eight 18- to 29-year-old transgender Latinas, who collectively self-identify as chicas trans. Codes were assigned deductively from the interview guide, and emerging themes were identified throughout data collection. RESULTS Most participants migrated to the United States from Central America after experiencing discrimination and violence in their countries of origin. Participants emphasized documentation status as a critical factor in three areas related to social and structural determinants of HIV risk: gender identity expression, access to services, and relationship power dynamics. Chicas trans who gained legal asylum reported greater control over sexual relationships, improved access to services, and less risky employment. CONCLUSIONS Documentation status emerged as a key HIV risk factor for this population. For undocumented transgender Latinas, legal asylum appears to be a promising HIV-related protective factor. Further research could assess whether legal assistance combined with wraparound support services affects HIV prevention for this population.
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Affiliation(s)
- Sarah L Palazzolo
- 1 School of International Service, American University , Washington, District of Columbia
| | - Thespina J Yamanis
- 1 School of International Service, American University , Washington, District of Columbia
| | - Maria De Jesus
- 1 School of International Service, American University , Washington, District of Columbia
| | - Molly Maguire-Marshall
- 1 School of International Service, American University , Washington, District of Columbia
| | - Suyanna L Barker
- 2 Community Health Action Department , La Clínica del Pueblo, Washington, District of Columbia
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Documet PI, Macia L, Thompson A, Gonzalez M, Boyzo R, Fox AR, Guadamuz TE. A Male Promotores Network for Latinos: Process Evaluation From a Community-Based Participatory Project. Health Promot Pract 2015; 17:332-42. [PMID: 26463171 DOI: 10.1177/1524839915609059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Lay health advisor (LHA) interventions with Latino men are rare, especially in emerging Latino communities. We present a process evaluation of a male LHA network aiming at connecting Latino men to various kinds of services and to the Latino community. It assesses the feasibility of (1) maintaining a steering coalition; (2) hiring, training, and retaining male LHA; and (3) recruiting and assisting underserved participants. Methods Project management data and LHA debriefings were analyzed qualitatively and compared to a logic model and evaluation table prepared before the project started. Results The community coalition steered the project during its implementation. Eleven men attended the initial LHA training. Two thirds of them reflected the community in educational level. One third did not and required extra mentoring from the other LHA to recruit participants. LHA requested topics for monthly trainings according to their needs in the field, including housing, sexual health, and immigration. LHA enrolled 182 participants. Participants' needs went beyond health issues. Therefore, LHA needed to forge new collaborations with local social service organizations. Conclusions Recruiting male LHA is feasible. LHA and the community coalition can suggest adaptations to fit the local context.
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Affiliation(s)
| | - Laura Macia
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Miguel Gonzalez
- Latino Engagement Group for Salud (LEGS), Pittsburgh, PA, USA
| | - Roberto Boyzo
- Latino Engagement Group for Salud (LEGS), Pittsburgh, PA, USA
| | - Andrea R Fox
- University of Pittsburgh, Pittsburgh, PA, USA Squirrel Hill Health Center, Pittsburgh, PA, USA
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Sun CJ, Mann L, Eng E, Downs M, Rhodes SD. Once a Navegante, Always a Navegante: Latino Men Sustain Their Roles as Lay Health Advisors to Promote General and Sexual Health to Their Social Network. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:465-73. [PMID: 26485235 PMCID: PMC6686176 DOI: 10.1521/aeap.2015.27.5.465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Little is known about the sustainability of male- and men's health-focused lay health advisors. HoMBReS Por un Cambio was a community-level social network intervention designed to improve sexual health among Latino men who were members of soccer teams. During the year after the intervention implementation, lay health advisors (Navegantes) continued to promote sexual health; over 84% (16 of the 19) Navegantes conducted 9 of 10 primary health promotion activities. Describing where to get condoms was the activity that the most Navegantes reported having conducted. Navegantes had broad reach with their social networks, although the number of Navegantes that conducted each activity differed across the categories of social network members (soccer teammates, nonteammates, and women). Results suggest that HIV-related health disparities may be addressed through lay health advisor interventions because they are sustained after the intervention ends and reach large numbers of community members.
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Affiliation(s)
- Christina J Sun
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, and now with the School of Community Health, Portland State University, Portland, Oregon
| | - Lilli Mann
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Eugenia Eng
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Mario Downs
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Scott D Rhodes
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Rhodes SD, Alonzo J, Mann L, Freeman A, Sun CJ, Garcia M, Painter TM. Enhancement of a Locally Developed HIV Prevention Intervention for Hispanic/Latino MSM: A Partnership of Community-Based Organizations, a University, and the Centers for Disease Control and Prevention. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:312-32. [PMID: 26241382 PMCID: PMC4537171 DOI: 10.1521/aeap.2015.27.4.312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral HIV/STD prevention interventions are currently available for use with this vulnerable population. We describe the enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated in North Carolina with support from the Centers of Disease Control and Prevention (CDC). Our intervention enhancement process included incorporating local data on risks and context; identifying community needs and priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If the CDC-sponsored evaluation determines that HOLA en Grupos is efficacious, it will be the first such behavioral HIV/STD prevention intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners.
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Affiliation(s)
- Scott D. Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Lilli Mann
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Arin Freeman
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention
| | - Christina J. Sun
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Manuel Garcia
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Thomas M. Painter
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention
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Anderson LM, Adeney KL, Shinn C, Safranek S, Buckner‐Brown J, Krause LK. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations. Cochrane Database Syst Rev 2015; 2015:CD009905. [PMID: 26075988 PMCID: PMC10656573 DOI: 10.1002/14651858.cd009905.pub2] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Racial and ethnic disparities in health status are pervasive at all stages of the life cycle. One approach to reducing health disparities involves mobilizing community coalitions that include representatives of target populations to plan and implement interventions for community level change. A systematic examination of coalition-led interventions is needed to inform decision making about the use of community coalition models. OBJECTIVES To assess effects of community coalition-driven interventions in improving health status or reducing health disparities among racial and ethnic minority populations. SEARCH METHODS We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index, Dissertation Abstracts, System for Information on Grey Literature in Europe (SIGLE) (from January 1990 through September 30, 2013), and Global Health Library (from January 1990 through March 31, 2014). SELECTION CRITERIA Cluster-randomized controlled trials, randomized controlled trials, quasi-experimental designs, controlled before-after studies, interrupted time series studies, and prospective controlled cohort studies. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population and at least two community public or private organizations are included. Major outcomes of interest are direct measures of health status, as well as lifestyle factors when evidence indicates that these have an effect on the direct measures performed. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias for each study. MAIN RESULTS Fifty-eight community coalition-driven intervention studies were included. No study was considered to be at low risk of bias. Behavioral change outcomes and health status change outcomes were analyzed separately. Outcomes are grouped by intervention type. Pooled effects across intervention types are not presented because the diverse community coalition-led intervention studies did not examine the same constructs or relationships, and they used dissimilar methodological designs. Broad-scale community system level change strategies led to little or no difference in measures of health behavior or health status (very low-certainty evidence). Broad health and social care system level strategies leds to small beneficial changes in measures of health behavior or health status in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions led to beneficial changes in health behavior measures of moderate magnitude in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions may lead to beneficial changes in health status measures in large samples of community residents; however, results were not consistent across studies (low-certainty evidence). Group-based health education led by professional staff resulted in moderate improvement in measures of health behavior (very low-certainty evidence) or health status (low-certainty evidence). Adverse outcomes of community coalition-led interventions were not reported. AUTHORS' CONCLUSIONS Coalition-led interventions are characterized by connection of multi-sectoral networks of health and human service providers with ethnic and racial minority communities. These interventions benefit a diverse range of individual health outcomes and behaviors, as well as health and social care delivery systems. Evidence in this review shows that interventions led by community coalitions may connect health and human service providers with ethnic and racial minority communities in ways that benefit individual health outcomes and behaviors, as well as care delivery systems. However, because information on characteristics of the coalitions themselves is insufficient, evidence does not provide an explanation for the underlying mechanisms of beneficial effects. Thus, a definitive answer as to whether a coalition-led intervention adds extra value to the types of community engagement intervention strategies described in this review remains unattainable.
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Affiliation(s)
- Laurie M Anderson
- University of WashingtonDepartment of Epidemiology, School of Public HealthP.O. Box 357236SeattleWAUSA98195‐7236
| | - Kathryn L Adeney
- Washington State Institute for Public PolicyEpidemiology and Public Health110 Fifth Avenue SE, Suite 214SeattleWAUSA98504
| | - Carolynne Shinn
- New Hampshire Department of Health and Human ServicesNew Hampshire Division of Public Health ServicesConcordNew HampshireUSA03301‐3852
| | - Sarah Safranek
- University of WashingtonHealth Sciences Library1959 NE Pacific StreetSeattleWAUSA98195‐7155
| | - Joyce Buckner‐Brown
- Centers for Disease Control and PreventionNational Center for Chronic Disease Prevention and Health Promotion, Division of Community Health, Research Surveillance & Evaluation Branch4770 Buford Hwy NE, Mailstop K81AtlantaGeorgiaUSA30341
| | - L Kendall Krause
- Bill & Melinda Gates FoundationEpidemiology and Surveillance DivisionSeattleWAUSA
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Wagoner KG, Downs M, Alonzo J, Daniel-Ulloa J, Rhodes SD. Latino men's qualitative perspectives on a lay health advisor intervention to promote their sexual health. HEALTH & SOCIAL CARE IN THE COMMUNITY 2015; 23:304-312. [PMID: 25475213 PMCID: PMC4390418 DOI: 10.1111/hsc.12148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/11/2014] [Indexed: 05/30/2023]
Abstract
Lay health advisor (LHA) approaches are a promising strategy to reduce health disparities among communities considered 'hard to reach' by researchers and practitioners. LHAs have addressed a variety of health issues, but limited studies have included men as LHAs. The purpose of this study was to better understand the roles of male LHAs and their male-helping relationships. We used an inductive approach to explore Latino men's perspectives on serving as LHAs for other Latino men and Latino men's views on receiving sexual health information from a male LHA. We collected qualitative data in 2009 and 2010 as part of an LHA intervention designed to reduce the risk of HIV infection among immigrant Latinos through the social networks of soccer teams. We analysed and interpreted data from 30 in-depth interviews with Latino men who served as LHAs and their social networks in North Carolina, USA. Participants shared perceptions on social network importance for immigrant Latinos, facilitators and challenges of helping other men, recommendations for intervention modification and suggestions for future work involving the Latino community. Findings revealed that Latino men are receptive to fulfilling the roles of health advisors and opinion leaders, and can effectively serve as LHAs. Social network members valued the social support they received. Working through sports teams and identifying existing leaders to be LHAs may be a culturally congruent approach to meeting Latino community needs. More research is needed on the potential of male LHAs to address other health issues.
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Affiliation(s)
- Kim G. Wagoner
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Mario Downs
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Jason Daniel-Ulloa
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Scott D. Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
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Altman L, Kuhlmann AKS, Galavotti C. Understanding the black box: a systematic review of the measurement of the community mobilization process in evaluations of interventions targeting sexual, reproductive, and maternal health. EVALUATION AND PROGRAM PLANNING 2015; 49:86-97. [PMID: 25615599 DOI: 10.1016/j.evalprogplan.2014.11.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 11/08/2014] [Accepted: 11/19/2014] [Indexed: 06/04/2023]
Abstract
Community mobilization (CM) interventions are often used to improve sexual, reproductive, and maternal health (SRMH). This systematic review provides an overview of CM indicators used in evaluation and then focuses on the use of linking constructs-those measures of the process of CM between programmatic outputs and outcomes. We identified 108 English-language articles evaluating 86 CM interventions that target SRMH. Content analysis was used to code CM indicators into five categories: qualitative descriptions of CM; participation, diffusion and community action indicators that measure tangible, programmatic outputs; and linking constructs that capture the process of moving from participation to empowerment. Fifty-five (64.0%) interventions include a CM indicator. Diffusion indicators are most common (56.4%); linking constructs are least common (20.0%). We found 23 linking constructs used in evaluations of 11 interventions, with limited information on psychometric properties available. Three evaluations report positive relationships between linking constructs and condom use, one of which was significant in multivariate analysis. To better understand how CM leads to improved outcomes, we recommend increasing the measurement of linking constructs in evaluations of CM interventions. Research should focus on developing and validating new linking construct indicators and better disseminating existing measurement tools.
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Affiliation(s)
- Lara Altman
- MANILA Consulting Group, Inc., 1420 Beverly Road Suite 220, McLean, VA 22101, USA; CARE USA, 51 Ellis Street, Atlanta, GA 30303, USA.
| | - Anne K Sebert Kuhlmann
- MANILA Consulting Group, Inc., 1420 Beverly Road Suite 220, McLean, VA 22101, USA; George Warren Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA.
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Community-academic partnerships in HIV-related research: a systematic literature review of theory and practice. J Int AIDS Soc 2015; 18:19354. [PMID: 25630823 PMCID: PMC4309828 DOI: 10.7448/ias.18.1.19354] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 11/07/2014] [Accepted: 11/28/2014] [Indexed: 11/23/2022] Open
Abstract
Introduction Community involvement in HIV research has increased over recent years, enhancing community-academic partnerships. Several terms have been used to describe community participation in research. Clarification is needed to determine whether these terms are synonymous or actually describe different research processes. In addition, it remains unclear if the role that communities play in the actual research process follows the recommendations given in theoretical frameworks of community-academia research. Objectives The objective of this study is to review the existing terms and definitions regarding community-academic partnerships and assess how studies are implementing these in relation to conceptual definitions. Methods A systematic literature review was conducted in PubMed. Two reviewers independently assessed each article, applying the following inclusion criteria: the article must be published in English before 2013; it must provide an explicit definition and/or defining methodology for a term describing research with a community component; and it has to refer to HIV or AIDS, reproductive health and/or STDs. When disagreements about the relevance of an article emerged, a third reviewer was involved until concordance was reached. Data were extracted by one reviewer and independently verified by a second. Qualitative data were analyzed using MaxQDA for content and thematic analyses while quantitative data were analyzed using descriptive statistics. Community feedback on data analysis and presentation of results was also incorporated. Results In total, 246 articles were retrieved, 159 of which fulfilled the inclusion criteria. The number of studies that included community participation in the field of HIV research increased between 1991 and 2012, and the terms used to describe these activities have changed, moving away from action research (AR) to participatory action research (PAR), community-based research (CBR) and community-based participatory research (CBPR), with the latter being the most commonly used term. While definitions of all terms had common characteristics (e.g. participation of community in research process), they varied with regard to the emphasis placed on these characteristics. The nature of community participation in reviewed studies differed considerably from that described in theoretical models. Conclusions This study indicates the increase of participatory approaches in HIV research and underlines the need for clarification of terms and a framework providing orientation to community-academia partnerships.
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Concannon TW, Fuster M, Saunders T, Patel K, Wong JB, Leslie LK, Lau J. A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research. J Gen Intern Med 2014; 29:1692-701. [PMID: 24893581 PMCID: PMC4242886 DOI: 10.1007/s11606-014-2878-x] [Citation(s) in RCA: 300] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Revised: 01/16/2014] [Accepted: 04/19/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We conducted a review of the peer-reviewed literature since 2003 to catalogue reported methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. METHODS AND RESULTS We worked with stakeholders before, during and after the review was conducted to: define the primary and key research questions; conduct the literature search; screen titles, abstracts and articles; abstract data from the articles; and analyze the data. The literature search yielded 2,062 abstracts. The review was conducted on 70 articles that reported on stakeholder engagement in individual research projects or programs. FINDINGS Reports of stakeholder engagement are highly variable in content and quality. We found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with stakeholders in other key decision-making groups across the healthcare system. Stakeholder engagement was more common in earlier (prioritization) than in later (implementation and dissemination) stages of research. The roles and activities of stakeholders were highly variable across research and program reports. RECOMMENDATIONS To improve on the quality and content of reporting, we developed a 7-Item Stakeholder Engagement Reporting Questionnaire. We recommend three directions for future research: 1) descriptive research on stakeholder-engagement in research; 2) evaluative research on the impact of stakeholder engagement on the relevance, transparency and adoption of research; and 3) development and validation of tools that can be used to support stakeholder engagement in future work.
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Parrado EA, Flippen CA. Migration, Social Organization, and the Sexual Partners of Mexican Men. SOCIAL PROBLEMS 2014; 61:380-401. [PMID: 26962267 PMCID: PMC4780843 DOI: 10.1525/sp.2014.12262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We build on recent developments in social organization theory to examine the sexual partnering of Mexican men in a new area of immigrant destination. We elaborate on two levels of contextual influence: 1) how differences in social capital between sending and receiving communities affect partner formation and 2) how neighborhood social cohesion influences immigrants' behavior. Data come from an original survey conducted in Durham, NC and migrant sending communities in Mexico. We show dramatic differences in sexual partnering between Mexico and the U.S. that are directly linked to lack of social networks and familial support. Neighborhood level social cohesion in part counteracts those effects. The role of social capital and neighborhoods, however, is highly gendered. The presence of women is a critical dimension of the social organization of immigrant communities and its effect extends beyond mere partner availability.
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Sexual health knowledge and health practices of female sex workers in Liuzhou, China, differ by size of venue. AIDS Behav 2014; 18 Suppl 2:S162-70. [PMID: 23612941 DOI: 10.1007/s10461-013-0474-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We conducted qualitative interviews with 48 female sex workers (FSW) recruited from entertainment venues in Liuzhou, China. Analyses found that HIV knowledge and sexual health seeking strategies differed by size of venue: (1) Women in smaller venues said they douched before/after sex and used condoms with all but their regular partners and clients. Most found the brochures distributed by Chinese CDC workers "irrelevant" or "boring" and relied on friends for health advice. (2) FSW in middle and large venues were less concerned about prevention, claiming their clients were "healthy." They relied more on the Internet for health information and were less concerned about the cost of seeing a doctor. (3) Pregnancies and abortions were frequent, especially among the younger women in large venues. This research documents the need to develop tailored HIV-related messages and prevention strategies with the help of FSW to address differences among FSW working in venues of different sizes.
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Martinez O, Roth AM, Kelle G, Downs M, Rhodes SD. Adaptation and implementation of HoMBReS: a community-level, evidence-based HIV behavioral intervention for heterosexual Latino men in the midwestern United States. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2014; 26:68-80. [PMID: 24450279 PMCID: PMC3987858 DOI: 10.1521/aeap.2014.26.1.68] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Over the past decade, the midwestern United States has witnessed a dramatic increase in its Latino population. The lack of culturally and linguistically congruent resources coupled with high incidence and prevalence rates of HIV among Latinos living in the Midwest merits attention. HoMBReS: Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Wellbeing and Healthy Relationships) is a community-level social network intervention designed for Latino men. We describe the adaptation and implementation of HoMBReS for Latino men living in Indianapolis, Indiana, the second largest city in the Midwest. Five Navegantes (lay health educators) were trained; they provided a total of 34 educational charlas (small group didactic sessions). A total of 270 Latino men attended the charlas and were offered no-cost screening for HIV and sexually transmitted infections (STI). Three participants tested HIV positive and 15 screened positive for STI. The charlas coupled with the testing initiative, served as a successful method to increase sexual health knowledge among Latino men and to link newly-diagnosed HIV/STI-positive individuals to treatment and care. The adaptation and implementation of HoMBReS respond to the CDC and NIH call to increase HIV testing and service provision among vulnerable populations.
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Hirsch JS. Labor migration, externalities and ethics: theorizing the meso-level determinants of HIV vulnerability. Soc Sci Med 2014; 100:38-45. [PMID: 24444837 PMCID: PMC4001245 DOI: 10.1016/j.socscimed.2013.10.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 10/18/2013] [Accepted: 10/21/2013] [Indexed: 11/16/2022]
Abstract
This paper discusses labor migration as an example of how focusing on the meso-level highlights the social processes through which structural factors produce HIV risk. Situating that argument in relation to existing work on economic organization and HIV risk as well as research on labor migration and HIV vulnerabilities, the paper demonstrates how analyzing the processes through which labor migration creates vulnerability can shift attention away from the proximate behavioral determinants of HIV risk and toward the community and policy levels. Further, it presents the concepts of externalities and the ethics of consumption, which underline how both producers and consumers benefit from low-waged migrant labor, and thus are responsible for the externalization of HIV risk characteristic of supply chains that rely on migrant labor. These concepts point to strategies through which researchers and advocates could press the public and private sectors to improve the conditions in which migrants live and work, with implications for HIV as well as other health outcomes.
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Affiliation(s)
- Jennifer S Hirsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States.
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Chang C, Minkler M, Salvatore AL, Lee PT, Gaydos M, Liu SS. Studying and addressing urban immigrant restaurant worker health and safety in San Francisco's Chinatown district: a CBPR case study. J Urban Health 2013; 90:1026-40. [PMID: 23793556 PMCID: PMC3853171 DOI: 10.1007/s11524-013-9804-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
With its emphasis on empowerment, individual and community capacity building, and translating research findings into action, community-based participatory research (CBPR) may be particularly advantageous in work with urban immigrant populations. This paper highlights eight ways in which CBPR has been shown to add value to work with urban underserved communities. It then describes the background, context, and methods of an ecological CBPR project, the Chinatown Restaurant Worker Health and Safety Study, conducted in San Francisco, California, and draws on study processes and outcomes to illustrate each of the eight areas identified. Challenges of using CBPR, particularly with urban immigrant populations, briefly are described, drawing again on the Chinatown study to provide illustrative examples. We discuss lessons learned, through this and other studies, for the effective use of CBPR with urban immigrant populations. We conclude that despite its challenges, this transdisciplinary, community-partnered and action-oriented approach to inquiry can make substantial contributions to both the processes and the outcomes of the research.
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Simonds VW, Christopher S. Adapting Western research methods to indigenous ways of knowing. Am J Public Health 2013; 103:2185-92. [PMID: 23678897 DOI: 10.2105/ajph.2012.301157] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Indigenous communities have long experienced exploitation by researchers and increasingly require participatory and decolonizing research processes. We present a case study of an intervention research project to exemplify a clash between Western research methodologies and Indigenous methodologies and how we attempted reconciliation. We then provide implications for future research based on lessons learned from Native American community partners who voiced concern over methods of Western deductive qualitative analysis. Decolonizing research requires constant reflective attention and action, and there is an absence of published guidance for this process. Continued exploration is needed for implementing Indigenous methods alone or in conjunction with appropriate Western methods when conducting research in Indigenous communities. Currently, examples of Indigenous methods and theories are not widely available in academic texts or published articles, and are often not perceived as valid.
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Affiliation(s)
- Vanessa W Simonds
- Vanessa W. Simonds is with the Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City. Suzanne Christopher is with the Department of Health and Human Development at Montana State University, Bozeman
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Roth A, Fortenberry JD, Van Der Pol B, Rosenberger J, Dodge B, Arno J, Waters J, Certo D, Reece M. Court-based participatory research: collaborating with the justice system to enhance sexual health services for vulnerable women in the United States. Sex Health 2013; 9:445-52. [PMID: 23036783 DOI: 10.1071/sh11170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 05/22/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although jail screening programs have an important role in the diagnosis and treatment of sexually transmissible infections (STI) and HIV among incarcerated individuals, many arrestees are not screened before release. Justice-involved women are at particularly high risk for these conditions because of individual risk behaviour as well as other network-level risk factors. Court-based programs could provide a critical bridge between these women, STI risk counselling and health services. This formative study explored the features of a program that would encourage STI testing among court-involved women. Further, we describe how community-based participatory research principles were adapted for use in a court setting and the resulting justice-public health partnership. METHODS Using semistructured interviews and focus group discussions, we explored issues related to health-seeking behaviours, perceived gaps in services for high-risk women and the components of a court-based screening program. RESULTS Six focus groups were conducted with women with a history of commercial sex work and staff from the court, as well as local organisations providing HIV and social support services for high-risk women. Community-based participatory research (CBPR) principles facilitated development of relevant research questions and equitable processes, and assisted partners to consider individual and sociostructural sources of health disparities. DISCUSSION Although not every principle was applicable in a court setting, the CBPR framework was helpful for building cohesion and support for the project. We provide a description of how CBPR principles were operationalised, describe the key lessons learned and discuss the implications for CBPR projects in a community court.
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Affiliation(s)
- Alexis Roth
- Indiana University School of Medicine, Indianapolis, IN 46202, USA.
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Rhodes SD, Daniel J, Alonzo J, Vissman AT, Duck S, Downs M, Gilbert PA. A snapshot of how latino heterosexual men promote sexual health within their social networks: process evaluation findings from an efficacious community-level intervention. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2012; 24:514-526. [PMID: 23206201 PMCID: PMC3959878 DOI: 10.1521/aeap.2012.24.6.514] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Hombres Manteniendo Bienestar y Relaciones Saludables (HoMBReS) was a community-level social network intervention designed to increase sexual health among Latino heterosexual men who were members of a multicounty soccer league. Process data were collected each month during 18 months of intervention implementation from each of 15 trained Latino male lay health advisors (known as Navegantes) to explore the activities that Navegantes conducted to increase condom and HIV testing among their social network members. The Navegantes reported conducting 2,364 activities, for a mean of 8.8 activities per Navegante per month. The most common activity was condom distribution. Most activities were conducted with men; about 2% were conducted with women. Among activities conducted with men, half were conducted with soccer teammates and half with nonteammates. Results suggest that Latino men's social networks can be leveraged to promote sexual health within the community. Innovative methods that reach large numbers of community members are needed given the lack of prevention resources for populations disproportionately impacted by HIV and STDs.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157-1063, USA.
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Otiniano AD, Carroll-Scott A, Toy P, Wallace SP. Supporting Latino communities' natural helpers: a case study of promotoras in a research capacity building course. J Immigr Minor Health 2012; 14:657-63. [PMID: 21901447 DOI: 10.1007/s10903-011-9519-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Promotores have unique access to underserved and hard-to-reach Latino communities facing health disparities. Although promotores are involved in community change, they rarely receive training that gives them the skills to be partners in research. We present a case study of promotoras who participated in a research capacity building course focused on assessing community health needs. Data comes from course application surveys, follow-up notes, and narratives from qualitative phone interviews of eight promotoras. Content analysis drawing from grounded theory was conducted to identify and describe emerging themes. Four themes emerged as promotoras discussed their experience learning basic research skills and teaching others: (1) challenges, (2) support, (3) building capacity, and (4) using research. Promotores play an important role in the health of Latino communities and are increasingly asked to participate in research processes; however they have few opportunities for training and professional development in this area. Capacity building opportunities for promotores need to be tailored to their needs and provide them with support. Fostering collaboration between promotores and partnering with local community-based organizations can help facilitate needed research skill-building among promotores.
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Rhodes SD, Daniel J, Alonzo J, Duck S, García M, Downs M, Hergenrather KC, Alegría-Ortega J, Miller C, Boeving Allen A, Gilbert PA, Marsiglia FF. A systematic community-based participatory approach to refining an evidence-based community-level intervention: the HOLA intervention for Latino men who have sex with men. Health Promot Pract 2012; 14:607-16. [PMID: 23075504 DOI: 10.1177/1524839912462391] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our community-based participatory research partnership engaged in a multistep process to refine a culturally congruent intervention that builds on existing community strengths to promote sexual health among immigrant Latino men who have sex with men (MSM). The steps were the following: (1) increase Latino MSM participation in the existing partnership, (2) establish an Intervention Team, (3) review the existing sexual health literature, (4) explore needs and priorities of Latino MSM, (5) narrow priorities based on what is important and changeable, (6) blend health behavior theory with Latino MSM's lived experiences, (7) design an intervention conceptual model, (8) develop training modules and (9) resource materials, and (10) pretest and (11) revise the intervention. The developed intervention contains four modules to train Latino MSM to serve as lay health advisors known as Navegantes. These modules synthesize locally collected data with other local and national data; blend health behavior theory, the lived experiences, and cultural values of immigrant Latino MSM; and harness the informal social support Latino MSM provide one another. This community-level intervention is designed to meet the expressed sexual health priorities of Latino MSM. It frames disease prevention within sexual health promotion.
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Corbie-Smith G, Isler MR, Miles MS, Banks B. Community-based HIV clinical trials: an integrated approach in underserved, rural, minority communities. Prog Community Health Partnersh 2012; 6:121-9. [PMID: 22820222 DOI: 10.1353/cpr.2012.0023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Although racial and ethnic minorities have disproportionately high rates of HIV infection, these groups are underrepresented in HIV-related clinical trials. This illustrates the need for more innovation in attempts to engage underrepresented populations in calls for interdisciplinary and translational research. OBJECTIVES Eleven focus groups and 35 interviews were conducted with people living with HIV/AIDS (PLWHA) to explore the perspectives of rural community leaders, service providers, and PLWHA about bringing HIV-related research, including clinical trials, into rural communities. METHODS Over a period of 3 months in spring 2007, we collected qualitative data from three sources: Community leaders, service providers, and PLWHA. Text data were analyzed using the constant comparative method and content analysis techniques of theme identification. RESULTS Respondents want an integrated approach to HIV research that builds trust, meets community needs, and respects their values. They conceptualize HIV research as part of a broader spectrum of HIV testing, prevention, and care, and suggest integrating HIV trials with existing community services, organizations, and structures, engaging various segments of the community, and conducting research using a personal approach. CONCLUSIONS These findings support calls for more relevant, translational, and engaged research. An integrated approach may be an important innovation to transform the research enterprise to meet these goals and more directly improve the health of individuals.
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Affiliation(s)
- Giselle Corbie-Smith
- The Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
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Martinez O, Dodge B, Goncalves G, Schnarrs P, Muñoz-Laboy M, Reece M, Malebranche D, Van Der Pol B, Kelle G, Nix R, Fortenberry JD. Sexual Behaviors and Experiences among Behaviorally Bisexual Latino Men in the Midwestern United States: Implications for Sexual Health Interventions. JOURNAL OF BISEXUALITY 2012; 12:283-310. [PMID: 22685383 PMCID: PMC3368508 DOI: 10.1080/15299716.2012.674865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The Midwestern United States (U.S.) has a high number of recent Latino migrants, but little information is available regarding their sexual behaviors. A total of 75 behaviorally bisexual men (25 Latino, 25 Black, and 25 White) participated in an exploratory study on sexual health. The data presented in this paper are restricted to the 25 self-identified Latino men. Qualitative in-depth interviews were conducted and optional self-administered sexual transmitted infection (STI) screening was provided. The measures used were taken from the National Survey of Sexual Health and Behavior (NSSHB), a probability study of the sexual behaviors of nearly 6000 individuals aged 14-94 in the U.S. In our sample of bisexual men, the most commonly reported sexual behaviors were masturbation, vaginal intercourse, and receiving oral sex from male and female partners. The majority of the participants were the insertive partner during anal sex with male partners. Many of the participants reported alcohol use during their most recent sexual activity. A fair number reported not using condoms during their last sexual event. Pleasure, arousal, orgasm, and erectile functioning were markedly similar despite partner gender. A small number of participants also engaged in sexual activities with transgender individuals. All of the Latino participants took part in the optional self-collection for STI specimens. The results of the study provide rich insights into the sexual behavior and related factors, as well as potential risk behaviors of bisexual Latino men that may be targeted for future sexual health promotion efforts.
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Affiliation(s)
- Omar Martinez
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | - Brian Dodge
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | - Gabriel Goncalves
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | - Phillip Schnarrs
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | - Miguel Muñoz-Laboy
- Columbia University, Department of Sociomedical Sciences, New York, NY, USA
| | - Michael Reece
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | | | - Barbara Van Der Pol
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
- Indiana University, Department of Kinesiology, Bloomington, IN, USA
- Indiana University, Division of Infectious Diseases, Indianapolis, IN, USA
| | - Guadalupe Kelle
- Casa Mateo/Latino Action League, Inc., Indianapolis, IN, USA
| | - Ryan Nix
- Step Up, Inc., Indianapolis, IN, USA
| | - J. Dennis Fortenberry
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
- Indiana University, Division of Adolescent Medicine, Indianapolis, IN, USA
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Using community-based participatory research (CBPR) to develop a community-level HIV prevention intervention for Latinas: a local response to a global challenge. Womens Health Issues 2012; 22:e293-301. [PMID: 22483581 DOI: 10.1016/j.whi.2012.02.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Revised: 02/17/2012] [Accepted: 02/21/2012] [Indexed: 11/21/2022]
Abstract
INTRODUCTION AND BACKGROUND The arsenal of interventions to reduce the disproportionate rates of HIV and sexually transmitted disease (STD) infection among Latinos in the United States lags behind what is available for other populations. The purpose of this project was to develop an intervention that builds on existing community strengths to promote sexual health among immigrant Latinas. METHODS Our community-based participatory research (CBPR) partnership engaged in a multistep intervention development process. The steps were to (1) increase Latina participation in the existing partnership, (2) establish an intervention team, (3) review the existing sexual health literature, (4) explore health-related needs and priorities of Latinas, (5) narrow priorities based on what is important and changeable, (6) blend health behavior theory with Latinas' lived experiences, (7) design an intervention conceptual model, (8) develop training modules and (9) resource materials, and (10) pretest and (11) revise the intervention. RESULTS The MuJEReS intervention contains five modules to train Latinas to serve as lay health advisors (LHAs) known as "Comadres." These modules synthesize locally collected data with other local and national data, blend health behavior theory with the lived experiences of immigrant Latinas, and harness a powerful existing community asset, namely, the informal social support Latinas provide one another. CONCLUSION This promising intervention is designed to meet the sexual health priorities of Latinas. It extends beyond HIV and STDs and frames disease prevention within a sexual health promotion framework. It builds on the strong, preexisting social networks of Latinas and the preexisting, culturally congruent roles of LHAs.
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Sánchez J, Silva-Suarez G, Serna CA, De La Rosa M. The Latino Migrant Worker HIV Prevention Program: building a community partnership through a community health worker training program. FAMILY & COMMUNITY HEALTH 2012; 35:139-46. [PMID: 22367261 PMCID: PMC5636189 DOI: 10.1097/fch.0b013e3182465153] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article describes the Latino Migrant Worker HIV Prevention Program and its efforts to train and engage community health workers in the prevention of HIV among LMWs in South Florida.
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Affiliation(s)
- Jesús Sánchez
- Department of Sociobehavioral and Administrative Pharmacy, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, Florida 33328, USA.
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Hernandez AM, Zule WA, Karg RS, Browne FA, Wechsberg WM. Factors That Influence HIV Risk among Hispanic Female Immigrants and Their Implications for HIV Prevention Interventions. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2012; 2012:876381. [PMID: 22518308 PMCID: PMC3296155 DOI: 10.1155/2012/876381] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 10/13/2011] [Accepted: 10/31/2011] [Indexed: 05/23/2023]
Abstract
Hispanics are the fastest growing minority group in North Carolina with increasing incidence of HIV infection. Gender roles, cultural expectations, and acculturation of women may explain some of Hispanic women's risks. The perspectives of Hispanic female immigrants and community-based providers were sought to identify services they offer, understand HIV risk factors, and support the adaptation of a best-evidence HIV behavioural intervention for Hispanic women. Two sets of focus groups were conducted to explicate risks and the opportunities to reach women or couples and the feasibility to conduct HIV prevention in an acceptable manner. Salient findings were that Hispanic female immigrants lacked accurate HIV/AIDS and STI knowledge and that traditional gender roles shaped issues surrounding sexual behaviour and HIV risks, as well as condom use, partner communication, and multiple sexual partnerships. Intervention implications are discussed such as developing and adapting culturally appropriate HIV prevention interventions for Hispanics that address gender roles and partner communication.
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Affiliation(s)
- Amy M. Hernandez
- Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
| | - William A. Zule
- Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
| | - Rhonda S. Karg
- Behavioral Health Epidemiology Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
| | - Felicia A. Browne
- Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
| | - Wendee M. Wechsberg
- Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
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Vissman AT, Hergenrather KC, Rojas G, Langdon SE, Wilkin AM, Rhodes SD. Applying the theory of planned behavior to explore HAART adherence among HIV-positive immigrant Latinos: elicitation interview results. PATIENT EDUCATION AND COUNSELING 2011; 85:454-460. [PMID: 21208772 DOI: 10.1016/j.pec.2010.12.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 11/14/2010] [Accepted: 12/06/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE This study explored influences on intention to adhere to highly active antiretroviral therapy (HAART) among immigrant Latinos living with HIV/AIDS in the southeastern USA. METHODS Our community-based participatory research (CBPR) partnership completed individual in-depth interviews with 25 immigrant Latinos, based on the theory of planned behavior (TPB), to explore beliefs toward HAART adherence and HIV testing. RESULTS Participants identified (a) seven outcomes of treatment adherence (e.g., "feeling good" and "controlling the virus"), (b) six groups of persons influencing adherence (e.g., family, partner/spouse), and (c) nine impediments to adherence (e.g., appointment scheduling, side effects of treatment). Fear of deportation, perceived costs of services, and barriers to communication emerged as impediments to both HAART adherence and HIV testing. CONCLUSION The findings suggest the utility of TPB in identifying factors to enhance HAART adherence among immigrant Latinos. Future research should explore the extent to which these identified TPB components quantitatively influence adherence intention and immunological and virological outcomes. PRACTICE IMPLICATIONS Culturally congruent interventions for immigrant Latinos may need to focus on facilitators of adherence, influential referent groups, and destigmatizing HIV/AIDS.
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Affiliation(s)
- Aaron T Vissman
- Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Philip EJ, Shelton RC, Erwin DO, Jandorf L. Characteristics of male attendees of health education interventions for Latinos. J Immigr Minor Health 2011; 14:523-32. [PMID: 22075962 DOI: 10.1007/s10903-011-9546-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Latino subgroups in the US often shoulder a greater burden of some common diseases, including cancer. The cultural norm of patriarchy in health-related decision-making has been found to be common among Latinos, and thus male members may be important in the adoption of health practices amongst family members. Demographic information was collected from 488 male attendees (20% of the total sample) as part of a larger randomized trial focused on promoting breast and cervical cancer screening among Latinas in which attendance was open to the entire community. The majority of male attendees were over the age of 40 (62%) and originally from Mexico (39%) or Puerto Rico (25%). Approximately half of attendees reported having no health coverage and living less than 5 years in the United States. Male attendees demonstrated significant increases in knowledge relevant to their group attendance. There were few significant differences between the characteristics of male attendees at a female focused cancer program (intervention) versus more general diabetes program (control). The current study describes characteristics of a group that may be influential in guiding health behaviors and decisions. This information extends our understanding of community participation in health interventions and will assist in the development of effective interventions in the Latino community.
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Affiliation(s)
- Errol J Philip
- Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA.
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A randomized controlled trial of a culturally congruent intervention to increase condom use and HIV testing among heterosexually active immigrant Latino men. AIDS Behav 2011; 15:1764-75. [PMID: 21301948 DOI: 10.1007/s10461-011-9903-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This randomized controlled trial tested the efficacy of an HIV prevention intervention to increase condom use and HIV testing among Spanish-speaking, heterosexually active immigrant Latino men. A community-based participatory research partnership developed the intervention and selected the study design. Following baseline data collection, 142 immigrant Latino men were randomized to the HIV prevention intervention or the cancer education intervention. Three-month follow-up data were collected from 139 participants, for a 98% retention rate. Mean age of participants was 31.6 years and 60% reported being from Mexico. Adjusting for baseline behaviors, relative to their peers in the cancer education comparison, participants in the HIV prevention intervention were more likely to report consistent condom use and receiving an HIV test. Community-based interventions for immigrant Latino men that are built on state of the art prevention science and developed in partnership with community members can greatly enhance preventive behaviors and may reduce HIV infection.
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Esperanza y Vida: training lay health advisors and cancer survivors to promote breast and cervical cancer screening in Latinas. J Community Health 2011; 36:219-27. [PMID: 20711645 DOI: 10.1007/s10900-010-9300-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The use of lay health advisors (LHAs) to promote community-based health education programs is well documented and is considered an effective way to reach underserved communities. Esperanza y Vida (Hope & Life) is an educational outreach program to increase breast and cervical cancer screening for diverse Latinas. It incorporates Latino LHAs (men and women) and cancer survivor role models, sobrevivientes, in the program delivery. An interactive training program, conducted by bilingual staff across three sites (Little Rock, Arkansas; Buffalo, New York and New York City) included 74 sobrevivientes and LHAs who were recruited and trained. All training attendees completed an initial application assessing socio-demographics, experience and availability as well as, true/false surveys at the beginning (pre-) and end of the training (post-) measuring knowledge levels of breast and cervical cancer health. Data analysis indicated a significant increase of both breast and cervical cancer knowledge for attendees trained as LHAs (pre = 60%; post = 80%; p = 0.000), whereas sobrevivientes had a higher baseline knowledge of breast health (74%), and therefore did not show a significant increase following training (79%). However, sobrevivientes did display a significant increase in cervical cancer knowledge (p = 0.003). These findings demonstrate the impact of training and how LHAs may be recruited at different levels of knowledge and experience and be successfully trained in key program elements. Moreover, results indicate that sobrevivientes may be impacted differently, or require variations in training approaches. This information can be useful in developing and customizing curriculum for future lay health training programs.
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Cashman R, Eng E, Simán F, Rhodes SD. Exploring the sexual health priorities and needs of immigrant Latinas in the southeastern United States: a community-based participatory research approach. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2011; 23:236-48. [PMID: 21696242 PMCID: PMC3282155 DOI: 10.1521/aeap.2011.23.3.236] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Latinas living in the United States are disproportionately affected by HIV/AIDS and sexually transmitted infections. However, few effective interventions currently exist that are designed to meet the priorities and needs of recently arrived and less acculturated immigrant Latinas who are settling in the southeastern United States. To identify sexual health priorities, gaps in information and skills, and key intervention characteristics to improve sexual health among immigrant Latinas, a community-based participatory research partnership conducted four focus groups with Latinas, in central North Carolina. Findings revealed a lack of knowledge about sexual health, shame and embarrassment related to clinical exams and conversations about sex, multilevel barriers to sexual health, and disease transmission misinformation. Findings also suggested that interventions should include information about a broad range of sexual and reproductive health topics and skill building. Such interventions could serve to assist in diminishing health disparities experienced among this vulnerable population.
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Affiliation(s)
- Rebecca Cashman
- HealthIntervention Specialist, Center for Health Equity Research, University of Pennsylvania School of Nursing; Claire M. Fagin Hall. 418 Curie Boulevard, Philadelphia, PA 19104-4217 Ph: (617)312-1417
| | - Eugenia Eng
- Professor, Department of Health Behavior and Health Education, University of North Carolina Gillings School of Global Public Health; 360 Rosenau Hall. 135 Dauer Drive, Campus Box 7440 Chapel Hill, NC 27599 Ph: (919)966-3909 Fax: (919)966-2921
| | - Florence Simán
- Directora, Health Programs/Programas de Salud El Pueblo, Inc. 4 N. Blount Street, 2nd floor Raleigh, NC 27601 Ph: (919)835-1525 Fax: (919)825-1526
| | - Scott D. Rhodes
- Associate Professor, Department of Social Sciences and Health Policy, Division of Public Health Sciences; Section on Infectious Diseases, Department of Internal Medicine; The Maya Angelou Center for Health Equity, Wake Forest University School of Medicine. Medical Center Boulevard, Winston-Salem, NC 27157-1063 Ph: (336)713-5080 Fax: (336)716-7554
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Rhodes SD, McCoy TP, Hergenrather KC, Vissman AT, Wolfson M, Alonzo J, Bloom FR, Alegría-Ortega J, Eng E. Prevalence estimates of health risk behaviors of immigrant latino men who have sex with men. J Rural Health 2011; 28:73-83. [PMID: 22236317 DOI: 10.1111/j.1748-0361.2011.00373.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Little is known about the health status of rural immigrant Latino men who have sex with men (MSM). These MSM comprise a subpopulation that tends to remain "hidden" from both researchers and practitioners. This study was designed to estimate the prevalence of tobacco, alcohol, and drug use, and sexual risk behaviors of Latino MSM living in rural North Carolina. METHODS A community-based participatory research (CBPR) partnership used respondent-driven sampling (RDS) to identify, recruit, and enroll Latino MSM to participate in an interviewer-administered behavioral assessment. RDS-weighted prevalence of risk behaviors was estimated using the RDS Analysis Tool. Data collection occurred in 2008. RESULTS A total of 190 Latino MSM was reached; the average age was 25.5 years and nearly 80% reported being from Mexico. Prevalence estimates of smoking everyday and past 30-day heavy episodic drinking were 6.5% and 35.0%, respectively. Prevalence estimates of past 12-month marijuana and cocaine use were 56.0% and 27.1%, respectively. Past 3-month prevalence estimates of sex with at least one woman, multiple male partners, and inconsistent condom use were 21.2%, 88.9%, and 54.1%, respectively. CONCLUSIONS Respondents had low rates of tobacco use and club drug use, and high rates of sexual risk behaviors. Although this study represents an initial step in documenting the health risk behaviors of immigrant Latino MSM who are part of a new trend in Latino immigration to the southeastern United States, a need exists for further research, including longitudinal studies to understand the trajectory of risk behavior among immigrant Latino MSM.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1063, USA.
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