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San Diego ERN, West NT, Pichon LC, Jiang Y, Powell TW, Rugless F, Lewis J, Campbell B, McCann L, McNeals S, Harmon BE. Associations Between Sociodemographic Variables, Social Determinants of Health, and Diabetes: Findings From a Congregational Health Needs Assessment. Am J Health Promot 2024:8901171241234662. [PMID: 38395415 DOI: 10.1177/08901171241234662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
PURPOSE To examine associations between sociodemographic variables, social determinants of health (SDOHs) and diabetes using health needs assessment data. DESIGN Cross-sectional study. SETTING Faith-based communities in the Mid-South U.S. SAMPLE Of the 378 churches, 92 participated in the study (24% response rate); N = 828 church leaders and members completed the survey. MEASURE The Mid-South Congregational Health Survey assessed perceived health-related needs of congregations and the communities they serve. ANALYSIS Generalized linear mixed modeling examined the associations between sociodemographic variables (age, sex, race/ethnicity, educational level), SDOHs (affordable healthcare, healthy food, employment), and diabetes. RESULTS Individuals with less education had lower odds of reporting all SDOHs as health needs compared to individuals with more education (ORrange = .59-.63). Men had lower odds of reporting diabetes as a health need or concern compared to women (OR = .70; 95% CI = .50, .97). African Americans had greater odds of reporting diabetes as a health need compared to individuals in the 'Other' race/ethnicity category (OR = 3.91; 95% CI = 2.20, 6.94). Individuals who reported affordable healthcare (OR = 2.54; 95% CI = 1.73, 3.72), healthy food (OR = 2.24; 95% CI = 1.55, 3.24), and employment (OR = 3.33; 95% CI = 2.29, 4.84) as health needs had greater odds of reporting diabetes as a health need compared to those who did not report these SDOHs as needs. CONCLUSIONS Future studies should evaluate strategies to merge healthcare and faith-based organizations' efforts to address SDOHs impacting diabetes.
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Affiliation(s)
- Emily Rose N San Diego
- Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA, USA
- Scripps Research Translational Institute, Scripps Research, La Jolla, CA, USA
| | - Nathan T West
- Institute of Social and Economic Research, University of Alaska, Anchorage, AK, USA
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, University of Memphis School of Public Health, Memphis, TN, USA
| | - Yu Jiang
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis School of Public Health, Memphis, TN, USA
| | - Terrinieka W Powell
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Fedoria Rugless
- Population Health Department, Amerigroup, Nashville, TN, USA
| | - Jonathan Lewis
- Community Partnerships, Methodist Le Bonheur Healthcare, Memphis, TN, USA
| | - Bettina Campbell
- Oak Hill Regional Community Development Center, Hernando, MS, USA
| | - Lauren McCann
- Le Bonheur Pediatrics, Le Bonheur Children's Hospital, Memphis, TN, USA
| | | | - Brook E Harmon
- Department of Nutrition and Healthcare Management, Appalachian State University, Boone, NC, USA
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West NT, Pichon LC, Ward KD, Rose N San Diego E, Ray M, Rugless F, Powell TW, Campbell B, Lewis JC, McCann L, McNeal S, Harmon BE. Perceived Health Needs of Church Leaders and Members: A Secondary Data Analysis of the Mid-South Congregational Health Survey. Health Promot Pract 2024; 25:96-104. [PMID: 36919279 DOI: 10.1177/15248399231160158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Needs assessments have been successful in helping communities and congregations focus their health ministry efforts; however, most have used leader perceptions of congregational health needs. The purpose of this study was to examine and compare the self-reported needs of both church leaders and members to be addressed by their congregation. Church leaders (n = 369) and members (n = 459) from 92 congregations completed the 2019 Mid-South Congregational Health Survey. Frequencies and generalized linear mixed models (GLMM) were performed to examine the top 10 self-reported needs and associations by church role, respectively. Of the top 10 congregational needs, anxiety or depression, high blood pressure, stress, and healthy foods were ranked identically regardless of church role. Church leaders perceived obesity and diabetes to be important congregational health needs, whereas members perceived affordable health care and heart disease to be important congregational health needs. GLMM, controlling for within-church clustering and covariates, revealed church leaders were more likely than members to report obesity (odds ratio [OR]: 1.93, 95% confidence interval [CI] = [1.39, 2.67], p < .0001) and diabetes (OR: 1.73, 95% CI = [1.24, 2.41], p = .001) as congregational needs. Findings display similarities and differences in needs reported by church role. Including many perspectives when conducting congregational health needs assessments will assist the development of effective faith-based health promotion programs.
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Affiliation(s)
| | | | | | - Emily Rose N San Diego
- Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA, USA
- Scripps Research Translational Institute, Scripps Research, La Jolla, CA, USA
| | | | | | | | - Bettina Campbell
- Oak Hill Regional Community Development Center, Hernando, MS, USA
| | | | | | - Sterling McNeal
- Faith Community Health Ministry Consultant, Memphis, TN, USA
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Lipira LE, Glick JL, German D, Glick SN, Moreno C, Elimam D, Brantley ML, Pichon LC, Barak N, Booth MM, Flynn C, Menza T. Type of Exchange Sex and Associated Behaviors and Outcomes Among Cisgender Men and Women at Increased Risk for HIV via Heterosexual Transmission in Six U.S. Metropolitan Areas. Arch Sex Behav 2023; 52:3313-3327. [PMID: 37612535 DOI: 10.1007/s10508-023-02663-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 07/03/2023] [Accepted: 07/12/2023] [Indexed: 08/25/2023]
Abstract
Exchange sex is associated with sexual risk behaviors and poor outcomes and different types may incur different levels of risk. We assessed risk profiles of different types of exchange sex among non-injecting cisgender men and women who participated in the 2019 National HIV Behavioral Surveillance project at six sites. Six percent of men and 19% of women reported exchange sex in the past year; most engaged in non-commercial exchange sex for drugs/money with smaller percentages reporting formal sex work or non-commercial exchange sex for goods or services other than drugs/money. Exchange sex was associated with sexual risk and prevention behaviors and psychosocial and sexual health outcomes and associations varied by type of exchange sex. Efforts to improve access to STI/HIV testing and PrEP may benefit from tailoring based on type of exchange sex. Findings indicate value in a broader definition of exchange sex with follow-up assessment of exchange sex typology.
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Affiliation(s)
- Lauren E Lipira
- Regional Research Institute, Portland State University, Portland, OR, USA.
- Public Health Division, Oregon Health Authority, 800 NE Oregon St, Portland, OR, 97232, USA.
| | - Jennifer L Glick
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Danielle German
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sara N Glick
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
- HIV/STD Program, Public Health-Seattle & King County, Seattle, WA, USA
| | - Courtney Moreno
- HIV/STD Program, Public Health-Seattle & King County, Seattle, WA, USA
| | - Dena Elimam
- Epidemiology Section, Georgia Department of Public Health, Division of Health Protection, Atlanta, GA, USA
| | - Meredith L Brantley
- HIV/STI/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | | | | | - Colin Flynn
- Maryland Department of Health, Baltimore, MD, USA
| | - Timothy Menza
- Public Health Division, Oregon Health Authority, 800 NE Oregon St, Portland, OR, 97232, USA
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
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Denney MR, Pichon LC, Brantley ML. Violence, Discrimination, Psychological Distress, and HIV Vulnerability Among Men Who Have Sex With Men in Memphis, Tennessee. Am J Mens Health 2023; 17:15579883231163727. [PMID: 36992529 PMCID: PMC10064477 DOI: 10.1177/15579883231163727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Gay, bisexual, and other men who have sex with men (MSM) are disproportionally impacted by HIV. Discrimination, violence, and psychological distress (PD) may influence engagement with HIV prevention services and amplify HIV vulnerability among this priority population. These dynamics are understudied in the Southern United States. Understanding how these relationships interact is critical to designing effective HIV programs. We examined associations between MSM-related discrimination, MSM-related violence, and severe PD with HIV status among 2017 National HIV Behavioral Surveillance study participants in Memphis, Tennessee. Eligible participants were aged ≥18 years, born and identified as male, and reported having sex with another man in their lifetime. Participants completed a Centers for Disease Control and Prevention-designed anonymous survey and self-reported discrimination and violence across their lifetime, and PD symptoms within the past month, scored on the Kessler-6 Scale. Optional HIV rapid tests were performed on-site. Logistic regressions examined the associations between the exposure variables and HIV antibody-positive results. Among 356 respondents, 66.9% were aged <35 years and 79.5% identified as non-Hispanic Black; 13.2% reported experiencing violence, 47.8% reported discrimination, and 10.7% experienced PD. Of the 297 participants who tested, 33.33% were living with HIV. Discrimination, violence, and PD were significantly associated with each other (p < .0001). HIV antibody-positive test results were associated with violence (p < .01). Memphis-based MSM face a complex array of social experiences, which may increase vulnerability to HIV. On-site testing at community-based organizations and clinical settings among MSM may be an opportunity to screen for violence and incorporate strategies when designing HIV programs.
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Affiliation(s)
- Meredith R Denney
- School of Medicine, Vanderbilt University, Nashville, TN, USA
- HIV/STI/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
| | - Latrice C Pichon
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Meredith L Brantley
- HIV/STI/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
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Pichon LC, Jewell EN, Williams Stubbs A, Jones D, Campbell B, Kimble KM, Stewart GM, Hurd-Sawyer L, Carroll L, Powell TW. An Engaged Community of Faith to Decrease HIV Stigma in the U.S. South. Int J Environ Res Public Health 2023; 20:2100. [PMID: 36767467 PMCID: PMC9915988 DOI: 10.3390/ijerph20032100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Community members from a city in the U.S. Deep South identified root causes of HIV racial disparities, including stigma. This meeting report describes how we developed and implemented a conference series to address HIV stigma. We used community feedback and bidirectional learning to host two meetings in observance of National HIV Testing Day (June 2021) and National Southern HIV/AIDS Awareness Day (August 2021). We established a 10-member organizing committee workgroup that met monthly to plan the Faith Summit in honor of National Black HIV Awareness Day (February 2022). Lessons learned include (a) the effectiveness of different community engagement strategies, including participatory evaluative approaches, and (b) strategies to maintain engagement and increase participation, such as reliance on personal and professional networks and prompting the community about forthcoming interventions. Sustaining a conference series to end HIV stigma requires commitment and inclusive participation. This collaborative project offers additional evidence that faith communities can be a part of the solution to ending the HIV epidemic and related health disparities.
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Affiliation(s)
- Latrice C. Pichon
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | - Erin N. Jewell
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | - Andrea Williams Stubbs
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | | | | | | | | | | | - Lacretia Carroll
- University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Terrinieka W. Powell
- Department of Population, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Pichon LC, Jewell EN, Diehl RE, Stubbs AW, Thompson DE, Hurd-Sawyer L, Campbell B, Teti M. Sharing Lived Experiences of HIV Stigmatization: Process of Disseminating a Traveling Photovoice Exhibit. J Health Care Poor Underserved 2023; 34:57-68. [PMID: 38661917 DOI: 10.1353/hpu.2023.a903352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
A Memphis-based, community-academic partnership created Snap Out Stigma, a photovoice project, to understand lived experiences of HIV stigma among people with HIV. This report describes traveling photovoice exhibit dissemination strategies, lessons learned, and goals for the future of photovoice dissemination activities and community engagement in Memphis.
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Pichon LC, Teti M, McGoy S, Murry VM, Juarez PD. Engaging Black men who have sex with men (MSM) in the South in identifying strategies to increase PrEP uptake. BMC Health Serv Res 2022; 22:1491. [PMID: 36476363 PMCID: PMC9727972 DOI: 10.1186/s12913-022-08914-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Promotion, uptake, and adherence of pre-exposure prophylaxis (PrEP) is paramount to ending the HIV epidemic among young Black men who have sex with men in the South. The purpose of this study was to explore strategies needed for and barriers to PrEP uptake needed to achieve HIV prevention goals identified in the U.S. Department of Health & Human Services initiative to reduce new HIV infections in the United States by 90 percent by 2030. METHOD Young adults (n = 25) between the ages of 15-34 were recruited from community-based organizations in Memphis to participate in four focus group discussions. Discussion topics included motivations, barriers, and facilitators to PrEP use. Data were analyzed using thematic analysis. RESULTS All (100%) of participants self-identified as HIV-negative, Black (96%), men who have sex with men (96%), and currently prescribed PrEP/Truvada (60%). Themes identified for increasing uptake included 1) trusted peers, 2) relatable healthcare provider (e.g., Historically Black College and University (HBCU) trained, LGBTQ), and 3) use of social media. Mislabeling of PrEP as promiscuity promoting and limitations with PrEP marketing (e.g., solely LGBTQ) were recognized as barriers that perpetuated stigma. CONCLUSION Findings suggest the importance of increasing awareness among health professions students matriculating at HBCUs of their perceived role as relatable healthcare providers by Black MSM; working closely with couples; and crafting of PrEP messaging that is non-stigmatizing. Findings will inform public health interventions for young Black MSM and facilitate HIV prevention efforts with other groups disproportionally affected by HIV in the South.
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Affiliation(s)
- Latrice C. Pichon
- grid.56061.340000 0000 9560 654XSchool of Public Health, Division of Social and Behavioral Sciences, The University of Memphis, 3825 Desoto Ave 209 Robison Hall, Memphis, TN 38152 USA
| | - Michelle Teti
- grid.134936.a0000 0001 2162 3504Department of Public Health, The University of Missouri, 806 Lewis Hall, Columbia, MO 65211 USA
| | - Shanell McGoy
- grid.416951.e0000 0004 0437 4464Formerly Tennessee Department of Health, 710 James Robertson Pkwy, Nashville, TN 37243 USA
| | - Velma McBride Murry
- grid.412807.80000 0004 1936 9916Departments of Health Policy Human and Organizational Development, Vanderbilt University Medical Center & Peabody College, PMB 90 230 Appleton Place, Nashville, TN 37203 USA
| | - Paul D. Juarez
- grid.259870.10000 0001 0286 752XDepartment of Family & Community Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Boulevard, Nashville, TN 37208 USA
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Ahuja N, Kedia SK, Jiang Y, Xie L, Ward KD, Pichon LC, Dillon PJ, Yu X. Factors Associated With E-Cigarette Quitting Behavior Among Adolescents in the United States: A Prospective Observational Study. J Adolesc Health 2022; 71:729-736. [PMID: 36088234 DOI: 10.1016/j.jadohealth.2022.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE This prospective observational study examined the association of socioecological factors with quitting behavior among US adolescents who exclusively use electronic cigarettes (e-cigarettes). METHODS We used data from past 30-day adolescent exclusive e-cigarette users (n = 243) participating in Wave 3 of the Population Assessment of Tobacco and Health study, who were then followed-up with approximately 12 months later for Wave 4. Weighted unadjusted and adjusted multivariate logistic regression models and structural equation modeling were performed to analyze the data. RESULTS Adolescents were significantly less likely to quit e-cigarettes if they perceived that nicotine in e-cigarettes was "slightly/somewhat harmful" to health (adjusted odds ratio [aOR] = 0.38; 95% confidence interval [CI]: 0.16-0.90, p = .02). Similarly, adolescents who reported that someone else in their home owned an e-cigarette (aOR = 0.43 [95% CI: 0.19-0.94], p = .03) or important people in their life used e-cigarettes (aOR = 0.45 [95% CI: 0.21-0.95], p = .03) were significantly less likely to quit e-cigarettes. The structural equation modeling showed a direct significant relationship of individual-level (b = 0.206, p = .02) and interpersonal-level factors (b = 0.170, p = .04) with e-cigarette quitting behavior. DISCUSSION Our findings suggest that individual-level (harm perception) and interpersonal-level (e-cigarette use at home and by important people) factors may play a significant role in e-cigarette quitting behavior among US adolescents.
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Affiliation(s)
- Nikhil Ahuja
- Department of Public Health and Social Work, Slippery Rock University of Pennsylvania, Slippery Rock, Pennsylvania.
| | - Satish K Kedia
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Yu Jiang
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Lu Xie
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, Ohio
| | - Xinhua Yu
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, Tennessee
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Harmon BE, San Diego ERN, Pichon LC, Powell TW, Rugless F, West NT, Minor L, McNeal S, McCann L, Hales LS, Davis R, Lewis J. Congregational health needs by key demographic variables: Findings from a congregational health needs assessment tool. Eval Program Plann 2022; 94:102138. [PMID: 35820287 PMCID: PMC9464720 DOI: 10.1016/j.evalprogplan.2022.102138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/26/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
Health needs assessments identify important issues to be addressed and assist organizations in prioritizing resources. Using data from the Mid-South Congregational Health Survey, top health needs (physical, mental, social determinants of health) were identified, and differences in needs by key demographic variables (age, sex, race/ethnicity, education) were examined. Church leaders and members (N = 828) from 92 churches reported anxiety/depression (65 %), hypertension/stroke (65 %), stress (62 %), affordable healthcare (60 %), and overweight/obesity (58 %) as the top health needs in their congregations. Compared to individuals < 55 years old and with a college degree, individuals ≥ 55 years old (ORrange=1.50-1.86) and with ≤ high school degree (ORrange=1.55-1.91) were more likely to report mental health needs (anxiety/depression; stress). African Americans were less likely to report physical health needs (hypertension/stroke; overweight/obesity) than individuals categorized as Another race/ethnicity (ORrange=0.38-0.60). Individuals with ≤ high school degree were more likely to report affordable healthcare as a need compared to individuals with some college or a college degree (ORrange=1.58). This research highlights the need for evaluators and planners to design programs that are comprehensive in their approach to addressing the health needs of congregations while also considering demographic variation that may impact program participation and engagement.
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Affiliation(s)
- Brook E Harmon
- Division of Social and Behavioral Sciences, The University of Memphis, School of Public Health, Memphis, TN, USA.
| | - Emily Rose N San Diego
- Division of Social and Behavioral Sciences, The University of Memphis, School of Public Health, Memphis, TN, USA.
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, The University of Memphis, School of Public Health, Memphis, TN, USA.
| | - Terrinieka W Powell
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Fedoria Rugless
- Research and Quality, Church Health, Memphis, TN, USA; College of Health Sciences, The University of Memphis, Memphis, TN, USA.
| | - Nathan T West
- Division of Social and Behavioral Sciences, The University of Memphis, School of Public Health, Memphis, TN, USA.
| | - Lottie Minor
- National Faith-Based Mobilization Network (Faith MoNet), Hernando, MS, USA.
| | - Sterling McNeal
- Faith Community Engagement, Church Health, Memphis, TN, USA.
| | - Lauren McCann
- Community Programs, Methodist Le Bonheur Healthcare, Memphis, TN, USA.
| | - Lauren S Hales
- Faith Community Engagement, Church Health, Memphis, TN, USA.
| | - Rachel Davis
- Faith and Health Programs, Church Health, Memphis, TN, USA.
| | - Jonathan Lewis
- Community Partnerships, Methodist Le Bonheur Healthcare, Memphis, TN, USA.
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Pettit AC, Pichon LC, Ahonkhai AA, Robinson C, Randolph B, Gaur A, Stubbs A, Summers NA, Truss K, Brantley M, Devasia R, Teti M, Gimbel S, Dombrowski JC. Comprehensive Process Mapping and Qualitative Interviews to Inform Implementation of Rapid Linkage to HIV Care Programs in a Mid-Sized Urban Setting in the Southern United States. J Acquir Immune Defic Syndr 2022; 90:S56-S64. [PMID: 35703756 PMCID: PMC9204789 DOI: 10.1097/qai.0000000000002986] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 02/23/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Rapid antiretroviral therapy (ART) initiation, in which people living with HIV start ART within days of diagnosis, is a key component of the US Ending the HIV Epidemic initiative. SETTING The Memphis Metropolitan Statistical Area ranked fourth in the United States for the highest HIV incidence per 100,000 population in 2018. Rapid ART programs are limited in the Memphis Metropolitan Statistical Area, and our objective was to identify local implementation barriers. METHODS We conducted participatory process mapping and in-depth interviews to detail steps between HIV testing at the municipal health department's Sexually Transmitted Infections Clinic and ART prescription from a nearby high-volume Ryan White-funded HIV Clinic. RESULTS Process mapping identified 4 modifiable, rate-limiting rapid ART barriers: (1) requiring laboratory-based confirmatory HIV results, (2) eligibility documentation requirements for Ryan White-funded services, (3) insufficient HIV Clinic medical provider availability, and (4) variability in ART initiation timing among HIV Clinic providers. Staff at both sites highlighted suboptimal communication and sense of shared management between facilities, limited resources to address important social determinants of health, and lack of Medicaid expansion in Tennessee as key barriers. In-depth interview themes negatively affecting rapid ART initiation included clinic burden; provider knowledge, attitudes, and beliefs; and client psychosocial needs. CONCLUSIONS Our preimplementation work identified modifiable and systemic barriers to systems flow and patient-level outcomes. This work will inform the design and implementation of a locally relevant rapid ART program in Memphis, a community disproportionately affected by the HIV epidemic.
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Affiliation(s)
| | | | | | | | | | - Aditya Gaur
- St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Andrea Stubbs
- St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Nathan A. Summers
- University of Tennessee Health Science Center and Regional One Health, Adult Special Care Clinic, Memphis, Tennessee
| | | | | | - Rose Devasia
- Tennessee Department of Health, Nashville, Tennessee
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Abstract
BACKGROUND The purpose of SNAP Out Stigma (SOS) was to design and implement a community-based intervention to reduce HIV-related stigma for people living with HIV (PLWH) in the Deep South. This region is a subset of 9 states including Memphis, Tennessee (project site) driving the epidemic in the United States. The purpose of this paper is to explain how PLWH in the U.S. South used Photovoice to communicate stigmatizing lived experiences and contextualize their intersection with multi-level sources of support. METHODS PLWH attended one-on-one and/or group sessions with other PLWH. In Session 1, PLWH received a project overview, met other participants, received a camera and camera training, completed a standardized internalized stigma scale, discussed experiences of internalized stigma, and were instructed to take 3-10 pictures that captured stigma. In Session 2, PLWH discussed the pictures and their meaning. In Session 3, PLWH expanded on what they shared in previous sessions in a one-on-one interview. Thematic analysis captured key patterns of how PLWH experienced stigma. RESULTS Forty-seven PLWH attended Session 1 and were issued a camera. Of those, 35 completed sessions 2 and 3. Participants self-identified as cis man who has sex with men (n = 18), ciswoman (n = 5), transwoman (n = 10), and non-binary (n = 2). Four emergent themes intersecting with internalizations of stigma were identified including: medical, social support, church, and self. CONCLUSIONS The SOS intervention created a safe space for PLWH to share lived experiences of stigmatization. Photovoice facilitated discussion topics ranging from healing and recovery to overcoming factors of social determinants of HIV. We identified trauma-informed growth as an area of future programs for PLWH.
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Affiliation(s)
- Latrice C. Pichon
- grid.56061.340000 0000 9560 654XDivision of Social and Behavioral Sciences, The University of Memphis, School of Public Health, 3825 Desoto Avenue
- 209 Robison Hall, TN 38152 Memphis, USA
| | - Andrea Williams Stubbs
- grid.56061.340000 0000 9560 654XDivision of Social and Behavioral Sciences, The University of Memphis, School of Public Health, 3825 Desoto Avenue
- 209 Robison Hall, TN 38152 Memphis, USA
| | - Michelle Teti
- grid.134936.a0000 0001 2162 3504Department of Public Health, The University of Missouri, 806 Lewis Hall, Columbia, MO 65211 USA
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Ahuja NA, Kedia SK, Ward KD, Pichon LC, Chen W, Dillon PJ, Navaparia H. Effectiveness of Interventions to Improve Oral Cancer Knowledge: a Systematic Review. J Cancer Educ 2022; 37:479-498. [PMID: 33506408 DOI: 10.1007/s13187-021-01963-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
Oral cancer is prone to late-stage diagnosis, and subsequent low five-year survival rates. A small number of interventions or campaigns designed to enhance knowledge of risk factors and symptoms associated with oral cancer have been attempted in the UK, US, and some other countries. The purpose of this systematic review is to assess the effectiveness of interventions designed to improve oral cancer knowledge. We searched five databases to identify randomized controlled trials (RCTs) and non-randomized/quasi-experimental (NR/QE) studies targeting the general population or high-risk groups (tobacco users or alcohol consumers), aged ≥15 years, and reporting the outcomes of individual and/or community level interventions. Two co-authors independently identified relevant studies, extracted data, and assessed the risk of bias. Adhering to PRISMA guidelines, 27 (eight RCTs and 19 NR/QE studies) of the 551 studies identified from the five databases met the inclusion criteria. All RCTs and nine NR/QE studies used either printed materials, health education sessions, multimedia aids, or some combinations of these tools. The other ten NR/QE studies were community-based and used mass media campaigns to increase oral cancer awareness. Overall, the majority of studies significantly improved oral cancer knowledge; however, heterogeneity in study design and variation in measurement tools made it difficult to compare outcomes. Findings suggest that individual and/or community level interventions are generally effective in increasing knowledge of oral cancer risk factors, signs and symptoms, and/or its early diagnosis and prevention strategies among the general population or high-risk groups. However, the long-term benefits of these interventions are understudied.
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Affiliation(s)
- Nikhil A Ahuja
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Satish K Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA.
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Weiyu Chen
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
| | - Hitesh Navaparia
- Department of Oral and Maxillofacial Surgery, Vaidik Dental College and Research Center, Daman, India
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Marshall B, Salabarría-Peña Y, Douglas C, Nakelsky S, Pichon LC. The utility of evaluation in optimizing implementation and improvement of HIV prevention programming. Eval Program Plann 2022; 90:101980. [PMID: 34400006 DOI: 10.1016/j.evalprogplan.2021.101980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/23/2021] [Accepted: 07/25/2021] [Indexed: 06/13/2023]
Abstract
The objective of this article is to describe Project PrIDE (PrEP Implementation, Data to Care, and Evaluation) through the lens of Evaluation Utilization and provide examples of how twelve funded health departments (HD) utilized evaluation findings to make decisions related to improving PrEP awareness and uptake, and/or enhancing capacity for data to care (D2C) activities. Each HD conducted a local evaluation (LE) and reported ongoing and planned utilization of evaluation findings in the final LE reports. Information from all reports was abstracted for qualitative analysis to identify main evaluation utilization themes. Findings showed that program evaluation was incorporated as early as the project development phase and designed with the goal of improving, and not just demonstrating the efficacy of the programs. Evaluation data were effectively utilized to improve PrEP and D2C activities, for example, by increasing community engagement throughout LEs, enhancing social media implementation, prioritizing the most effective referral sources at re-linking clients into HIV care, reducing client wait time between receiving PrEP referral and obtaining appointment with provider, and incorporating evaluation findings into program planning and development. Project PrIDE highlights the importance of a planned evaluation in providing ongoing improvements to HIV prevention services to better serve priority populations.
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Affiliation(s)
| | | | | | | | - Latrice C Pichon
- The University of Memphis, School of Public Health, Division of Social and Behavioral Sciences, United States
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Pichon LC, Teti M, Betts JE, Brantley M. 'PrEP'ing Memphis: A qualitative process evaluation of peer navigation support. Eval Program Plann 2022; 90:101989. [PMID: 34419307 PMCID: PMC9523887 DOI: 10.1016/j.evalprogplan.2021.101989] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/23/2021] [Accepted: 08/06/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND HIV PrEP (pre-exposure prophylaxis) navigation comprises intervention strategies used to improve PrEP uptake via education, linkage, and follow-up/ongoing engagement. During 2016-2019, the Tennessee Department of Health (TDH) implemented a CDC-funded demonstration project ("Project PrIDE") focused on PrEP navigation in Memphis community-based organizations (CBOs) and the Shelby County Health Department (HD). A process evaluation was conducted to determine facilitators and barriers to the implementation of the Memphis-based Project PrIDE PrEP navigation activities. METHODS A total of fourteen in-depth qualitative interviews were conducted, with nine PrEP navigators in evaluation year 1 (2018) and five of the original navigators in evaluation year 2 (2019), to understand the navigation processes using thematic analysis. RESULTS Facilitators of PrEP navigation included accessing clients at testing events, accompanying clients to first appointments, rapport building with patient and clinic staff, and maintaining consistent engagement with clients. Factors impeding PrEP navigation included difficulties assessing client readiness, tracking client navigation status, and stigmatizing clinic and social experiences for clients. CONCLUSIONS AND LESSONS LEARNED Findings have informed the scale-up of PrEP navigation implementation statewide, along with priority setting and resource allocation for the local Ending the HIV Epidemic (EHE) initiative in Memphis.
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Affiliation(s)
- Latrice C Pichon
- The University of Memphis School of Public Health, Division of Social and Behavioral Sciences, 3825 Desoto Avenue, 209 Robison Hall, Memphis, TN 38152, USA.
| | - Michelle Teti
- The University of Missouri Department of Public Health, 512 Clark Hall Columbia, MO 65211, USA.
| | - Joshua E Betts
- ICF, 2635 Century Center Parkway, Suite 1000, Atlanta, GA 30345, USA; CDC, Atlanta, GA, USA.
| | - Meredith Brantley
- Tennessee Department of Health, HIV/STD/Viral Hepatitis, 710 James Robertson Pkwy, Nashville, TN 37243, USA.
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Ahuja NA, Kedia SK, Jiang Y, Ward KD, Pichon LC, Dillon PJ, Yu X, Xie L. Factors Associated with E-Cigarette Quit Intention Among Adolescents in the United States. Subst Use Misuse 2022; 57:2074-2084. [PMID: 36205511 DOI: 10.1080/10826084.2022.2130000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
Background: Given increasing use of e-cigarettes among adolescents in the United States and its potential for nicotine addiction, encouraging adolescents to quit using these products has become a public health priority. This study examined factors at various socio-ecological levels associated with e-cigarette quit intention (pre-contemplation, contemplation, or preparation) using the Stages of Change of the Trans-theoretical Model among the U.S. adolescents. Methods: We used cross-sectional data from the past 30-day adolescent exclusive e-cigarette users participating in Wave 4 of the Population Assessment of Tobacco and Health study (n = 349). Weighted adjusted multinomial logistic regression models were used to analyze the data. Results: Compared to pre-contemplators and contemplators, preparators were more likely to believe that nicotine in e-cigarettes was "very/extremely harmful" (vs. "not at all harmful") to health (p < 0.001) and people cause a "lot of harm" (vs. "no harm") to themselves when they use e-cigarettes (p < 0.001). In comparison to pre-contemplators, contemplators and preparators were more likely to report that their parents/guardians talked with them about not using e-cigarettes than those whose parents/guardians did not talk with them (p < 0.001). Additionally, contemplators and preparators were also more likely to report that they "often/very often" (vs. never) noticed health warnings on e-cigarette packages (p < 0.001). Conclusion: Our findings suggest that harm perception, influence of family, and e-cigarette health warnings are some of the important factors associated with the stages of change for intention to quit among adolescent e-cigarette users. This study will help public health practitioners and researchers design multi-level e-cigarette cessation interventions for adolescents.
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Affiliation(s)
- Nikhil A Ahuja
- Department of Public Health and Social Work, Slippery Rock University of Pennsylvania, Slippery Rock, Pennsylvania, USA
| | - Satish K Kedia
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Yu Jiang
- Division of Epidemiology and Biostatistics, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, Ohio, USA
| | - Xinhua Yu
- Division of Epidemiology and Biostatistics, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Lu Xie
- Division of Epidemiology and Biostatistics, School of Public Health, University of Memphis, Memphis, Tennessee, USA
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Pichon LC, Rossi KR, Chapple-McGruder T, Krull LJ, Kmet J, Carswell AL. A Pilot Outreach HIV Testing Project Among Homeless Adults. Front Public Health 2021; 9:703659. [PMID: 34395372 PMCID: PMC8356944 DOI: 10.3389/fpubh.2021.703659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The Memphis metropolitan statistical area (MSA) represents a Deep Southern U.S. city disproportionally affected by the ongoing transmission of new HIV cases as well as those diagnosed in late-stage disease. This region is a subset of nine states, including Memphis, Tennessee (project site), driving the epidemic in the United States. Memphis ranks 4th among all U.S. MSAs for new HIV infections and has been identified in the CDC's Ending the HIV Epidemic Initiative as a high HIV burden geographic focus area. The Memphis Ryan White Part A Program conducted a pilot project among adults seeking services in Memphis emergency and transitional housing shelters to offer on-site, rapid HIV testing. In this paper we describe the results from this aforementioned pilot study, including the rate of HIV test acceptance and potential factors associated with a history of HIV testing in Memphis. Methods: Community-engaged research approaches were employed via a partnership between the local health department, a federally qualified faith-based health center, and an academic university. An interviewer-administered survey to measure potential factors associated with HIV testing history and voluntary HIV testing services were offered to adults living in transitional housing establishments. Bivariate chi-square analyses were performed to determine the association between predisposing, enabling, and need variables with HIV testing history in the past 12 months. Results: Survey respondents (n = 109) were mostly cisgender male (n = 96; 88.1%), African American (n = 79; 72.5%) and reported engaging in condomless sex in the past 12 months (n = 55; 50.5%). Acceptability and uptake of HIV testing was high (n = 97; 89.0%). Conclusions: Implementing rapid HIV testing programs outside of traditional health care settings is a strategy that can be used to engage high-risk individuals and those unaware of their HIV status to get tested. To our knowledge, this study represents the first that documents HIV testing acceptance rates offered outside of traditional health care settings for homeless and transitionally housed adults in a Deep Southern state.
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Affiliation(s)
- Latrice C Pichon
- School of Public Health, The University of Memphis, Memphis, TN, United States
| | - Kristen Rae Rossi
- Battelle Formerly Shelby County Health Department, Memphis, TN, United States
| | | | - Lisa Jane Krull
- School of Public Health, The University of Memphis, Memphis, TN, United States
| | - Jennifer Kmet
- Shelby County Health Department, Bureau of Epidemiology and Infectious Diseases, Memphis, TN, United States
| | - April L Carswell
- School of Public Health, The University of Memphis, Memphis, TN, United States
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McKay VR, Cambey CL, Combs TB, Stubbs AW, Pichon LC, Gaur AH. Using a Modeling-Based Approach to Assess and Optimize HIV Linkage to Care Services. AIDS Behav 2021; 25:886-896. [PMID: 33000356 PMCID: PMC7887057 DOI: 10.1007/s10461-020-03051-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 12/31/2022]
Abstract
Evidence-based linkage to care interventions (LTCs) help recently diagnosed HIV+ individuals engage in care in a timely manner yet are heavily impacted by the systems in which they are embedded. We developed a prototype agent-based model informed by data from an established LTC program targeting youth and young adults aged 13-24 in Memphis, Tennessee. We then tested two interventions to improve LTC in a simulated environment: expanding testing sites versus using current testing sites but improving direct referral to LTC staff from organizations providing testing, to understand the impact on timely linkage to care. Improving direct referral to the LTC program decreased days to successful linkage from an average of 30 to 23 days but expanding testing sites increased average days to 31 days unless those sites also made direct referrals. We demonstrated how LTC is impacted by the system and interventions for shortening days to linkage to care.
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Affiliation(s)
- V R McKay
- Center for Public Health Systems Science, Brown School, Washington University in St. Louis, 1 Brookings Drive, Campus Box #1196, St. Louis, MO, 63130, USA.
| | - C L Cambey
- Department of Biology, Vassar College, Poughkeepsie, NY, USA
| | - T B Combs
- Center for Public Health Systems Science, Brown School, Washington University in St. Louis, 1 Brookings Drive, Campus Box #1196, St. Louis, MO, 63130, USA
| | - A W Stubbs
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - L C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA
| | - A H Gaur
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
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18
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Harmon BE, San Diego ER, Pichon LC, Powell TW, Rugless F, McCann L, Minor LL, Davis R, Underhill C, Campbell B, Smith JB, McNeal S, Evans J, Calvin V. Developing a Congregational Health Needs Assessment: Lessons Learned from Using a Participatory Research Approach. Prog Community Health Partnersh 2021; 15:47-58. [PMID: 33775960 DOI: 10.1353/cpr.2021.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Health needs assessments help congregations identify issues of importance to them and the communities they serve. Few tools exist, with little known about the processes needed to develop such tools. OBJECTIVE Develop a congregational health needs assessment tool and implementation protocol with community, health-care, and academic partners. METHODS Meetings began in August 2018 to develop the Mid-South Congregational Health Needs Survey (MSCHS) and implementation protocol. Pilot testing occurred in December 2018 and feedback from 95 churches was used in modifications. RESULTS The MSCHS includes: demographics section, a 36-item health index, and the congregation's top five needs.The implementation protocol includes steps for working with congregation leadership to identify members to complete the survey. CONCLUSIONS Cross-disciplinary partnerships made the creation of the MSCHS and implementation protocol possible. Successes include long-term engagement across partnership sectors, organizational "buy-in," and development of a common language. These lessons can help others wanting to develop successful multi-sector partnerships.
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Obong'o CO, Patel SN, Cain M, Kasese C, Mupambireyi Z, Bangani Z, Pichon LC, Miller KS. Suffering whether You Tell or Don't Tell: Perceived Re-Victimization as a Barrier to Disclosing Child Sexual Abuse in Zimbabwe. J Child Sex Abus 2020; 29:944-964. [PMID: 33174814 DOI: 10.1080/10538712.2020.1832176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/31/2020] [Accepted: 08/02/2020] [Indexed: 06/11/2023]
Abstract
Disclosing child sexual abuse (CSA) is a necessary first step to access the legal, health, and psycho-social services that survivors and their families need. However, disclosure rates are low: of young women who experienced CSA in Zimbabwe, only 9% disclosed the first incident. The purpose of this qualitative study was to explore and describe perceived barriers to disclosing CSA in Zimbabwe. We conducted focus group discussions with children aged 10-14 years (n = 40) and their parents/caregivers aged 20-62 years (n = 40), participating in an intervention trial in Chitungwiza, Zimbabwe. We found that potential retaliation against survivors and their families is a major barrier to disclosing CSA. These retaliatory acts, which we refer to as "re-victimization," arise from stigma or the victim feeling blamed or doubted and manifest through physical violence, emotional violence, and deprivation of family life and education. Our findings suggest that addressing social and cultural norms related to sex and strengthening legal protection for CSA survivors and their families could encourage CSA disclosure and could help end this violence. Our findings also highlight a need to increase children's awareness of their rights and to create safe systems for disclosure of sexual abuse.
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Affiliation(s)
- Christopher O Obong'o
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis , Memphis, TN, USA
| | - Shilpa N Patel
- Centers for Disease Control and Prevention, Center for Global Health, Division of Global HIV , Atlanta, GA, USA
| | - Meagan Cain
- Centers for Disease Control and Prevention, Center for Global Health, Division of Global HIV , Atlanta, GA, USA
| | - Constance Kasese
- Children and Adolescents Department , Centre for Sexual Health and HIV AIDS Research Zimbabwe (Ceshhar) , Harare, Zimbabwe
| | - Zivai Mupambireyi
- Children and Adolescents Department , Centre for Sexual Health and HIV AIDS Research Zimbabwe (Ceshhar) , Harare, Zimbabwe
| | - Zwashe Bangani
- Children and Adolescents Department, Centers for Disease Control and Prevention , Harare, Zimbabwe
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis , Memphis, TN, USA
| | - Kim S Miller
- Centers for Disease Control and Prevention, Center for Global Health, Division of Global HIV , Atlanta, GA, USA
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Kennedy T, Teti M, Hayes D, Pichon LC, Farnan R. "Unmasked to a Positive Triumph": Women With HIV Share the Benefits of Showing Their Faces Through Photovoice. Prog Community Health Partnersh 2017; 10:505-513. [PMID: 28569675 DOI: 10.1353/cpr.2016.0058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The human immunodeficiency virus (HIV) and AIDS continue to affect the quality of life for minority and low-income women at alarming rates. As a result, research studies that collaborate with women with HIV are increasing with the intent of identifying ways to improve their outcomes. OBJECTIVES This article identifies the effects on women with HIV who chose to show their faces in photographs taken to express their personal experiences. METHODS In multiple community-based participatory research (CBPR) studies, researchers collaborated with participants to identify personal experiences of women with HIV using photovoice. During the data analysis of photographs, discussions, and interviews, the women with HIV shared the importance of showing their faces. This article presents the common themes to explain why some of the women desired to or actually chose to show their faces in the photographs. RESULTS Of the 35 women with HIV who collaborated, 14 chose to show their self-portraits. Reasons for showing their faces varied and included to express self-pride, to reduce stigma by fighting stereotypes, to get help for their HIV, to help or educate others, and to show progression from sickness to health. The most prominent themes in the analysis were to (1) reveal the "real" face of HIV/AIDS, (2) share self-portraits as an act of resistance, and (3) help other women living with HIV. CONCLUSIONS Photovoice is valuable and beneficial for participants. The women with HIV demonstrated strength and power as they explained reasons for showing their faces and revealing their selfies.
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Abstract
This study employed a community-based participatory research approach to understand factors that influence church readiness to engage in HIV prevention and treatment activities. A convenience sample of twenty-six Black faith leaders participated in four focus groups. Data analysis was done through qualitative content analysis. Three themes emerged. First, the pastor's blessing and authority as the church's decision-maker determines readiness to engage in HIV prevention. Second, the church's purview of sexual health as part of a holistic ministry facilitates faith leader's readiness. Lastly, securing financial and human resources makes it feasible for faith leaders to implement activities. Findings suggest HIV-related stigma alone does not explain readiness to address HIV. Participants also discussed activities their churches are equipped to handle, including HIV testing events and health fairs.
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Affiliation(s)
- Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3820 Desoto Ave, Robison Hall Room 209, Memphis, TN, USA.
| | | | - Siri A Ogg
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3820 Desoto Ave, Robison Hall Room 209, Memphis, TN, USA
| | - Andrea L Williams
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
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Williams TT, Pichon LC, Davey-Rothwell M, Latkin CA. Church Attendance as a Predictor of Number of Sexual Health Topics Discussed Among High-Risk HIV-Negative Black Women. Arch Sex Behav 2016; 45:451-8. [PMID: 25966802 PMCID: PMC4644119 DOI: 10.1007/s10508-015-0506-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 12/12/2014] [Accepted: 02/13/2015] [Indexed: 06/04/2023]
Abstract
Research suggests that sexual health communication is associated with safer sex practices. In this study, we examined the relationship between church attendance and sexual health topics discussed with both friends and sexual partners among a sample of urban Black women. Participants were 434 HIV-negative Black women who were at high risk for contracting HIV through heterosexual sex. They were recruited from Baltimore, Maryland using a network-based sampling approach. Data were collected through face-to-face interviews and Audio-Computer-Assisted Self-Interviews. Fifty-four percent of the participants attended church once a month or more (regular attendees). Multivariate logistic regression analyses revealed that regular church attendance among high-risk HIV-negative Black women was a significant predictor of the number of sexual health topics discussed with both friends (AOR = 1.85, p = .003) and sexual partners (AOR = 1.68, p = .014). Future efforts to reduce HIV incidence among high-risk Black women may benefit from partnerships with churches that equip faith leaders and congregants with the tools to discuss sexual health topics with both their sexual partners and friends.
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Affiliation(s)
- Terrinieka T Williams
- Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, E4614, Baltimore, MD, 21205, USA.
| | | | - Melissa Davey-Rothwell
- Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, E4614, Baltimore, MD, 21205, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, E4614, Baltimore, MD, 21205, USA
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Abstract
Across the United States, Black Churches play a significant role among the Black community and are increasingly being used to deliver Human Immunodeficiency Virus (HIV) prevention services. This study sought to investigate HIV service providers' strategies for strengthening partnerships with churches to deliver HIV prevention services. Using a community-based participatory research approach, an HIV coalition and an academic institution formed a partnership to address the study aim. Individual interviews (n = 16) were conducted with providers from medical institutions and HIV social support agencies. A thematic analysis focusing on recommendations for addressing the challenges and benefits of partnership with churches for HIV services was conducted. Participants' interest in and intention to work with churches, as well as their comfort level discussing sexual health-related topics with religious congregations, was high. Four themes emerged to highlight the different perspectives of service providers' recommendations for addressing challenges and strengthening partnerships with churches to deliver HIV services including: (1) carefully selecting churches and HIV services to provide, (2) gaining "buy-in" and support of church leadership, (3) taking advantage of conflict with church doctrine, and (4) choosing appropriate delivery strategies. Study findings demonstrate that although challenges exist, heath service providers in this region of the United States may be interested in addressing HIV among faith communities. Study findings also provide concrete solutions to previously documented barriers to HIV prevention in Black Churches. Such information will benefit researchers and practitioners seeking to expand effective HIV prevention efforts with Black Churches in communities who bear a disproportionate burden of HIV infections.
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Affiliation(s)
| | - Latrice C Pichon
- a School of Public Health , The University of Memphis , Memphis , TN , USA
| | - Terrinieka W Powell
- b Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA
| | - Andrea L Williams
- c Department of Infectious Diseases , St. Jude Children's Research Hospital , Memphis , TN , USA
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Kennedy T, Teti M, Hayes D, Pichon LC, Farnan R. “Unmasked to a Positive Triumph”: Women With HIV Share the Benefits of Showing Their Faces Through Photovoice. Prog Community Health Partnersh 2016; 10:491-492. [DOI: 10.1353/cpr.2016.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pichon LC, Griffith DM, Campbell B, Allen JO, Williams TT, Addo AY. Faith leaders' comfort implementing an HIV prevention curriculum in a faith setting. J Health Care Poor Underserved 2014; 23:1253-65. [PMID: 24212172 DOI: 10.1353/hpu.2012.0108] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
YOUR Blessed Health (YBH) is a faith-based HIV prevention pilot program designed to increase faith-based organizations' capacity to address HIV/AIDS among African American congregations. Faith leaders (e.g., pastors, pastors' spouses) were trained to deliver youth and adult HIV education sessions. Perceptions of comfort with discussing 11 sexual health topics were assessed after program implementation. Twenty-nine faith leaders self-reported their comfort discussing sexual behaviors, sexual communication, and sexual abuse. Overall, faith leaders were comfortable discussing these sexual health topics; however, denominational and leadership role differences were found. These findings suggest African American faith leaders are willing to lead faith-based HIV prevention efforts, but that consideration of denominational differences and organizational roles in faith-based health promotion programs is critical.
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Abstract
While research suggests youth prefer parents and family members to serve as the primary sources of sexual health information, fear and discomfort around discussing sex with their parents may leave youth misinformed and underinformed. This study explored sexual heath communication within religious African-American families. Thirty adolescents participated in four focus groups, and 19 adults and 30 adolescents participated in six focus groups, at two predominantly African-American Christian churches in Flint, MI. All data were analyzed inductively using a constant comparison approach. Nearly all participants reported attending church weekly. Three themes emerged and are described: initiating sex talks, using mistakes as teaching tools, and clarifying prevention messages. Participants highlighted the need for religious parents to offer both religious and practical guidance to adolescents about sexual health. Findings from this study may be used to inform future sexual health promotion interventions for religious African-American families.
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Abstract
This study describes the ways in which two African-American churches discuss adolescent sexual health topics. Six focus groups were conducted in two churches in Flint, Michigan, that reported no formal sexual health programming for their congregants. Three themes emerged to highlight the different perspectives about the role of churches in adolescent sexual decision-making and sexual health education: (1) churches as sources of sexual information, (2) churches as complex communities, and (3) recommendations for sexual education in churches. Participant responses suggest that churches can and should serve a resource for sexual health information. Implications for practice and research are discussed.
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Affiliation(s)
- Terrinieka T Williams
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, E4614, Baltimore, MD, 21205, USA,
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Williams TT, Pichon LC, Latkin CA, Davey-Rothwell M. Practicing What is Preached: The Relationship between Congregational Support and HIV Prevention Behaviors among Black Women. J Community Psychol 2014; 42:365-378. [PMID: 25435597 PMCID: PMC4243173 DOI: 10.1002/jcop.21615] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Through the current analysis, we aimed to better understand the relationship between congregational support and HIV prevention behaviors among a sample of high risk, HIV negative Black women. Participants were 434 Black women who were at high risk for contracting HIV through heterosexual sex. They were recruited from a city in the Mid Atlantic Region. Data were collected through face-to-face interviews and Audio-Computer-Assisted Self-Interviews (ACASI). Results revealed three congregational characteristics were important for Black women's comfort level discussing HIV and their likelihood of returning for their HIV test results: feeling loved by their congregation, having ministries that helped people with their problems and feeling listened to by their congregation. Thus, religious congregational support was a significant correlate of Black women's comfort discussing HIV prevention and treatment as well as their motivation to return to get their HIV test results.
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Affiliation(s)
| | | | - Carl A. Latkin
- Johns Hopkins Bloomberg School of Public Health,
Baltimore, Maryland
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Abstract
This study examined the relationship between gender roles and sociosexuality (an individual difference variable describing attitudes about sexual permissiveness and promiscuity), and their predictive pattern of HIV-related sexual risk behaviors. A geographically diverse sample of 275 adult, heterosexual Black women (mean age = 33.60 years), participated in a self-administered survey. Significant relationships were found between feminine traits and sociosexuality, and between sociosexuality and four of the five risky sexual behavior variables. Neither masculine nor feminine gender roles were related to any risky sexual behavior variables. Sociosexuality emerged as an important correlate that requires further exploration of its relationship to the attitudes and behaviors of Black women, and its potential relationship to HIV risk-related sexual behavior. The need for more attention to psychosocial variables, and consideration of context, cultural norms, and values is discussed as an important undertaking in order to garner an accurate picture of sexual risk behavior.
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Affiliation(s)
- Naomi M Hall
- Department of Psychological Sciences, Winston-Salem State University, Coltrane Hall 203, Winston-Salem, NC 27110, USA
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
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Landrine H, Corral I, Simms DA, Roesch SC, Pichon LC, Ake D, Villodas F. Telephone Surveys Underestimate Cigarette Smoking among African-Americans. Front Public Health 2013; 1:36. [PMID: 24350205 PMCID: PMC3859986 DOI: 10.3389/fpubh.2013.00036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 09/06/2013] [Indexed: 12/03/2022] Open
Abstract
Background: This study tested the hypothesis that data from random digit-dial telephone surveys underestimate the prevalence of cigarette smoking among African-American adults. Method: A novel, community-sampling method was used to obtain a statewide, random sample of N = 2118 California (CA) African-American/Black adults, surveyed door-to-door. This Black community sample was compared to the Blacks in the CA Health Interview Survey (N = 2315), a statewide, random digit-dial telephone survey conducted simultaneously. Results: Smoking prevalence was significantly higher among community (33%) than among telephone survey (19%) Blacks, even after controlling for sample differences in demographics. Conclusion: Telephone surveys underestimate smoking among African-Americans and probably underestimate other health risk behaviors as well. Alternative methods are needed to obtain accurate data on African-American health behaviors and on the magnitude of racial disparities in them.
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Affiliation(s)
- Hope Landrine
- Center for Health Disparities, East Carolina University , Greenville, NC , USA
| | - Irma Corral
- Department of Psychiatric Medicine, Brody School of Medicine, East Carolina University , Greenville, NC , USA
| | | | - Scott C Roesch
- Department of Psychology, San Diego State University , San Diego, CA , USA
| | - Latrice C Pichon
- School of Public Health, University of Memphis , Memphis, TN , USA
| | - Diane Ake
- California Black Health Network , San Diego, CA , USA
| | - Feion Villodas
- Department of Psychology, San Diego State University , San Diego, CA , USA
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Pichon LC, Williams TT, Campbell B. An exploration of faith leaders' beliefs concerning HIV prevention: thirty years into the epidemic. Fam Community Health 2013; 36:260-268. [PMID: 23718961 DOI: 10.1097/fch.0b013e318292eb10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Despite the growing body of research on faith-based human immunodeficiency virus (HIV) initiatives, there are few studies exploring the perspective of faith leaders involved in HIV prevention efforts. This exploratory study examined how 29 faith leaders conceptualized key aspects of HIV prevention. Sexual health beliefs, perspectives on condom distribution, and facilitating factors and barriers to implementing an HIV program were explored. Seventy-six percent of participants agreed with the statement "they would be willing to make condoms available to adolescents." These findings highlight the importance of reconciling any differences between religious doctrine, leadership role, and beliefs of faith leaders in addressing HIV in churches.
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Affiliation(s)
- Latrice C Pichon
- The University of Memphis, School of Public Health, Memphis, TN, USA.
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Mayer JA, Woodruff SI, Slymen DJ, Sallis JF, Forster JL, Clapp EJ, Hoerster KD, Pichon LC, Weeks JR, Belch GE, Weinstock MA, Gilmer T. Adolescents' use of indoor tanning: a large-scale evaluation of psychosocial, environmental, and policy-level correlates. Am J Public Health 2011; 101:930-8. [PMID: 21421947 PMCID: PMC3076411 DOI: 10.2105/ajph.2010.300079] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2010] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated psychosocial, built-environmental, and policy-related correlates of adolescents' indoor tanning use. METHODS We developed 5 discrete data sets in the 100 most populous US cities, based on interviews of 6125 adolescents (aged 14-17 years) and their parents, analysis of state indoor tanning laws, interviews with enforcement experts, computed density of tanning facilities, and evaluations of these 3399 facilities' practices regarding access by youths. After univariate analyses, we constructed multilevel models with generalized linear mixed models (GLMMs). RESULTS In the past year, 17.1% of girls and 3.2% of boys had used indoor tanning. The GLMMs indicated that several psychosocial or demographic variables significantly predicted use, including being female, older, and White; having a larger allowance and a parent who used indoor tanning and allowed their adolescent to use it; and holding certain beliefs about indoor tanning's consequences. Living within 2 miles of a tanning facility also was a significant predictor. Residing in a state with youth-access legislation was not significantly associated with use. CONCLUSIONS Current laws appear ineffective in reducing indoor tanning; bans likely are needed. Parents have an important role in prevention efforts.
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Affiliation(s)
- Joni A Mayer
- School of Public Health, San Diego State University, CA, USA.
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Hoerster KD, Mayer JA, Sallis JF, Pizzi N, Talley S, Pichon LC, Butler DA. Dog walking: its association with physical activity guideline adherence and its correlates. Prev Med 2011; 52:33-8. [PMID: 21047528 DOI: 10.1016/j.ypmed.2010.10.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Revised: 10/12/2010] [Accepted: 10/27/2010] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We examined the prevalence and correlates of dog walking among dog owners, and whether dog walking is associated with meeting the American College of Sports Medicine/American Heart Association physical activity guidelines. METHODS In March 2008, we mailed a survey to dog-owning clients from two San Diego County veterinary clinics. Useable data were obtained from 984 respondents, and 75 of these completed retest surveys. We assessed associations between potential correlates and dog walking (i.e., yes/no dog walking for at least 10 min in past week). RESULTS Test-retest reliability of measures was generally high. Approximately one-third of the sample (31.5%) were not dog walkers. Proportions of dog walkers versus non-dog walkers meeting United States guidelines were 64.3% and 55.0%, respectively. Dog walking was independently associated with meeting guidelines in a multivariate model (odds ratio=1.59, p=0.004). Three variables were independently associated with dog walking in a multivariate model: dog encouragement of dog walking, dog-walking obligation, and dog-walking self-efficacy. CONCLUSION Dog walking was associated with meeting physical activity guidelines, making it a viable method for promoting physical activity. Dog-walking obligation and self-efficacy may be important mediators of dog walking and may need to be targeted if interventions are to be successful.
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Affiliation(s)
- Katherine D Hoerster
- San Diego State University Graduate School of Public Health, 9245 Sky Park Court, Suite 220, San Diego, CA 92123, USA.
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Williams TT, Griffith DM, Pichon LC, Campbell B, Allen JO, Sanchez JC. Involving faith-based organizations in adolescent HIV prevention. Prog Community Health Partnersh 2011; 5:425-431. [PMID: 22616210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The rates of sexually transmitted infections (STIs; including HIV/AIDS) among African Americans in Flint, Michigan, are among the highest in the state. In Genesee County, where Flint is located, the incidence of HIV/AIDS cases increased at an average rate of 24% each year from 2003 to 2007 for adolescents between the ages of 13 and 19. OBJECTIVES YOUR Blessed Health (YBH) is a multilevel, faith-based HIV prevention program designed to increase HIV awareness and knowledge and reduce HIV risk behaviors among African American congregations. This article describes one of the five components of the intervention--training of faith leaders to implement a sexual health curriculum for adolescents in their congregations. METHODS Staff from YOUR Center, a community-based HIV service organization, and researchers from the University of Michigan, School of Public Health, partnered with faith-based organizations (FBOs) to address HIV/AIDS in Flint, Michigan. RESULTS Participating FBOs selected faith leaders to be trained by YOUR Center staff to implement the YBH program in their congregations. Using the HIV Outreach, Prevention and Education (HOPE) curriculum, faith leaders from 20 FBOs provided HIV education to 212 adolescents in Flint, Michigan. CONCLUSION Study findings demonstrate that faith leaders who participate in specific and ongoing HIV prevention education training can be useful sexual health resources for youth in faith-based settings. Implications for research and practice highlight the advantages of continued partnerships between FBOs and public health professionals in future HIV prevention efforts for adolescents.
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Pichon LC, Corral I, Landrine H, Mayer JA, Adams-Simms D. Perceived skin cancer risk and sunscreen use among African American adults. J Health Psychol 2010; 15:1181-9. [PMID: 20522507 DOI: 10.1177/1359105310364177] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We examined perceived skin cancer risk and its relationship to sunscreen use among a large (N = 1932) random sample of African American adults for the first time. Skin cancer risk perceptions were low (Mean = 16.11 on a 1-100 scale). Sun-sensitive skin type and a prior cancer diagnosis were associated with higher perceived skin cancer risk, but demographic factors were not. Unlike findings for Whites, perceived skin cancer risk was not associated with sunscreen use among African Americans. Directions for future research, and suggestions for increasing sunscreen use among African Americans are provided.
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Affiliation(s)
- Latrice C Pichon
- School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA.
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Griffith DM, Pichon LC, Campbell B, Allen JO. YOUR Blessed Health: a faith-based CBPR approach to addressing HIV/AIDS among African Americans. AIDS Educ Prev 2010; 22:203-17. [PMID: 20528129 DOI: 10.1521/aeap.2010.22.3.203] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Despite substantial federal, state, and local efforts to reduce the transmission of HIV/AIDS, African Americans experience higher rates of infection than any other ethnic or racial group in the United States. It is imperative to develop culturally and ecologically sensitive interventions to meet the sexual health needs of this population. Capitalizing on the assets, resources, and strengths of faith-based organizations, YOUR Blessed Health (YBH) is a community-based participatory research project developed to increase HIV/AIDS awareness and reduce HIV-related stigma among the African American faith community in Flint, Michigan. This article describes the historical context and development of YBH, discusses the results of the pilot study, and illustrates how YBH grew into a community mobilization effort led by faith leaders and their congregations to address HIV/AIDS. YBH highlights the importance of developing and testing intervention models that originate from community-based organizations to address complex and sensitive health issues among marginalized populations.
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Affiliation(s)
- Derek M Griffith
- Department of Health Behavior and Health Education, School of Public Health, the University of Michigan, Ann Arbor, MI 48109-2029, USA.
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Pichon LC, Corral I, Landrine H, Mayer JA, Norman GJ. Sun-protection behaviors among African Americans. Am J Prev Med 2010; 38:288-95. [PMID: 20171530 DOI: 10.1016/j.amepre.2009.10.041] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 08/12/2009] [Accepted: 10/31/2009] [Indexed: 11/20/2022]
Abstract
BACKGROUND Data suggest that the prevalence of sun-protection behaviors is low (44%) among African Americans; the samples in such studies, however, tended to be small or nonrepresentative. PURPOSE This article aims to examine the prevalence and correlates of sun-protection behaviors among a large, random, statewide sample of African-American adults living in California to ascertain behavioral patterns and highlight directions for targeted interventions. METHODS From September 2006 through May 2008, an anonymous health survey collected data on sunscreen, sunglasses, and wide-brim hat use among a random sample of 2187 African-American adults, and assessed demographic, regional, skin type, and other potential correlates of these behaviors. The analysis was conducted in 2009. RESULTS Only 31% engaged in at least one sun-protection behavior; of the three behaviors, sunscreen use was the least prevalent, with 63% never using sunscreen. Multivariate logistic regressions revealed that gender, SES, and skin type were significant predictors of sun-protection behaviors. CONCLUSIONS Tailored interventions to increase sun-protection behaviors among African Americans (men in particular) are needed.
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Affiliation(s)
- Latrice C Pichon
- Department of Health Management and Policy, School of Public Health, University of Michigan, 109 Observatory, Ann Arbor MI 48109-2029, USA.
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Pichon LC, Landrine H, Corral I, Hao Y, Mayer JA, Hoerster KD. Measuring skin cancer risk in African Americans: is the Fitzpatrick Skin Type Classification Scale culturally sensitive? Ethn Dis 2010; 20:174-179. [PMID: 20503899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE Fitzpatrick's Skin Type Classification Scale often is used to assess sun sensitivity and skin cancer risk. Because the scale was developed with Whites, its utility and validity with Blacks may be limited by its reliance on the European-cultural terms suntan and sunburn. We tested the hypothesis that most Blacks would be unable to classify their skin into the four Fitzpatrick skin types. DESIGN, SETTING, PARTICIPANTS A random, statewide sample of 2085 California Black adults were administered a survey to categorize their skin into the Fitzpatrick types of always burn/never tan (I), usually burn/rarely tan (II), rarely burn/usually tan (III), and never burn/always tan (IV). We also added a response option not available in the scale, "none of the above describes me." Questions on sunscreen use and demographics were included. MAIN OUTCOME MEASURE Self-reported skin type. RESULTS 1231 (59%) selected none of the above, and only 559 (26.8%) categorized themselves as type IV. When the none option is removed and the 59% who chose it were excluded as non-responders, the 559 who selected type IV constitute 65.5% of the remaining sample. Those who selected none were significantly less likely than all others to use sunscreen, and income and residential segregation were the strongest predictors of type I/II skin. CONCLUSION Standard administration of the Fitzpatrick Scale excludes the majority of Blacks, yields data that overestimate Black population prevalence of type IV skin, and excludes the Blacks who are least likely to use sunscreen. Suggestions are provided for improving the cultural sensitivity of the skin-type assessment.
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Affiliation(s)
- Latrice C Pichon
- The University of Michigan, School of Public Health, Health Management and Policy, Ann Arbor, MI 48109-2029, USA.
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Pichon LC, Mayer JA, Hoerster KD, Woodruff SI, Slymen DJ, Belch GE, Clapp EJ, Hurd AL, Forster JL, Weinstock MA. Youth access to artificial UV radiation exposure: practices of 3647 US indoor tanning facilities. ACTA ACUST UNITED AC 2009; 145:997-1002. [PMID: 19770438 DOI: 10.1001/archdermatol.2009.85] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess indoor tanning facility practices in a sample of facilities in 116 cities representing all 50 states. DESIGN Cross-sectional study. SETTING United States. PARTICIPANTS Employees of 3647 indoor tanning facilities were contacted by telephone. Data collectors (ie, confederates) posed as prospective, fair-skinned, 15-year-old female customers who had never tanned before. MAIN OUTCOME MEASURES Confederates asked respondents about their facility's practices related to parental consent, parental accompaniment, and allowable tanning session frequency. RESULTS Approximately 87% of the facilities required parental consent, 14% required parental accompaniment, 5% said they would not allow the confederate to tan owing to her age, and 71% would allow tanning every day the first week of indoor tanning. In Wisconsin, which bans indoor tanning among those younger than 16 years, 70% of facilities would not allow the confederate to tan. Multivariate analyses indicated that facilities in states with a youth access law were significantly more likely to require parental consent (P <.001) and parental accompaniment (P <.001) than those in states without a youth access law. Law was not significantly related to allowable tanning frequency (P = .81). Conclusion We recommend that additional states pass youth access legislation, preferably in the form of bans.
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Affiliation(s)
- Latrice C Pichon
- Graduate School of Public Health, 9245 Sky Park Ct, Ste 220, San Diego, CA 92123, USA
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Mayer JA, Slymen DJ, Clapp EJ, Pichon LC, Elder JP, Sallis JF, Eichenfield LF, Weinstock MA. Long-term maintenance of a successful occupational sun safety intervention. ACTA ACUST UNITED AC 2009; 145:88-9. [PMID: 19153354 DOI: 10.1001/archdermatol.2008.544] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Mayer JA, Hoerster KD, Pichon LC, Rubio DA, Woodruff SI, Forster JL. Enforcement of state indoor tanning laws in the United States. Prev Chronic Dis 2008; 5:A125. [PMID: 18793513 PMCID: PMC2578791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Twenty-eight US states have passed legislation for indoor tanning facilities. To our knowledge, whether these state laws are actually enforced has not been evaluated previously in all 28 states. Therefore, we interviewed key informants in these states to assess enforcement practices. METHODS Two trained interviewers used a structured survey instrument to interview 28 key informants who were knowledgeable about enforcement practices for laws regarding indoor tanning. Respondents provided information specific to the most populous city in their states. RESULTS Licensure for indoor tanning businesses was required in 22 of the 28 cities. Slightly less than half of the cities gave citations to tanning facilities that violated state law. Approximately 32% of the cities did not inspect indoor tanning facilities for compliance with state law, and another 32% conducted inspections less than annually. Of those cities that inspected at all, most conducted unannounced inspections. CONCLUSION The relatively low rates of annual inspections and citations are of concern. We recommend that future studies assess whether legislation, enforcement practices, or a combination of the 2 affects the practices of indoor tanning facilities or of consumers.
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Affiliation(s)
- Joni A Mayer
- Graduate School of Public Health, San Diego State University
| | - Katherine D Hoerster
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California
| | - Latrice C Pichon
- Joint Doctoral Program in Public Health, Health Behavior, San Diego State University/University of California
| | - Debra A Rubio
- School of Social Work, San Diego State University, San Diego, California
| | - Susan I Woodruff
- School of Social Work, San Diego State University, San Diego, California. At the time of this research, Susan I. Woodruff was affiliated with the Graduate School of Public Health, San Diego State University, San Diego, California
| | - Jean L Forster
- School of Public Health, University of Minnesota, Minneapolis, Minnesota
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Pichon LC, Arredondo EM, Roesch S, Sallis JF, Ayala GX, Elder JP. The relation of acculturation to latinas’ perceived neighborhood safety and physical activity: A structural equation analysis. Ann Behav Med 2007; 34:295-303. [PMID: 18020939 DOI: 10.1007/bf02874554] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Galindo GR, Mayer JA, Slymen D, Almaguer DD, Clapp E, Pichon LC, Hoerster K, Elder JP. Sun sensitivity in 5 US ethnoracial groups. Cutis 2007; 80:25-30. [PMID: 17725060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Some sun safety activities have included only non-Hispanic white individuals, even though individuals in other ethnoracial groups may be at risk for skin cancer. The objectives of this study were to investigate distributions of self-reported Fitzpatrick skin type within 5 ethnoracial groups and substantiate each group's self-report with an objective measure. The study used a cross-sectional design. The research was conducted at 70 postal stations in Southern California. Participants were US Postal Service letter carriers and included 115 Pacific Islanders, 222 black individuals, 329 Asians, 513 Hispanics, and 1364 non-Hispanic white individuals. Participants self-reported skin type and had skin color measurements taken with colorimeters. Some individuals in each ethnoracial group reported having sun-sensitive skin. Correlation tests assessing the relationship between skin type and colorimeter data showed substantial associations for each group except Asians. Future sun safety research and educational messages should include all potentially high-risk individuals, irrespective of ethnoracial identity.
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Affiliation(s)
- Gabriel R Galindo
- Graduate School of Public Health, San Diego State University, California 92182-4162, USA
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Woodruff SI, Pichon LC, Hoerster KD, Forster JL, Gilmer T, Mayer JA. Measuring the stringency of states' indoor tanning regulations: instrument development and outcomes. J Am Acad Dermatol 2007; 56:774-80. [PMID: 17276543 PMCID: PMC2659685 DOI: 10.1016/j.jaad.2006.12.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2006] [Revised: 11/14/2006] [Accepted: 12/26/2006] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We sought to describe the development of an instrument to quantify the stringency of state indoor tanning legislation in the United States, and the instrument's psychometric properties. The instrument was then used to rate the stringency of state laws. METHODS A 35-item instrument was developed. An overall stringency measure and 9 stringency subscales were developed, including one measuring minors' access to indoor tanning. Stringency measures showed good internal consistency and interrater reliability. RESULTS In all, 55% of the 50 states and the District of Columbia had any indoor tanning law, and 41% had any law addressing minors' access. Oregon, Illinois, South Carolina, Florida, Indiana, Iowa, and Rhode Island had high overall stringency scores, and Texas and New Hampshire were the most restrictive with regard to minors' access. LIMITATIONS Measurement of actual enforcement of the laws was not included in this study. CONCLUSIONS The instrument appears to be an easy-to-use, reliable, and valid methodology. Application of the instrument to actual laws showed that, in general, state laws are relatively weak, although there was considerable variability by state.
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Affiliation(s)
- Susan I Woodruff
- Graduate School of Public Health, San Diego State University, CA 92123, USA.
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Mayer JA, Slymen DJ, Clapp EJ, Pichon LC, Eckhardt L, Eichenfield LF, Elder JP, Sallis JF, Weinstock MA, Achter A, Balderrama C, Galindo GR, Oh SS. Promoting sun safety among US Postal Service letter carriers: impact of a 2-year intervention. Am J Public Health 2007; 97:559-65. [PMID: 17267715 PMCID: PMC1805012 DOI: 10.2105/ajph.2005.083907] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined whether US Postal Service letter carriers who received a sun safety intervention would wear wide-brim hats and sunscreen significantly more often than those who did not receive the intervention. METHODS We used a 2-group randomized design with 2662 evaluation cohort participants from 70 US postal stations. Evaluations were conducted at baseline, 3 months, 1 year, and 2 years. Questionnaire items assessed occupational use of sun-screen and wide-brim hats. The 2-year sun safety intervention included the provision of wide-brim hats, accessible sunscreen, reminders, and 6 educational sessions. RESULTS At the 3-month follow-up evaluations, the odds ratio (OR) for regular sun-screen use was 2.8 times higher among the intervention group than among the control group (95% confidence interval [CI]=2.2, 3.5); at the 2-year follow-up evaluations, the rate was still significantly higher (OR=2.0; 95% CI=1.6, 2.6). Intervention group participants also had significantly higher rates of hat use, with the differences remaining consistent across all follow-ups (OR=2.9; 95% CI=2.3, 3.6). CONCLUSIONS The intervention should be disseminated to postal stations nationwide and possibly to other occupational groups that work outdoors.
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Affiliation(s)
- Joni A Mayer
- Graduate School of Public Health, San Diego State University, San Diego 92123, USA.
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Abstract
BACKGROUND Few sun-safety studies have included ethnoracially diverse groups. Comparison across such groups of sun-safety behaviors was the main objective of this analysis. METHODS Postal workers (n =2543) self-reported frequency of sunscreen, wide-brim hat, and sunglasses use during the last 5 workdays on 5-point Likert-type scales ranging from "never" to "always." Responses were dichotomized by "always" versus all other responses. Generalized estimating equations were used to assess the association between ethnicity/race and frequency of each sun safety behavior. The baseline data reported in this paper were collected in the summer of 2001, and the randomized trial was completed in the summer of 2004. RESULTS Ethnicity/race was significantly related to sunscreen and sunglasses use. For both sunscreen and sunglasses, the white group had significantly higher "always" rates than the other four groups (30% vs 14% to 23% and 63% vs 44% to 52%, respectively). CONCLUSIONS The results of this study indicated that although non-Latino white employees tended to have higher rates of sun-safety behaviors, the rates of adequate protection of all groups were low.
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Affiliation(s)
- Latrice C Pichon
- Graduate School of Public Health, San Diego State University, San Diego, California 92182-4162, USA
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Oh SS, Mayer JA, Lewis EC, Slymen DJ, Sallis JF, Elder JP, Eckhardt L, Achter A, Weinstock M, Eichenfield L, Pichon LC, Galindo GR. Validating outdoor workers' self-report of sun protection. Prev Med 2004; 39:798-803. [PMID: 15351548 DOI: 10.1016/j.ypmed.2004.03.011] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Few studies assessing sun safety behaviors have used validated survey instruments. Using an observational strategy, this study measured the validity of self-report of occupational sun protection behaviors. METHODS Postal workers (N = 1,036) self-reported their frequency of protective clothing and sunglasses use during the past 5 workdays on Likert scales ranging from "Never" to "Always". Responses were dichotomized by Always vs. all other responses. Data collectors observed these same behaviors during mail delivery several days before survey administration. Agreement between the two measures was computed. RESULTS Self-report for all items was significantly related to observed behaviors, with Kappa values in the good to excellent range (Kappas = 0.51-0.83). CONCLUSIONS For outdoor postal workers, survey items assessing recent occupational use of sun-protective items had high levels of validity.
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Affiliation(s)
- Sam S Oh
- Graduate School of Public Health, San Diego State University, Hardy Tower 119, CA 92182-4162, USA
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