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Lavoie MCC, Okui L, Blanco N, Stoebenau K, Magidson JF, Gokatweng G, Ikgopoleng K, Charurat ME, Ndwapi N. Feasibility and acceptability of peer-delivered interventions using mHealth for PrEP services among adolescent girls and young women in DREAMS program in Botswana. Glob Health Action 2023; 16:2231256. [PMID: 37462118 DOI: 10.1080/16549716.2023.2231256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Adolescent girls and young women accounted for 25% of all new HIV infections despite representing only 10% of the population in Sub Saharan Africa. PEPFAR has launched the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) initiative, a comprehensive HIV prevention program including PrEP services. Among adolescent girls and young women, PrEP adherence is currently sub-optimal. Tailored strategies for adolescent girls and young women to improve access and use of PrEP delivery are urgently needed to maximise its potential. Recommended interventions include peer-delivered interventions using mobile technology. However, data on the feasibility and acceptability of this approach is limited for SSA. OBJECTIVES We assessed the feasibility and perceived acceptability of providing mHealth peer-delivered interventions to support PrEP services among adolescent girls and young women in Botswana. METHODS This cross-sectional study included HIV-negative women aged 18-24 years old seeking health services at DREAMS-supported facilities. Participants completed a survey assessing the feasibility and perceived acceptability of the mHealth peer-delivered interventions, which included the Acceptability of Intervention Measure (AIM). Descriptive analyses were performed. RESULTS A total of 131 participated in the study. Overall, 89% owned a mobile phone (feasibility). There was no difference in cell phone ownership between participants from rural and urban settings. Among participants, 85% reported interest in participating in a mHealth peer-delivered intervention if it was available to them. Regarding perceived acceptability for mHealthpeer support groups for PrEP, the average score on the AIM was 3.8 out of 5 (SD = 0.8). CONCLUSION mHealthpeer-delivered interventions appear to be feasible and perceived acceptable among adolescent girls and young women in Botswana. This modality should be incorporated into PEPFAR's programmatic toolkit of implementation strategies to improve PrEP services.
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Affiliation(s)
- Marie-Claude C Lavoie
- Division of Global Health Sciences, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
- Center for International Health Education and Biosecurity (Ciheb), University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lillian Okui
- Center for International Health, Education, and Biosecurity (Ciheb), Maryland Global Initiative Corporation, University of Maryland Baltimore, Gaborone, Botswana
| | - Natalia Blanco
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
- Center for International Health Education and Biosecurity (Ciheb), University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kirsten Stoebenau
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
| | | | - Gadzikanani Gokatweng
- Botswana-University of Maryland School of Medicine Health Initiative (Bummhi), Gaborone, Botswana
| | - Kaizer Ikgopoleng
- Center for International Health, Education, and Biosecurity (Ciheb), Maryland Global Initiative Corporation, University of Maryland Baltimore, Gaborone, Botswana
| | - Manhattan E Charurat
- Division of Global Health Sciences, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
- Center for International Health Education and Biosecurity (Ciheb), University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ndwapi Ndwapi
- Botswana-University of Maryland School of Medicine Health Initiative (Bummhi), Gaborone, Botswana
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Dawe J, Cassano D, Keane R, Ruth S, Wilkinson AL, Elsum I, Gunn J, Brown G, West M, Hoy J, Power J, Stoové M. Quality of life among people living with HIV aged 50 years and over in Australia: Identifying opportunities to support better ageing. HIV Med 2023; 24:1253-1267. [PMID: 37990812 DOI: 10.1111/hiv.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES Improved life expectancy has led to an ageing population of people living with HIV in most countries. Research on ageing among people living with HIV has predominantly focused on physical and health-related quality of life rather than multidimensional quality of life. We measured quality of life among older people living with HIV in Australia and identified opportunities to guide the development and implementation of appropriate interventions. METHODS In a national health and wellbeing survey of Australian people living with HIV, participants aged ≥50 years completed additional questions relevant to ageing. Quality of life was measured using PozQoL, a validated multidimensional instrument assessing quality of life among people living with HIV (range 1-5). Exploratory bivariate analyses aimed to identify sociodemographic characteristics associated with quality of life. Adjusted linear regressions aimed to assess changes in PozQoL score associated with recent experiences (last 12 months) of four exposures: food insecurity, HIV-related stigma, isolation from the HIV community, and difficulties accessing non-HIV health services. RESULTS Among 319 older people living with HIV, the mean PozQol score was 3.30 (95% confidence interval [CI] 3.20-3.39). In bivariate analyses, PozQol scores were significantly higher among participants who were older (p = 0.006), had higher educational attainment (p = 0.009), were in a relationship (p = 0.005), were employed (p = 0.005), and had a higher income (p = 0.001). In adjusted regression models, PozQoL scores were lower among participants who reported recent experiences of food insecurity (β -0.49; 95% CI -0.74 to -0.24), stigma (β -0.53; 95% CI -0.73 to -0.33), isolation from the HIV community (β -0.49; 95% CI -0.70 to -0.29), and difficulties accessing non-HIV health services (β -0.50; 95% CI -0.71 to -0.30). CONCLUSIONS Overall, older people living with HIV in this study had a moderate quality of life. Our findings suggest that HIV services should integrate programmes to support economic security and foster connections within the HIV community and across health services.
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Affiliation(s)
- Joshua Dawe
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Dean Cassano
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Richard Keane
- Living Positive Victoria, Melbourne, Victoria, Australia
| | - Simon Ruth
- Thorne Harbour Health, Melbourne, Victoria, Australia
| | - Anna Lee Wilkinson
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- University of Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Imogen Elsum
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Jack Gunn
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Michael West
- Department of Health, Melbourne, Victoria, Australia
| | - Jennifer Hoy
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Jennifer Power
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Mark Stoové
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
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Hunsicker M, Maloul E, Amanda K. G, Gilady D, Brownstone LM. Filling a gap: virtual clinician-led support groups for disordered eating. COUNSELLING PSYCHOLOGY QUARTERLY 2023. [DOI: 10.1080/09515070.2023.2192461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Sun CJ, Shato T, Steinbaugh A, Pradeep S, Amico KR, Horvath K. Virtual voices: examining social support exchanged through participant-generated and unmoderated content in a mobile intervention to improve HIV antiretroviral therapy adherence among GBMSM. AIDS Care 2023; 35:7-15. [PMID: 35156485 PMCID: PMC9374845 DOI: 10.1080/09540121.2022.2038364] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
Abstract
Antiretroviral therapy (ART) adherence is suboptimal among gay, bisexual, and other men who have sex with men (GBMSM). Online interventions that incorporate social support represent new opportunities to improve adherence. This study focused on how social support was provided and sought within a technology-based ART adherence intervention. We coded and analyzed 1,751 messages. Within the social support messages, half of the time participants sought social support and half of the time they provided social support. Emotional and informational support were the most frequently exchanged forms. The most frequent topic that participants sought support around was interpersonal relationships (29%), followed by HIV care and treatment (28%). Similarly, 31% and 27% of messages in which participants provided support was related to HIV treatment and care and interpersonal relationships, respectively. HIV treatment and care issues most salient were ART adherence, lab results and upcoming tests, ART side effects, changes in ART regimens, and relationships with healthcare providers. Participants used the messaging feature in this intervention to spontaneously discuss and exchange support around HIV treatment and care. This analysis provided an opportunity to understand how participants informally interact with one another, how they seek and provide social support online, and their salient personal issues.
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Affiliation(s)
- Christina J. Sun
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
| | - Thembekile Shato
- Implementation Science Center for Cancer Control, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Sharanya Pradeep
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
| | - K. Rivet Amico
- Department of Health Behavior & Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Keith Horvath
- Department of Psychology, San Diego State University, San Diego, CA, USA
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Flickinger TE, Campbell BR, Timm A, Baee S, Datta D, Shenoi SV, Rozanova J, Dillingham R. Use of a Mobile Health Intervention by Older Versus Younger People with HIV: Analysis of Usage, Social Support, and Network Interactions. TELEMEDICINE REPORTS 2022; 3:191-200. [PMID: 36636167 PMCID: PMC9811827 DOI: 10.1089/tmr.2022.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND People with HIV in the United States are aging, with risk for negative health outcomes from social isolation. PositiveLinks is a mobile health (mHealth) intervention that includes an anonymous Community Message Board (CMB) for peer-to-peer conversations. We investigated differences in CMB usage and social support between younger (<50 years) and older (≥50) members. METHODS We assessed the relationship between age groups and app use using chi-square tests. CMB posts were analyzed qualitatively to categorize forms of social support. To have a visual understanding of this relationship, we created a network diagram to display interactions among PL members. RESULTS Among 87 participants, 31 (42.5%) were in the older age group. Older members launched the app more often at 6 months (445.5 vs. 240.5 mean launches per participant, p ≤ 0.001) and 12 months (712.3 vs. 292.6 launches, p ≤ 0.001) compared with younger members. Older members also demonstrated more CMB posts at 6 months (47.4 vs. 7.6 mean posts per participant, p = 0.02) and 12 months (77.5 vs. 10.6 posts, p = 0.04). Of 1861 CMB posts, 7% sought support and 72% provided support. In addition, the network visualization showed that four participants, who were in the older age group, had more post generation than others and most of their posts provided support. CONCLUSIONS Older PL members demonstrated significantly more app use than younger members, including CMB posts for social support. This durable app engagement indicates that mHealth can enable social connection among people living with chronic disease across the lifespan.
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Affiliation(s)
- Tabor E. Flickinger
- Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Breanna R. Campbell
- Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Allyson Timm
- School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Sonia Baee
- School of Engineering and Applied Science, University of Virginia, Charlottesville, Virginia, USA
| | - Debajyoti Datta
- School of Engineering and Applied Science, University of Virginia, Charlottesville, Virginia, USA
| | - Sheela V. Shenoi
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Julia Rozanova
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rebecca Dillingham
- Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
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Latif MS, Wang JJ, Shahzad M. Do ethics drive value co-creation behavior in online health communities? INFORMATION TECHNOLOGY & PEOPLE 2022. [DOI: 10.1108/itp-07-2022-0554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PurposeOnline health communities (OHCs) have been recognized as emerging platforms on the Internet used for health purposes. Despite its emergence, developing a successful OHC is still a challenge. Prior studies identified that value co-creation behavior (VCB) of members is an essential factor for sustaining OHCs; however, little is known about how members’ behavior drives to co-create value? Therefore, this study aims to discover the inclusive mechanism for members’ VCB in OHCs.Design/methodology/approachThe authors develop the study model and hypothesis based on the service-dominant logic of value co-creation theory and social support (SS) literature. The survey data of 608 active OHCs users in China were analyzed using partial least squares structural equation modeling (PLS-SEM).FindingsThe results revealed that SS positively affects members’ VCBs. Ethical aspects; Trust and ethical interaction (EI) partially mediate their relationships. In addition, community members’ current health status (CHS) negatively moderates the relationships between SS and VCB. From the findings, it becomes evident that only SS is not enough; developing an ethical environment in OHCs, i.e. trust and ethically rich interactions among members, significantly helps OHCs to promote co-creation. Also, the negative moderation of CHS findings provides novel insights when cramming health conditions.Originality/valueExploring the complex mechanism of co-creation in OHC, the authors illustrate the potential of service-dominant logic to create new theoretical insight for healthcare and provide the framework of co-creation with ethics for the first time. This will extend the application of ethics in healthcare services and offer a robust platform from which the understanding of drivers of members’ VCB can be advanced in the OHC context.
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Sallabank G, Blackburn NA, Threats M, Pulley DV, Barry MC, LeGrand S, Harper GW, Bauermeister JA, Hightow-Weidman LB, Muessig KE. Media representation, perception and stigmatisation of race, sexuality and HIV among young black gay and bisexual men. CULTURE, HEALTH & SEXUALITY 2022; 24:1729-1743. [PMID: 34895082 PMCID: PMC9188628 DOI: 10.1080/13691058.2021.2008506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
Young Black gay and bisexual men who have sex with men experience stigma related to race, gender expression, sexuality and HIV status. Stigma impacts access to HIV care and prevention as well as interactions with healthcare providers. The amplification of stigma through popular media is under-researched in the health sciences. HealthMpowerment is a mobile phone optimised intervention to reduce sexual risk and support community-building for young Black gay and bisexual men (age 18-30). We analysed Forum conversations from 48 participants, 45.8% living with HIV. Of 322 stigma-relevant conversations, 18.9% referenced the media (e.g. television, news, social media) as a source of stigma. Forum conversations covered media representations of Black gay and bisexual men, media's influence on identity, and the creation of stigma by association with media representations. Cultural messages embedded in the media may accentuate stereotypes that influence perceptions of Black gay and bisexual men and disregard intersectional identities. HealthMpowerment provided a space to challenge stigmatising representations. Participants used HealthMpowerment to garner social support and celebrate positive media representations. Interventions for young Black gay and bisexual men should consider the influential role of media and include spaces for participants to process and address stigma.
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Affiliation(s)
- Gregory Sallabank
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Natalie A. Blackburn
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
- Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Megan Threats
- Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Information Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deren V. Pulley
- Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Information Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Megan C. Barry
- Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sara LeGrand
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Gary W. Harper
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - José A. Bauermeister
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kathryn E. Muessig
- Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Costa-Cordella S, Grasso-Cladera A, Rossi A, Duarte J, Guiñazu F, Cortes CP. Internet-based peer support interventions for people living with HIV: A scoping review. PLoS One 2022; 17:e0269332. [PMID: 36040950 PMCID: PMC9426879 DOI: 10.1371/journal.pone.0269332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
Peer support interventions for people living with HIV and AIDS (PLWHA) are effective, but their associated time and material costs for the recipient and the health system make them reachable for only a small proportion of PLWHA. Internet-based interventions are an effective alternative for delivering psychosocial interventions for PLWHA as they are more accessible. Currently, no reviews are focusing on internet-based interventions with peer support components. This scoping review aims to map the existing literature on psychosocial interventions for PLWHA based on peer support and delivered through the internet. We conducted a systematic scoping review of academic literature following methodological guidelines for scoping reviews, and 28 articles met our criteria. We summarized the main characteristics of the digital peer support interventions for PLWHA and how they implemented peer support in a virtual environment. Overall the reported outcomes appeared promising, but more robust evidence is needed.
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Affiliation(s)
- Stefanella Costa-Cordella
- Centro de Estudios en Psicología Clínica y Psicoterapia (CEPPS), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Instituto Milenio Depresión y Personalidad (MIDAP), Santiago, Chile
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Aitana Grasso-Cladera
- Centro de Estudios en Psicología Clínica y Psicoterapia (CEPPS), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Alejandra Rossi
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Javiera Duarte
- Centro de Estudios en Psicología Clínica y Psicoterapia (CEPPS), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Instituto Milenio Depresión y Personalidad (MIDAP), Santiago, Chile
| | - Flavia Guiñazu
- Web Intelligence Centre, Facultad de Ingeniería Industrial, Universidad de Chile, Santiago, Chile
| | - Claudia P. Cortes
- Hospital Clínico San Borja Arriarán & Fundación Arriarán, Santiago, Chile
- Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- * E-mail:
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Coulson NS, Buchanan H. The Role of Online Support Groups in Helping Individuals Affected by HIV and AIDS: Scoping Review of the Literature. J Med Internet Res 2022; 24:e27648. [PMID: 35881456 PMCID: PMC9364165 DOI: 10.2196/27648] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/29/2021] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Online support groups provide opportunities for individuals affected by HIV and AIDS to seek information, advice, and support from peers. However, whether and how engagement with online support groups helps individuals affected by HIV and AIDS remains unclear, as does the nature of the evidence on this topic. Objective This scoping review sought to explore whether engagement with HIV and AIDS–related online support groups benefits members in terms of psychosocial well-being and illness management, whether members experienced any negative aspects of these groups, and what types of social support are exchanged within HIV and AIDS–related online support groups. Methods A scoping review of English-language articles (including both qualitative and quantitative studies) was undertaken using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The databases searched included MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL (Cochrane Register of Controlled Trials), and Scopus. Key findings were synthesized using a narrative and thematic approach. Results A total of 22 papers met the inclusion criteria from an initial pool of 3332 abstracts. These papers included 23% (5/22) quantitative studies, 9% (2/22) mixed methods studies, and 68% (15/22) qualitative studies published between 2007 and 2019. Cross-sectional evidence suggests that engagement with HIV and AIDS–related online support groups is empowering for members and may lead to a range of psychosocial benefits. Furthermore, qualitative evidence suggests that these groups provide an opportunity to connect with similar people and share experiences. This can help improve self-worth, reduce stigma, facilitate improved illness management, and gain greater confidence when interacting with health professionals. However, online support groups are not without their limitations as qualitative evidence suggests that users may encounter examples of interpersonal conflict between members as well as be exposed to challenging content. Finally, HIV and AIDS–related online support groups are avenues through which individuals can solicit support, most commonly informational or emotional. Conclusions HIV and AIDS–related online support groups may have some benefits for members, particularly in terms of providing social support. There is a need for a systematic review of this literature that includes an assessment of the methodological quality of the available evidence.
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Affiliation(s)
- Neil S Coulson
- School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Heather Buchanan
- School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
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Li H, Huang J, Liu J. External Support for Elderly Care Social Enterprises in China: A Government-Society-Family Framework of Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148244. [PMID: 35886102 PMCID: PMC9323916 DOI: 10.3390/ijerph19148244] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023]
Abstract
As Chinese population ageing becomes increasingly severe, the disjunct between supply and demand for pension services is becoming increasingly serious. The development of elderly care social enterprises plays an important role in solving this disjunction. Such development comes from both the enterprise's own capacity building and from external support. There are abundant studies on the capacity-building of pension social enterprises in the existing literature, but there are relatively few studies on their external support. In order to better study the external support of elderly care social enterprises in China, we adopted the case study method; we selected GY (a typical elderly care social enterprise in China) as a case study according to certain criteria, and we conducted a series of discussions. Firstly, an analytical 'government-society-family' framework was constructed. Second, it was argued that there is insufficient external support for elderly care social enterprises. At the government level, there is a lack of policies, difficulties in implementation and significant geographical differences; at the social level, there are weak support platforms and lack of community supports; and at the family level, there are constraints in regard to traditional concepts and the ability to pay. Finally, an external support system of Chinese elderly care social enterprises was constructed to help more elderly care social enterprises overcome the lack of external support in the development process.
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Affiliation(s)
- Huimin Li
- Research Institute for Population Science, School of Public Administration, Hohai University, Nanjing 211100, China; (J.H.); (J.L.)
- School of Marxism, Taishan University, Tai’an 271021, China
- Correspondence: ; Tel.: +86-13953830823
| | - Jianyuan Huang
- Research Institute for Population Science, School of Public Administration, Hohai University, Nanjing 211100, China; (J.H.); (J.L.)
| | - Jiayun Liu
- Research Institute for Population Science, School of Public Administration, Hohai University, Nanjing 211100, China; (J.H.); (J.L.)
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Hossin A, Asante Boadi E, Bosompem J, Avornyo P, Okae-Adjei S, Atuobuah Boadi V, Say J. Personal and Organisational Resources on Electronic Health Usage Intentions in an Emerging Economy. TELEMATICS AND INFORMATICS 2022. [DOI: 10.1016/j.tele.2022.101832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Talebi-Tamijani Z, Lotfi R, Kabir K. Tele-counseling based on motivational interviewing to change sexual behavior of women living with HIV: a randomized controlled clinical trial. AIDS Behav 2022; 26:3506-3515. [PMID: 35467228 DOI: 10.1007/s10461-022-03678-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/28/2022]
Abstract
Sexual transmission accounts for the majority of new HIV infections in Iran. More than 80% of HIV-positive persons are sexually active, and nearly 68% reported never using a condom. The present RCT study was conducted on a group of HIV-positive women using internet-based motivational interviewing. The participants, including 100 HIV-positive women, were randomly assigned to an intervention or control group. The intervention group received five weekly internet-based group motivational interviewing sessions focused on reducing risky behaviors, and the control group received routine care. Follow-ups occurred one month and three months after the end of the intervention. The participants completed demographic information, sexual behaviors, HIV knowledge, condom negotiation skills, and HIV-specific perceived social support scales before, one month, and three months after the intervention. Motivational interviewing was effective in improving knowledge about HIV/AIDS, condom negotiation skills, and HIV-specific perceived social support in the intervention group compared to controls. The intervention significantly increased using condoms in vaginal or anal intercourse in the last three months. Still, it was not effective at consistent condom use in all vaginal and anal sex. Further investigation or a larger RCT needs to confirm the using tele-counseling for women living with HIV.
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Affiliation(s)
| | - Razieh Lotfi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
- Department of Midwifery and Reproductive Health, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | - Kourosh Kabir
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Hodges J, Waldman AL, Koshkina O, Suzdalnitsky A, Schwendinger J, Vitko S, Plenskey A, Plotnikova Y, Moiseeva E, Koshcheyev M, Sebekin S, Zhdanova S, Ogarkov O, Heysell S, Dillingham R. Process evaluation for the adaptation, testing and dissemination of a mobile health platform to support people with HIV and tuberculosis in Irkutsk, Siberia. BMJ Open 2022; 12:e054867. [PMID: 35351714 PMCID: PMC8966533 DOI: 10.1136/bmjopen-2021-054867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We developed and tested a mobile health-based programme to enhance integration of HIV and tuberculosis (TB) care and to promote a patient-centred approach in a region of high coinfection burden. Phases of programme development included planning, stakeholder interviews and platform re-build, testing and iteration. SETTING In Irkutsk, Siberia, HIV/TB coinfection prevalence is high relative to the rest of the Russian Federation. PARTICIPANTS Pilot testing occurred for a cohort of 60 people with HIV and TB. RESULTS Key steps emerged to ensure the mobile health-based programme could be operational and adequately adapted for the context, including platform language adaptation, optimisation of server management, iteration of platform features, and organisational practice integration. Pilot testing of the platform rebuild yielded favourable patient perceptions of usability and acceptability at 6 months (n=47 surveyed), with 18 of 20 items showing scores above 4 (on a scale from 1 to 5) on average. Development of this mobile health-based programme for integrated care of infections highlighted the importance of several considerations for tailoring these interventions contextually, including language adaptation and technological capacity, but also, importantly, contextualised patient preferences related to privacy and communication with peers and/or providers, existing regional capacity for care coordination of different comorbidities, and infection severity and treatment requirements. CONCLUSIONS Our experience demonstrated that integration of care for TB and HIV can be well served by using multimodal mobile health-based programmes, which can enhance communication and streamline workflow between providers across multiple collaborating institutions and improve continuity between inpatient and outpatient care settings. Further study of programme impact on contextual disease-related stigma and social isolation as well as evaluation of implementation on a broader scale for HIV care is currently under way. TRIAL REGISTRATION NUMBER NCT03819374.
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Affiliation(s)
- Jacqueline Hodges
- Division of Infectious Diseases & International Health, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Ava Lena Waldman
- Division of Infectious Diseases & International Health, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Olga Koshkina
- Irkutsk Regional Tuberculosis Referral Hospital, Irkutsk, Russian Federation
| | - Alexey Suzdalnitsky
- Irkutsk Regional Tuberculosis Referral Hospital, Irkutsk, Russian Federation
| | - Jason Schwendinger
- Division of Infectious Diseases & International Health, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Serhiy Vitko
- Division of Infectious Diseases & International Health, University of Virginia Health System, Charlottesville, Virginia, USA
| | | | | | - Elena Moiseeva
- Irkutsk Regional Tuberculosis Referral Hospital, Irkutsk, Russian Federation
| | - Mikhail Koshcheyev
- Irkutsk Regional Tuberculosis Referral Hospital, Irkutsk, Russian Federation
| | - Sergey Sebekin
- Irkutsk Regional AIDS Centre, Irkutsk, Russian Federation
| | - Svetlana Zhdanova
- Department of Epidemiology and Microbiology, Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Oleg Ogarkov
- Department of Epidemiology and Microbiology, Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Scott Heysell
- Division of Infectious Diseases & International Health, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Rebecca Dillingham
- Division of Infectious Diseases & International Health, University of Virginia Health System, Charlottesville, Virginia, USA
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14
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LeBaron V, Boukhechba M, Edwards J, Flickinger T, Ling D, Barnes LE. Exploring the use of wearable sensors and natural language processing technology to improve patient-clinician communication: Protocol for a feasibility study (Preprint). JMIR Res Protoc 2022; 11:e37975. [PMID: 35594139 PMCID: PMC9166632 DOI: 10.2196/37975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Virginia LeBaron
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Mehdi Boukhechba
- School of Engineering & Applied Science, University of Virginia, Charlottesville, VA, United States
| | - James Edwards
- School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Tabor Flickinger
- School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - David Ling
- School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Laura E Barnes
- School of Engineering & Applied Science, University of Virginia, Charlottesville, VA, United States
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15
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Gerritzen EV, Lee AR, McDermott O, Coulson N, Orrell M. Online peer support for people with Parkinson’s Disease: a narrative synthesis systematic review (Preprint). JMIR Aging 2021; 5:e35425. [PMID: 35896025 PMCID: PMC9377481 DOI: 10.2196/35425] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/27/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Esther Vera Gerritzen
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Abigail Rebecca Lee
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Orii McDermott
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Neil Coulson
- Population and Lifespan Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Martin Orrell
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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16
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Wiginton JM, Maksut JL, Murray SM, Augustinavicius JL, Kall M, Delpech V, Baral SD. Brief report: HIV-related healthcare stigma/discrimination and unmet needs among persons living with HIV in England and Wales. Prev Med Rep 2021; 24:101580. [DOI: 10.1016/j.pmedr.2021.101580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 11/25/2022] Open
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17
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Canan CE, Flickinger TE, Waselewski M, Tabackman A, Baker L, Eger S, Waldman ALD, Ingersoll K, Dillingham R. Toward understanding the impact of mHealth features for people with HIV: a latent class analysis of PositiveLinks usage. Transl Behav Med 2021; 11:172-181. [PMID: 31816017 PMCID: PMC7877298 DOI: 10.1093/tbm/ibz180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PositiveLinks (PL) is a multi-feature smartphone-based platform to improve engagement-in-care and viral suppression (VS) among clinic patients living with HIV. Features include medication reminders, mood/stress check-ins, a community board, and secure provider messaging. Our goal was to examine how PL users interact with the app and determine whether usage patterns correlate with clinical outcomes. Patients (N = 83) at a university-based Ryan White clinic enrolled in PL from June 2016 to March 2017 and were followed for up to 12 months. A subset (N = 49) completed interviews after 3 weeks of enrollment to explore their experiences with and opinions of PL. We differentiated PL members based on 6-month usage of app features using latent class analysis. We explored characteristics associated with class membership, compared reported needs and preferences by class, and examined association between class and VS. The sample of 83 PL members fell into four classes. "Maximizers" used all app features frequently (27%); "Check-in Users" tended to interact only with daily queries (22%); "Moderate All-Feature Users" used all features occasionally (33%); and "As-Needed Communicators" interacted with the app minimally (19%). VS improved or remained high among all classes after 6 months. VS remained high at 12 months among Maximizers (baseline and 12-month VS: 100%, 94%), Check-in Users (82%, 100%), and Moderate All-Feature Users (73%, 94%) but not among As-Needed Communicators (69%, 60%). This mixed-methods study identified four classes based on PL usage patterns that were distinct in characteristics and clinical outcomes. Identifying and characterizing mHealth user classes offers opportunities to tailor interventions appropriately based on patient needs and preferences as well as to provide targeted alternative support to achieve clinical goals.
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Affiliation(s)
- Chelsea E Canan
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Tabor E Flickinger
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Marika Waselewski
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Alexa Tabackman
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Logan Baker
- University of Virginia's College at Wise, Wise, VA, USA
| | - Samuel Eger
- University of Virginia's College at Wise, Wise, VA, USA
| | - Ava Lena D Waldman
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Karen Ingersoll
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Rebecca Dillingham
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
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18
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Peer Support Group for Intensive Care Unit Survivors: Perceptions on Supportive Recovery in the Era of Social Distancing. Ann Am Thorac Soc 2021; 18:177-182. [PMID: 33108225 PMCID: PMC7780980 DOI: 10.1513/annalsats.202007-799rl] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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19
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Kim GS, Shim MS, Yi J. Using decision tree analysis to understand the influence of social networks on disclosure of HIV infection status. AIDS Care 2021; 34:118-126. [PMID: 34292105 DOI: 10.1080/09540121.2021.1954587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Disclosure of human immunodeficiency virus (HIV) infection status improves treatment adherence and HIV prevention. Social networks influence such disclosure by people living with HIV/AIDS (PLWH). This study aimed to investigate the disclosure status of Korean PLWH and determine the social network characteristics associated with disclosure. A cross-sectional study design was used, and 148 Korean PLWH answered self-report questionnaires that included items on the characteristics of social networks and disclosure. Logistic regression and decision tree analysis were performed. In total, 81 participants (54.7%) reported disclosing HIV status to the most important supporter. Five factors were found to influence disclosure: age, self-help group participation, living arrangement, social network relationship, and tie strength; three groups had higher percentages of nondisclosure. The findings suggest that healthcare practitioners should provide adequate counseling by considering the characteristics of social networks and disclosure status of PLWH. Researchers should identify high-risk populations using decision tree analysis.
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Affiliation(s)
- Gwang Suk Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Mi-So Shim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Jeongmin Yi
- Hongcheon Hospital, Hongchen-gun, Gangwon-do, Republic of Korea
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20
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Arinaitwe I, Amutuhaire H, Atwongyeire D, Tusingwire E, Kawungezi PC, Rukundo GZ, Ashaba S. Social Support, Food Insecurity, and HIV Stigma Among Men Living with HIV in Rural Southwestern Uganda: A Cross-Sectional Analysis. HIV AIDS (Auckl) 2021; 13:657-666. [PMID: 34163254 PMCID: PMC8216066 DOI: 10.2147/hiv.s316174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND HIV stigma is one of the major barriers to HIV care due to the fear of disclosure and social discrimination. HIV stigma among men in sub-Saharan countries, including Uganda, has been linked to the fear about how HIV status might affect their status in society. HIV among men in sub-Saharan settings has been associated with feelings of shame, reduced self-worth, and self-blame for their HIV positive status. Information about HIV stigma and its associated factors among men living with HIV in rural Uganda is limited. This study assessed the burden of HIV stigma and its association with social support and food insecurity among men accessing HIV care at a rural health facility in southwestern Uganda. METHODS We conducted a clinic-based cross-sectional study and consecutively enrolled 252 adult men accessing HIV care at a rural health centre in southwestern Uganda. We collected information on sociodemographic information, HIV stigma, social support, and food insecurity. We fitted modified Poisson regression models to determine the associations between social support, food insecurity, and HIV stigma. RESULTS The mean HIV stigma score of the study participants was 70.08 (SD 19.34) and 75% reported food insecurity 5% of whom were severely food insecure. The risk of HIV stigma was lower among those aged 35 years and above (adjusted risk ratio [ARR]=0.89; 95% CI 0.83-0.96; P=0.003, those who had been on ART for more than 5 years (ARR=0.92; 95% CI=0.84-0.99; P=0.04), and those who had social support (ARR=0.99; 95% CI=0.98-0.99; P=<0.001). Food insecurity was associated with an increased risk of HIV stigma (ARR=1.07; 95% CI 1.00-1.15; P=0.03). Social support moderated the effect of food insecurity on HIV stigma (P=0.45). CONCLUSION Stigma is common among men living with HIV in rural Uganda and is significantly associated with food insecurity. Social support moderated the effect of severe food insecurity on HIV stigma among men living with HIV. Interventions to build social support systems and to economically empower men living with HIV should be incorporated into the mainstream HIV care clinics.
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Affiliation(s)
- Innocent Arinaitwe
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Hildah Amutuhaire
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Davis Atwongyeire
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Esther Tusingwire
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Peter Chris Kawungezi
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Scholastic Ashaba
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
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21
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Peer Group Focused eHealth Strategies to Promote HIV Prevention, Testing, and Care Engagement. Curr HIV/AIDS Rep 2021; 17:557-576. [PMID: 32794071 DOI: 10.1007/s11904-020-00527-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Electronic communication platforms are increasingly used to support all steps of the HIV care cascade (an approach defined as eHealth). Most studies have employed individual-level approaches in which participants are connected with information, reminders, or a healthcare worker. Recent growth in use of social media platforms, which create digital communities, has created an opportunity to leverage virtual peer-to-peer connection to improve HIV prevention and care. In this article, we describe the current landscape of peer group eHealth interventions in the HIV field, based on a review of published literature, an online survey of unpublished ongoing work, and discussions with practitioners in the field in an in-person workshop. RECENT FINDINGS We identified 45 published articles and 12 ongoing projects meeting our inclusion criteria. Most reports were formative or observational; only three randomized evaluations of two interventions were reported. Studies indicated that use of peer group eHealth interventions is acceptable and has unique potential to influence health behaviors, but participants reported privacy concerns. Evaluations of health outcomes of peer group eHealth interventions show promising data, but more rigorous evaluations are needed. Development of group eHealth interventions presents unique technological, practical, and ethical challenges. Intervention design must consider privacy and data sovereignty concerns, and respond to rapid changes in platform use. Innovative development of open-source tools with high privacy standards is needed.
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22
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Flickinger TE, Sherbuk JE, Petros de Guex K, Añazco Villarreal D, Hilgart M, McManus KA, Ingersoll K, Dillingham R. Adapting an m-Health Intervention for Spanish-Speaking Latinx People Living with HIV in the Nonurban Southern United States. TELEMEDICINE REPORTS 2021; 2:46-55. [PMID: 33817694 PMCID: PMC8009288 DOI: 10.1089/tmr.2020.0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
Background: Latinx people in the United States are disproportionately diagnosed with HIV and are more likely to experience worse HIV-related health outcomes. Although m-health has demonstrated success in improving HIV care, a gap remains in the development of m-health platforms tailored to Latinx populations. Methods: We conducted formative study to guide the adaptation of an evidence-based m-health intervention, PositiveLinks (PL), for Spanish-speaking Latinx people living with HIV (PLWH). Spanish-speaking Latinx PLWH in the nonurban Southern United States completed semistructured interviews and viewed a demo version of the m-health intervention. Qualitative analysis was performed using a grounded theory approach. Emerging themes were identified in four topic areas: (1) prior experiences with technology, (2) desired m-health features, (3) experiences with prototype app, and (4) iteration of prototype. Results: All PLWH who participated (n = 22) were born outside the continental United States. Participants included 10 men, 10 women, and 2 transgender participants. Mean age was 41.1 years (standard deviation 11.6 years). Participants expressed concerns about privacy, a need for reliable information, and interest in practical m-health features such as appointment and medication reminders. After trialing the Spanish-language PL prototype, participants reported that peer support and positive reinforcement were strong motivators to use the app. The ability to individualize the app to meet one's own needs was also considered important. Conclusion: This formative study provides baseline attitudes about m-health among Latinx PLWH as well as desired m-health features. m-Health interventions are acceptable to Spanish-speaking PLWH and involving the target population in a user-centered formative process led to improvements in app accessibility and usability.
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Affiliation(s)
- Tabor E. Flickinger
- University of Virginia Department of Medicine, Division of General Medicine, Geriatrics, and Palliative Care, Charlottesville, Virginia, USA
| | - Jacqueline E. Sherbuk
- University of Virginia Department of Medicine, Division of Infectious Disease and International Health, Charlottesville, Virginia, USA
| | - Kristen Petros de Guex
- University of Virginia Department of Medicine, Division of Infectious Disease and International Health, Charlottesville, Virginia, USA
| | - Diego Añazco Villarreal
- Colegio de Ciencias de la Salud, Escuela de Medicina, Universidad San Francisco de Quito, Quito, Ecuador
| | - Michelle Hilgart
- University of Virginia Center for Behavioral Health and Technology, Charlottesville, Virginia, USA
| | - Kathleen A. McManus
- University of Virginia Department of Medicine, Division of Infectious Disease and International Health, Charlottesville, Virginia, USA
| | - Karen Ingersoll
- University of Virginia Department of Psychiatry and Neurobehavioral Sciences, Charlottesville, VA, USA
| | - Rebecca Dillingham
- University of Virginia Department of Medicine, Division of Infectious Disease and International Health, Charlottesville, Virginia, USA
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23
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Conte M, Eshun-Wilson I, Geng E, Imbert E, Hickey MD, Havlir D, Gandhi M, Clemenzi-Allen A. Brief Report: Understanding Preferences for HIV Care Among Patients Experiencing Homelessness or Unstable Housing: A Discrete Choice Experiment. J Acquir Immune Defic Syndr 2020; 85:444-449. [PMID: 33136742 PMCID: PMC8028840 DOI: 10.1097/qai.0000000000002476] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Homelessness and unstable housing (HUH) negatively impact care outcomes for people living with HIV (PLWH). To inform the design of a clinic program for PLWH experiencing HUH, we quantified patient preferences and trade-offs across multiple HIV-service domains using a discrete choice experiment (DCE). METHODS We sequentially sampled PLWH experiencing HUH presenting at an urban HIV clinic with ≥1 missed primary care visit and viremia in the last year to conduct a DCE. Participants chose between 2 hypothetical clinics varying across 5 service attributes: care team "get to know me as a person" versus not; receiving $10, $15, or $20 gift cards for clinic visits; drop-in versus scheduled visits; direct phone communication to care team versus front-desk staff; and staying 2 versus 20 blocks from the clinic. We estimated attribute relative utility (ie, preference) using mixed-effects logistic regression and calculated the monetary trade-off of preferred options. RESULTS Among 65 individuals interviewed, 61% were >40 years old, 45% White, 77% men, 25% heterosexual, 56% lived outdoors/emergency housing, and 44% in temporary housing. Strongest preferences were for patient-centered care team [β = 3.80; 95% confidence interval (CI): 2.57 to 5.02] and drop-in clinic appointments (β = 1.33; 95% CI: 0.85 to 1.80), with a willingness to trade $32.79 (95% CI: 14.75 to 50.81) and $11.45 (95% CI: 2.95 to 19.95) in gift cards/visit, respectively. CONCLUSIONS In this DCE, PLWH experiencing HUH were willing to trade significant financial gain to have a personal relationship with and drop-in access to their care team rather than more resource-intensive services. These findings informed Ward 86's "POP-UP" program for PLWH-HUH and can inform "ending the HIV epidemic" efforts.
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Affiliation(s)
- Madellena Conte
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
- Institute of Global Health Sciences, University of California, San Francisco, San Francisco, CA
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Ingrid Eshun-Wilson
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO; and
| | - Elvin Geng
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO; and
| | - Elizabeth Imbert
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
| | - Matthew D Hickey
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
| | - Diane Havlir
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
| | - Monica Gandhi
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
| | - Angelo Clemenzi-Allen
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA
- San Francisco Department of Public Health, San Francisco, CA
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24
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Associations Between Influencing Factors, Perceived Symptom Burden, and Perceived Overall Function Among Adults Living With HIV. J Assoc Nurses AIDS Care 2020; 31:325-336. [PMID: 32084038 DOI: 10.1097/jnc.0000000000000166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
With adherence to combination antiretroviral therapy, HIV infection is now a chronic, but manageable, disease with associated symptoms and complications. However, there is limited evidence on how symptom burden affects perceived overall function among people living with HIV (PLWH). Furthermore, there is no consensus on the factors that affect symptom burden in PLWH. We examined relationships between factors that may influence symptom burden and perceived overall function, and the association between symptom burden and overall function in 179 adult PLWH. This study was a cross-sectional, secondary analysis using the Theory of Unpleasant Symptoms (Lenz, Pugh, Milligan, Gift, & Suppe, 1997). We found strong evidence that symptoms, especially pain, tiredness, and depression, are prevalent in PLWH, and that symptoms were predicted by perceived social support and the number of comorbidities. Increased symptom burden predicts reduced overall function. Interventions are needed to reduce symptoms and strengthen social support in PLWH. Initiating symptom assessment and management strategies early is paramount.
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Njie-Carr VPS, Zhu S, Williams GC, Corless IB, Himelhoch S. Evaluation of a technology-enhanced intervention for older women with HIV infection: a proof of concept study. AIDS Care 2020; 33:983-992. [PMID: 32835493 DOI: 10.1080/09540121.2020.1810617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The syndemic effects of HIV infection, side effects of highly active antiretroviral medications, and age-related changes lead to increased risk for comorbidities and functional decline for older people with HIV. This proof of concept (PoC) study evaluated perceived usefulness, satisfaction, acceptability, intervention processes, resource management, and outcome effect variances of ThE CARE Intervention guided by the Self-Determination Theory. To test the utility of ThE CARE, we conducted a one-group pre/posttest intervention design with a convenience sample of 20 women, 50 years and older. The mean age was 56 years (SD = 11) and years since HIV diagnosis was 23.7 (SD = 8.6). ThE CARE intervention was found useful and participants "felt empowered" utilizing the app. Fourteen participants (70%) reported high-intensity distress and negative impact on life from neuropathic pain, anxiety (55%), fatigue (50%), and depressive symptoms (35%). Self-awareness and self-regulation also improved. Modest results of acceptability, usability, and positive trends in the outcome measures suggest possible effects. The interactivity and cultural relevance of ThE CARE would enhance women's autonomous motivation and perceived competence to actively engage in self-care. The PoC study provides important foundational information to advance science in mHealth interventions for older women with HIV.
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Affiliation(s)
- Veronica P S Njie-Carr
- School of Nursing, Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, MD, USA
| | - Shijun Zhu
- School of Nursing, Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, MD, USA
| | - Geoffrey C Williams
- Department of Medicine, and Center for Community Health and Prevention, University of Rochester, Rochester, NY, USA
| | - Inge B Corless
- School of Nursing, MGH Institute of Health Professions, Boston, MA, USA
| | - Seth Himelhoch
- College of Medicine, University of Kentucky, Lexington, KY, USA
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26
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Wolfers LN, Festl R, Utz S. Do smartphones and social network sites become more important when experiencing stress? Results from longitudinal data. COMPUTERS IN HUMAN BEHAVIOR 2020; 109:106339. [PMID: 32747849 PMCID: PMC7224514 DOI: 10.1016/j.chb.2020.106339] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Previous research on stress and media use mainly concentrated on between-person effects. We add to this research field by additionally assessing within-person associations, assuming that experiencing more stress than usual goes along with more nomophobia (“no-mobile-phone phobia”) and more passive and active Facebook use than usual, cross-sectionally and over time, and by exploring potential age differences. We conducted a secondary analysis of three waves of a representative multi-wave survey of adult Dutch internet users (N = 861). Specifically, we used two subsamples: (1) smartphones users for the analyses on nomophobia (n = 600) and (2) Facebook users for the analyses on social media (n = 469). Employing random-intercept cross-lagged panel models, we found within-person correlations between nomophobia and stress at one time-point, but not over time. For the younger age group (18–39 years), more passive Facebook use than usual was associated with more stress than usual six months later, and more stress than usual was followed by less passive Facebook use six month later. There were no longitudinal relationships for active Facebook use across the different age groups. Methodological and theoretical implications are discussed. We study the relationships of nomophobia, Facebook use and stress over time. Nomophobia and stress correlate on the within-person level at one time-point. Passive Facebook use is associated with more stress over time for younger adults. Stress relates to less passive Facebook use six months later for younger adults. There are no longitudinal effects for nomophobia, active Facebook use, and stress.
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Affiliation(s)
| | - Ruth Festl
- Leibniz-Institut für Wissensmedien Tübingen, Germany
| | - Sonja Utz
- Leibniz-Institut für Wissensmedien Tübingen, Germany.,University of Tübingen, Germany
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Liu S, Xiao W, Fang C, Zhang X, Lin J. Social support, belongingness, and value co-creation behaviors in online health communities. TELEMATICS AND INFORMATICS 2020. [DOI: 10.1016/j.tele.2020.101398] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Fisher CB, Bragard E, Bloom R. Ethical Considerations in HIV eHealth Intervention Research: Implications for Informational Risk in Recruitment, Data Maintenance, and Consent Procedures. Curr HIV/AIDS Rep 2020; 17:180-189. [PMID: 32358768 PMCID: PMC7263316 DOI: 10.1007/s11904-020-00489-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Along with the benefits of eHealth HIV interventions are challenges to participant privacy and confidentiality inherent in the use of online strategies. This paper reviews current guidelines and recent publications to identify ethical issues and suggested solutions in recruitment, data management, and informed consent. RECENT FINDINGS Across eHealth HIV research, recruitment, data collection, and storage efforts to protect informational risk highlight the tension between the investigators' ability to protect participant confidentiality and the evolving informational risk posed by the online platforms on which they are operating. Adequately addressing these challenges requires updating technical competencies and educating participants on their own responsibilities to guard against privacy violations. Additional protections are required when interventions involve peer or community support, especially with minors. The rapid progression of technology presents challenges in solidifying best practices for future interventions. This article draws on published works describing investigator experiences to contribute to the ongoing development of guidance in this area.
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Affiliation(s)
- Celia B Fisher
- Center for Ethics Education and Department of Psychology, Fordham University, 117 Dealy Hall, Rose Hill Campus, 441 E. Fordham Road, Bronx, NY, 10458, USA.
| | - Elise Bragard
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Rachel Bloom
- Department of Psychology, Fordham University, Bronx, NY, USA
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29
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Step MM, McMillen Smith J, Kratz J, Briggs J, Avery A. "Positive Peers": Function and Content Development of a Mobile App for Engaging and Retaining Young Adults in HIV Care. JMIR Form Res 2020; 4:e13495. [PMID: 32012035 PMCID: PMC7055772 DOI: 10.2196/13495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/23/2019] [Accepted: 09/26/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Although treatment for HIV infection is widely available and well tolerated, less than 30% of adolescents and young adults living with HIV infection achieve stable viral suppression. Mobile technology affords increased opportunities for young people living with HIV to engage with information, health management tools, and social connections that can support adherence to treatment recommendations and medication. Although mobile apps are increasingly prevalent, few are informed by the target population. OBJECTIVE The objective of this study was to describe the "Positive Peers" app, a mobile app currently being evaluated in a public hospital in the Midwestern United States. Formative development, key development strategies, user recruitment, and lessons learned are discussed in this paper. METHODS "Positive Peers" was developed in collaboration with a community advisory board (CAB) comprising in-care young adults living with HIV and a multidisciplinary project team. Mobile app functions and features were developed over iterative collaborative sessions that were tailored to the CAB members. In turn, the CAB built rapport with the project team and revealed unique information that was used in app development. RESULTS The study was funded on September 1, 2015; approved by the MetroHealth Institutional Review Board on August 31, 2016; and implemented from October 11, 2016, to May 31, 2019. The "Positive Peers" mobile app study has enrolled 128 users who reflect priority disparity population subgroups. The app administrator had frequent contact with users across app administration and study-related activities. Key lessons learned from the study include changing privacy concerns, data tracking reliability, and user barriers. Intermediate and outcome variable evaluation is expected in October 2019. CONCLUSIONS Successful development of the "Positive Peers" mobile app was supported by multidisciplinary expertise, an enthusiastic CAB, and a multifaceted, proactive administrator.
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Affiliation(s)
- Mary M Step
- College of Public Health, Kent State University, Kent, OH, United States
| | | | | | | | - Ann Avery
- Metrohealth Medical Center, Cleveland, OH, United States.,Case Western Reserve University, School of Medicine, Cleveland, OH, United States
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Canan CE, Waselewski ME, Waldman ALD, Reynolds G, Flickinger TE, Cohn WF, Ingersoll K, Dillingham R. Long term impact of PositiveLinks: Clinic-deployed mobile technology to improve engagement with HIV care. PLoS One 2020; 15:e0226870. [PMID: 31905209 PMCID: PMC6944340 DOI: 10.1371/journal.pone.0226870] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/07/2019] [Indexed: 01/23/2023] Open
Abstract
Background PositiveLinks (PL) is a smartphone-based platform designed in partnership with people living with HIV (PLWH) to improve engagement in care. PL provides daily medication reminders, check-ins about mood and stress, educational resources, a community message board, and an ability to message providers. The objective of this study was to evaluate the impact of up to 24 months of PL use on HIV viral suppression and engagement in care and to examine whether greater PL use was associated with improved outcomes. Setting This study occurred between September 2013 and March 2017 at a university-based Ryan White HIV clinic. Methods We assessed engagement in care and viral suppression from study baseline to the 6-, 12-, 18- and 24-month follow-up time periods and compared trends among high vs. low PL users. We compared time to viral suppression, proportion of days virally suppressed, and time to engagement in care in patients with high vs. low PL use. Results 127 patients enrolled in PL. Engagement in care and viral suppression improved significantly after 6 months of PL use and remained significantly improved after 24 months. Patients with high PL use were 2.09 (95% CI 0.64–6.88) times more likely to achieve viral suppression and 1.52 (95% CI 0.89–2.57) times more likely to become engaged in care compared to those with low PL use. Conclusion Mobile technology, such as PL, can improve engagement in care and clinical outcomes for PLWH. This study demonstrates long-term acceptability of PL over two years and provides evidence for long-term improvement in engagement in care and viral suppression associated with PL use.
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Affiliation(s)
- Chelsea E. Canan
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Marika E. Waselewski
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Ava Lena D. Waldman
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - George Reynolds
- Health Decision Technologies, Oakland, CA, United States of America
| | - Tabor E. Flickinger
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Wendy F. Cohn
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Karen Ingersoll
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Rebecca Dillingham
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
- * E-mail:
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31
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Maloney KM, Bratcher A, Wilkerson R, Sullivan PS. Electronic and other new media technology interventions for HIV care and prevention: a systematic review. J Int AIDS Soc 2020; 23:e25439. [PMID: 31909896 PMCID: PMC6945883 DOI: 10.1002/jia2.25439] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 11/04/2019] [Accepted: 12/04/2019] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Electronic and other new media technologies (eHealth) can facilitate large-scale dissemination of information and effective delivery of interventions for HIV care and prevention. There is a need to both monitor a rapidly changing pipeline of technology-based care and prevention methods and to assess whether the interventions are appropriately diversified. We systematically review and critically appraise the research pipeline of eHealth interventions for HIV care and prevention, including published studies and other funded projects. METHODS Two peer-reviewed literature databases were searched for studies describing the development, trial testing or implementation of new technology interventions, published from September 2014 to September 2018. The National Institutes of Health database of grants was searched for interventions still in development. Interventions were included if eHealth was utilized and an outcome directly related to HIV treatment or prevention was targeted. We summarized each intervention including the stage of development, eHealth mode of delivery, target population and stage of the HIV care and prevention continua targeted. RESULTS AND DISCUSSION Of 2178 articles in the published literature, 113 were included with 84 unique interventions described. The interventions utilize a variety of eHealth technologies and target various points on the prevention and care continua, with greater emphasis on education, behaviour change and testing than linkage to medical care. There were a variety of interventions for HIV care support but none for PrEP care. Most interventions were developed for populations in high income countries. An additional 62 interventions with funding were found in the development pipeline, with greater emphasis on managing HIV and PrEP care. CONCLUSIONS Our systematic review found a robust collection of eHealth interventions in the published literature as well as unpublished interventions still in development. In the published literature, there is an imbalance of interventions favouring education and behaviour change over linkage to care, retention in care, and adherence, especially for PrEP. The next generation of interventions already in the pipeline might address these neglected areas of care and prevention, but the development process is slow. Researchers need new methods for more efficient and expedited intervention development so that current and future needs are addressed.
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Affiliation(s)
| | - Anna Bratcher
- Department of EpidemiologyUniversity of CaliforniaLos AngelesCAUSA
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32
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Kashian N, Jacobson S. Factors of Engagement and Patient-Reported Outcomes in a Stage IV Breast Cancer Facebook Group. HEALTH COMMUNICATION 2020; 35:75-82. [PMID: 30351185 DOI: 10.1080/10410236.2018.1536962] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examines the factors of online engagement, and the relationship between online engagement and health expectations in a Stage IV breast cancer Facebook group. Members of the Facebook group completed a survey that assessed tie strength, homophily, and health expectations. A content analysis measured optimal social support, and Facebook analytics measured engagement. The results show optimal social support and tie strength are positively related to engagement. However, only optimal social support explains variance in engagement independent of tie strength and homophily. Additionally, the more engaged members are, the more positive their health expectations. The results emphasize the value of optimal social support and engagement in online support groups for individuals with Stage IV breast cancer.
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Affiliation(s)
- Nicole Kashian
- Department of Communication, Florida International University
| | - Susan Jacobson
- Department of Journalism + Media, Florida International University
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33
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Webster NL, Oyebode JR, Jenkins C, Bicknell S, Smythe A. Using technology to support the emotional and social well-being of nurses: A scoping review. J Adv Nurs 2019; 76:109-120. [PMID: 31599997 DOI: 10.1111/jan.14232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 07/25/2019] [Accepted: 10/03/2019] [Indexed: 11/30/2022]
Abstract
AIMS (a) To review the literature on the use of technology to offer emotional and social support to nurses; (b) to identify and evaluate gaps in the research; (c) to assess whether a systematic review would be valuable and (d) to make recommendations for future research. DESIGN A robust methodological scoping framework was used as the basis for this review design. A manualized systematic approach to quality appraisal was implemented. DATA SOURCES Between 11-12 June 2018, five databases were searched. A search of the grey literature was conducted alongside hand searching reference lists of included studies. REVIEW METHODS Two researchers conducted the literature search, data extraction and quality appraisal. Three searches were conducted, combining nursing and technological terms. A narrative review approach to knowledge synthesis was used to compare and evaluate included studies. RESULTS Eleven articles were retrieved. Results are presented under three subheadings: (a) text messaging and messenger apps; (b) social media and online forums; and (c) online interventions accessible via PC, smartphone and tablet. All included studies described how such provision could be beneficial; decreasing stress, isolation and anxiety and fostering a sense of community. CONCLUSION The review identified a dearth of research into how technology can support the well-being of nurses. A high proportion of studies were based on student nurse populations using small sample sizes, therefore further research is needed. IMPACT Technology may offer a sustainable and accessible means of providing support for nurses who find it difficult to communicate in person due to time pressures at work. It is important that the psychological well-being of nurses is seriously addressed as more nurses are now leaving than joining the profession. Online interventions may offer a sustainable and accessible means of providing support for busy nursing staff who have difficulty finding time to communicate with one another face-to-face. Nurse retention is an international issue linked to quality of patient care. There are financial implications for healthcare providers who compensate for the workforce deficit by employing costly agency staff. This scoping review aims to map and evaluate the available literature on technology-mediated support for the emotional and social well-being of nurses. Recommendations for future research, policy and practice will be offered from the findings of the review.
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Affiliation(s)
| | | | | | - Sarah Bicknell
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Analisa Smythe
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
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34
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Brener L, Broady T, Cama E, Hopwood M, de Wit JBF, Treloar C. The role of social support in moderating the relationship between HIV centrality, internalised stigma and psychological distress for people living with HIV. AIDS Care 2019; 32:850-857. [PMID: 31482729 DOI: 10.1080/09540121.2019.1659914] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Research has documented the negative impact of stigma on health outcomes for people living with HIV (PLHIV). How central HIV is to the identity of the individual may increase the negative effects of stigma, including greater psychological distress, while having strong social supports may play a buffering role. This study aimed to establish whether internalised stigma mediates the relationship between the centrality of HIV identity and psychological distress, while also assessing the role of social support as a moderator. PLHIV (n = 181) responded to a survey assessing experiences of living with HIV focussed on centrality of HIV identity, internalised stigma, and wellbeing. After controlling for age and education, findings from the mediation analysis show that the more central HIV is to an individual's identity, the more stigma is internalised and the greater the negative impact on psychological wellbeing. However, this is only the case for people with low levels of social support. Regardless of how central HIV is to identity, social support appears to act as a buffer and promote positive wellbeing. For those working with PLHIV, promoting the importance of good social support systems may be one way to address some of the negative impacts of stigma.
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Affiliation(s)
- Loren Brener
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
| | - Timothy Broady
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
| | - Elena Cama
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
| | - Max Hopwood
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
| | - John B F de Wit
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
| | - Carla Treloar
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
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35
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Shim EJ, Lee SH, Kim NJ, Kim ES, Bang JH, Sohn BK, Park HY, Son KL, Hwang H, Lee KM, Hahm BJ. Suicide Risk in Persons with HIV/AIDS in South Korea: a Partial Test of the Interpersonal Theory of Suicide. Int J Behav Med 2019; 26:38-49. [PMID: 30255219 DOI: 10.1007/s12529-018-9749-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE The high disease burden associated with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is linked to the elevated suicide risk in this population. Informed by the interpersonal theory of suicide, this study examined how and under which conditions depression is related to suicide risk in people living with HIV/AIDS. METHODS A total of 202 outpatients with HIV/AIDS participated in a cross-sectional and multi-center survey involving four university hospitals in South Korea. This self-reported survey included the Hospital Anxiety and Depression Scale, Interpersonal Needs Questionnaire, and Mini-International Neuropsychiatric Interview suicidality module. RESULTS Participants' mean age was 48.6 (SD = 13.4) and the majority was male (89.1%). The proportions of those at high, medium, and low suicide risk were 18.5%, 20%, and 15.4%, respectively. Depression was associated with suicide risk directly and indirectly by increasing perceived burdensomeness (PB) and the indirect effect of depression on suicide risk mediated by PB was contingent on the level of thwarted belongingness (TB). PB was associated with suicide risk even after controlling for depression, suggesting its independent effect on suicide risk. CONCLUSIONS PB and TB are potential mechanisms through which depression is associated with suicide risk, supporting the applicability of the interpersonal theory of suicide to understanding a complex interplay of risk factors in people with HIV/AIDS. Moreover, given the independent association of PB with suicide risk, as well as a protective effect of TB in suicide risk, monitoring and management of these factors should be included in the care of people with HIV/AIDS.
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Affiliation(s)
- Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, South Korea
| | - Sun Hee Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Hwan Bang
- Division of Infectious Diseases, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Bo Kyung Sohn
- Department of Psychiatry, Sanggye Paik Hospital, Seoul, South Korea.,Department of Psychiatry, Inje University College of Medicine, Busan, South Korea
| | - Hye Youn Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyung-Lak Son
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Heesung Hwang
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Kwang-Min Lee
- Public Health and Medical Service, Seoul National University Hospital, Seoul, South Korea
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea. .,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
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36
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Laurence C, Wispelwey E, Flickinger TE, Grabowski M, Waldman AL, Plews-Ogan E, Debolt C, Reynolds G, Cohn W, Ingersoll K, Dillingham R. Development of PositiveLinks: A Mobile Phone App to Promote Linkage and Retention in Care for People With HIV. JMIR Form Res 2019; 3:e11578. [PMID: 30892269 PMCID: PMC6446157 DOI: 10.2196/11578] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 12/01/2018] [Accepted: 12/31/2018] [Indexed: 12/31/2022] Open
Abstract
Background Linkage to and retention in HIV care are challenging, especially in the Southeastern United States. The rise in mobile phone app use and the potential for an app to deliver just in time messaging provides a new opportunity to improve linkage and retention among people living with HIV (PLWH). Objective This study aimed to develop an app to engage, link, and retain people in care. We evaluated the acceptability, feasibility, and impact of the app among users. Methods App development was informed by principles of chronic disease self-management and formative interviews with PLWH. Once developed, the app was distributed among participants, and usability feedback was incorporated in subsequent iterations. We interviewed app users after 3 weeks to identify usability issues, need for training on the phone or app, and to assess acceptability. We tracked and analyzed usage of app features for the cohort over 2 years. Results A total of 77 participants used the app during the pilot study. The query response rate for the first 2 years was 47.7%. Query response declined at a rate of 0.67% per month. The community message board was the most popular feature, and 77.9% (60/77) of users posted on the board at least once during the 2 years. Conclusions The PositiveLinks app was feasible and acceptable among nonurban PLWH. High participation on the community message board suggests that social support from peers is important for people recently diagnosed with or returning to care for HIV.
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Affiliation(s)
- Colleen Laurence
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Erin Wispelwey
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Tabor E Flickinger
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Marika Grabowski
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Ava Lena Waldman
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Erin Plews-Ogan
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Claire Debolt
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | | | - Wendy Cohn
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Karen Ingersoll
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Rebecca Dillingham
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
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Smith E, Bélisle-Pipon JC, Resnik D. Patients as research partners; how to value their perceptions, contribution and labor? CITIZEN SCIENCE : THEORY AND PRACTICE 2019; 4:10.5334/cstp.184. [PMID: 32064121 PMCID: PMC7021275 DOI: 10.5334/cstp.184] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Citizen Science refers to the consultation, participation, engagement or involvement of the general public in research. Rationales for this interaction include increased public access and involvement of citizens in research, immersion of community values relevant to research, outreach and educational potential with the public, and ultimately, the democratization of science. This paper focuses on the specific subset of citizen science that seeks to engage "patient partners" in health research to gain the valuable experiential knowledge of those living with a disease. Greater patient engagement in research (PER) can provide researchers with insights about citizen values and needs relevant to determining research priorities, methodology, applications and ethical parameters; this would ideally lead to more effective real-world applications. Over the last decade, projects involving patients partners in research (PPR) have varied from mere tokenism and undervaluation to full involvement and empowerment of patient participants - the former, a subject of criticism, and the latter, promoted as an ideal. In this article, we will argue that the value of that experiential knowledge from patient partners in research should not only be acknowledged through its ongoing use, but also through recognition of participants who contribute to the creation and application of new knowledge. We will explore types of recognition that might be attributed to PPR, including scientific recognition; financial recognition or reward; personal and altruistic recognition; and the benefial outcomes of research applications. We will also consider whether such types of recognition could be applied to the broader field of citizen science.
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Affiliation(s)
- Elise Smith
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709 USA
| | - Jean-Chrisophe Bélisle-Pipon
- The Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard Law School, Cambridge, MA 02138 USA
| | - David Resnik
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709 USA
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Webster N, Oyebode J, Jenkins C, Smythe A. Using technology to support the social and emotional well‐being of nurses: A scoping review protocol. J Adv Nurs 2019; 75:898-904. [DOI: 10.1111/jan.13942] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/29/2018] [Accepted: 11/08/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Natalie Webster
- Birmingham and Solihull Mental Health NHS Foundation Trust Birmingham UK
| | | | | | - Analisa Smythe
- Birmingham and Solihull Mental Health NHS Foundation Trust Birmingham UK
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39
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Lewinski AA, Anderson RA, Vorderstrasse AA, Johnson CM. Developing Methods That Facilitate Coding and Analysis of Synchronous Conversations via Virtual Environments. INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2019; 18:10.1177/1609406919842443. [PMID: 31130832 PMCID: PMC6534273 DOI: 10.1177/1609406919842443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Programs via the Internet are uniquely positioned to capture qualitative data. One reason is because the Internet facilitates the creation of a community of similar individuals who can exchange information and support related to living with a chronic illness. Synchronous conversations via the Internet can provide insight into real-time social interaction and the exchange of social support. One way to analyze interactions among individuals is by using qualitative methods such as content, conversation, or discourse analysis. This manuscript describes how we used content analysis with aspects from conversation and discourse analysis to analyze synchronous conversations via the Internet to describe what individuals talk about and how individuals talk in an Internet-mediated interaction. With the increase in Internet interventions that facilitate collection of real-time conversational data, this article provides insight into how combining qualitative methods can facilitate the coding and analysis of these complex data.
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Affiliation(s)
- Allison A. Lewinski
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
| | - Ruth A. Anderson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Constance M. Johnson
- School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
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40
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Flickinger TE, DeBolt C, Xie A, Kosmacki A, Grabowski M, Waldman AL, Reynolds G, Conaway M, Cohn WF, Ingersoll K, Dillingham R. Addressing Stigma Through a Virtual Community for People Living with HIV: A Mixed Methods Study of the PositiveLinks Mobile Health Intervention. AIDS Behav 2018; 22:3395-3406. [PMID: 29882048 PMCID: PMC6153974 DOI: 10.1007/s10461-018-2174-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Stigma has negative consequences for quality of life and HIV care outcomes. PositiveLinks is a mobile health intervention that includes a secure anonymous community message board (CMB). We investigated discussion of stigma and changes in stigma scores. Of 77 participants in our pilot, 63% were male, 49% Black, and 72% had incomes below the federal poverty level. Twenty-one percent of CMB posts (394/1834) contained stigma-related content including negative (experiencing stigma) and positive (overcoming stigma) posts addressing intrapersonal and interpersonal stigma. Higher baseline stigma was positively correlated with stress and negatively correlated with HIV care self-efficacy. 12-month data showed a trend toward more improved stigma scores for posters on the CMB versus non-posters (- 4.5 vs - 0.63) and for posters of stigma-related content versus other content (- 5.1 vs - 3.3). Preliminary evidence suggests that a supportive virtual community, accessed through a clinic-affiliated smartphone app, can help people living with HIV to address stigma.
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Affiliation(s)
- Tabor E Flickinger
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Claire DeBolt
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Alice Xie
- University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Alison Kosmacki
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Marika Grabowski
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Ava Lena Waldman
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | - Mark Conaway
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Wendy F Cohn
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Karen Ingersoll
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Rebecca Dillingham
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
- UVA Center for Global Health, P.O. Box 801379, Charlottesville, VA, 22908, USA.
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Taylor BS, Fornos L, Tarbutton J, Muñoz J, Saber JA, Bullock D, Villarreal R, Nijhawan AE. Improving HIV Care Engagement in the South from the Patient and Provider Perspective: The Role of Stigma, Social Support, and Shared Decision-Making. AIDS Patient Care STDS 2018; 32:368-378. [PMID: 30179530 DOI: 10.1089/apc.2018.0039] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Initial linkage to medical care is a critical step in the HIV care continuum leading to improved health outcomes, reduced morbidity and mortality, and decreased HIV transmission risk. We explored differences in perspectives on engagement in HIV care between people living with HIV who attended (Arrived) their initial medical provider visit (IMV) and those who did not (Missed), and between patients and providers. The study was conducted in two large majority/minority HIV treatment centers in the United States (US) south, a geographical region disproportionately impacted by HIV. The Theory of Planned Behavior informed semistructured interviews eliciting facilitators and barriers to engagement in care from 53 participants: 40 patients in a structured sample of 20 Missed and 20 Arrived, and 13 care providers. Using Grounded Theory to frame analysis, we found similar perspectives for all groups, including beliefs in the following: patients' control over care engagement, a lack of knowledge regarding HIV within the community, and the impact of structural barriers to HIV care such as paperwork, transportation, housing, and substance use treatment. Differences were noted by care engagement status. Missed described HIV-related discrimination, depression, and lack of social support. Arrived worried what others think about their HIV status. Providers focused on structural barriers and process, while patients focused on relational aspects of HIV care and personal connection with clinics. Participants proposed peer navigation and increased contact from clinics as interventions to reduce missed IMV. Context-appropriate interventions informed by these perspectives are needed to address the expanding southern HIV epidemic.
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Affiliation(s)
- Barbara S. Taylor
- Department of Medicine, Division of Infectious Diseases, UT Health Science Center San Antonio, San Antonio, Texas
| | - Laura Fornos
- Department of Research and Information Management, University Health System, San Antonio, Texas
| | - Jesse Tarbutton
- Department of Medicine, Division of Infectious Diseases, UT Southwestern Medical Center, Dallas, Texas
| | - Jana Muñoz
- Round Rock Cancer Center, Baylor Scott & White Health, Round Rock, Texas
| | - Julie A. Saber
- HIV/STD Care Services Group, Texas Department of State Health Services, Austin, Texas
| | - Delia Bullock
- Department of Medicine, Division of Infectious Diseases, UT Health Science Center San Antonio, San Antonio, Texas
| | - Roberto Villarreal
- Department of Research and Information Management, University Health System, San Antonio, Texas
| | - Ank E. Nijhawan
- Department of Medicine, Division of Infectious Diseases, UT Southwestern Medical Center, Dallas, Texas
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Dillingham R, Ingersoll K, Flickinger TE, Waldman AL, Grabowski M, Laurence C, Wispelwey E, Reynolds G, Conaway M, Cohn WF. PositiveLinks: A Mobile Health Intervention for Retention in HIV Care and Clinical Outcomes with 12-Month Follow-Up. AIDS Patient Care STDS 2018; 32:241-250. [PMID: 29851504 PMCID: PMC5982157 DOI: 10.1089/apc.2017.0303] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Mobile health interventions may help People Living with HIV (PLWH) improve engagement in care. We designed and piloted PositiveLinks, a clinic-affiliated mobile intervention for PLWH, and assessed longitudinal impact on retention in care and viral suppression. The program was based at an academic Ryan White Clinic serving a nonurban population in Central Virginia. The PL intervention included a smartphone app that connected participants to clinic staff and provided educational resources, daily queries of stress, mood and medication adherence, weekly quizzes, appointment reminders, and a virtual support group. Outcomes were analyzed using McNemar's tests for HRSA-1, visit constancy, and viral suppression and nonparametric Wilcoxon signed-rank tests for CD4 counts and viral loads. Of 77 participants, 63% were male, 49% black non-Hispanic, and 72% below the federal poverty level. Participants' achievement of a retention in care benchmark (HRSA-1) increased from 51% at baseline to 88% at 6 months (p < 0.0001) and 81% at 12 months (p = 0.0003). Visit constancy improved from baseline to 6 months (p = 0.016) and 12 months (p = 0.0004). Participants' mean CD4 counts increased from baseline to 6 months (p = 0.0007) and 12 months (p = 0.0005). The percentage of participants with suppressed viral loads increased from 47% at baseline to 87% at 6 months (p < 0.0001) and 79% at 12 months (p = 0.0007). This study is one of the first to demonstrate that a mobile health intervention can have a positive impact on retention in care and clinical outcomes for vulnerable PLWH. Next steps include integration with clinical practice and dissemination.
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Affiliation(s)
- Rebecca Dillingham
- 1Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Karen Ingersoll
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Tabor E. Flickinger
- 1Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Ava Lena Waldman
- 1Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Marika Grabowski
- 1Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Colleen Laurence
- 1Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Erin Wispelwey
- 1Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
| | | | - Mark Conaway
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Wendy F. Cohn
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia
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Gray ME, Nieburg P, Dillingham R. Pediatric Human Immunodeficiency Virus Continuum of Care: A Concise Review of Evidence-Based Practice. Pediatr Clin North Am 2017; 64:879-891. [PMID: 28734516 PMCID: PMC5576578 DOI: 10.1016/j.pcl.2017.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Children and adolescents living with human immunodeficiency virus (HIV) represent a population that requires a unique approach to HIV care. Prevention, testing, initiation of antiretroviral therapy (ART), and retention and engagement in care are critical steps. Each step requires providers to address age-specific barriers, so that successful and prolonged viral suppression can occur. Adherence to ART, disclosure of HIV-positive status, and stigma are examples of struggles faced by youth, their families, and health care providers. A multifaceted approach and thoughtful transitions of care are needed, but with sustained ART, youth living with HIV can survive and thrive with the expectation of a normal lifespan.
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Affiliation(s)
- Megan E. Gray
- Division of Infectious Diseases and International Health. University of Virginia, Charlottesville, VA
| | - Phillip Nieburg
- Visiting Associate Professor of Pediatrics. University of Virginia, Charlottesville, VA
| | - Rebecca Dillingham
- Division of Infectious Diseases and International Health, University of Virginia, PO Box 801340, Charlottesville, VA 22908-1340, USA.
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Lima ICVD, Galvão MTG, Pedrosa SC, Silva CAC, Pereira MLD. Validação de mensagens telefônicas para promoção da saúde de pessoas com HIV. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Avaliar a opinião de experts sobre o conteúdo de mensagens telefônicas para a promoção da saúde de pessoas vivendo com HIV. Métodos Estudo de desenvolvimento metodológico direcionado à validação de dez mensagens telefônicas, com participação de 11 experts que avaliaram sua clareza e grau de relevância. O índice de validade de conteúdo relativo a cada mensagem foi calculado e estabeleceu-se uma concordância mínima de 75%. Resultados Foram consideradas mensagens claras (79,1%) e muito relevantes (98,2%). O índice de validade de conteúdo geral foi 0,98. Principais alterações sugeridas: inclusão de um questionamento sobre o tema no início de cada mensagem; adequação para uma linguagem mais simples e interativa; substituição de termos específicos e exclusão de palavras ou expressões relacionadas ao HIV. Conclusão Os experts consideraram as mensagens claras e relevantes para a promoção da saúde das pessoas vivendo com HIV.
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Turner JA. Online Support Groups: The Good, the Bad, and the Motivated. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2017. [DOI: 10.1080/15398285.2017.1279930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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