1
|
Hill SV, Pratt MC, Elopre L, Simpson T, Gaines Lanzi R, Matthews LT. "Nobody wants to have conversation about HIV." A thematic analysis of in-depth interviews with Black adolescent women and providers about strategies for discussing sexual health and HIV prevention. Sex Transm Dis 2024:00007435-990000000-00344. [PMID: 38597652 DOI: 10.1097/olq.0000000000001972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND Black adolescent girls and young women (AGYW) in the U.S. Southeast are disproportionately burdened by HIV. Infrequent assessment of sexual health in clinical encounters may contribute to low PrEP uptake for this population. This study explores Black AGYW and providers' perspectives on engaging in discussions about sexual health, including PrEP. METHODS In-depth interviews (IDIs) were conducted with Black AGYW ages 14-24 and healthcare providers (MD, DO, NP, PA) who self-reported caring for Black AGYWs in Alabama. IDIs were grounded in Andersen's Behavioral Model of Health Service Utilization to explore barriers and facilitators to sexual health discussions. After separate analyses, AGYW and provider IDIs were aggregated and reanalyzed using thematic analysis to identify themes related to their views on ways to improve Black AGYW engagement in sexual health discussions while in clinical settings. RESULTS Twelve Black AGYW and 11 providers completed IDIs. Client median age was 21, representing nine Alabama counties. Providers were predominately non-Hispanic White (82%), female (73%), and physicians (64%). Themes about ways to improve sexual health discussions included: 1) Improve sexual health education for providers and adolescents; 2) Normalize conversations in clinical settings; 3) Engage communities to continue these conversations outside of clinical settings. CONCLUSIONS Sexual health and HIV prevention discussions with Black AGYW are not occurring. This study is one of the first to to identify and highlight Black AGYW and provider-identified shared strategies for improving these discussions. Operationalizing these strategies is crucial to facilitating these discussions.
Collapse
Affiliation(s)
- Samantha V Hill
- University of Alabama at Birmingham (UAB), School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Birmingham, Alabama, USA
| | - Madeline C Pratt
- University of Alabama at Birmingham (UAB), School of Medicine, Department of Medicine, Division of Infectious Diseases, Birmingham, Alabama, USA
| | - Latesha Elopre
- University of Alabama at Birmingham (UAB), School of Medicine, Department of Medicine, Division of Infectious Diseases, Birmingham, Alabama, USA
| | - Tina Simpson
- University of Alabama at Birmingham (UAB), School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Birmingham, Alabama, USA
| | | | - Lynn T Matthews
- University of Alabama at Birmingham (UAB), School of Medicine, Department of Medicine, Division of Infectious Diseases, Birmingham, Alabama, USA
| |
Collapse
|
2
|
Hill SV, Hao J, Newlin-Bradner M, Long DM, Budhwani H, Simpson T. Re-evaluating the relationship between youth with HIV and BMI in an age of increasing rates of overweight and obese youth. BMC Res Notes 2024; 17:97. [PMID: 38561785 PMCID: PMC10983650 DOI: 10.1186/s13104-024-06741-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Newer antiretrivirals (ART) have shifted the metabolic experiences of people with HIV (PWH) from those of wasting syndrome to increases in body mass index (BMI). This study sought to examine the relationship between BMI and ART use among youth with HIV (YWH). METHODS Charts from YWH ages 10-24 with at least two documented BMIs at least 6 months apart between 2017 and 2020 were included (N = 44). Statistical analyses were conducted in SAS 9.4. RESULTS Clients were predominately African American (66%) males (73%) aged 19-24 years (64%), with men having sex with men (48%) being the most common mode of transmission. YWH on non-integrase inhibitor (INSTI) regimens had greater absolute increases in BMI compared to those on INSTI regimens (p = 0.03). Fourteen percent of clients using INSTI experienced an increase in BMI class from normal to overweight or overweight to obese; no non-INSTI users changed BMI class. Time since diagnosis and BMI change due to weight gain were positively associated (p = 0.03) among behaviorally-acquired YWH. CONCLUSIONS Increasing BMI and changing BMI classes may be more likely among YWH using INSTI. More longitudinal studies inclusive of diet and exercise profiles are needed to understand the relationship between INSTI and YWH BMI.
Collapse
Affiliation(s)
| | - Jiaying Hao
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Dustin M Long
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | |
Collapse
|
3
|
Budhwani H, Hao J, Maragh-Bass AC, Hill S, Long DM, Simpson T. Viral load and sexually transmitted infection testing among youth with HIV in a southern United States clinic. Int J STD AIDS 2024; 35:11-17. [PMID: 37678958 DOI: 10.1177/09564624231200917] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Background: As compared to their older peers, youth with HIV (YWH) are less likely to attain viral suppression and have higher rates of sexually transmitted infections (STI). In this exploratory study, we examine the relationship between HIV viral suppression, STI testing, and STI diagnosis among YWH receiving care at a clinic in the southern United States.Methods: Data from 933 clinical visits (2017-2020) were aggregated into singular patient records for YWH aged 10-24 years in Alabama (N = 139). Analyses included univariate generalized linear mixed models performed with the PROC GLIMMIX procedure approximating the marginal likelihood by using Laplace's method.Results: Sample median age was 22 years at the index visit. Most YWH were 20-24 years old (69.1%), male (67.6%), and identified as Black (77%); 58.3% were virally unsuppressed at index visit. YWH who identified as White or of other races had 4.79 times higher odds of being virally suppressed as compared to Black YWH (p < .01); STI testing behavior and STI positive diagnosis were associated with lower odds of being virally suppression.Conclusions: Findings suggest that among YWH, receiving STI testing and having an STI diagnosis is associated with a lack of viral suppression, suggesting that extra efforts may be necessary to support YWH who have an STI to attain suppression. Research is needed to examine individual behaviors, structural forces, and clinic features that could impact STI care engagement, specifically among unsuppressed YWH.
Collapse
Affiliation(s)
- Henna Budhwani
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Jiaying Hao
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allysha C Maragh-Bass
- Behavioral, Epidemiological, and Clinical Sciences Division, FHI 360, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Samantha Hill
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dustin M Long
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tina Simpson
- Tulane University, School of Medicine, New Orleans, LA, USA
| |
Collapse
|
4
|
Isehunwa OO, Hill SV, Menninger AT, Hubner B, Krakower D, Long DM, Pratt MC, Clement ME, Wagoner NV, Lanzi RG, Simpson T, Elopre L, Matthews LT. A Multicomponent Intervention to Train and Support Family Medicine Providers to Promote Pre-exposure Prophylaxis (PrEP) for Adolescent Girls and Young Women in the Deep South: Protocol for the PrEP-Pro Study. JMIR Res Protoc 2023; 12:e44908. [PMID: 36943364 PMCID: PMC10131664 DOI: 10.2196/44908] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP) is a highly effective biomedical prevention intervention and a major strategy for reducing the HIV burden in the United States. However, PrEP provision and uptake remain lower than estimated needs, and in ways that may exacerbate HIV disparities among Black adolescent girls and young women in the southern United States. Data suggest that gaps in provider knowledge of HIV epidemiology and PrEP and skills assessing sexual health practices are important barriers to provision and uptake, with limited evidence-based interventions to address these gaps. OBJECTIVE This paper describes the "PrEP-Pro" intervention, a multicomponent intervention to train and support family medicine (FM) trainees to promote PrEP for adolescent girls and young women in Alabama. METHODS The PrEP-Pro intervention comprises 3 main components guided by the Capability-Opportunity-Motivation-Behavior (COM-B) model for behavioral change and the Consolidated Framework for Implementation Research (CFIR): (1) provider HIV epidemiology and PrEP education, (2) sexual history taking, and (3) PrEP Champions. In phase 1, we will work with community advisory boards (providers and clients) and then conduct focus groups with FM trainees to adapt content to train FM residents on HIV epidemiology and PrEP and develop implementation strategies, including provider-facing tools and client-facing educational materials. In phase 2, we will pretest and then pilot-test the initially adapted PrEP-Pro intervention with FM trainees. FM trainees will complete baseline, 3-, and 6-month questionnaires post PrEP-Pro intervention. We will also conduct in-depth interviews (IDIs) with FM pilot participants, adolescent girls and young women who accessed care after the PrEP-Pro pilot, and key stakeholders. The primary outcomes are PrEP-Pro acceptability and feasibility, which would be assessed using validated instruments at months 3 (among pretest participants) and 6 (among pilot participants). Secondary outcomes will also be assessed, including PrEP knowledge, sexual history-taking attitudes and practices, PrEP prescriptions among adolescent girls and young women encounters, and sexually transmitted infections (STIs) and HIV testing among adolescent girls and young women encounters in 6 months. RESULTS Study results will be disseminated to practices, state health officials, and other key stakeholders to solicit feedback on implementation opportunities and challenges to inform a hybrid effectiveness implementation trial. Our results will also be presented at local and national conferences and submitted to peer-reviewed journals. CONCLUSIONS As PrEP grows, there is a pressing need to train FM providers and develop appropriate, contextually relevant tools to support PrEP implementation. The PrEP-Pro intervention is a multicomponent intervention to train FM residents across Alabama on sexual history-taking, PrEP provision for adolescent girls and young women, and supporting practice-based PrEP Champions. The PrEP-Pro intervention is anticipated to increase PrEP prescriptions for adolescent girls and young women and expand comprehensive sexual and reproductive health care for adolescent girls and young women in rural and urban Alabama. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/44908.
Collapse
Affiliation(s)
- Oluwaseyi O Isehunwa
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Samantha V Hill
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Alex Tobias Menninger
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
- School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Brook Hubner
- Department of Medical Education, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Douglas Krakower
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Dustin M Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Madeline C Pratt
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Meredith E Clement
- Section of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Nicholas Van Wagoner
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Robin Gaines Lanzi
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tina Simpson
- Tulane University School of Medicine, New Orleans, LA, United States
| | - Latesha Elopre
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Lynn T Matthews
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| |
Collapse
|
5
|
Grealish L, Todd J, Teodorczuk A, Krug M, Simpson T, Jenkinson K, Soltau D, Stockwell-Smith G. Erratum to ’Feasibility of a two-part person-centred care initiative for people living with dementia in acute hospitals: A mixed method study’ International Journal of Nursing Studies Advances, 3 (2021) Article Number: 100040. International Journal of Nursing Studies Advances 2022. [DOI: 10.1016/j.ijnsa.2022.100104] [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: 12/12/2022] Open
|
6
|
Simpson T, Evans J, Goepfert A, Elopre L. Implementing a graduate medical education anti-racism workshop at an academic university in the Southern USA. Med Educ Online 2022; 27:1981803. [PMID: 34813390 PMCID: PMC8635611 DOI: 10.1080/10872981.2021.1981803] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Coronavirus Disease 2019 (COVID-19) and the social justice movement in early 2020 awakened many Americans to the health disparities and health care inequities affecting Black communities. This heightened awareness has strengthened the call to address social determinants of health, like racism. Physicians can play an important role in dismantling racism through knowledge of implicit biases and understanding of historical trauma resulting in medical distrust as a crucial step to help advance the health of minority communities. The purpose of this project was to develop an anti-racism workshop for Graduate Medical Education. Two discussants led 1.5-hour interactive workshops. Content covered microagressions, colorblindness, tokenism, stereotypes, levels of racism, the impact of racism on health, and anti-racism concepts. Facilitated breakout sessions allowed participants to provide examples of witnessed racism and discuss application of anti-racism tools in those settings. Following the workshops, participants were asked to complete a 16-item survey to evaluate workshop effectiveness. Between July and August 2020, four workshops were delivered to 131 attendees. Fifty-nine completed post workshop surveys. Most respondents were White (75%), female (63%), and aged 31-40 (29%). Over half were faculty; 24% were residents, 8% fellows. The majority agreed they could apply knowledge to their work (95%) and found the workshop useful (95%). Over two-thirds reported being able to better identify disparities and better identify and communicate about racism. In open-ended questions, many participants requested an interactive longitudinal curriculum. Developing an antiracism workshop for an academic medical center located in the Deep South provided more insight into tangible next steps to foster an institutional culture centered on antiracism.
Collapse
Affiliation(s)
- Tina Simpson
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, USA
| | - Justin Evans
- Department of Medicine USA, University of Alabama at Birmingham, Birmingham, USA
| | - Alice Goepfert
- Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, USA
| | - Latesha Elopre
- Department of Medicine USA, University of Alabama at Birmingham, Birmingham, USA
- CONTACT Latesha Elopre Department of Medicine USA, University of Alabama at Birmingham, 845 19 Street South, BBRB 206, Birmingham, AL35205, USA
| |
Collapse
|
7
|
Billy H, Simpson T. IBC-Ox24 Routine Oversewing of Staple Lines to Prevent Leaks is Unnecessary in Patients with Normal Iintraoperative Indocyanine Green (ICG) Perfusion Studies Uundergoing Sleeve Gastrectomy. Br J Surg 2022. [DOI: 10.1093/bjs/znac402.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Abstract
Anastomotic staple line leaks following laparoscopic sleeve gastrectomy is a devastating complication. Gastric ischemia and poor tissue perfusion has been hypothesized to be a contributing factor. Various interventions including oversewing of staple lines are commonly used hoping to decrease staple line leaks. Indocyanine green (ICG) can be used to assess bowel perfusion and anastomotic viability following laparoscopic surgery. 50 consecutive patients underwent laparoscopic sleeve gastrectomy utilizing intravenous administration of ICG to assess tissue perfusion and the need for staple line oversewing.
Methods
50 consecutive patients undergoing laparoscopic sleeve gastrectomy were studied intraoperatively after completion of sleeve gastrectomy using intravenous administration of ICG. 7.5 mg of ICG was administered intravenously. Arterial perfusion and end stage tissue perfusion of the completed sleeve gastrectomy was then evaluated. Vascular arterial inflow of the gastric cardia, body and antrum was carefully evaluated both anteriorly and posteriorly for evidence of delayed tissue perfusion or tissue ischemia.
Results
In all cases the staple line was examined for staple line formation and evidence of poor tissue perfusion using ICG. Both anterior and posterior evaluation was performed of the distal esophagus, gastric cardia, gastric body and antrum. Absence of tissue perfusion in the resected gastric body was used as a comparison control in all cases. ICG perfusion of the gastric cardia, body and antrum was found to be excellent and brisk in all patients. There were no areas of decreased perfusion or tissue ischemia. Oversewing of the staple line was avoided in all cases. Hemostatic clips were deployed as needed for staple line bleeding until there was no evidence of bleeding on visual inspection and final ICG administration. Patients were followed for evidence of leakage or obstruction for 30 days following completion of the sleeve gastrectomy. There were no leaks, there were no deaths. There were no obstructions and no readmissions. There were no complications related to administration of ICG. Average operative time was 48.7 minutes.
Conclusions
Our series of 50 consecutive sleeve gastrectomies utilizing ICG to assess for tissue perfusion demonstrated no evidence of tissue perfusion deficiencies along the staple line or at the angle of His. Staple line oversewing was not used in any patients. Staple line oversewing in cases without evidence of tissue perfusion deficits on ICG evaluation following sleeve gastrectomy is unnecessary. Further multicenter studies and prospective randomized series are necessary to confirm these initial findings.
Collapse
|
8
|
Simpson T, Billy H. IBC-Ox22 Greater Adherence to Mediterranean Diet leads to longer term weight loss. Br J Surg 2022. [DOI: 10.1093/bjs/znac402.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Abstract
We were able to obtain dietary data of 134 weight loss surgery patients with an average follow up of five years with annual scoring of the 9 point Mediterranean Diet. The closer adherence to the MD showed more weight loss than those who had not.
Background
The Mediterranean Diet has been associated with decreased all cause mortality for those who adhere strongly to it, as well as decreased risk of heart disease, and cancer. The diet is rich in polyphenols with fruits, vegetables, legumes, fish, mono-unsaturated fats, whole grains, while minimizing dairy, meat and poultry, and some moderate alcohol consumption.
Methods
Pre operatively all bariatric patients patients were counseled about the Mediterranean diet, how to score the diet, and adherence to the diet was reemphasized at their follow ups. Annually they were asked to fill out their scores. We looked at other diet plans that some of the patients reported (low carbohydrate, weight watchers) and the results were not significant.
Results
Of the 134 patients there were 65 which had scores of 5 points or more and showed an absolute reduction in weight of 54% total weight loss on average, vs those of 1-3 who had 32% total weight loss (total of 60 patients). The remaining 9 patients who escorted 4 points had a wide spread of weight loss that could not be calculated (these patients predominantly followed a self-described low-carbohydrate diet). There was no difference in weight loss regarding the type of surgery that the patient had (Lap-Band (N=74) vs Gastric Sleeve (N=50) vs Gastric bypass (N=10). Nor was there any difference in weight loss when measuring physical activity.
Using the 9 point scale of the Mediterranean Diet those who had greater than 5 of the 9 points on the MD had greater weight loss over five years than those who were 0-3. Those who scored 4 points were indeterminate.
Conclusions
The Mediterranean Diet scale provides a quick and easy guide, providing targets for patients (example, less than 4 ounces per day of poultry or meat is a point, more is 0 points). The emphasis on a post operative diet for health, as opposed to weight loss, inadvertently provided a good model for post operative weight loss.
Collapse
|
9
|
Budhwani H, Hao J, Maragh-Bass AC, Hill SV, Long DM, Simpson T. Gaps in sexually transmitted infection screening among youth living with HIV in Alabama. BMC Res Notes 2022; 15:347. [PMID: 36348439 PMCID: PMC9644521 DOI: 10.1186/s13104-022-06241-7] [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] [Received: 05/12/2022] [Revised: 09/21/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Gaps in sexually transmitted infection (STI) testing can lead to poor health outcomes due to untreated illness among youth living with HIV (YLHIV). Thus, the objective of this study is to examine STI testing behavior and outcomes among a sample of YLHIV in the southern United States. Clinical records of 139 YLHIV who received HIV care in Alabama (2017-2020) were evaluated for receipt of STI testing (gonorrhea, chlamydia, syphilis), prevalence of positive test results, and factors associated with testing outcomes (933 clinical visits). RESULTS Nearly 80% of our sample identified as African American, most were 20-24 years, and about 60% reported detectable viral load at first visit during the study period. Just under 60% of cisgender male and transgender female clients reported receipt of at least one STI test, compared to less than 40% of cisgender females. Identifying as a cisgender male and having been diagnosed with HIV related to sex with men were associated with greater likelihood receiving STI testing. Cisgender males reported higher rates of positive syphilis test results than cisgender females; the highest rates of positive STI tests were among transgender females. Results underscore need for providers to promote routine STI testing to YLHIV.
Collapse
Affiliation(s)
- Henna Budhwani
- College of Nursing, Florida State University, Tallahassee, FL, USA.
| | - Jiaying Hao
- grid.265892.20000000106344187School of Public Health, University of Alabama at Birmingham, Birmingham, AL USA
| | - Allysha C. Maragh-Bass
- Behavioral, Epidemiological, and Clinical Sciences Division, FHI 360 Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Global Health Institute, Duke University, Durham, NC USA
| | - Samantha V. Hill
- grid.265892.20000000106344187School of Medicine, University of Alabama at Birmingham, Birmingham, AL USA
| | - Dustin M. Long
- grid.265892.20000000106344187School of Public Health, University of Alabama at Birmingham, Birmingham, AL USA
| | - Tina Simpson
- grid.265892.20000000106344187School of Medicine, University of Alabama at Birmingham, Birmingham, AL USA
| |
Collapse
|
10
|
Hill SV, Pratt MC, Elopre L, Smith TV, Simpson T, Lanzi R, Matthews LT. "Let's take that [stop sign] down." Provider perspectives on barriers to and opportunities for PrEP prescription to African American girls and young women in Alabama. AIDS Care 2022; 34:1473-1480. [PMID: 35914114 PMCID: PMC9889573 DOI: 10.1080/09540121.2022.2105799] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/20/2022] [Indexed: 02/03/2023]
Abstract
HIV disproportionately impacts many groups, including Black adolescent girls and young women (AGYW) aged 13-24 living in the Deep South. Current prevention efforts have the potential to further exacerbate disparities within this population as HIV pre-exposure prophylaxis (PrEP) remains underutilized by Black AGYW in the South. We conducted in-depth interviews (IDIs) grounded in Andersen's Model of Healthcare Utilization exploring providers' PrEP prescribing practices to Black AGYW in Alabama. Eleven providers completed IDIs exploring providers' PrEP prescription knowledge and experiences. Cross-cutting themes included: (1) Community and provider-level stigmas (including those propagated by legislation) relating to HIV and sexuality limit sexual health discussions with Black AGYW clients; (2) Low PrEP knowledge and comfort with guidelines limits PrEP conversations and reinforces low uptake and prescriptions; (3) Healthcare systems and structural barriers impede PrEP access for youth. Multi-level (structural, community, and provider) barriers to PrEP prescription demands high activation energy for providers to prescribe PrEP. We present recommendations in training in sexual health assessment, updates to PrEP guidelines to accommodate risk assessment appropriate for AGYW, and increased implementation science focused on PrEP prescription for Black AGYW in order to reduce HIV incidence for this population.
Collapse
Affiliation(s)
- Samantha V. Hill
- Department of Pediatrics, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - M. C. Pratt
- Division of Infectious Diseases, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - L. Elopre
- Division of Infectious Diseases, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - T. V. Smith
- Department of Pediatrics, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - T. Simpson
- Department of Pediatrics, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - R. Lanzi
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - L. T. Matthews
- Division of Infectious Diseases, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| |
Collapse
|
11
|
Budhwani H, Sharma V, Long D, Simpson T. Developing a Clinic-Based, Vaccine-Promoting Intervention for African American Youth in Rural Alabama: Protocol for a Pilot Cluster-Randomized Controlled Implementation Science Trial. JMIR Res Protoc 2022; 11:e33982. [PMID: 35212640 PMCID: PMC8998367 DOI: 10.2196/33982] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/20/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND African American youth in rural Alabama are clinically underserved and have limited knowledge about the human papillomavirus and the novel coronavirus 2019 (COVID-19) vaccines, including knowledge about the risk for developing cervical or oropharyngeal cancers or COVID-19. OBJECTIVE In this 30-month study, we propose to develop an in-clinic, youth-tailored, vaccine-promoting intervention for vaccine hesitancy reduction that can be seamlessly integrated into the existing environments of pediatric and family practice settings in rural Alabama. METHODS This exploratory, sequential mixed methods study will be conducted in 3 phases. In the first phase, we will assess stakeholders' knowledge, sentiments, and beliefs related to vaccination in general, COVID-19 vaccination, and human papillomavirus vaccination. We will also assess stakeholders' perceptions of barriers to vaccination that exist in rural Alabama. This will be followed by a second phase wherein we will use the data collected in the first phase to inform the development and finalization of a noninvasive, modular, synchronous counseling intervention that targets the behaviors of 15- to 26-year-old adolescents. In the third phase, we will conduct a pilot hybrid type 1 effectiveness-implementation cluster-randomized controlled trial to assess intervention acceptability and feasibility (clinics: N=4; African American youth: N=120) while assessing a "clinical signal" of effectiveness. We will document implementation contexts to provide real-world insight and support dissemination and scale-up. RESULTS The study was funded at the end of December 2020. Approval from the University of Alabama at Birmingham Institutional Review Board was obtained in May 2021, and the qualitative data collection process outlined in the first phase of this project concluded in November 2021. The entire study is expected to be complete at the end of December 2023. CONCLUSIONS The results of the trial will provide much needed information on vaccine hesitancy in rural Alabama, and if found efficacious, the intervention could notably increase rates of vaccinations in one of the most underserved parts of the United States. The results from the trial will provide information that is valuable to public health practitioners and providers in rural settings to inform their efforts in increasing vaccination rates among 15- to 26-year-old African American youth in rural southern United States. TRIAL REGISTRATION ClinicalTrials.gov NCT04604743; https://clinicaltrials.gov/ct2/show/NCT04604743. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/33982.
Collapse
Affiliation(s)
- Henna Budhwani
- Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Vinita Sharma
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States
| | - Dustin Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tina Simpson
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| |
Collapse
|
12
|
Pratt MC, Jeffcoat S, Hill SV, Gill E, Elopre L, Simpson T, Lanzi R, Matthews LT. "We Feel Like Everybody's Going to Judge us": Black Adolescent Girls' and Young Women's Perspectives on Barriers to and Opportunities for Improving Sexual Health Care, Including PrEP, in the Southern U.S. J Int Assoc Provid AIDS Care 2022; 21:23259582221107327. [PMID: 35699978 PMCID: PMC9201301 DOI: 10.1177/23259582221107327] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Black adolescent girls and young women (AGYW) are disproportionately affected by
HIV in the southern U.S.; however, PrEP prescriptions to Black AGYW remain
scarce. We conducted in-depth interviews (IDIs) with Black AGYW ages 14-24 in
Alabama to explore opportunities for and barriers to sexual health care
including PrEP prescription. Twelve AGYW participated in IDIs with median age 20
(range 19-24). All reported condomless sex, 1-3 sexual partners in the past 3
months, and 6 reported prior STI. Themes included: 1) Stigma related to sex
contributes to inadequate discussions with educators, healthcare providers, and
parents about sexual health; 2) Intersecting stigmas around race and gender
impact Black women's care-seeking behavior; 3) Many AGYW are aware of PrEP but
don't perceive it as an option for them. Multifaceted interventions utilizing
the perspectives, voices, and experiences of Black cisgender AGYW are needed to
curb the HIV epidemic in Alabama and the U.S. South.
Collapse
Affiliation(s)
- Madeline C Pratt
- Division of Infectious Diseases, Department of Medicine, School of Medicine, 9968University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | | | - Samantha V Hill
- Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Elizabeth Gill
- School of Medicine, 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Latesha Elopre
- Division of Infectious Diseases, Department of Medicine, School of Medicine, 9968University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Tina Simpson
- Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robin Lanzi
- Department of Health Behavior, School of Public Health, 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lynn T Matthews
- Division of Infectious Diseases, Department of Medicine, School of Medicine, 9968University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| |
Collapse
|
13
|
Pratt MC, Hill SV, Elopre L, Simpson T, Lanzi R, Matthews LT. PrEP Prescription for Black Adolescent Girls and Young Women in Alabama: Findings from a Survey of Healthcare Providers. J Int Assoc Provid AIDS Care 2022; 21:23259582221127936. [PMID: 36147031 PMCID: PMC9511308 DOI: 10.1177/23259582221127936] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Black adolescent girls and young women (AGYW) are disproportionately affected by HIV in the United States. HIV pre-exposure prophylaxis (PrEP) is effective for HIV prevention, but prescription rates remain low. We conducted a survey of medical providers caring for Black AGYW in Alabama to explore PrEP prescription practices. While over half of the N = 36 providers reported minimal HIV testing of AGYW in clinic, most (N = 29, 81%) reported feeling confident discussing HIV prevention. Most reported willingness to prescribe PrEP to Black AGYW (58%-72%), but only 11 (31%) had prescribed PrEP to any female client. Low familiarity with CDC guidelines (N = 20, 56%) and PrEP options (N = 19, 53%) were barriers to prescription. Prescribing PrEP to AGYW was associated with provider training, with internal medicine providers being least likely to prescribe. These findings support the need to develop training tools to directly address unique training needs of providers who care for this population.
Collapse
Affiliation(s)
- Madeline C Pratt
- Department of Medicine, Division of Infectious Diseases, 9967School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Samantha V Hill
- Department of Pediatrics, Division of Adolescent Medicine, 9967School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Latesha Elopre
- Department of Medicine, Division of Infectious Diseases, 9967School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Tina Simpson
- Department of Pediatrics, Division of Adolescent Medicine, 9967School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Robin Lanzi
- Department of Health Behavior, 48653School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Lynn T Matthews
- Department of Medicine, Division of Infectious Diseases, 9967School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| |
Collapse
|
14
|
Ford CA, Bourgeois F, Buckelew SM, Emans SJ, English A, Evans YN, Irwin CE, Richardson LP, Sherer S, Short S, Sieving RE, Simpson T, Tanaka D, White K. Twenty-First Century Cures Act Final Rule and Adolescent Health Care: Leadership Education in Adolescent Health (LEAH) Program Experiences. J Adolesc Health 2021; 69:873-877. [PMID: 34666958 DOI: 10.1016/j.jadohealth.2021.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Carol A Ford
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine/Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
| | - Fabienne Bourgeois
- Department of Pediatrics, Harvard Medical School/Boston Children's Hospital, Boston, Massachusetts
| | - Sara M Buckelew
- Department of Pediatrics, University of California at San Francisco/Benioff Children's Hospitals, San Francisco, California
| | - S Jean Emans
- Department of Pediatrics, Harvard Medical School/Boston Children's Hospital, Boston, Massachusetts
| | - Abigail English
- Center for Adolescent Health & the Law, Chapel Hill, North Carolina
| | - Yolanda N Evans
- Department of Pediatrics, University of Washington/Seattle Children's Hospital, Seattle, Washington
| | - Charles E Irwin
- Department of Pediatrics, University of California at San Francisco/Benioff Children's Hospitals, San Francisco, California
| | - Laura P Richardson
- Department of Pediatrics, University of Washington/Seattle Children's Hospital, Seattle, Washington
| | - Sara Sherer
- Department of Pediatrics, University of Southern California/Children's Hospital of Los Angeles, Los Angeles, California
| | - Sonja Short
- Department of Medical Informatics, University of Minnesota/Fairview Health System, Eagan, Minnesota
| | - Renee E Sieving
- School of Nursing and Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Tina Simpson
- Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | - Diane Tanaka
- Department of Pediatrics, University of Southern California/Children's Hospital of Los Angeles, Los Angeles, California
| | - Krishna White
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine/Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| |
Collapse
|
15
|
Budhwani H, Maycock T, Murrell W, Simpson T. COVID-19 Vaccine Sentiments Among African American or Black Adolescents in Rural Alabama. J Adolesc Health 2021; 69:1041-1043. [PMID: 34666953 PMCID: PMC8494651 DOI: 10.1016/j.jadohealth.2021.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/20/2021] [Accepted: 09/09/2021] [Indexed: 12/25/2022]
Abstract
Considering the urgent need to increase vaccine uptake in Alabama, a rural state with the lowest rates of COVID-19 vaccination in the country, we conducted an exploratory study to elucidate sentiments toward vaccination among African American or black adolescents. We conducted in-depth interviews with 15-17 year olds in rural Alabama (N = 28). About 54% of our sample were female. Nearly a third lived with an older family member; 18% knew someone who contracted COVID-19. Using Rapid Qualitative Analysis, 3 COVID-19 vaccine-related themes emerged: influence of community leaders and older family members, fear of side effects and misinformation, and institutional distrust. To address COVID-19 vaccine hesitancy among rural African American or black adolescents, we suggest adopting a socioecological approach to public health messaging that addresses misinformation and government distrust and is delivered by local influencers with the social capital necessary to promote behavior change, namely older family members and Church officials.
Collapse
Affiliation(s)
- Henna Budhwani
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Tiffani Maycock
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Wilnadia Murrell
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Tina Simpson
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| |
Collapse
|
16
|
Gupta K, Harrison SA, Davis NA, Culp ML, Hand SC, Simpson T, Van Der Pol B, Galbraith JW, Van Wagoner NJ, Morrison SG, Morrison RP, Geisler WM. Prevalence of Chlamydia trachomatis Infection in Young Women and Associated Predictors. Sex Transm Dis 2021; 48:529-535. [PMID: 34110759 PMCID: PMC8847232 DOI: 10.1097/olq.0000000000001372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chlamydia trachomatis (CT) infection remains highly prevalent, and young women are disproportionately affected. Most CT-infected women are asymptomatic, and their infection often goes unrecognized and untreated. We hypothesized that testing for active CT infection with molecular diagnostics and obtaining a reported history of CT infection underestimate the prevalence of current and past CT infection, and incorporating serum CT antibody testing in addition to these other prevalence measures would generate more accurate estimates of the prevalence of CT infection in asymptomatic young women. METHODS We enrolled 362 asymptomatic women aged 16 to 29 years at 4 different clinical settings in Birmingham, AL, between August 2016 and January 2020 and determined the prevalence of CT infection based on having 1 or more of the following prevalence measures: an active urogenital CT infection based on molecular testing, reported prior CT infection, and/or being CT seropositive. Multivariable regression analysis was used to determine predictors of the prevalence of CT infection after adjustment for participant characteristics. RESULTS The prevalence of CT infection was 67.7% (95% confidence interval, 62.6%-72.5%). Addition of CT antibody testing to the other individual prevalence measures more than doubled the CT infection prevalence. Non-Hispanic Black race, reported prior gonorrhea, and reported prior trichomoniasis predicted a higher prevalence of CT infection. CONCLUSIONS More than half of women were unaware of ever having CT infection, suggesting many were at risk for CT-associated reproductive complications. These data reinforce the need to adhere to chlamydia screening guidelines and to increase screening coverage in those at risk.
Collapse
Affiliation(s)
- Kanupriya Gupta
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sally A. Harrison
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nkele A. Davis
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Matilda L. Culp
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Samuel C. Hand
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tina Simpson
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barbara Van Der Pol
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James W. Galbraith
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nicholas J. Van Wagoner
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sandra G. Morrison
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Richard P. Morrison
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - William M. Geisler
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
17
|
Coyne-Beasley T, Hill SV, Zimet G, Kanbur N, Kimberlin D, Raymond-Flesch M, Simpson T, Svetaz MV, Trent M, Walker-Harding L. COVID-19 Vaccination of Adolescents and Young Adults of Color: Viewing Acceptance and Uptake With a Health Equity Lens. J Adolesc Health 2021; 68:844-846. [PMID: 33814282 PMCID: PMC8016552 DOI: 10.1016/j.jadohealth.2021.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Tamera Coyne-Beasley
- Division of Adolescent Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Samantha V. Hill
- Division of Adolescent Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gregory Zimet
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University, Indianapolis, Indiana
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara-Turkey, Ihsan Dogramaci Childrens Hospital, Altindag, Ankara-Turkey
| | - David Kimberlin
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Marissa Raymond-Flesch
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Philip R. Lee Institute of Health Policy Studies, University of California, San Francisco, California
| | - Tina Simpson
- Division of Adolescent Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Maria Veronica Svetaz
- Department of Family and Community Medicine, School of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Maria Trent
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins Children's Center, Baltimore, Maryland
| | | |
Collapse
|
18
|
Oketah N, Wokoma C, Klein JD, Galagali P, Simpson T, Offutt L. International Adolescent Health Week: Nothing About Them Without Them. J Adolesc Health 2021; 68:646-647. [PMID: 33582016 DOI: 10.1016/j.jadohealth.2021.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Ngozi Oketah
- Department of Pediatrics, Royal Belfast Hospital for Sick Children, Belfast, United Kingdom
| | | | - Jonathan D Klein
- Department of Pediatrics, The University of Illinois at Chicago, Chicago, Illinois
| | - Preeti Galagali
- Bengaluru Adolescent Care and Counselling Centre, Bengaluru, Karnataka, India
| | - Tina Simpson
- Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Laura Offutt
- Real Talk with Dr. Offutt, LLC; International Adolescent Health Week, Wayne, Pennsylvania.
| |
Collapse
|
19
|
Hill SV, Johnson J, Rahman F, Dauria EF, Mugavero M, Matthews LT, Simpson T, Elopre L. Exploring adults as support persons for improved pre-exposure prophylaxis for HIV use among select adolescents and young adults in the Deep South. PLoS One 2021; 16:e0248858. [PMID: 33740005 PMCID: PMC7978356 DOI: 10.1371/journal.pone.0248858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Pre-exposure prophylaxis for HIV (PrEP) is an effective yet underutilized biomedical tool for adolescents and young adults' (AYA) HIV prevention due to barriers such as PrEP adherence. We assessed HIV prevention knowledge, attitudes and beliefs from adults who self-identified as a primary support person to an AYA. METHODS We surveyed AYA primary support persons at an academic hospital. Univariate and multivariate regression analyses were completed to identify factors associated with the belief AYAs engaging in HIV-associated behaviors should use PrEP and willingness to support AYAs on PrEP. RESULTS 200 primary support persons completed the survey. Participants were predominately female (77%) and black (56%). Nearly all primary support persons believed AYAs engaging in HIV-associated behaviors should take PrEP (94%) and 98% would support an AYA taking PrEP via transportation to appointments, assistance with refilling prescriptions, medication reminders, or encouragement. CONCLUSIONS Primary support persons are willing to support AYAs using PrEP.
Collapse
Affiliation(s)
- Samantha V Hill
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States of America
| | - Jarvis Johnson
- Division of Infectious Diseases, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Fazlur Rahman
- Department of Biostatistics, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Emily F Dauria
- Division of Infant, Child and Adolescent Psychiatry, The University of California San Francisco, San Francisco, California, United States of America
| | - Michael Mugavero
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Lynn T Matthews
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Tina Simpson
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States of America
| | - Latesha Elopre
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| |
Collapse
|
20
|
Svetaz MV, Barral R, Kelley MA, Simpson T, Chulani V, Raymond-Flesch M, Coyne-Beasley T, Trent M, Ginsburg K, Kanbur N. Inaction Is Not an Option: Using Antiracism Approaches to Address Health Inequities and Racism and Respond to Current Challenges Affecting Youth. J Adolesc Health 2020; 67:323-325. [PMID: 32829758 PMCID: PMC7439086 DOI: 10.1016/j.jadohealth.2020.06.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Maria Veronica Svetaz
- Department of Family and Community Medicine, Leadership Education for Adolescent Health Program, Hennepin Healthcare, University of Minnesota, Minneapolis, Minnesota.
| | - Romina Barral
- Division of Adolescent Medicine, Children's Mercy Hospital Kansas City, Kansas City, Missouri,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, University of Kansas, Kansas City, Missouri
| | | | - Tina Simpson
- Division of Adolescent Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Vinny Chulani
- Department of Pediatrics and Adolescent Medicine, Phoenix Children's Hospital, Phoenix, Arizona
| | - Marissa Raymond-Flesch
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, San Francisco, California
| | - Tamera Coyne-Beasley
- Division of Adolescent Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Maria Trent
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kenneth Ginsburg
- Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
21
|
Emans SJ, Ford CA, Irwin CE, Richardson LP, Sherer S, Sieving RE, Simpson T. Early COVID-19 Impact on Adolescent Health and Medicine Programs in the United States: LEAH Program Leadership Reflections. J Adolesc Health 2020; 67:11-15. [PMID: 32402799 PMCID: PMC7177083 DOI: 10.1016/j.jadohealth.2020.04.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 11/04/2022]
Affiliation(s)
- S. Jean Emans
- Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Carol A. Ford
- Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania,Address correspondence to: Carol A. Ford, M.D., Division of Adolescent Medicine, Department of Pediatrics, University of Pennsylvania, Children’s Hospital of Philadelphia, Buerger Building, 12th Floor, Philadelphia, PA 19104-4399.
| | - Charles E. Irwin
- University of California, San Francisco, San Francisco, California
| | | | - Sara Sherer
- Children’s Hospital of Los Angeles and the University of Southern California, Los Angeles, California
| | | | - Tina Simpson
- University of Alabama at Birmingham, Birmingham, Alabama
| |
Collapse
|
22
|
Budhwani H, Mills L, Marefka LEB, Eady S, Nghiem VT, Simpson T. Preliminary study on HIV status disclosure to perinatal infected children: retrospective analysis of administrative records from a pediatric HIV clinic in the southern United States. BMC Res Notes 2020; 13:253. [PMID: 32448309 PMCID: PMC7247121 DOI: 10.1186/s13104-020-05097-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/16/2020] [Accepted: 05/19/2020] [Indexed: 11/20/2022] Open
Abstract
Objective The World Health Organization recommends disclosing HIV-status between 6 and 12 years; American Academy of Pediatrics recommends that children are informed at “school age.” Neither suggests an optimal age when children should learn of their status to improve viral load suppression. Considering that virally suppressed people do not transmit HIV and that interrupting the transmission cycle is critical to ending the HIV epidemic, our objective is to examine the relationship between age of disclosure and viral load suppression by evaluating data from a pediatric HIV clinic in the southern United States. Records from perinatal infected patients seen between 2008 and 2018 were analyzed (N = 61). Results Longitudinal suppression was low across all groups when benchmarked against the UNAIDS 90% global target; black patients were less likely to achieve suppression compared to white patients (41% vs. 75%, p = 0.04). Adopted children were more likely to achieve suppression than children living with biological family (71% vs. 44%, p < 0.05). Children who learned of their status between 10 and 12 had the highest rate of suppression (65%) compared to peers who learned of their status younger (56%) or older (38%). Our preliminary study is designed to spark research on refining the current recommendations on HIV-status disclosure to perinatal infected children.
Collapse
Affiliation(s)
- Henna Budhwani
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA.
| | - Lori Mills
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA
| | - Lauren E B Marefka
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA
| | - Sequoya Eady
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA
| | - Van T Nghiem
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA
| | - Tina Simpson
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, 35294, USA
| |
Collapse
|
23
|
Swartzendruber A, English A, Greenberg KB, Murray PJ, Freeman M, Upadhya K, Simpson T, Miller E, Santelli J. Crisis Pregnancy Centers in the United States: Lack of Adherence to Medical and Ethical Practice Standards; A Joint Position Statement of the Society for Adolescent Health and Medicine and the North American Society for Pediatric and Adolescent Gynecology. J Pediatr Adolesc Gynecol 2019; 32:563-566. [PMID: 31679958 DOI: 10.1016/j.jpag.2019.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Crisis pregnancy centers (CPCs) attempt to dissuade pregnant people from considering abortion, often using misinformation and unethical practices. While mimicking health care clinics, CPCs provide biased, limited, and inaccurate health information, including incomplete pregnancy options counseling and unscientific sexual and reproductive health information. The centers do not provide or refer for abortion or contraception but often advertise in ways that give the appearance that they do provide these services without disclosing the biased nature and marked limitations of their services. Although individuals working in CPCs in the United States have First Amendment rights to free speech, their provision of misinformation might be harmful to young people and adults. The Society for Adolescent Health and Medicine and North American Society for Pediatric and Adolescent Gynecology support the following positions: (1) CPCs pose risk by failing to adhere to medical and ethical practice standards; (2) governments should only support health programs that provide accurate, comprehensive information; (3) CPCs and individuals who provide CPC services should be held to established standards of ethics and medical care; (4) schools should not outsource sexual education to CPCs or other entities that do not provide accurate and complete health information; (5) search engines and digital platforms should enforce policies against misleading advertising by CPCs; and (6) health professionals should educate themselves, and young people about CPCs and help young people identify safe, quality sources of sexual and reproductive health information and care.
Collapse
Affiliation(s)
| | - Abigail English
- Center for Adolescent Health and the Law, Chapel Hill, North Carolina
| | | | - Pamela J Murray
- West Virginia University School of Medicine, Morgantown, West Virginia
| | | | - Krishna Upadhya
- Children's National Health System, Washington, District of Columbia
| | - Tina Simpson
- University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama
| | - Elizabeth Miller
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - John Santelli
- Columbia University, Mailman School of Public Health, New York, New York
| |
Collapse
|
24
|
Hill S, Kuo HC, Aban I, Gray S, Simpson T, Dionne-Odom J. A comparative analysis of documented contraceptive use among women aged 18-30 living with and without HIV in Alabama. Contraception 2019; 100:275-278. [PMID: 31242441 DOI: 10.1016/j.contraception.2019.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/01/2018] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare contraception use in 18-30-year-old women living with and without HIV. We also explored factors associated with contraceptive use. STUDY DESIGN We reviewed outpatient medical records for women living with HIV aged 18-30 years seen in one of two university-affiliated HIV-subspecialty clinics in Birmingham, Alabama, between July 2015 and June 2016. We selected an age-matched sample of women living without HIV seen in one of two university-affiliated non-HIV primary care clinics as the comparator group and focused our analysis on women with a documented discussion of contraception in clinic. For women with more than one clinic visit during the 1-year study period, the most recent visit was used for analysis. Multinominal and binary logistic regressions were used to identify factors associated with contraception use, and models were adjusted for HIV status. RESULTS This study included 197 women (58 HIV-positive, 139 HIV-negative). Short-acting contraception methods were the most common methods used by women with (41.4%) and without HIV (47.5%, p=.43). Long-acting reversible contraception (LARC) use was 14% among women with HIV and 32% among women without HIV (p=.12). Contraception use predictors included HIV status, mental health comorbidities, obesity and number of pregnancies. CONCLUSION Documented contraceptive method use among 18-30-year -old women seen in clinics in urban Alabama varied by HIV status. Women with HIV were less likely to use LARC methods compared to women without HIV. IMPLICATIONS Future studies should focus on identifying factors that influence contraceptive choice and which methods are offered to young women in the South. Providers should document contraception discussions at each visit and remove any barriers to LARC provision.
Collapse
Affiliation(s)
- Samantha Hill
- Department of Pediatrics, Division of Adolescent Medicine, The University of Alabama at Birmingham.
| | - Hui-Chien Kuo
- Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham
| | - Inmaculada Aban
- Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham
| | - Shirlacia Gray
- Department of Public Health, The University of Alabama at Birmingham
| | - Tina Simpson
- Department of Pediatrics, Division of Adolescent Medicine, The University of Alabama at Birmingham
| | - Jodie Dionne-Odom
- Department of Internal Medicine, Division of Infectious Disease, The University of Alabama at Birmingham
| |
Collapse
|
25
|
Coates C, Gordon CM, Simpson T. A Qualitative Study Exploring Contraceptive Practices and Barriers to Long-Acting Reversible Contraceptive Use in a Sample of Adolescents Living in the Southern United States. J Pediatr Adolesc Gynecol 2018; 31:605-609. [PMID: 30012426 DOI: 10.1016/j.jpag.2018.07.006] [Citation(s) in RCA: 9] [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: 04/04/2018] [Revised: 06/29/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
Abstract
STUDY OBJECTIVE To understand contraceptive practices of female adolescents in the Deep South and determine barriers to their use of long-acting reversible contraception (LARC). DESIGN Semistructured interviews were conducted that addressed current contraceptive choice, factors influencing choice, LARC awareness, concerns, and barriers to using LARC. Interviews were audio recorded, transcribed, and analyzed using qualitative content analysis to identify themes. SETTING Adolescent medicine clinic in an urban academic medical center in the Deep South region of the United States. PARTICIPANTS Sexually active girls between the ages of 14 and 21 years who were not currently using LARC. INTERVENTIONS AND MAIN OUTCOME MEASURES Themes generated during semistructured interviews. RESULTS Fifteen participants were interviewed with a mean age of 17 years. Fourteen of 15 were African American. Thirteen of 15 were currently using non-LARC methods and 2 of 15 were not using any contraceptive method. Contraceptive choice was driven by perceived ease of use, desire for pregnancy prevention, and seeking relief of menstrual concerns. Thirteen of 15 participants were aware of LARC with 11 of 15 (73%) noting information came from a health care provider. Barriers to current and future LARC use included concerns about side effects, LARC ineffectiveness, device longevity, and LARC invasiveness. Sixty-three percent of participants noted that they would not consider using a LARC in the future. CONCLUSION Increasing use of LARC goes beyond awareness. Concerns about effectiveness, future fertility, duration of devices, and perceived invasiveness represent barriers for adolescents. Further research is needed to determine how to address these barriers because it pertains to counseling of sexually active girls on the use of LARC.
Collapse
Affiliation(s)
- Charrelle Coates
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Catherine M Gordon
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Tina Simpson
- Division of Adolescent Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| |
Collapse
|
26
|
Brady SS, Parker CJ, Jeffries EF, Simpson T, Brooke-Weiss BL, Haggerty KP. Implementing the Communities That Care Prevention System: Challenges, Solutions, and Opportunities in an Urban Setting. Am J Prev Med 2018; 55:S70-S81. [PMID: 30670204 PMCID: PMC10363377 DOI: 10.1016/j.amepre.2018.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 01/26/2018] [Revised: 03/11/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Communities That Care, refined and tested for more than 25years, offers a step-by-step coalition-based approach to promote well-being and prevent risk behaviors among youth. Communities That Care guides coalitions to identify and prioritize underlying risk and protective factors; set specific, measurable community goals; adopt tested, effective prevention programs to target selected factors; and implement chosen programs with fidelity. Communities That Care has been implemented in a variety of communities, but has only recently begun to be systematically evaluated in diverse, urban communities. METHODS This paper presents a process evaluation of Communities That Care implementation within a Midwestern ethnically diverse, urban community. In-depth surveys of 25 black male youth aged 8-14years and their caregivers were conducted to determine the degree to which coalition-selected priorities aligned with the experience of black families. Implementation and survey data were collected in 2014-2017 and analyzed in 2017-2018. RESULTS Roughly 30% of youth reported ever being bullied or bullying someone else on school property; this aligned with the coalition's decision to focus on positive social skills and bullying prevention. Additional data aligned with the coalition's intent to expand its community action plan to encompass other priorities, including family transitions and mobility. For example, roughly one third of caregivers went on welfare and one third of families moved to a new home or apartment in the past year. CONCLUSIONS In communities whose residents have experienced historical and current inequities, an effective community prevention plan may need to address structural as well as social determinants of well-being among youth and their families. SUPPLEMENT INFORMATION This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.
Collapse
Affiliation(s)
- Sonya S Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.
| | - Capetra J Parker
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Elijah F Jeffries
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Tina Simpson
- Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
| | | | - Kevin P Haggerty
- University of Washington School of Social Work, Seattle, Washington
| |
Collapse
|
27
|
Phillips JM, Branch CJ, Brady SS, Simpson T. Parents Speak: A Needs Assessment for Community Programming for Black Male Youth. Am J Prev Med 2018; 55:S82-S87. [PMID: 30670205 DOI: 10.1016/j.amepre.2018.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/31/2018] [Revised: 03/04/2018] [Accepted: 05/16/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Although adolescence can be a difficult developmental period for all children, negative environmental forces make this period particularly risky for many inner-city black males. As part of the Center for Healthy African American Men through Partnerships, this project is utilizing community-based participatory concepts to design and implement programs to address risk-taking behaviors among middle school black males. METHODS In 2014, parents of black males between the ages of 11 and 14years were recruited from an urban middle school to participate in focus group discussions. Letters were provided to the school to be mailed to parents inviting them to participate in discussion groups. Four focus groups were conducted. Data analyses were conducted fall 2014. RESULTS Twenty-one parents participated. The major issue affecting the well-being and future success of young black males reported by parents was the lack of social support. Other areas of concern included negative peer pressure, bullying, violence, and lack of opportunities. Across groups, parents identified the lack of male parental presence in households and the subsequent perceived need by the young males to assume leadership roles, anger among the young males, and the lack of licensed counselors to address mental health issues as barriers to success and well-being. Parents emphasized the needs of the individual, family, and community for social support, positive role models, self-esteem, and respect. CONCLUSIONS The present data can inform prevention programs designed to reduce disparities, such as educational underachievement, exposure to violence, and premature mortality experienced by black males. SUPPLEMENT INFORMATION This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.
Collapse
Affiliation(s)
- Janice M Phillips
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - C Jason Branch
- Department of Education, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sonya S Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Tina Simpson
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
| |
Collapse
|
28
|
Mink R, Schwartz A, Carraccio C, High P, Dammann C, McGann KA, Kesselheim J, Herman B, Baffa G, Herman B, Turner DA, Fussell J, High P, Hsu D, Stafford D, Aye T, Sauer C, Kesselheim J, Myers A, McGann K, Dammann C, Chess P, Mahan J, Weiss P, Curran M, Schwartz A, Carraccio C, Herman B, Mink R, Havalad V, Pinheiro J, Alderman E, Fuloria M, McCabe ME, Mehta J, Rivas Y, Rosenberg M, Doughty C, Hergenroeder A, Kale A, Lee-Kim Y, Rama JA, Steuber P, Voigt B, Hardy K, Johnston S, Boyer D, Mauras C, Schonwald A, Sharma T, Barron C, Dennehy P, Jacobs ES, Welch J, Kumar D, Mason K, Roizen N, Rose JA, Bokor B, Chapman JI, Frank L, Sami I, Schuette J, Lutes RE, Savelli S, Amirnovin R, Harb R, Kato R, Marzan K, Monzavi R, Vanderbilt D, Doughty L, McAneney C, Rice W, Widdice L, Erenberg F, Gonzalez BE, Adkins D, Green D, Narayan A, Rehder K, Clingenpeel J, Starling S, Karpen HE, Rouster-Stevens K, Bhatia J, Fuqua J, Anders J, Trent M, Ramanathan R, Nicolau Y, Dozor AJ, Kinane TB, Stanley T, Rao AN, Bone M, Camarda L, Heffner V, Kim O, Nocton J, Rabbitt AL, Tower R, Amaya M, Jaroscak J, Kiger J, Macias M, Titus O, Awonuga M, Vogt K, Warwick A, Coury D, Hall M, Letson M, Rose M, Glickstein J, Lusman S, Roskind C, Soren K, Katz J, Siqueira L, Atlas M, Blaufox A, Gottleib B, Meryash D, Vuguin P, Weinstein T, Armsby L, Madison L, Scottoline B, Shereck E, Henry M, Teaford PA, Long S, Varlotta L, Zubrow A, Barlow C, Feldman H, Ganz H, Grimm P, Lee T, Weiner LB, Molle-Rios Z, Slamon N, Guillen U, Miller K, Federman M, Cron R, Hoover W, Simpson T, Winkler M, Harik N, Ross A, Al-Ibrahim O, Carnevale FP, Waz W, Bany-Mohammed F, Kim JH, Printz B, Brook M, Hermiston M, Lawson E, van Schaik S, McQueen A, Booth KVP, Tesher M, Barker J, Friedman S, Mohon R, Sirotnak A, Brancato J, Sayej WN, Maraqa N, Haller M, Stryjewski B, Brophy P, Rahhal R, Reinking B, Volk P, Bryant K, Currie M, Potter K, Falck A, Weiner J, Carney MM, Felt B, Barnes A, Bendel CM, Binstadt B, Carlson K, Garrison C, Moffatt M, Rosen J, Sharma J, Tieves KS, Hsu H, Kugler J, Simonsen K, Fastle RK, Dannaway D, Krishnan S, McGuinn L, Lowe M, Witchel SF, Matheo L, Abell R, Caserta M, Nazarian E, Yussman S, Thomas AD, Hains DS, Talati AJ, Adderson E, Kellogg N, Vasquez M, Allen C, Brion LP, Green M, Journeycake J, Yen K, Quigley R, Blaschke A, Bratton SL, Yost CC, Etheridge SP, Laskey T, Pohl J, Soprano J, Fairchild K, Norwood V, Johnston TA, Klein E, Kronman M, Nanda K, Smith L, Allen D, Frohna JG, Patel N, Estrada C, Fleming GM, Gillam-Krakauer M, Moore P, El Khoury JC, Helderman J, Barretto G, Levasseur K, Johnston L. Creating the Subspecialty Pediatrics Investigator Network. J Pediatr 2018; 192:3-4.e2. [PMID: 29246355 DOI: 10.1016/j.jpeds.2017.09.079] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Richard Mink
- Harbor-UCLA Medical Center and David Geffen School of Medicine at UCLA, Torrance, CA
| | | | | | - Pamela High
- W Alpert Medical School of Brown University, Providence, RI
| | | | | | | | - Bruce Herman
- University of Utah/Primary Children's Hospital, Salt Lake City, UT
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Hughes TP, Kerry JT, Simpson T. Large-scale bleaching of corals on the Great Barrier Reef. Ecology 2017; 99:501. [DOI: 10.1002/ecy.2092] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/20/2017] [Accepted: 08/25/2017] [Indexed: 11/06/2022]
Affiliation(s)
- T. P. Hughes
- Australian Research Council Centre of Excellence for Coral Reef Studies; James Cook University; Townsville Queensland 4811 Australia
| | - J. T. Kerry
- Australian Research Council Centre of Excellence for Coral Reef Studies; James Cook University; Townsville Queensland 4811 Australia
| | - T. Simpson
- Torres Strait Regional Authority; P.O. Box 261 Thursday Island Queensland 4875 Australia
| |
Collapse
|
30
|
Mason D, Crossland M, Simpson T, Peterson R, Kirkwood M. B-60Health-Related Quality of Life Following Youth Soccer-Related Concussion. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.145] [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: 11/14/2022] Open
|
31
|
Came HA, McCreanor T, Doole C, Simpson T. Realising the rhetoric: refreshing public health providers' efforts to honour Te Tiriti o Waitangi in New Zealand. Ethn Health 2017; 22:105-118. [PMID: 27323889 DOI: 10.1080/13557858.2016.1196651] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES New Zealand has a unique tool, Te Tiriti o Waitangi, the Treaty of Waitangi, for addressing health disparities. Indigenous Māori have compromised health status compared to other groups. This paper investigates ways in which public health units (PHUs) and non-governmental organisations (NGOs) use Te Tiriti o Waitangi in service delivery to Māori. DESIGN A nationwide telephone survey of primary health providers (n=162) was conducted in 2014-15. Participants were asked about effectiveness and monitoring of their service delivery to Māori. RESULTS PHUs reported actively working with Māori, and Te Tiriti o Waitangi to reduce health disparities. Direct Māori engagement with development and delivery of programmes was viewed as essential. Strategies included designated PHU staff in positions of responsibility, formal partnerships with Māori, and providing operational and strategic guidance. Some PHUs supported development of cultural competencies. NGO responsiveness to Māori was variable. Some NGOs described prioritising service delivery and programmes for Māori. Others reported the focus of their service was European or other non-Māori ethnicities. Lack of resources or past difficulties engaging with Māori were barriers. CONCLUSION Public health has an ethical commitment to reduce health disparities. Advancing Te Tiriti obligations in everyday practice has the potential to address inequalities.
Collapse
Affiliation(s)
- H A Came
- a Faculty of Health and Environmental Sciences , Auckland University of Technology , Auckland , New Zealand
| | - T McCreanor
- b Te Rōpū Whāriki , Massey University , Auckland , New Zealand
| | - C Doole
- a Faculty of Health and Environmental Sciences , Auckland University of Technology , Auckland , New Zealand
| | - T Simpson
- c Health Promotion Forum , Auckland , New Zealand
| |
Collapse
|
32
|
Affiliation(s)
- H. A. Came
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - T. McCreanor
- Te Rōpū Whāriki, Massey University, Auckland, New Zealand
| | - T. Simpson
- Health Promotion Forum, Auckland, New Zealand
| |
Collapse
|
33
|
Barnes M, Davis K, Mancini M, Ruffin J, Simpson T, Casazza K. Setting Adolescents Up for Success: Promoting a Policy to Delay High School Start Times. J Sch Health 2016; 86:552-557. [PMID: 27246680 DOI: 10.1111/josh.12405] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 08/04/2015] [Revised: 12/22/2015] [Accepted: 03/29/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND A unique biological shift in sleep cycles occurs during adolescence causing later sleep and wake times. This shift is not matched by a concurrent modification in school start times, resulting in sleep curtailment for a large majority of adolescents. Chronic inadequate sleep is associated with poor academic performance including executive function impairments, mood, and behavioral issues, as well as adverse health outcomes such as an increased risk of obesity, hypertension, and cardiovascular disease. In order to address sleep deficits and the potential negative outcomes associated with chronic sleep deprivation, the American Academy of Pediatrics (AAP) and US Centers for Disease Control and Prevention (CDC) support delaying school start times for middle and high school students. METHODS We summarize current evidence, explicate the need for policy change, and urge school districts to put adolescent students' health as top priority and implement school start times consistent with their developmental needs. RESULTS Whereas substantial evidence illustrating adverse consequences of inadequate sleep on psychological and physical health, and recommendations exist to adapt daytime school schedules to match sleep needs have been released, actual implementation of these recommendations have been limited. CONCLUSIONS This is a call to action for the implementation of AAP/CDC recommendations across the state and nation.
Collapse
Affiliation(s)
- Margaux Barnes
- Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233.
| | - Krista Davis
- Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233.
| | - Mackenzie Mancini
- Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233.
| | - Jasmine Ruffin
- Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233.
| | - Tina Simpson
- Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233.
| | - Krista Casazza
- Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233.
| |
Collapse
|
34
|
Smith W, Turan JM, White K, Stringer KL, Helova A, Simpson T, Cockrill K. Social Norms and Stigma Regarding Unintended Pregnancy and Pregnancy Decisions: A Qualitative Study of Young Women in Alabama. Perspect Sex Reprod Health 2016; 48:73-81. [PMID: 27166869 PMCID: PMC5022769 DOI: 10.1363/48e9016] [Citation(s) in RCA: 19] [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] [Received: 07/15/2015] [Revised: 01/09/2016] [Accepted: 01/19/2016] [Indexed: 05/06/2023]
Abstract
CONTEXT Social norms and stigma may play important roles in reproductive health behavior and decision making among young women in the U.S. South, who disproportionately experience unintended pregnancies. No research has described the presence and manifestations of social norms and stigmas associated with unintended pregnancy and related decision making from the perspective of this population. METHODS Six focus groups and 12 cognitive interviews were conducted between December 2013 and July 2014 with 46 low-income women aged 19-24 living in Birmingham, Alabama; respondents were recruited from two public health department centers and a community college. Semistructured interview guides were used to facilitate discussion about social perceptions of unintended pregnancy and related pregnancy decisions. Sessions were audio-recorded, and transcripts were analyzed using a theme-based approach. RESULTS Participants described community expectations that pregnancy occur in the context of monogamous relationships, in which both partners are mature, educated and financially stable. However, respondents reported that unintended pregnancy outside of these circumstances was common, and that the community expected young women faced with unintended pregnancies to bear and raise their children. Women who chose to do so were viewed more positively than were women who chose abortion or adoption. The community generally considered these alternatives to parenting unacceptable, and participants discussed them in terms of negative labels, social judgment and nondisclosure. CONCLUSIONS Findings suggest a need to reduce stigma and create a social environment in which young women are empowered to make the best reproductive decisions for themselves.
Collapse
Affiliation(s)
- Whitney Smith
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Janet M. Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Kari White
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Kristi L. Stringer
- Department of Medical Sociology, College of Arts and Sciences/Center for Outcomes and Effectiveness Research, University of Alabama at Birmingham, Birmingham, AL
| | - Anna Helova
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Tina Simpson
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | | |
Collapse
|
35
|
Reese JM, Joseph RP, Cherrington A, Allison J, Kim YI, Spear B, Childs G, Simpson T, Durant NH. Development of Participant-Informed Text Messages to Promote Physical Activity Among African American Women Attending College: A Qualitative Mixed-Methods Inquiry. J Transcult Nurs 2016; 28:236-242. [PMID: 27093904 DOI: 10.1177/1043659616644959] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 11/16/2022] Open
Abstract
The purpose of this study was to develop a participant-informed technology-based physical activity (PA) promotion tool for young overweight and obese African American (AA) women. A mixed-method 3-phase study protocol design was used to develop text messages to promote PA in AA women attending the University of Alabama at Birmingham during the Spring of 2013. Nominal focus groups and a 2-week pilot were used to generate and test participant-developed messages. Participants ( n = 14) had a mean age of 19.79 years ( SD = 1.4) and mean body mass index of 35.9 ( SD = 5.926). Focus group data identified key themes associated with the use of text messages to promote PA including message frequency, length, tone, and time of day. Participants preferred text messages that were brief, specific, and time sensitive. Results showed that text messaging was a feasible and acceptable strategy to promote PA in overweight and obese AA women in a university setting.
Collapse
|
36
|
Hanks LJ, Simpson T, McCormick K, Casazza K. Pediatric obesity prevention: From naïve examination of energy imbalance towards strategies that influence the competition for nutrient resources among tissues. World J Clin Pediatr 2015; 4:50-4. [PMID: 26566477 PMCID: PMC4637809 DOI: 10.5409/wjcp.v4.i4.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/14/2015] [Accepted: 10/16/2015] [Indexed: 02/06/2023] Open
Abstract
Current pediatric obesity interventions have collectively yielded relatively unsuccessful results. In this Field of Vision, we present plausible physiologic underpinnings fostering ineffectiveness of conventional strategies grounded in requisite induction of negative energy imbalance. Moreover, such recommendations exacerbate the underlying metabolic dysfunction by further limiting metabolic fuel availability, lowering energy expenditure, and increasing hunger (recapitulating the starvation response amid apparent nutritional adequacy) which precede and promote obesity during growth and development. The qualitative aspects of musculoskeletal system (i.e., endocrine response, muscle functional capacity) are likely to improve metabolic function and increase nutrient delivery and utilization. An intricate and complex system including multiple feedback mechanisms operates to homeostatically regulate energy balance and support optimal body composition trajectories and metabolic health, during growth and development. Thus, ignoring the interdependencies of regulatory growth processes initiates a nuanced understanding of energy regulation and thus misguided attempts at preventive strategies. Importantly, these gains are not dependent upon weight-loss, rather we suggest can be achieved through resistance training. Collectively, optimizing musculoskeletal health via resistance training elicits augmentation of competitive capacity across systems. Further, substantial gains can be achieved in skeletal muscle mass, strength, and functional capacity through resistance training in a relatively short period of time.
Collapse
|
37
|
Kelly F, Cook T, Boniface N, Hughes J, Seller C, Simpson T. Videolaryngoscopes confer benefits in human factors in addition to technical skills. Br J Anaesth 2015; 115:132-3. [DOI: 10.1093/bja/aev188] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
38
|
Dearnley N, Eyres R, Simpson T, Stephenson E, Belton M, Palchaudhuri P. S76 Tb Infection In The Nepali Population In South-east London Displays Different Characteristics Compared To The Tb Population In Nepal. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.82] [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: 11/04/2022]
|
39
|
Simpson T, Ling C, Glover G, Barrett N, Ioannou N, Lams B, Langrish C, Meadows C, Agarwal N, D'Cruz D. P278 Extra-corporeal Membrane Oxygenation And Diffuse Alveolar Haemorrhage - A Single Centre Case Series And Analysis Of The Elso Database. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
40
|
Ling C, Simpson T, Glover G, Nicholas B, D'Cruz D. FRI0451 Extra-Corporeal Membrane Oxygenation and Diffuse Alveolar Haemorrhage - A Single Centre CASE Series and Analysis of the ELSO Database: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4191] [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: 11/04/2022]
|
41
|
Acquaye AA, Vera-Bolanos E, Gilbert MR, Armstrong TS, Lin L, Amidei C, Lovely M, Arzbaecher J, Page M, Mogensen K, Lupica K, Maher ME, Armstrong TS, Won M, Wefel JS, Gilbert MR, Pugh S, Wendland MM, Brachman DG, Brown PD, Crocker IR, Robins HI, Lee RJ, Mehta M, Arvold N, Wang Y, Zigler C, Schrag D, Dominici F, Boele F, Douw L, de Groot M, van Thuijl H, Cleijne W, Heimans J, Taphoorn M, Reijneveld J, Klein M, Bunevicius A, Tamasauskas S, Tamasauskas A, Deltuva V, Bunevicius R, Cahill J, Lin L, Armstrong T, Acquaye A, Vera-Bolanos E, Gilbert M, Padhye N, Chan J, Clarke J, Lawton K, Rabbitt J, DeSilva A, Prados M, Rosen M, Cher L, Diamond E, Applebaum A, Corner G, DeRosa A, Breitbart W, DeAngelis L, Hoogendoorn P, Ikuta S, Muragaki Y, Maruyama T, Nitta M, Tamura M, Okamoto S, Iseki H, Okada Y, Lacouture M, Davis ME, Elzinga G, Butowski N, Tran D, Villano J, Wong E, Legge D, Cher L, Legge D, Cher L, Mills K, Lin L, Acquaye A, Vera-Bolanos E, Gilbert M, Armstrong T, Lovely M, Sullivan D, Mueller S, Fullerton H, Stratton K, Leisenring W, Armstrong G, Weathers R, Stovall M, Goldsby R, Sklar C, Robison L, Krull K, Pace A, Villani V, Focarelli S, Benincasa D, Benincasa A, Carapella CM, Pompili A, Peiffer AM, Burke A, Leyer CM, Shing E, Kearns WT, Hinson WH, Case D, Rapp SR, Shaw EG, Chan MD, Porensky E, Cavaliere R, Newton H, Shilds A, Burgess S, Ravelo A, Taylor F, Mazar I, Abrey L, Rooney A, Graham C, McKenzie H, Fraser M, MacKinnon M, McNamara S, Rampling R, Carson A, Grant R, Rooney A, Heimans L, Woltz S, Kerrigan S, McNamara S, Grant R, Seibl-Leven M, Wittenstein K, Rohn G, Goldbrunner R, Timmer M, Kennedy J, Sherman W, Sen-Gupta I, Garic I, Macken M, Gerard E, Raizer J, Schuele S, Grontoft M, Stragliotto G, Taphoorn MJ, Henriksson R, Bottomley A, Cloughesy T, Wick W, Mason W, Saran F, Nishikawa R, Ravelo A, Hilton M, Chinot OL, Trad W, Simpson T, Wright K, Tran T, Choong C, Barton M, Hovey E, Robinson K, Koh ES, Vera-Bolanos E, Acquaye AA, Brown PD, Chung C, Gilbert MR, Vardy J, Armstrong TS, Walbert T, Mendoza T, Vera-Bolanos E, Gilbert M, Acquaye A, Armstrong T, Walbert T, Glantz M, Schultz L, Puduvalli VK, Oudenhoven M, Farin C, Hoffman R, Armstrong T, Ewend M, Wu J. SYMPTOM MANAGEMENT/QUALITY OF LIFE. Neuro Oncol 2013; 15:iii226-iii234. [PMCID: PMC3823907 DOI: 10.1093/neuonc/not192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
|
42
|
Pennycuick A, Simpson T, Crawley D, Lal R, Santis G, Cane P, Tobal K, Spicer J. Routine EGFR and KRAS Mutation analysis using COLD-PCR in non-small cell lung cancer. Int J Clin Pract 2012; 66:748-752. [PMID: 22805266 DOI: 10.1111/j.1742-1241.2012.02961.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [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] [Indexed: 11/27/2022] Open
Abstract
Aims: Epidermal growth factor receptor (EGFR) antagonists are particularly active in non-small cell lung cancer (NSCLC) patients with tumours bearing mutations in the EFGR gene. EGFR mutation prevalence is very low in squamous histology. Response rates using these drugs in patients with KRAS mutations are low, so available KRAS mutation information may aid treatment selection in the second-line setting. Since 2009, patients presenting to this hospital with non-squamous histology have been routinely screened for mutations in both the EGFR and KRAS genes, with results used to inform treatment. We present an analysis of 215 consecutive patients for whom EGFR mutation analysis was informative. Methodology: EGFR and KRAS mutations were identified using a COLD-PCR technique confirmed with sequencing, which makes no prior assumption about location of specific mutations. Results were correlated with clinical and demographic data from hospital records, where available. Results: The prevalence of patients with EGFR mutations was 14% and for KRAS mutations it was 27%. Despite the conventional understanding that EGFR and KRAS mutations are mutually exclusive, we identified two dual mutations. Of 29 patients identified with mutated EGFR, there were 3/8/8/10 mutations in exons 18/19/20/21 respectively. Exon 20 mutations were identified in a proportion exceeding many other series because of the unbiased mutation analysis used, and clinical benefit was seen in some of these. Of 23 different EGFR mutations identified, 11 have not previously been described in the literature. Conclusions: The high prevalence of EGFR, KRAS or both mutations (40%) in this non-squamous population tested in clinical practice supports a policy of routine screening for these mutations in NSCLC.
Collapse
Affiliation(s)
- A Pennycuick
- School of Medicine, King's College London, Guy's Hospital, London, UK Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Huon G, Simpson T, Holzer F, Maini G, Will F, Kopinke FD, Roland U. In Situ Radio-Frequency Heating for Soil Remediation at a Former Service Station: Case Study and General Aspects. Chem Eng Technol 2012. [DOI: 10.1002/ceat.201200027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
44
|
Whiting DL, Simpson GK, Koh ES, Wright KM, Simpson T, Firth R. A multi-tiered intervention to address behavioural and cognitive changes after diagnosis of primary brain tumour: a feasibility study. Brain Inj 2012; 26:950-61. [PMID: 22630044 DOI: 10.3109/02699052.2012.661912] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Untreated behavioural and cognitive changes after primary brain tumour (PBT) can result in challenging behaviours (CBs), with limited documentation on treatment approaches. This study explored the feasibility of employing a Behavioural Consultancy approach to manage CBs, targeting individuals with PBT, family and treating staff. METHODS Participants were patients and families of two hospitals and health professionals from cancer/neurological services. A single-case experimental design piloted skill-based training and environmental changes in managing socio-behavioural impairments in a person with a low grade astrocytoma. A half-day workshop to train family members (n = 7) in compensatory strategy use to manage CBs after PBT was piloted. Finally, a 1-day workshop was provided to 43 health professionals in managing CBs after PBT. For both workshops, a pre-post impact evaluation was conducted employing a purpose-designed Strategies Use Measure. RESULTS All three interventions demonstrated positive results. The single case showed a 71% decrease in the target behaviour (time spent talking) post-intervention. Some attrition to these gains was observed at two follow-up time points (3 and 5 months). Participants from both workshops demonstrated significant post-intervention increases in perceived knowledge of Strategy Use (family members z = 2.03, p < 0.05; health professionals z = 4.95, p < 0.00; Wilcoxon signed-rank test). CONCLUSIONS These initial studies highlight the potential of employing an integrated multi-tiered intervention based on a Behavioural Consultancy model to manage CBs after PBT.
Collapse
Affiliation(s)
- D L Whiting
- Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia.
| | | | | | | | | | | |
Collapse
|
45
|
Lucas MR, Robinson KM, Koh ES, Hovey EJ, Wright KM, Simpson T, Price MA, Shafiq J, Kaadan N, Barton MB, Armstrong T, Wefel JS, Wang M, Won M, Bottomley A, Mendoza TR, Coens C, Werner-Wasik M, Brachman DG, Choucair AK, Mehta M, Gilbert MR, Spezeski J, de Melo SM, Taylor LP, Otero H, Zuurveld MA, Peerdeman SM, Bouma GJ, Feller RE, Klein M, Aaronson NK, Taphoorn MJB, Heimans JJ, Postma TJ, Gundy CM, Beute GN, Slotman BJ, Klein M, Satoer D, Vincent A, Dirven C, Smits M, Visch-Brink E, Vera-Bolanos E, Armstrong TS, Mendoza T, Fisher A, Kuo CW, Sherwood P, Peters KB, Coan AD, West MJ, Reardon DA, Desjardins A, Vredenburgh JJ, Friedman HS, Jones LW, Acquaye AA, Lin L, Aspenson AS, Cahill J, Vera-Bolanos E, Gilbert MR, Armstrong TS, Lamki T, Ammirati M, Lin L, Acquaye AA, Vera-Bolanos E, Cahill J, Gilbert MR, Armstrong TS, Lin L, Acquaye AA, Vera-Bolanos E, Cahill J, Gilbert MR, Armstrong TS, Lai JS, Acquaye A, Armstrong TS, Acquaye AA, Lin L, Aspenson AC, Cahill J, Vera-Bolanos E, Gilbert MR, Armstrong TS, Stell BV, Jacobs DI, Grimm SA, Rademaker A, Rice L, Schwartz M, Chandler J, Muro K, Helenowki IB, Marymont MH, Wagner LI, Mehta M, Raizer J, Gerard ME, Drappatz J, Muzikansky A, Weiss S, Kesari S, Wong E, Fadul CE, Norden AD, Quant EC, Beroukhim R, Alexander B, Ruland S, Ciampa AS, LaFrankie DC, Sceppa C, Smith KH, Hammond SN, Wen PY, Farace E, Sheehan J, Bonneau R, Glantz M, McDonald KL, Ryu S, Rock J, Jain R, Casas C, Schultz L, Pace M, Aho T, Horio M, Doshi P, Cahill J, Padhye N, Vera-Bolanos E, Gning I, Mendoza T, Gilbert M, Armstrong T, Hoover JM, Mandrekar J, Meyer FB, Parney IF. QUALITY OF LIFE. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor159] [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: 11/13/2022] Open
|
46
|
Beringer RM, Kelly F, Cook TM, Nolan J, Hardy R, Simpson T, White MC. A cohort evaluation of the paediatric i-gel™ airway during anaesthesia in 120 children*. Anaesthesia 2011; 66:1121-6. [DOI: 10.1111/j.1365-2044.2011.06884.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
47
|
Abstract
Aims: Evaluation of the pediatric appendicitis score (PAS), in all patients who had an appendicectomy over a one-year period. Methods: Retrospective study of 56 patients aged 4–15 years, who underwent an emergency appendicectomy. PAS was applied and patients were divided according to the PAS protocol into high probability and low probability groups. These results were then correlated with histology. Results: The PAS had sensitivity 0.87, specificity 0.59, positive predictive value 0.83, and negative predictive value 0.67. The negative appendicectomy rate would have been reduced to 17%, but five patients with appendicitis would have been denied early surgical treatment and may have been discharged. Conclusions: The PAS cannot be recommended as it would lead to an unacceptable risk of wrongly discharging or delaying necessary surgery in 13% of patients with appendicitis.
Collapse
Affiliation(s)
- F Goulder
- Department of General Surgery, Kent and Sussex Hospital, UK
| | | |
Collapse
|
48
|
Simpson T, Pennycuick A, Crawley D, Tobal K, Santis G. 46 Prevalence of EGFR and K-RAS mutation status in clinical practice - relationship to patient characteristics. Lung Cancer 2011. [DOI: 10.1016/s0169-5002(11)70046-0] [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: 11/17/2022]
|
49
|
Simpson T. Evaluation of a 3-month-old female with cough. Pediatr Nurs 2009; 35:306-307. [PMID: 19916347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Tina Simpson
- University of Alabama at Birmingham, Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, Birmingham, AL, USA
| |
Collapse
|
50
|
Pass RF, Zhang C, Evans A, Simpson T, Andrews W, Huang ML, Corey L, Hill J, Davis E, Flanigan C, Cloud G. Vaccine prevention of maternal cytomegalovirus infection. N Engl J Med 2009; 360:1191-9. [PMID: 19297572 PMCID: PMC2753425 DOI: 10.1056/nejmoa0804749] [Citation(s) in RCA: 582] [Impact Index Per Article: 38.8] [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: 11/19/2022]
Abstract
BACKGROUND Congenital infection with cytomegalovirus (CMV) is an important cause of hearing, cognitive, and motor impairments in newborns. METHODS In this phase 2, placebo-controlled, randomized, double-blind trial, we evaluated a vaccine consisting of recombinant CMV envelope glycoprotein B with MF59 adjuvant, as compared with placebo. Three doses of the CMV vaccine or placebo were given at 0, 1, and 6 months to CMV-seronegative women within 1 year after they had given birth. We tested for CMV infection in the women in quarterly tests during a 42-month period, using an assay for IgG antibodies against CMV proteins other than glycoprotein B. Infection was confirmed by virus culture or immunoblotting. The primary end point was the time until the detection of CMV infection. RESULTS We randomly assigned 234 subjects to receive the CMV vaccine and 230 subjects to receive placebo. A scheduled interim analysis led to a stopping recommendation because of vaccine efficacy. After a minimum of 1 year of follow-up, there were 49 confirmed infections, 18 in the vaccine group and 31 in the placebo group. Kaplan-Meier analysis showed that the vaccine group was more likely to remain uninfected during a 42-month period than the placebo group (P=0.02). Vaccine efficacy was 50% (95% confidence interval, 7 to 73) on the basis of infection rates per 100 person-years. One congenital infection among infants of the subjects occurred in the vaccine group, and three infections occurred in the placebo group. There were more local reactions (pain, erythema, induration, and warmth) and systemic reactions (chills, arthralgias, and myalgias) in the vaccine group than in the placebo group. CONCLUSIONS CMV glycoprotein B vaccine has the potential to decrease incident cases of maternal and congenital CMV infection. (ClinicalTrials.gov number, NCT00125502.)
Collapse
Affiliation(s)
- Robert F Pass
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham 35233, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|