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Arena S, Adams M, Burns J. Exploring the Use of Customized Links to Improve Electronic Engagement With Sexual and Reproductive Health Care Among Young African American Male Individuals: Web-Based Survey Study. JMIR Form Res 2024; 8:e48371. [PMID: 38656772 PMCID: PMC11079755 DOI: 10.2196/48371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 01/09/2024] [Accepted: 02/13/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Research has shown that heterosexual African American male individuals aged 18-24 years have a higher prevalence of sexually transmitted infections (STIs) and are more likely to engage in risky sexual behavior. There is a critical need to promote sexual reproductive health (SRH) services among this population, especially in urban settings. Young African American male individuals use social media platforms to access health information, showcasing the potential of social media and web-based links as tools to leverage electronic engagement with this population to promote SRH care. OBJECTIVE This study aims to explore electronic engagement with young African American male individuals in discussions about SRH care. This paper focuses on the recruitment and social media marketing methods used to recruit young, heterosexual African American male individuals aged 18-24 years for the Stay Safe Project, a larger study that aims to promote SRH services among this population in Detroit, Michigan. We investigate the use of TinyURL, a URL shortener and customized tool, and culturally informed social media marketing strategies to promote electronic engagement within this population. METHODS Participants were recruited between December 2021 and February 2022 through various modes, including email listserves, Mailchimp, the UMHealthResearch website, X (formerly Twitter), Facebook, and Instagram. Images and vector graphics of African American male individuals were used to create social media advertisements that directed participants to click on a TinyURL that led to a recruitment survey for the study. RESULTS TinyURL metrics were used to monitor demographic and user data, analyzing the top countries, browsers, operating systems, and devices of individuals who engaged with the customized TinyURL links and the total human and unique clicks from various social media platforms. Mailchimp was the most successful platform for electronic engagement with human and unique clicks on the custom TinyURL link, followed by Instagram and Facebook. In contrast, X, traditional email, and research recruiting websites had the least engagement among our population. Success was determined based on the type of user and follower for each platform, whether gained in the community through sign-ups or promoted at peak user time and embedded and spotlighted on nontraditional media (eg, social media sites, blogs, and podcasts) for the user. Low engagement (eg, traditional email) from the target population, limited visibility, and fewer followers contributed to decreased engagement. CONCLUSIONS This study provides insight into leveraging customized, shortened URLs, TinyURL metrics, and social media platforms to improve electronic engagement with young African American male individuals seeking information and resources about SRH care. The results of this study have been used to develop a pilot intervention for this population that will contribute to strategies for encouraging sexual well-being, clinic use, and appropriate linkage to SRH care services among young, heterosexual African American male individuals.
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Affiliation(s)
- Sandy Arena
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Mackenzie Adams
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Jade Burns
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
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AL Naabi M, Al Zaabi A. Quantitative Evaluation of Cancer Stigma among Non-Patient Population in Oman. Asian Pac J Cancer Prev 2024; 25:1223-1229. [PMID: 38679981 PMCID: PMC11162736 DOI: 10.31557/apjcp.2024.25.4.1223] [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: 08/26/2023] [Accepted: 04/12/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND Cancer is widely considered as one of the most stigmatized diseases globally, despite scientific advances in the medicine. While most existing literatures focuses on cancer stigma as perceived by patients, there has been limited research on stigma towards cancer among the non-cancer population. In 2014, Marlow et al developed and validated the "Cancer Stigma Scale" (CASS) specifically for the non-Cancer population. This study aims to quantitatively evaluate cancer stigma within the non-patient population in Oman. METHODS This is a cross-sectional study conducted in Oman. The Cancer Stigma Scale (CASS) has been used to evaluate the cancer-related stigma among the non-cancer patient population in Oman. RESULTS A total of 510 participants completed the survey of whom 57.6% were male. The personal responsibility section had the highest mean score, followed by the avoidance and financial discrimination. The lowest mean scores were observed in the danger and policy opposition sections. Female participants showed ore disagreement with cancer stigma statements compared to males. Participants who knew someone with cancer expressed more disagreement with stigma statements than those who did not know anyone with cancer. CONCLUSION This study provides a baseline measurement of cancer-related stigma among non-cancer patients in Oman, tilizing the CASS in a representative sample of the population. The results indicate generally low levels of stigma, though certain aspects are more pronounced, varying according to the participants' gender, age, and personal connections to someone with cancer.
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Affiliation(s)
| | - Adhari Al Zaabi
- Human and Clinical Anatomy, College of Medicine and Health Sciences, Muscat, Sultanate of Oman.
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Palmer R, Smith BJ, Kite J, Phongsavan P. The socio-ecological determinants of help-seeking practices and healthcare access among young men: a systematic review. Health Promot Int 2024; 39:daae024. [PMID: 38513244 PMCID: PMC10957130 DOI: 10.1093/heapro/daae024] [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] [Indexed: 03/23/2024] Open
Abstract
Delayed engagement with health services is a key contributor to poorer health outcomes experienced by men. Patterns of health service usage which reduce the opportunity for disease prevention and health promotion appear to be especially prominent amongst young men. To identify the multiple and intersecting determinants of young men's help-seeking practices and health services usage, this review uses the social ecological model (SEM) to guide a critical synthesis of the literature on barriers and facilitators experienced by young men in accessing health services. A systematic review was conducted across five databases (MEDLINE, Embase, PsychINFO, CINAHL and Scopus). Included studies presented primary data regarding young men's (12-24 years) barriers and/or facilitators to seeking and accessing health care. Thirty-one studies (24 qualitative and 7 quantitative) underwent data extraction, quality appraisal and thematic analysis under the guiding framework of the SEM. Seven key themes were constructed, encapsulating the perceived barriers and facilitators to help-seeking and accessing health care experienced by young men, including masculine attitudes, health literacy, social pressure, service accessibility, economic factors, service characteristics and cultural attitudes. These findings highlight the complex interplay between the individual, interpersonal, organizational and societal factors impacting young men's healthcare engagement. They also illuminate avenues for multifaceted, context-specific interventions to enhance healthcare accessibility for this group, including addressing health literacy gaps, providing culturally sensitive care and reducing cost barriers.
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Affiliation(s)
- Robert Palmer
- Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Johns Hopkins Dr, Camperdown, Sydney, NSW 2050, Australia
| | - Ben J Smith
- Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Johns Hopkins Dr, Camperdown, Sydney, NSW 2050, Australia
| | - James Kite
- Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Johns Hopkins Dr, Camperdown, Sydney, NSW 2050, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Johns Hopkins Dr, Camperdown, Sydney, NSW 2050, Australia
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Guilamo-Ramos V, Thimm-Kaiser M, Benzekri A. Paternal Communication and Sexual Health Clinic Visits Among Latino and Black Adolescent Males With Resident and Nonresident Fathers. J Adolesc Health 2023; 73:567-573. [PMID: 37330708 DOI: 10.1016/j.jadohealth.2023.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/06/2023] [Accepted: 04/17/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Latino and Black adolescent males experience sexual health inequities, and their engagement in sexual health services remains low. Parents shape adolescent sexual health behavior and other youth outcomes. However, the role of Latino and Black fathers in promoting male adolescent sexual health is understudied, in part because about one in four fathers resides apart from their children and nonresident fathers are presumed to be less influential. We examined associations of paternal communication with sexual health service use and perceived paternal role modeling among Latino and Black adolescent males with resident and nonresident fathers. METHODS We recruited 191 Latino and Black adolescent males aged 15-19 years and their fathers in the South Bronx, New York City, using area sampling methods; dyads completed surveys. We estimated bivariate and adjusted associations of paternal communication with adolescent male sexual health service use and perceived paternal role modeling using logistic and linear regressions. Effect measure modification by paternal residence was assessed. RESULTS A unit increase on a five-point paternal communication scale was associated with approximately twice and 1.7 times the likelihood of clinical sexual health service use during adolescent males' lifetime and in the past 3 months, respectively; there was no significant effect measure modification by paternal residence. Paternal communication was associated with increased levels of perceived paternal role modeling and usefulness of paternal advice, with stronger associations for nonresident fathers. DISCUSSION Both resident and nonresident Latino and Black fathers warrant greater consideration as partners in promoting male adolescent sexual health service use.
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Affiliation(s)
- Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, Duke University, Durham, North Carolina; School of Nursing, Duke University, Durham, North Carolina; Department of Family Medicine and Community Health, Department of Infectious Diseases, School of Medicine, Duke University, Durham, North Carolina; Presidential Advisory Council on HIV/AIDS, US Department of Health and Human Services, Washington, D.C..
| | - Marco Thimm-Kaiser
- Center for Latino Adolescent and Family Health, Duke University, Durham, North Carolina; School of Nursing, Duke University, Durham, North Carolina
| | - Adam Benzekri
- Center for Latino Adolescent and Family Health, Duke University, Durham, North Carolina; School of Nursing, Duke University, Durham, North Carolina
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Valdez ES, Valdez L, Gorry E, Chan J, Dixon S, Fisher T, Simoun A, Weil M, Collins-Lovell C, Egan J, Gubrium A. Mind the Gaps: The Need for Inclusion of Male-Identified Voices in Adolescent Sexual and Reproductive Health. Am J Mens Health 2023; 17:15579883231181570. [PMID: 37334894 DOI: 10.1177/15579883231181570] [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: 06/21/2023] Open
Abstract
Adolescent sexual and reproductive health (ASRH) inequities are well documented for historically excluded youth (i.e., youth of color, LGBTQIA+ youth, youth with disabilities, recently im/migrated youth) living in the U.S. Northeast. However, the lived experience of male-identifying young people from historically excluded backgrounds in ASRH remains largely unexamined. The purpose of this paper is to present findings related to male-identified perspectives on social constructions of sexuality, sexual and reproductive health, and sexuality education. A research team composed of two local youth-serving organizations, eight youth researchers, and university researchers, used Youth Participatory Action Research (YPAR) methods to examine how structural violence contributes to inequitable ASRH outcomes for historically excluded youth. Photovoice and community mapping were used as YPAR methods. We also completed individual interviews on the same topic with the youth and with 17 key stakeholders that either provide services to youth or are emerging adult service recipients. Community-driven data reveal two major themes around the silencing of male-identified voices in ASRH: lack of culture-centered and gender-expansive approaches for ASRH, and the subsequent toll of sexism and (cis)gendered social and educational norms on young people. Our findings highlight that sexuality education, cisgender hetero culture, and social norms have put the onus of responsibility on people identifying as women for sexual and reproductive health. An unintended consequence of that is that young people identifying as men may feel powerless and uninformed around their own SRH. Our findings illustrate the importance of using culture-centered and gender-transformative approaches to ASRH to address inequity.
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Affiliation(s)
- Elizabeth Salerno Valdez
- Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Luis Valdez
- Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Eddie Gorry
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Jazmine Chan
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Saharra Dixon
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Tiarra Fisher
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Alya Simoun
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Mira Weil
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Camille Collins-Lovell
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Justine Egan
- Massachusetts Department of Public Health, Boston, MA, USA
| | - Aline Gubrium
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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Improving Adolescent Perceptions of Barriers and Facilitators to Sexual and Reproductive Health Services Through Sexual Health Education. J Adolesc Health 2023; 72:138-146. [PMID: 36289042 DOI: 10.1016/j.jadohealth.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/21/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE This study examines whether comprehensive sexual health education that provides information on clinical services can change adolescents' perceptions of barriers, facilitators, and intention to use services and whether changes in perceptions differ by participant characteristics. METHODS Adolescent participants in a statewide sexual health education program in California were surveyed at baseline and at exit about their perceptions of barriers, facilitators, and intention to use clinical services. Linked baseline and exit surveys (n = 7,460) assessed change in perceptions after program completion. Logistic regression analyses that accounted for the clustered data structure assessed associations between participant characteristics and improvement in perceptions. RESULTS After the program, there were significant reductions in two perceived barriers (worry about cost and judgment by staff), but there were also small but significant increases in perceptions of two barriers (worry about confidentiality of services and test results). There were significant increases in all three perceived facilitators and intention to use sexual and reproductive health services, which rose from 90.6% at baseline to 96.2% at exit. Younger youth were more likely than older youth to show improvement in all perceived facilitators and intentions. Girls and Black youth were more likely than boys and Hispanic youth to show improvement in two facilitators (knowing what to expect and access). No sociodemographic characteristics were consistently associated with reductions in perceived barriers. DISCUSSION Comprehensive sexual health education that addresses adolescents' questions and concerns regarding clinical services can help to reduce perceived barriers, increase facilitators, and increase intention to use services if needed.
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Anakwe A, Xian H, BeLue R, Xaverius P. Men's preconception health and the social determinants of health: What are we missing? FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:955018. [PMID: 36303655 PMCID: PMC9580700 DOI: 10.3389/frph.2022.955018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/01/2022] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Life course perspectives suggest that optimizing men's health before conception is requisite to equitably improve population health, an area of increasing public health focus. Although scholarship on the social determinants of health (SDOH) suggests that men's health and health behaviors do not occur in a vacuum, preconception health studies have not explicitly examined how these factors influence men's preconception health. OBJECTIVE To identify latent classes of men's preconception health and the role of the SDOHs in predicting class membership. METHODS Pooled data from the 2011-2019 male file of the National Survey of Family Growth were analyzed (n = 10,223). Latent class analysis (LCA) was used to identify distinct classes of men's preconception health. Eight manifest variables were used to fit latent class models. A classify-analyze approach was subsequently used to create a preconception health phenotype (PhP) outcome variable. SDOHs (exposure variable) were assessed in four domains (rural/urban residence, health access, socioeconomic status, and minority/immigrant status) to predict class membership. Survey-weighted multinomial regression models were fitted to examine the association between the exposure and the outcome. RESULTS Three unique PhPs were identified (lowest risk (69%), substance users (22.9%), and sexual risk-takers (8.1%) from the LCA model. Health access, socioeconomic status, and minority/immigrant status were significant predictors of class membership but not rural/urban residence. Sexual risk takers were more likely to be uninsured (aOR: 1.25, 95% CI 1.02, 1.52), college-educated (aOR: 1.94 95% CI: 1.34, 2.79), and non-Hispanic Black (aOR: 1.99 95% CI: 1.55, 2.54) while substance users were more likely to have unstable employment (aOR: 1.23 95% CI:1.04, 1.45) and have a high school degree or higher (aOR 1.48 95% CI: 1.15, 1.90) than men in the lowest risk category. CONCLUSION Social determinants may impact men's preconception health in ways that are not conventionally understood. These findings raise important questions about how preconception health interventions should be created, tailored, and/or retooled. Specifically, studies that examine the sociocultural and political contexts underpinning the relationship between social class, masculinity, and men's preconception health are needed to provide nuanced insights on factors that shape these outcomes.
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Affiliation(s)
- Adaobi Anakwe
- Department of Health Sciences, University of Missouri, Columbia, MO, United States
| | - Hong Xian
- Department of Epidemiology and Biostatistics, Saint Louis University, St. Louis, MO, United States
| | - Rhonda BeLue
- College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, United States
| | - Pamela Xaverius
- Office of the Vice President for Research and Scholarly Activity, University of Health Sciences and Pharmacy, St. Louis, MO, United States
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Marcell AV, Byrne ME, Yao-N'dry N, Thiongo M, Gichangi P, OlaOlorun FM, Radloff S, Anglewicz PA, Tsui AO. Males' Awareness of Female and Male Contraception Methods, Information, Outreach, and Acquisition Locations in Abidjan, Côte d'Ivoire, Nairobi, Kenya, and Lagos, Nigeria. J Adolesc Health 2022; 71:351-359. [PMID: 35550329 PMCID: PMC9365297 DOI: 10.1016/j.jadohealth.2022.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/17/2022] [Accepted: 03/16/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study is to describe modern female and male method awareness, information sources, outreach exposures, and acquisition source awareness among young men aged 15-24 by sexual behavior status in sub-Saharan Africa. METHODS Cross-sectional surveys were conducted with unmarried, young men aged 15-24 recruited via respondent-driven sampling in Abidjan, Côte d'Ivoire (n = 1,028), Nairobi, Kenya (n = 691), and Lagos, Nigeria (n = 706). Descriptive statistics characterized contraception awareness of male and female methods and information sources, outreach exposures, acquisition source awareness, and preferred contraception source. Multivariate regressions characterized factors associated with awareness of each method. RESULTS Majority of respondents were aged 15-20 (59%), sexually active (65%), and had secondary or more education (89%). Awareness was low for all methods (short-acting reversible contraception, 47%; emergency contraception, 35%; long-acting reversible contraception, 32%; withdrawal, 18%), except condoms (85%). Respondents reported low levels of contraception information sources, recent outreach exposures, and acquisition location awareness that varied by sexual behavior (higher among sexually active than nonsexually active respondents). Multivariate analyses demonstrated common factors associated across awareness of all methods included information sources (teacher, friend, Internet, social media for all respondents; pharmacist for sexually active respondents) and acquisition locations (private healthcare, pharmacy, market/store for all respondents; public healthcare, mobile clinic, faith-based organizations for sexually active respondents). Sexually active respondents' rank order for preferred contraception source was doctors/nurses followed by teachers, friends, mothers, and fathers; and for nonsexually active respondents' rank order was teachers followed by friends, mothers, doctors/nurses, and health centers. DISCUSSION Findings have implications for increasing young men's method awareness, specific sources, and settings to target contraceptive outreach.
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Affiliation(s)
- Arik V. Marcell
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland,Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,Address correspondence to: Arik V. Marcell, M.D., M.P.H., Division of Adolescent/Young Adult Medicine, Departments of Pediatrics and Population, Family & Reproductive Health, The Johns Hopkins University, 200 N. Wolfe Street, Room 2062, Baltimore, MD 21287.
| | - Meagan E. Byrne
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nathalie Yao-N'dry
- Association Ivoirienne pour le Bien-Etre Familial (AIBEF), Abidjan, Côte d’Ivoire
| | - Mary Thiongo
- International Centre for Reproductive Health, Mombasa, Kenya
| | - Peter Gichangi
- International Centre for Reproductive Health, Mombasa, Kenya,Technical University of Mombasa, Mombasa, Kenya,Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Funmilola M. OlaOlorun
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Scott Radloff
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Philip A. Anglewicz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Amy O. Tsui
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Thomson A, Christensen E, Wiklund M, Christianson M. A safe place - Adolescents' and young adults' perceptions of youth clinics in northern Sweden. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 33:100752. [PMID: 35803180 DOI: 10.1016/j.srhc.2022.100752] [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: 11/30/2021] [Revised: 05/19/2022] [Accepted: 06/27/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND/OBJECTIVE Adolescents and young adults are a diverse group with varied health needs. In Sweden, youth clinics are critical for improving their sexual, reproductive, mental, and general health. The aim of this qualitative study was to gain a deeper understanding of key conditions needed for youth friendliness, and to better understand youth-friendly health services from the perspective of adolescents and young adults in northern Sweden. METHODS Information was collected through focus group discussions and interviews with 23 adolescents and young adults (aged 16 to 25) at youth clinics in each of the four northernmost regions of Sweden. Interviews were analysed inductively using Braun and Clarke's thematic analysis. RESULTS Three themes and six sub-themes emerged. A safe, empowering and holistic space, outlines how youth-friendly physical spaces and staff contributed to a sense of safety in contrast to other healthcare facilities. The theme Youth clinics are accessible - but reaching out is challenging, refers to low thresholds for visiting youth clinics and perceived barriers to access. The third theme "You feel a bit vulnerable" - the importance of privacy, highlights privacy dimensions and young people's vulnerability when their privacy is compromised. CONCLUSION Adolescents and young adults perceived youth clinics as being youth-friendly. Key conditions for youth friendliness were safety, respect, a holistic and empowering approach, accessibility, and privacy. Youth-friendly opening hours and outreach to specifically target groups with access barriers are needed. Young people should be involved in the development of equitable youth-friendly health services.
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Affiliation(s)
- Anna Thomson
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Maria Wiklund
- Unit of Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden; Sweden Arctic Research Centre (Arcum), Umeå University, Umeå, Sweden
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Lightfoot M, Jackson-Morgan J, Pollack L, Bennett A. Acceptability and Feasibility of Peer-to-Peer Text Messaging Among Adolescents to Increase Clinic Visits and Sexually Transmitted Infection Testing: Interrupted Times-Series Analysis. JMIR Form Res 2022; 6:e32416. [PMID: 35686737 PMCID: PMC9227642 DOI: 10.2196/32416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 04/05/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adolescents are disproportionately affected by sexually transmitted infections (STIs), including HIV. Many youths with asymptomatic STI or related symptoms do not seek treatment and may not be screened if accessing the health care system for other reasons. Objective We examined intervention completion and changes in the number of new patients, the number of STI or HIV tests, and the sexual risk profile of patients over time to determine the feasibility and acceptability of a peer-driven text messaging strategy to connect youth to STI and HIV services. Methods The intervention enlisted consecutive patients at an adolescent medicine clinic to send a text message to 5 peers they believed were sexually active and lived in the clinic’s service area. The intervention was evaluated using an interrupted time-series design in which baseline clinic service levels were documented during a 35-week lead-in period, followed by a 20-week intervention implementation period, and a 16-week period of continued clinic observation. Clinic and patient data were obtained through chart abstraction from intake forms that occurred during the entire study period. Analyses conducted in 2015 used a generalized linear mixed model. Results Of the 153 patients approached to participate, 100 agreed to send SMS text messages. Most (n=55, 55%) reported no concerns with sending the text message. No adverse events or negative outcomes were reported. Adolescent STI testing, positive test results, and reported risk behavior increased post intervention, although this was not statistically significant, likely because of the small sample size. Conclusions Given low youth uptake of health care services, and STI/HIV screening, in particular, new strategies are needed to address access barriers. Common approaches for reaching youth are resource-intensive and often miss those not connected to school or community programs. The peer-based text messaging strategy showed promise for both increasing the number of youths accessing health services and finding youths engaging in sexual risk behaviors and most in need of sexual health screening and services.
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Affiliation(s)
- Marguerita Lightfoot
- Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | | | - Lance Pollack
- Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Ayanna Bennett
- 3rd Street Youth Center and Clinic, San Francisco, CA, United States
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Manlove J, Parekh J, Whitfield B, Griffith I, Garg A, Fasula AM. A Mixed-Methods Pilot Evaluation of Manhood 2.0, a Program to Reduce Unintended Pregnancy Among Young Men. Am J Mens Health 2022; 16:15579883221104895. [PMID: 35723069 PMCID: PMC9344189 DOI: 10.1177/15579883221104895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
One promising though understudied approach to addressing race/ethnic disparities in teen pregnancy rates is through sexual and reproductive health (SRH) programming for young men. This pilot study assessed the feasibility, quality, and preliminary efficacy of Manhood 2.0-a group-based, after-school SRH program for young Black and Latino men, which examines gender norms. This mixed-methods study describes program attendance and quality; participant experiences and engagement in the program; and changes in participant gender norms, knowledge, attitudes, self-efficacy, and social support. Quantitative data from baseline and post-intervention surveys (n = 51) were analyzed using paired t-tests and McNemar's tests. Qualitative data from five post-intervention focus groups (n = 27) were transcribed, coded, and analyzed for themes. At baseline, participants were ages 15 to18 years (M = 16.4 years), 30% were Latino, 66% were Black, 34% ever had sex, and 44% of sexually active participants had sex without any contraceptive method or condom. Quality ratings by program observers were high. The majority of participants (61%) attended at least 75% of sessions, and 96% rated Manhood 2.0 as "very good" or "excellent." Pre-post comparisons showed increases in receipt of SRH information; contraception knowledge; positive attitudes about supporting partners in pregnancy prevention; self-efficacy in partner communication about sex; discussing program content with friends and family; and social competence and support. Focus group participants described benefits from the Manhood 2.0 content (i.e., full range of contraceptive methods, sexual consent, gender norms) and delivery (i.e., reflective discussion, nonjudgmental facilitators). Findings suggest that Manhood 2.0 is a promising SRH program for young men.
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Affiliation(s)
| | | | | | | | | | - Amy M Fasula
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Gollub EL, Beauvais S, Roye C. College-attending young men's sexual and reproductive health knowledge, attitudes and practices. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:706-716. [PMID: 32432978 DOI: 10.1080/07448481.2020.1762609] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/10/2020] [Accepted: 04/26/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveMale involvement in contraceptive practice remains low. Family planning and pediatric health associations have recommended an emphasis on long-acting reversible contraceptives (LARC) in clinical counseling with adolescents and young adults, raising concerns about the resulting adverse impact on sexually transmitted infection (STI) rates. Participants: College-attending men responded to an internet based questionnaire (n=31) and a phone-based qualitative interview (n=25). Methods: Our survey solicited attitudes toward and knowledge of contraceptive methods and assessed communication practices with sexual partners regarding use of contraception and disease prevention. Results: Knowledge about female methods of contraception was low, with a comparatively high level of knowledge about Plan B. Parents and health care providers were cited as the most helpful sources of information. Conversations about protection with sexual partners were reported by most men, due mainly to fear of unplanned pregnancy, not STI. Conclusion: Addressing couple communication and dual protection among college-attending men needs greater emphasis.
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Affiliation(s)
- Erica L Gollub
- Health Science Program, Pace University College of Health Professions, Pleasantville, New York, USA
| | - Shirley Beauvais
- Lienhard School of Nursing, Pace University College of Health Professions, Pleasantville, New York, USA
| | - Carol Roye
- Lienhard School of Nursing, Pace University College of Health Professions, Pleasantville, New York, USA
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13
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Burns JC, Reeves J, Calvert WJ, Adams M, Ozuna-Harrison R, Smith MJ, Baranwal S, Johnson K, Rodgers CRR, Watkins DC. Engaging Young Black Males in Sexual and Reproductive Health Care: A Review of the Literature. Am J Mens Health 2021; 15:15579883211062024. [PMID: 34877895 PMCID: PMC8664320 DOI: 10.1177/15579883211062024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Young Black males (YBM) ages 18 to 24 years are more at risk of contracting sexually transmitted infections (STIs) and have a substantially greater need for sexual reproductive health (SRH) services than other groups. Despite this significant need, the extant literature does not provide a comprehensive picture of how YBM seek preventive care services (e.g., STI testing). Therefore, the purpose of this review is to address YBM’s SRH access and use of STI/HIV testing and screening in this population, with a specific emphasis on young heterosexual Black males, by identifying barriers and facilitators of engaging with SRH care. An electronic search was performed using Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, PubMed, and Scopus online databases. Keywords were adapted to each database and included variations of “Black males,” “sexual reproductive healthcare services,” “youth (18-24 years old),” and “healthcare access and utilization.” Studies from the review reported that barriers to engaging in SRH care included lack of health insurance, ideas of masculinity that conflict with SRH care, stigma related to accessing services, and lack of knowledge regarding available services and care options. The top facilitators for utilizing SRH care were engagement on behalf of health clinics, confidence gained from social support, access to quality health care in one’s community, and trust in the health care system and providers. This review contributes to the current state of the science and is important to the improvement of high-quality services for this population, including respect, choice in care, confidentially, and compassion.
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Affiliation(s)
- Jade C Burns
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Jaquetta Reeves
- College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Mackenzie Adams
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Rico Ozuna-Harrison
- College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Maya J Smith
- Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Salisha Baranwal
- College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Kedar Johnson
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Caryn R R Rodgers
- Department of Pediatrics, Division of Academic General Pediatrics, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Daphne C Watkins
- Vivian A. and James L. Curtis Center for Health Equity Research and Training, School of Social Work, University of Michigan, Ann Arbor, MI, USA
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14
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Decker MJ, Atyam TV, Zárate CG, Bayer AM, Bautista C, Saphir M. Adolescents' perceived barriers to accessing sexual and reproductive health services in California: a cross-sectional survey. BMC Health Serv Res 2021; 21:1263. [PMID: 34809640 PMCID: PMC8609799 DOI: 10.1186/s12913-021-07278-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Adolescents may forego needed sexual and reproductive health (SRH) services due to a variety of concerns and barriers. The purpose of this study is to compare adolescents’ perceptions of these barriers by participant characteristics including race/ethnicity, gender, sexual orientation, housing situation, and sexual experience. Methods Adolescents in a California-wide sexual health education program completed an anonymous survey at baseline (N = 10,015) about perceived barriers to using SRH services. Logistic regression analyses that accounted for the clustered data structure assessed differences by gender, age, sexual orientation, race/ethnicity, living situation, and sexual experience. Results The majority of participants were Hispanic/Latino (76.4%) with an average age of 14.9 years, and 28.8% had sexual experience. Half of the youth reported concerns about test results (52.7%), cost of services (52.0%), and confidentiality of services (49.8%). When controlling for other characteristics, youth identifying as transgender/non-binary/multiple genders had the highest odds of perceiving cost (odds ratio (OR) 1.89) and confidentiality (OR 1.51) as barriers. Increasing age was associated with decreasing odds of all barriers. Sexual orientation was a consistent predictor, with LGBQ+ youth having higher odds of perceiving test results (OR 1.21), cost (OR 1.36), and confidentiality (OR 1.24) as barriers. Asian or Pacific Islander/Native Hawaiian youth had higher odds of perceiving test results (OR 1.68) and cost (OR 1.37) as barriers. In contrast, Black youth had lower odds of reporting cost (OR 0.65) and confidentiality (OR 0.77) as barriers. Younger respondents and youth who identified as female, transgender/non-binary/multiple genders, LGBQ+, and Asian or Pacific Islander/Native Hawaiian had higher odds of reporting five or more barriers compared to reference groups. Conclusions The majority of adolescents face barriers to accessing appropriate SRH services, with females, gender-minority youth, younger adolescents, LGBQ+ youth, and Asian and Pacific Islander/Native Hawaiian youth more likely than others to report barriers. Access to SRH services can be improved through strengthening linkages between clinics and SRH education programs, providing youth-friendly clinical services, and ensuring youth have sufficient information, skills, and support to access care. Trial registration Approved by California Health and Human Services Agency’s Committee for the Protection of Human Subjects [12-08-0658, 11/30/2017]. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07278-3.
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Affiliation(s)
- Martha J Decker
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA. .,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois St, San Francisco, CA, 94107, USA. .,Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, USA.
| | - Tara V Atyam
- California Department of Public Health, Maternal, Child and Adolescent Health Division, 1615 Capitol Ave, MS 8300, P.O. Box 997420, Sacramento, CA, 95899-7420, USA
| | - Catherine Gilmore Zárate
- California Department of Public Health, Maternal, Child and Adolescent Health Division, 1615 Capitol Ave, MS 8300, P.O. Box 997420, Sacramento, CA, 95899-7420, USA
| | - Angela M Bayer
- California Department of Public Health, Maternal, Child and Adolescent Health Division, 1615 Capitol Ave, MS 8300, P.O. Box 997420, Sacramento, CA, 95899-7420, USA
| | - Consuelo Bautista
- California Department of Public Health, Maternal, Child and Adolescent Health Division, 1615 Capitol Ave, MS 8300, P.O. Box 997420, Sacramento, CA, 95899-7420, USA
| | - Melissa Saphir
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois St, San Francisco, CA, 94107, USA
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15
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Van Eck K, Thakkar M, Matson PA, Hao L, Marcell AV. Adolescents' Patterns of Well-Care Use Over Time: Who Stays Connected. Am J Prev Med 2021; 60:e221-e229. [PMID: 33648787 PMCID: PMC8068632 DOI: 10.1016/j.amepre.2020.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/17/2020] [Accepted: 12/04/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Well-care use can positively impact adolescents' current and future health. Understanding adolescents' longitudinal well-care use is critical to determine to whom and when to target engagement strategies to improve healthcare access. This study describes prospective well-care use patterns from childhood through adolescence stratified by sex. METHODS The sample (N=6,872) was drawn from the Child/Young Adult component of the household-based 1979 National Longitudinal Survey of Youth consisting of biological children born to female respondents (1980-1997). Well-care use (routine checkup with a doctor within last year) data were assessed from age 5 years (1986-2003) until age 17 years (1998-2015). Conducted in 2019, latent class analyses stratified by sex identified well-care use patterns reported over 7 biennial time points adjusted for cohort, race/ethnicity, urbanicity, maternal education, and insurance. RESULTS A total of 4 well-care use classes emerged for female adolescents: the majority belonged to Engaged (37%) and Moderately Engaged (39%) classes and the remainder belonged to Gradually Re-engaged (14%) and Disengaged-with-Rebound (10%) classes. A total of 3 classes emerged for male adolescents: the majority belonged to the Persistently Disengaged (48%) class and the remainder belonged to Engaged (34%) and Gradually Re-engaged (18%) classes. For both sexes, comparing each cohort with the first, Engaged class membership increased for subsequent cohorts. Less engaged well-care use classes had more non-Hispanic White adolescents living in rural areas with lower insurance coverage. Maternal education differentiated well-care use classes for male but not for female adolescents, being higher for male adolescents in the Engaged class than in other classes. CONCLUSIONS These findings highlight that well-care use patterns for both sexes changed during the transition from childhood to adolescence and that class membership differed by covariates. These results suggest that sex-specific strategies may be needed to enhance adolescents' well-care use engagement over time.
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Affiliation(s)
- Kathryn Van Eck
- Child and Adolescent Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Psychiatry, Kennedy Krieger Institute, Baltimore, Maryland
| | - Madhuli Thakkar
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Pamela A Matson
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Lingxin Hao
- Department of Sociology, Johns Hopkins Krieger School of Arts & Sciences, Baltimore, Maryland
| | - Arik V Marcell
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
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16
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Sexually transmitted disease clinics in the United States: Understanding the needs of patients and the capabilities of providers. Prev Med 2021; 145:106411. [PMID: 33388328 DOI: 10.1016/j.ypmed.2020.106411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/13/2020] [Accepted: 12/28/2020] [Indexed: 11/21/2022]
Abstract
Reports of bacterial sexually transmitted infections are at the highest levels ever reported in the United States, and state and local budgetary issues are placing specialized sexually transmitted disease (STD) care at risk. This study collected information from 4138 patients seeking care at 26 STD clinics in large metropolitan areas across the United States with high levels of reported STDs to determine patient needs and clinic capabilities. Surveys were provided to patients attending these STD clinics to assess their demographic information as well as reasons for coming to the clinic and surveys were also provided to clinic administrators to determine their operational capacities and services provided by the clinic. For this initial study, we conducted univariate analyses to report all data collected from these surveys. Patients attending STD clinics across the country indicated that they do so because of the relative ease of getting an appointment; including walk-in and same-day appointments as well as the welcoming environment and expertise of the staff at the clinic. Additionally, STD clinics provide specialized care to patients; including HIV testing and counseling as well as on-site, injectable medications for the treatment of gonorrhea and syphilis in an environment that helps to reduce the role of stigma in seeking this kind of care. Sexually transmitted disease clinics continue to play an important role in helping to curb the rising epidemic of sexually transmitted infections.
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17
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Jackman KMP, Hightow-Weidman L, Poteat T, Wirtz AL, Kane JC, Baral SD. Evaluating psychometric determinants of willingness to adopt sexual health patient portal services among black college students: A mixed-methods approach. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:190-197. [PMID: 31710578 PMCID: PMC7211543 DOI: 10.1080/07448481.2019.1660352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 08/16/2019] [Accepted: 08/22/2019] [Indexed: 06/10/2023]
Abstract
Objectives: To describe, using mixed-methods, perceptions of access to sexually transmitted infection test results via electronic personal health record (PHR) and correlates of willingness to adopt its use. Participants: Students at a mid-Atlantic historically black college. Methods: Focus-groups and interviews were conducted to explore themes on sexual health-related PHR-use (N = 35). Codes were operationalized into survey measures assessing beliefs in a cross-sectional sample (N = 354). Exploratory factor analysis identified latent factors among survey items. Multiple logistic regression models measured correlates of adoption willingness. Results: Three qualitative themes emerged on relative advantages, barriers, and functionality of PHRs. 57.6% of survey participants were willing to use PHRs for sexual health services. Reliable latent factors, centering on PHR convenience and functionality, were positively associated with adoption willingness. Conclusions: Data highlights interest among black college-age youth in adopting PHRs for comprehensive sexual health-related services. Adoption may be boosted with tailored designs responsive to expressed service needs.
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Affiliation(s)
- Kevon-Mark P Jackman
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lisa Hightow-Weidman
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Tonia Poteat
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrea L Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jeremy C Kane
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stefan D Baral
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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18
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Brindis CD, Decker MJ, Gutmann-Gonzalez A, Berglas NF. Perspectives on Adolescent Pregnancy Prevention Strategies in the United States: Looking Back, Looking Forward. Adolesc Health Med Ther 2020; 11:135-145. [PMID: 33117030 PMCID: PMC7567553 DOI: 10.2147/ahmt.s219949] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/29/2020] [Indexed: 01/05/2023] Open
Abstract
Attempts to solve the "problem of adolescent pregnancy" have long been a focus of national, state, and local efforts in the United States. This review article summarizes trends and strategies around adolescent pregnancy prevention, provides lessons learned and best practices, and presents ideas for future directions. Over the past decades, a wide variety of policy and programmatic interventions have been implemented - including educational efforts, clinical health services, and community-wide coalitions - accompanied by a growing consensus regarding viable solutions. While notable reductions in adolescent pregnancy and childbearing have occurred across all sociodemographic groups, racial/ethnic, geographic, and socioeconomic disparities persist. Many adolescents who most need sexual health information and services are underserved by current programs and policies. A growing understanding of the role of social determinants of health, the impacts of structural racism, and the need for equity and inclusion must inform the next set of interventions and societal commitments to not only ameliorate the occurrence of unintended adolescent pregnancy but also foster healthy adolescent development. Recommendations for future efforts include improving the content, quality, and sustainability of education programs; actively engaging youth in the design of policies, programs, and clinical services; using technology thoughtfully to improve health literacy; expanding access to services through telehealth and other delivery options; and designing programs and policies that recognize and address structural racism, health equity, and inclusion.
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Affiliation(s)
- Claire D Brindis
- Philip R. Lee Institute for Health Policy Studies, Adolescent and Young Adult Health National Resource Center, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA94118, USA,Correspondence: Claire D Brindis Philip R. Lee Institute for Health Policy Studies, Adolescent and Young Adult Health National Resource Center, Bixby Center for Global Reproductive Health, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA94118, USATel +1 (415) 517-4521 Email
| | - Martha J Decker
- Philip R. Lee Institute for Health Policy Studies, Adolescent and Young Adult Health National Resource Center, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA94118, USA,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA94118, USA
| | - Abigail Gutmann-Gonzalez
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA94118, USA
| | - Nancy F Berglas
- Philip R. Lee Institute for Health Policy Studies, Adolescent and Young Adult Health National Resource Center, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA94118, USA,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA94118, USA,Bixby Center for Global Reproductive Health, University of California, San Francisco, Oakland, CA94612, USA
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19
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Burns J, Johnstone K, Chavanduka T, Jamison C, Pena V, Stephenson R, Darbes L. Evaluation of the Sexual Health Behaviors of Black Male Adolescents and Young Adults Through Social Media Platforms: Web-Based Survey Study. JMIR Public Health Surveill 2020; 6:e19219. [PMID: 32693387 PMCID: PMC7539156 DOI: 10.2196/19219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 11/26/2022] Open
Abstract
Background Social media platforms such as Facebook, Instagram, and Twitter, which have millions of users who interact and communicate every day, have been effective in promoting sexual health interventions and in disseminating reproductive health education. They have also been shown to be useful in health promotion and have been used to track several key metrics (eg, comments, posts) among users of all demographics. However, there is a lack of research on the impact and reach of these social media platforms as a community-based tool for disseminating sexual health information and for increasing engagement among Black adolescents and young adults, which is a targeted high-risk population. Objective The purpose of this study was to determine the social media platforms and banner advertisements that affected engagement among Black male adolescents and young adults in participating in web-based health surveys. Methods A web-based survey was conducted from March 2019 to July 2019 to assess sexual health and health behaviors in a convenience sample of Black male adolescents and young adults in the age range of 18-24 years (N=170). Social media metrics from Facebook, Instagram, and Twitter were monitored. This cross-sectional survey comprised several categories, including basic personal information, drug-related risk behaviors, health care, sexual reproductive health questions, attitudes, norms, and perceived control, mental health, violence-related risk behaviors, and social media preferences. Results Social media advertisements on the Black Male Opinion survey reached approximately 146,412 individuals. Our primary finding of the web-based survey engagement was that referral (eg, group chat, indirect social media sharing) led to as the greatest proportion of recruitment, with Twitter and YouTube as the preferred sites to receive sexual health information. Conclusions Recognizing the variety of technologies being used among Black male young adults and adolescents can help the community, researchers, and health care providers understand the web-based engagement of this high-risk population. This information may also promote culturally sensitive, customized marketing on sexual health information for this population.
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Affiliation(s)
- Jade Burns
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Keith Johnstone
- Ross School of Business, University of Michigan, Ann Arbor, MI, United States
| | - Tanaka Chavanduka
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Cornelius Jamison
- Department of Family Medicine, Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor, MI, United States
| | - Valery Pena
- The College of Arts and Sciences, Cornell University, Ithaca, NY, United States
| | - Rob Stephenson
- Department of Systems, Population and Leadership, Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Lynae Darbes
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States
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20
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Jackman KMP, Murray S, Hightow-Weidman L, Trent ME, Wirtz AL, Baral SD, Jennings JM. Digital technology to address HIV and other sexually transmitted infection disparities: Intentions to disclose online personal health records to sex partners among students at a historically Black college. PLoS One 2020; 15:e0237648. [PMID: 32822360 PMCID: PMC7442257 DOI: 10.1371/journal.pone.0237648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 07/30/2020] [Indexed: 12/26/2022] Open
Abstract
Patient portals are creating new opportunities for youth to disclose high-fidelity sexually transmitted infection (STI) laboratory test result histories to sex partners. Among an online survey sample, we describe latent constructs and other variables associated with perceived behavioral intentions to disclose STI test history using patient portals. Participants were co-ed students aged 18 to 25 years (N = 354) attending a southern United States Historically Black College and University in 2015. Three reliable latent constructs were identified by conducting psychometric analyses on 27 survey items. Latent constructs represent, a) STI test disclosure valuation beliefs, b) communication practices, and c) performance expectancy beliefs for disclosing with patient portals. Multivariable logistic regression was used to estimate the relationship of latent constructs to perceived behavioral intentions to disclose STI test history using patient portals. Approximately 14% (48/354) reported patient portal use prior to study and 59% (208/354) endorsed behavioral intentions to use patient portals to disclose STI test history. The latent construct reflecting performance expectancies of patient portals to improve communication and accuracy of disclosed test information was associated with behavioral intentions to disclose STI test histories using patient portals [adjusted odds ratio (AOR) = 1.15; 95% CI = 1.08 to 1.22; p<0.001]. Latent constructs representing communication valuation beliefs and practices were not associated with intentions. Self-reporting prior STI diagnosis was also associated with intentions to disclose using patient portals (AOR = 2.84; 95% CI = 1.15 to 6.96; p = 0.02). Point of care messages focused on improvements to validating test results, communication, and empowerment, may be an effective strategy to support the adoption of patient portals for STI prevention among populations of college-aged Black youth.
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Affiliation(s)
- Kevon-Mark P. Jackman
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail: ,
| | - Sarah Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Lisa Hightow-Weidman
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Maria E. Trent
- Department of Pediatrics, Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Andrea L. Wirtz
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Stefan D. Baral
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Jacky M. Jennings
- Department of Pediatrics, Center for Child and Community Health Research (CCHR), Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
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21
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Gannon B, Davis R, Kuhns LM, Rodriguez RG, Garofalo R, Schnall R. A Mobile Sexual Health App on Empowerment, Education, and Prevention for Young Adult Men (MyPEEPS Mobile): Acceptability and Usability Evaluation. JMIR Form Res 2020; 4:e17901. [PMID: 32254043 PMCID: PMC7175191 DOI: 10.2196/17901] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/20/2020] [Accepted: 02/29/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND HIV incidence among young adult men who have sex with men (MSM), particularly among black and Latino men, continues to rise. As such, continued HIV prevention interventions for young MSM of color are of utmost importance. Male Youth Pursuing Empowerment, Education and Prevention around Sexuality (MyPEEPS) Mobile is a comprehensive HIV prevention and sexual health education smartphone app initially created to promote sexual health and HIV prevention among adolescent sexual minority young men aged 13 to 18 years. OBJECTIVE The objective of this study was to critically appraise the acceptability and usability of MyPEEPS Mobile for young adult MSM aged 19 to 25 years. METHODS Study participants used the mobile app, completed usability questionnaires and in-depth interviews, and reported their experience using the app. Analysis of interview data was guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) to better understand the usability and acceptability of this intervention for young adults. Interview data were coded using the following constructs from the UTAUT model: performance expectancy, effort expectancy, and social influence. RESULTS A total of 20 young adult MSM (n=10 in Chicago, Illinois, and n=10 in New York, New York) were enrolled in the study. Participants reported that MyPEEPS Mobile was free of functional problems (Health Information Technology Usability Evaluation Scale scores and Post-Study System Usability Questionnaire scores consistent with high usability), easy to use, and useful, with an engaging approach that increased acceptability, including the use of avatars and animation, and inclusive representation of the diverse identities by race and ethnicity, gender identity, and sexual orientation. Recommended areas for improving MyPEEPS Mobile for the target demographic included more adult-oriented graphics, advanced educational content, scenarios for youth with more sexual experience, and search function to increase accessibility of key content. CONCLUSIONS Overall, young adult MSM aged 19 to 25 years described the MyPEEPS Mobile as educational, informative, and usable for their sexual health education and HIV prevention needs, and they provided actionable recommendations to optimize its use and applicability for this age group.
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Affiliation(s)
- Brittany Gannon
- School of Nursing, Columbia University, New York, NY, United States
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York City, NY, United States
| | - Rindcy Davis
- Gertrude H Sergievsky Center, Columbia University, New York, NY, United States
| | - Lisa M Kuhns
- Lurie Children's Hospital, Chicago, IL, United States
- Ann & Robert H Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IN, United States
| | | | - Robert Garofalo
- Lurie Children's Hospital, Chicago, IL, United States
- Ann & Robert H Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IN, United States
| | - Rebecca Schnall
- School of Nursing, Columbia University, New York, NY, United States
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Adebayo OW, Williams JR, Garcia A. "The right place and the right time": A qualitative study of the decision-making process of self-initiated HIV testing among young adults. Res Nurs Health 2020; 43:186-194. [PMID: 32048749 DOI: 10.1002/nur.22015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/25/2020] [Indexed: 11/08/2022]
Abstract
Young adults continue to have very low rates of human immunodeficiency virus (HIV) testing, which contribute to transmission, late diagnoses, and poor health outcomes. The access and uptake of HIV testing among young adults can be improved by promoting self-initiated testing (i.e., testing without the immediate recommendation of a clinician). Little is known, however, about how young adults self-initiate HIV testing. The purpose of this study was to explore the decision-making process of young adults who self-initiated HIV testing. A qualitative descriptive study was conducted with 30 young adults aged 18-24 years. The findings from this study describe how young adults acknowledge their vulnerability to HIV infection and navigate the process of deciding to self-initiate testing. Some subcategories include Self-Convincing, Conversation Prompts, and The Right Place and Right Time. Findings from this study are pivotal for subsequent studies to further understand self-initiated HIV testing among young adults and design targeted interventions that will improve testing uptake.
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Affiliation(s)
| | - Jessica R Williams
- The University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina
| | - Ana Garcia
- University of Miami, Miller School of Medicine, Miami, Florida
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Hogben M, Leichliter J, Aral SO. An Overview of Social and Behavioral Determinants of STI. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Pilgrim NA, Jennings JM, Sanders R, Page KR, Loosier PS, Dittus PJ, Marcell AV. Understanding Quality of Care and Satisfaction With Sexual and Reproductive Healthcare Among Young Men. J Healthc Qual 2019; 40:354-366. [PMID: 30399033 PMCID: PMC6224152 DOI: 10.1097/jhq.0000000000000149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Sexual and reproductive healthcare (SRHC) guidelines recommend the delivery of quality preventive SRHC to males beginning in adolescence. A quality of care (QOC) framework was used to examine factors associated with young male's perceptions of QOC and satisfaction with care, which can influence their engagement and use of SRHC. METHODS Cross-sectional surveys were conducted from August 2014 to September 2016 with 385 male patients aged 15-24 years, recruited from primary care and sexually transmitted disease (STD) clinics. Surveys measured QOC received, satisfaction with care, and domains of a QOC framework. Poisson regression analyses examined associations between domains of quality and perceived QOC as well as satisfaction with care. RESULTS Over half of males reported QOC as excellent (59%) and were very satisfied with the services (56.7%). Excellent QOC and high satisfaction with services was associated with timely care, higher Clinician-Client Centeredness, and being a bisexual male. Excellent QOC was also associated with greater comfort in the clinic, being tested for human immunodeficiency virus/STDs, attending primary care settings, and receipt of higher number of SRHC services. CONCLUSIONS Using a QOC framework as part of providing SRHC to young males can be important in improving their perceptions of QOC and satisfaction with services.
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Kubicek K, Beyer WJ, Wong CF, Kipke MD. Engaging Young Men in the HIV Prevention and Care Continua: Experiences From Young Men of Color Who Have Sex With Men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2019; 31:325-343. [PMID: 31361519 DOI: 10.1521/aeap.2019.31.4.325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sexual minority individuals experience barriers to receiving equitable health care. Research also indicates that young men who have sex with men (YMSM), particularly young men of color, have limited engagement in the HIV care continuum and there are significant disparities across the continuum. This study aims to uncover how providers can engage YMSM of color in all forms of care, including primary care and HIV prevention through an HIV prevention continuum. This qualitative study reports data from the Healthy Young Men's Cohort Study; a total of 49 YMSM participated in the eight focus groups. This study provides a description of YMSM's overall health concerns, experiences with health care, and under what circumstances YMSM seek care. We then present a model describing the salient characteristics of a HIV prevention continuum for YMSM of color and provide clear areas for education, intervention, and policy change to support better overall health for YMSM of color.
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Affiliation(s)
| | | | | | - Michele D Kipke
- Community, Health Outcomes, and Intervention Research Program, Children's Hospital Los Angeles
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Bakko M, Kattari SK. Differential Access to Transgender Inclusive Insurance and Healthcare in the United States: Challenges to Health across the Life Course. J Aging Soc Policy 2019; 33:67-81. [PMID: 31230581 DOI: 10.1080/08959420.2019.1632681] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This commentary explores how different types of insurance (Medicare, Medicaid, state government, and private insurance) address issues of transgender-related care, and how access to transgender affirming insurance coverage and healthcare across life stages depends both on type of insurance and geographical location. We argue that the current state of transgender health insurance policy and practices are inadequate for achieving goals of continuity of care and positive health outcomes across the life course. Transgender individuals are uninsured at a higher rate than their cisgender (non-transgender) counterparts, face discrimination or refusal of care from their providers, and, if insured, experience denials of coverage from insurance companies. These ruptures in coverage can be addressed through extending insurance coverage for all treatments necessary to affirm a transgender person's gender identity, training to support transgender affirming healthcare, and research on the health needs of the transgender community across the life course.
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Affiliation(s)
- Matthew Bakko
- University of Michigan School of Social Work and Department of Sociology , Ann Arbor, Michigan, USA
| | - Shanna K Kattari
- University of Michigan School of Social Work , Ann Arbor, Michigan, USA
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Vrinten C, Gallagher A, Waller J, Marlow LAV. Cancer stigma and cancer screening attendance: a population based survey in England. BMC Cancer 2019; 19:566. [PMID: 31185949 PMCID: PMC6561035 DOI: 10.1186/s12885-019-5787-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 05/31/2019] [Indexed: 02/07/2023] Open
Abstract
Background Cancer-related stigma attracts considerable research interest, but few studies have examined stigmatisation in the healthy population. Qualitative studies suggest that stigma can discourage people from attending cancer screening. We aimed to quantify the prevalence and socio-demographic patterning of cancer stigma in the general population and to explore its association with cancer screening attendance. Methods In 2016, 1916 adults aged 18–70 years took part in home-based interviews in England. Measures assessed demographic characteristics, self-reported screening uptake for cervical (n = 681), breast (n = 326) and colorectal cancer (n = 371), and cancer stigma. Cancer stigma was measured with the validated Cancer Stigma Scale which assesses six subdomains (Severity, Personal Responsibility, Awkwardness, Avoidance, Policy Opposition, and Financial Discrimination), from which a mean score was calculated. Logistic regression analyses examined the association between cancer stigma and having been screened as recommended versus not. Results Levels of cancer stigma were low, but varied across the six subdomains. Items regarding the severity of a cancer diagnosis attracted the highest levels of agreement (30–51%), followed by statements about the acceptability of making financial decisions on the basis of a cancer diagnosis such as allowing banks to refuse a mortgage (16–31%) and policy opposition statements such as not having a responsibility to provide the best possible care for cancer patients (10–17%). A similar proportion anticipated feeling awkward around someone with cancer (10–17%). Only 8–11% agreed with personal responsibility statements, such as that a person with cancer is to blame for their condition, while 4–5% of adults anticipated avoiding someone with cancer. Stigma was significantly higher in men (p < .05) and in those from ethnic minority backgrounds (p < .001). Higher cancer stigma was associated with not being screened as recommended for all three screening programmes (cervical: adjusted OR 1.59, 95% CI 1.15–2.20; breast: adjusted OR = 1.97, 95% CI 1.17–3.32; colorectal: adjusted OR = 1.59, 95% CI 1.06–2.38). Conclusions Cancer stigma is generally low, but some aspects of stigma are more prevalent than others. Stigma is more prevalent in certain population subgroups and is negatively associated with cancer screening uptake. These benchmark findings may help track and reduce cancer stigma over time. Electronic supplementary material The online version of this article (10.1186/s12885-019-5787-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Charlotte Vrinten
- Cancer Communication and Screening Group, Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK.
| | - Ailish Gallagher
- Cancer Communication and Screening Group, Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - Jo Waller
- Cancer Communication and Screening Group, Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - Laura A V Marlow
- Cancer Communication and Screening Group, Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
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MirzaiiNajmabadi K, Karimi L, Ebadi A. Exploring the Barriers to Sexual and Reproductive Health Education for Men in Iran: A Qualitative Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:179-186. [PMID: 31057633 PMCID: PMC6485022 DOI: 10.4103/ijnmr.ijnmr_132_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Considering the obvious reasons for the necessity of men's sexual and reproductive health education, the present qualitative study aims to identify and contextualize the barriers to sexual and reproductive health education to men in Iran. Materials and Methods This qualitative research was conducted using conventional procedures of content analysis. A total of 34 participants consisting of authorities in health organizations, healthcare providers, clergies, and adult men in a general population were interviewed in two large cities of Iran including Tehran and Mashhad in 2016. Purposive sampling continued until data saturation was ensured. Data were collected through individual in-depth semi-structured interviews. All interviews were tape-recorded and transcribed in verbatim. Finally, the data were analyzed using conventional qualitative content analysis. Results Participants' experiences were categorized into three main themes including (1) individual barriers, (2) sociocultural barriers, and (3) structural barriers along with seven subthemes including low perceived threat, unwillingness to learn, sociocultural taboos, family's lack of knowledge and malperformance, policy-making barriers, executive barriers, and health system deficiency barriers. Conclusions Considering the results obtained, many barriers to men's sexual and reproductive health education could be eliminated through overcoming the individual and structural barriers and sociocultural taboos, as major obstacles. The findings suggest overcoming these barriers and promoting men's health require raising awareness overcoming sociocultural taboos. In this regard, policy-makers should provide sexual and reproductive health education programs and create opportunities and facilities along with appropriate learning environments for men.
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Affiliation(s)
| | - Leila Karimi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Teheran, Iran
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De Santis JP, Quidley-Rodriguez N, Valdes B, Alves SL, Provencio-Vasquez E. Contemplating Co-Occurring Cultures: A Grounded Theory Study of Sexual Decision Making Among Hispanic Men Who Have Sex With Men. HISPANIC HEALTH CARE INTERNATIONAL 2019; 16:85-98. [PMID: 30157694 DOI: 10.1177/1540415318790554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction HIV infection continues to be a serious health concern globally. Of the 1.2 million people with HIV infection in the United States, men who have sex with men (MSM) account for 57% of cases. Hispanic/Latino individuals accounted for 24% of new HIV diagnoses, with male-to-male sexual contact responsible for the majority of cases. A factor in HIV prevention is the sexual decision-making process. The purpose of this study was to describe the process by which sexual decision making occurs among Hispanic MSM. Method Utilizing a grounded theory approach, 19 in-depth, semistructured interviews were conducted from participants ages 25 to 65 years living in South Florida. After consent, participants completed an in-depth interview. Interviews were audio-recorded and transcribed verbatim. Data were analyzed to identify categories and subcategories. Findings A theory grounded in the data called Contemplating Co-Occurring Cultures (Hispanic, gay, and health cultures) emerged that described the central phenomenon. These co-occurring cultures were the foundation of sexual decision making among participants. Conclusion Clinicians providing care to this population should be aware of the complexity of the sexual decision-making process. Awareness of these factors may provide the opportunity for HIV risk reduction strategies developed specifically for Hispanic MSM.
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Affiliation(s)
- Joseph P De Santis
- 1 University of Miami, Coral Gables, FL, USA.,2 University of Texas at El Paso, TX, USA
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Perin J, Jennings JM, Arrington-Sanders R, Page KR, Loosier PS, Dittus PJ, Marcell AV. Evaluation of an Adapted Project Connect Community-based Intervention Among Professionals Serving Young Minority Men. Sex Transm Dis 2019; 46:165-171. [PMID: 30652988 PMCID: PMC6631304 DOI: 10.1097/olq.0000000000000977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To address sexual and reproductive health (SRH) needs of young minority urban males, we developed and evaluated Project Connect Baltimore (Connect), which was adapted from a program with demonstrated effectiveness among young females. The objectives were to determine (1) the feasibility of Connect as adapted for young minority men, (2) whether the program increased SRH knowledge and resource sharing of youth-serving professionals (YSPs) working with young men, and (3) whether the program improved awareness and use of resources for young minority men in Baltimore City, an urban environment with high rates of sexually transmitted diseases. METHODS Connect developed a clinic referral guide for male youth-friendly resources for SRH. The YSPs working with partners and organizations serving young minority men were trained to use Connect materials and pretraining, immediate, and 3-month posttraining surveys were conducted to evaluate program effects. A before-after evaluation study was conducted among young men attending five urban Connect clinics where sexually transmitted disease/human immunodeficiency virus rates are high, recruiting young men in repeated cross-sectional surveys from April 2014 to September 2017. RESULTS Two hundred thirty-five YSPs were trained to use Connect materials, including a website, an article-based pocket guide, and were given information regarding SRH for young men. These professionals demonstrated increased knowledge about SRH for young men at immediate posttest (60.6% to 86.7%, P < 0.05), and reported more sharing of websites for SRH (23% to 62%, P < 0.05) from pretraining to 3-month posttraining. 169 young minority men were surveyed and reported increased awareness of Connect over 3 and a half years (4% to 11%, P = 0.015), although few young men reported using the website to visit clinics. CONCLUSIONS Project Connect Baltimore increased knowledge of SRH needs among youth-serving professionals and sharing of SRH resources by these professionals with young men. This program also demonstrated increases in awareness of SRH resources among young minority urban men.
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Affiliation(s)
- Jamie Perin
- Johns Hopkins School of Public Health, Baltimore, MD
| | - Jacky M Jennings
- Johns Hopkins School of Public Health, Baltimore, MD
- Johns Hopkins School of Medicine, Baltimore, MD
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Thakkar MY, Hao L, Marcell AV. Adolescents' and Young Adults' Routine Care Use: The Role of Their Mothers' Care Use Behaviors. J Adolesc Health 2019; 64:107-115. [PMID: 30314866 PMCID: PMC6309640 DOI: 10.1016/j.jadohealth.2018.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/11/2018] [Accepted: 07/11/2018] [Indexed: 01/25/2023]
Abstract
PURPOSE Little is known whether mothers' own care use is differentially associated with their adolescents' routine care use by gender. The main purpose of this study is to examine whether mothers' healthcare use prospectively predicts their adolescents' routine care use stratified by gender, after controlling for predisposing (child's age, race/ethnicity, region of residence, urbanicity, and mother's age at child's birth), enabling (mother's education, adolescent and mother health insurance), and need (child health status) factors. METHODS In 2018, a prospective analysis was conducted using data from 5,040 adolescents aged 9-24 and their mothers who completed the two-generation National Longitudinal Survey of Youth in 2006 (first interview) and 2008 (second interview). Findings include percentages and adjusted odds ratios of the factors that predict adolescents' self-report of routine care use in the past year measured at the second interview. RESULTS In 2008, over half of participants reported a routine doctor visit during the prior 12 months and this varied by gender; more females (68.7%) had a visit than males (53.5%). Factors that independently predicted a greater odds of adolescents' routine doctor visits included mothers with routine doctor visits at both interviews or the second interview only, and adolescents' health insurance and past routine visit, regardless of gender. Males aged 18-20 and 21-24 years had lower odds of having a routine doctor visit than males aged 9-11 years. CONCLUSIONS This study provides evidence for the potential role that mothers' care use can play in their adolescents' routine care use, especially for their sons, independent of insurance status.
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Affiliation(s)
| | - Lingxin Hao
- Krieger School of Arts and Sciences, Baltimore, Maryland
| | - Arik V Marcell
- Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Chernick LS, Siden JY, Bell DL, Dayan PS. A Qualitative Assessment to Understand the Barriers and Enablers Affecting Contraceptive Use Among Adolescent Male Emergency Department Patients. Am J Mens Health 2019; 13:1557988319825919. [PMID: 30819063 PMCID: PMC6440070 DOI: 10.1177/1557988319825919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/09/2018] [Accepted: 12/18/2018] [Indexed: 11/16/2022] Open
Abstract
Early fatherhood is common in the United States (U.S.). The emergency department (ED) plays a disproportionate role in serving patients with unmet reproductive and sexual health needs. With 8 million adolescent males visiting U.S. EDs annually, the ED is a potential site to implement interventions to minimize early fatherhood and unintended teenage pregnancy. Little is known about how adolescent male ED patients perceive and behave in sexual relationships and how they influence contraceptive decision making. The objective of this study was to identify the barriers and enablers affecting contraceptive and condom use among adolescent male ED patients. Semistructured interviews were conducted with males aged 14-19 in one urban ED. Enrollment continued until saturation of key themes. Interviews were recorded, transcribed, and coded based on thematic analysis using NVivo 10. The Social Ecological Model was used to organize and understand themes. Participants ( n = 24) were predominantly 18-19 years (63%) and Hispanic (92%). Most (71%) had sex ≤3 months prior but infrequently used a condom at last intercourse (42%). The primary barrier influencing contraceptive use was lack of knowledge of effective contraceptives. Other barriers consisted of perceived gender roles, poor partner communication, and little relationship with a primary provider. Enablers included intention not to get a partner pregnant, school-based sexual health education, normalcy to use condoms, and a trustworthy confidante. The identified barriers and enablers influencing adolescent males' perspectives toward contraceptives should be addressed if designing future ED-based pregnancy prevention interventions targeting teen males.
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Affiliation(s)
- Lauren S. Chernick
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine and Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Jonathan Y. Siden
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine and Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - David L. Bell
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Peter S. Dayan
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine and Pediatrics, Columbia University Medical Center, New York, NY, USA
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Wheeler NJ, Pilgrim N, Jennings JM, Sanders R, Page KR, Loosier PS, Dittus PJ, Marcell AV. Missed Opportunities to Address Pregnancy Prevention With Young Men in Primary Care. Clin Pediatr (Phila) 2018; 57:1558-1566. [PMID: 30095017 PMCID: PMC6631036 DOI: 10.1177/0009922818793351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Young men (aged 15-24 years) have pregnancy prevention needs, yet little is known about whether they perceive they learn about pregnancy prevention in primary care. A sample of 190 young men seen in primary care in one city from April 2014 to September 2016 were assessed on perceived learning about pregnancy prevention, background and visit characteristics, pregnancy prevention care receipt, and contraception needs at last sex. The majority of participants were non-Hispanic black (92%), aged 15 to 19 years (54%), seen for a physical examination (52%), and established patients (87%). Few participants perceived they learned about pregnancy prevention (32%), regardless of sexual activity (33% among sexually active participants, 26% among never sexually active). Poisson regression models determined that perceived learning about pregnancy prevention was independently associated with young men's pregnancy prevention care receipt and contraception needs at last sex. Findings highlight the need to improve providers' delivery of pregnancy prevention services to young men.
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Affiliation(s)
- Noah J. Wheeler
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- School of Medicine, Baltimore, MD, USA
| | - Nanlesta Pilgrim
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Population Council, Washington, DC, USA
| | | | | | | | | | | | - Arik V. Marcell
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- School of Medicine, Baltimore, MD, USA
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Marcell AV, Gibbs SE, Pilgrim NA, Page KR, Arrington-Sanders R, Jennings JM, Loosier PS, Dittus PJ. Sexual and Reproductive Health Care Receipt Among Young Males Aged 15-24. J Adolesc Health 2018; 62:382-389. [PMID: 29128296 PMCID: PMC6080721 DOI: 10.1016/j.jadohealth.2017.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/01/2017] [Accepted: 08/24/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to describe young men's sexual and reproductive health care (SRHC) receipt by sexual behavior and factors associated with greater SRHC receipt. METHODS There were 427 male patients aged 15-24 who were recruited from 3 primary care and 2 sexually transmitted disease (STD) clinics in 1 urban city. Immediately after the visit, the survey assessed receipt of 18 recommended SRHC services across four domains: screening history (sexual health, STD/HIV test, family planning); laboratories (STDs/HIV); condom products (condoms/lubrication); and counseling (STD/HIV risk reduction, family planning, condoms); in addition, demographic, sexual behavior, and visit characteristics were examined. Multivariable Poisson regressions examined factors associated with each SRHC subdomain adjusting for participant clustering within clinics. RESULTS Of the participants, 90% were non-Hispanic black, 61% were aged 20-24, 90% were sexually active, 71% had female partners (FPs), and 20% had male or male and female partners (M/MFPs). Among sexually active males, 1 in 10 received all services. Half or more were asked about sexual health and STD/HIV tests, tested for STDs/HIV, and were counseled on STD/HIV risk reduction and correct condom use. Fewer were asked about family planning (23%), were provided condom products (32%), and were counseled about family planning (35%). Overall and for each subdomain, never sexually active males reported fewer services than sexually active males. Factors consistently associated with greater SRHC receipt across subdomains included having M/MFPs versus FPs, routine versus non-STD-acute visit, time alone with provider without parent, and seen at STD versus primary care clinic. Males having FPs versus M/MFPs reported greater family planning counseling. CONCLUSIONS Findings have implications for improving young men's SRHC delivery beyond the narrow scope of STD/HIV care.
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Affiliation(s)
- Arik V Marcell
- Department of Pediatrics, The Johns Hopkins University, School of Medicine, Baltimore, Maryland; Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland.
| | - Susannah E Gibbs
- Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Nanlesta A Pilgrim
- Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Kathleen R Page
- Department of Medicine, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | | | - Jacky M Jennings
- Department of Pediatrics, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Penny S Loosier
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patricia J Dittus
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Affiliation(s)
- J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
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Echenique M, Bookman RS, Rodriguez VJ, LaCabe RP, Potter JE, Jones DL. HIV is always with me: men living with perinatally acquired HIV and planning their families. Open Access J Contracept 2017; 8:35-43. [PMID: 28751827 PMCID: PMC5523133 DOI: 10.2147/oajc.s137789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Once expected to not survive childhood, youth with perinatally acquired HIV (YPHIV) have now reached young adulthood and are of reproductive age and sexually active. Given the health impact of pregnancy among YPHIV, understanding reproductive decision making may inform preconception counseling strategies. Most literature regarding reproductive health among YPHIV focuses on women, overlooking one of the most important factors influencing the reproductive decision-making process, male sexual partners. This study examined attitudes, perceptions, and experiences of young men with perinatally acquired HIV (YMPHIV) regarding family planning and relationships, safer sex, disclosure, stigma, and psychological health. Participants (n=21) were YMPHIV aged 18–24 years recruited in Miami, Florida. Focus groups (n=4) were conducted; qualitative data were analyzed using grounded theory. HIV disclosure, stigma, fertility intentions, safer preconception knowledge, attitudes and practices, family planning communication with medical providers and family, and mental health emerged as themes. Results suggest that despite accurate knowledge regarding healthy preconception practices, psychopathology, substance use, and stigma impact the uptake of HIV health care interventions. Effective interventions on preconception counseling may require more tailored approaches than knowledge-based psychoeducation alone, such as inclusion of psychological treatment, which could be offered in HIV health care settings to optimize health outcomes.
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Affiliation(s)
- Marisa Echenique
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine
| | - Rachel S Bookman
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine
| | - Violeta J Rodriguez
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine
| | - Richard P LaCabe
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine
| | - JoNell Efantis Potter
- Department of Obstetrics & Gynecology, University of Miami Miller School of Medicine
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine
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