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Garcia RS, Hollis T, Baratta J, King Z, Faulks M, Ricketts M, Brown-Johnson C, Shankar M, Guerin A, Wong HN, Zulman DM, Floyd BD. Building Trust and Partnership with Black Pediatric Patients and their Caregivers. Acad Pediatr 2024; 24:216-227. [PMID: 37659602 DOI: 10.1016/j.acap.2023.08.016] [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: 04/05/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/04/2023]
Abstract
Systemic racism embedded within the US health care system results in disproportionately worse health outcomes for Black pediatric patients and their caregivers. One meaningful mechanism through which these health disparities persist is through discriminatory treatment and anti-Black bias from clinicians. Strengthening care provided to Black pediatric patients and their caregivers requires that clinicians adopt culturally tailored communication strategies that promote health equity and counter racism. We conducted a scoping review of evidence-based communication practices in the medical literature that improve care for Black pediatric patients. We mapped the specific practices to the Presence 5 for Racial Justice framework and identified cross-cutting themes to describe practices across the five domains. There are three cross-cutting themes that underlie the recommended practices: 1) promote unbiased implementation of clinician communication strategies (eg, providing equitable recommendations for preventive care), 2) tailor care to Black pediatric patients (eg, explore the importance of the family unit), and 3) address racism experienced by Black pediatric patients and their caregivers (eg, acknowledge any previous negative experiences with the health care system). This review highlights communication practices that clinicians can adopt to build trusting relationships, empower Black families, and promote racial justice in clinical care. Future opportunities include expanding to system level change and validating these practices with patients and clinicians.
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Affiliation(s)
- Raquel S Garcia
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; Department of Medicine (RS Garcia), Duke University School of Medicine, Durham, NC
| | - Taylor Hollis
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; University of Alabama at Birmingham Heersink School of Medicine (T Hollis)
| | - Juliana Baratta
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; Massachusetts Institute of Technology Sloan School of Management (J Baratta), Cambridge, Mass
| | - Zoe King
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif; Stanford Prevention Research Center (Z King), Stanford University School of Medicine, Palo Alto, Calif
| | - Melvin Faulks
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif
| | - Maya Ricketts
- Meharry Medical College School of Medicine (M Ricketts), Nashville, Tenn
| | - Cati Brown-Johnson
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif
| | - Megha Shankar
- Division of General Internal Medicine (M Shankar), Department of Medicine, University of California San Diego, La Jolla, Calif; Presence Center (M Shankar), Stanford University School of Medicine, Stanford, Calif
| | - Allison Guerin
- Department of Pediatrics (A Guerin), Office of Pediatric Education and Office of Diversity, Equity, Inclusion, and Justice in Pediatrics, Stanford University School of Medicine, Palo Alto, Calif
| | - Hong-Nei Wong
- Lane Medical Library (HN Wong), Stanford University School of Medicine, Stanford, Calif
| | - Donna M Zulman
- Division of Primary Care and Population Health (RS Garcia, T Hollis, J Baratta, Z King, M Faulks, C Brown-Johnson, and DM Zulman), Department of Medicine, Stanford University School of Medicine, Palo Alto, Calif
| | - Baraka D Floyd
- Department of Pediatrics (BD Floyd), Division of General Pediatrics and Office of Diversity Equity, Inclusion, and Justice in Pediatrics, Stanford University School of Medicine, Palo Alto, Calif.
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Kirschnick LB, Calderipe CB, Villa A, Santana Dos Santos E, Migliorati C, Martins MD, Santos-Silva AR. Patient communication protocols for sexually transmitted infections: A systematic review. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38375918 DOI: 10.1111/scd.12976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/27/2023] [Accepted: 02/04/2024] [Indexed: 02/21/2024]
Abstract
AIMS We conducted a systematic review of post-test communication protocols and observational studies regarding counseling for a positive sexually transmitted infection (STI) result and also discuss the role of dental specialist (e.g., oral medicine) in this sense. METHODS AND RESULTS The search process followed the parameters of PRISMA 2020 guidelines. MEDLINE/PubMed, Web of Science, Scopus, EMBASE, and LILACS were consulted with a specific search strategy for each one. Additionally, the references of the included studies, grey literature, and experts were consulted. Four protocols and 18 observational studies were included in this systematic review, published between 1997 and 2022 in the Americas and Europe. The communication protocols emphasized the importance of conducting personal and private discussions with patients to address their fears and questions. Among the observational studies, 56% indicated that post-test counseling was either ineffective or absent. Furthermore, 22% of the studies used telephone communication to deliver results to patients. CONCLUSIONS Our study showed that the communication process of a positive STI result affects the patients in several aspects, as treatment adherence and their relationship with the community. Nevertheless, this process of STI post-test communication seems to be flawed, which brings potential negative effects to patients.
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Affiliation(s)
- Laura Borges Kirschnick
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Camila Barcellos Calderipe
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Alessandro Villa
- Oral Medicine, Oral Oncology and Dentistry, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Erison Santana Dos Santos
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Cesar Migliorati
- Department of Oral & Maxillofacial Diagnostic Sciences, University of Florida, Gainesville, Florida, USA
| | - Manoela Domingues Martins
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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Cordova D, Bauermeister JA, Warner S, Wells P, MacLeod J, Neilands TB, Mendoza Lua F, Delva J, Fessler KB, Smith V, Khreizat S, Boyer C. Efficacy of a Digital Health Preventive Intervention for Adolescents With HIV or Sexually Transmitted Infections and Substance Use Disorder: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e47216. [PMID: 38373025 PMCID: PMC10912993 DOI: 10.2196/47216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND HIV or sexually transmitted infections remain a significant public health concern in the United States, with adolescents affected disproportionately. Adolescents engage in HIV/STI risk behaviors, including drug use and condomless sex, which increase the risk for HIV/STIs. At-risk adolescents, many of whom are racial minorities, experience HIV/STI disparities. Although at-risk adolescents are disproportionately affected by HIV/STI risk behaviors and infections and although the Centers for Disease Control and Prevention recommends routine HIV/STI testing for adolescents, relatively few adolescents report having ever been tested for HIV/STI. With expected increases in health clinic visits as a result of the Affordable Care Act combined with technological advances, health clinics and mobile health (mHealth), including apps, provide innovative contexts and tools to engage at-risk adolescents in HIV/STI prevention programs. Yet, there is a dearth of efficacious mHealth interventions in health clinics to prevent and reduce both condomless sex and drug use and increase HIV/STI testing for at-risk adolescents. OBJECTIVE To address this gap in knowledge, we developed a theory-driven, culturally congruent mHealth intervention (hereon referred to as S4E [Storytelling 4 Empowerment]) that has demonstrated feasibility and acceptability in a clinical setting. The next step is to examine the preliminary efficacy of S4E on adolescent HIV/STI testing and risk behaviors. This goal will be accomplished by 2 aims: the first aim is to develop a cross-platform and universal version of S4E. The cross-platform and universal version of S4E will be compatible with both iOS and Android operating systems and multiple mobile devices, aimed at providing adolescents with ongoing access to the intervention once they leave the clinic, and the second aim is to evaluate the preliminary efficacy of S4E, relative to usual care control condition, in preventing or reducing drug use and condomless sex and increasing HIV/STI testing in a clinical sample of at-risk adolescents aged 14-21 years living in Southeast Michigan. METHODS In this study, 100 adolescents recruited from a youth-centered community health clinic will be randomized via blocked randomization with random sequences of block sizes to one of the 2 conditions: S4E mHealth intervention or usual care. Theory-driven and culturally congruent, S4E is an mHealth adaptation of face-to-face storytelling for empowerment, which is registered with the Substance Abuse and Mental Health Services Administration's National Registry of Evidence-Based Programs and Practices. RESULTS This paper describes the protocol of our study. The recruitment began on May 1, 2018. This study was registered on December 11, 2017, in ClinicalTrials.gov. All participants have been recruited. Data analysis will be complete by the end of March 2024, with study findings available by December 2024. CONCLUSIONS This study has the potential to improve public health by preventing HIV/STI and substance use disorders. TRIAL REGISTRATION ClinicalTrials.gov NCT03368456; https://clinicaltrials.gov/study/NCT03368456. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47216.
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Affiliation(s)
- David Cordova
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - José A Bauermeister
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Sydni Warner
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | | | - Jennifer MacLeod
- Livingston Physician Organization, Livingston, MI, United States
| | - Torsten B Neilands
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Frania Mendoza Lua
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, United States
| | - Jorge Delva
- School of Social Work, Boston University, Boston, MA, United States
| | | | | | - Sarah Khreizat
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Cherrie Boyer
- School of Medicine, University of California San Francisco, San Francisco, CA, United States
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Owen A, Owen R, Batz R, Marasco-Wetzel J. Adolescent Perceptions of Adult-Mediated Healthcare Communication. SOCIAL WORK IN PUBLIC HEALTH 2023; 38:400-415. [PMID: 38319709 DOI: 10.1080/19371918.2024.2314022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Adolescence is a time of rapid growth and development and may be accompanied by increased risk-taking behaviors and independence. Youth are particularly at risk for high levels of stress, decreased physical activity, unsafe sexual activity, abuse, depression, and suicide. Considering the unique health risks adolescents face, healthcare service access and utilization can play a pivotal role in promoting positive long term health outcomes throughout adulthood. At the same time, adolescents must often rely on parents/caregivers to mediate their healthcare access. Understanding how adolescents perceive adult interactions within healthcare is important for developing interventions that increase youth access to healthcare. We found that adolescents perceived adult-mediated healthcare experiences as either supportive (Subthemes: Recognition Builds Trust and Validation) or unsupportive (Subthemes: Adult-Focused Communication and Lack of Privacy). Based on our findings, we argue that prevention-focused interventions should include communication-based strategies. We discuss social work and healthcare practice and policy implications of these findings.
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Affiliation(s)
- Aleksa Owen
- School of Social Work, University of Nevada, Reno, NL, USA
| | - Randall Owen
- Special Education, College of Education and Human Development, University of Nevada, Reno, NL, USA
| | - Ruby Batz
- Special Education, College of Education and Human Development, University of Nevada, Reno, NL, USA
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Ibitoye M, Bennett AS, Bugaghis M, Chernick LS, Des Jarlais DC, Aronson ID. Provider Perspectives on Barriers to Routine HIV Testing of Adolescent and Young Adult Patients in Emergency Department Settings. Behav Med 2023; 49:204-211. [PMID: 34965832 PMCID: PMC9240108 DOI: 10.1080/08964289.2021.2020207] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/28/2021] [Accepted: 12/06/2021] [Indexed: 12/28/2022]
Abstract
HIV testing rates among US youth aged 13-24 years are sub-optimal, with high rates of missed testing opportunities in emergency departments (EDs). We assessed barriers to routine HIV testing of youth in urban ED settings from the perspective of healthcare providers. Ten physicians and nurses were recruited from the pediatric and adult EDs at a high-volume hospital in New York City, USA to complete in-depth interviews to provide their perspectives on barriers to routine HIV testing of youth ages 13 to 24 in EDs. Interviews were conducted using a semi-structured interview guide with questions and probes. All interviews were conducted via Zoom due to the COVID-19 pandemic and were audio-recorded and transcribed verbatim. Transcripts were coded independently by two researchers using an inductive thematic analysis approach. Participants often offered HIV testing to youth in the ED based on their perceptions of patients' HIV risk, with pediatric providers sometimes discouraging adolescents they perceived to be at low HIV risk from testing. Participants cited other priorities, logistics of blood-based testing, and discomfort discussing HIV as other reasons for not offering HIV testing to all youth in the ED. Efforts are needed to encourage providers to offer HIV testing to all youth regardless of perceived risk, as the ED often serves as youths' only point of contact with the healthcare system. Emphasis on this and the importance of early detection, along with institutional change, clear guidance, and support for the testing process may help increase youth testing and avoid missed HIV diagnosis opportunities.
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Affiliation(s)
- Mobolaji Ibitoye
- Digital Health Empowerment, Brooklyn, NY, USA
- Institute for Population Research, The Ohio State University, Columbus, OH, USA
| | - Alex S. Bennett
- Digital Health Empowerment, Brooklyn, NY, USA
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | - Mona Bugaghis
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Lauren S. Chernick
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Don C. Des Jarlais
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, USA
| | - Ian David Aronson
- Digital Health Empowerment, Brooklyn, NY, USA
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
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Teixeira da Silva D, Petsis D, Santos T, Mahajan A, Bonett S, Wood S. Chlamydia Trachomatis/Neisseria Gonorrhea Retesting Among Adolescents and Young Adults in a Primary Care Network. J Adolesc Health 2022; 71:545-551. [PMID: 35963759 PMCID: PMC9588690 DOI: 10.1016/j.jadohealth.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 05/12/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE Chlamydia trachomatis/Neisseria gonorrhea (CT/NG) retesting three months after diagnosis is a guideline-recommended strategy to detect re-infections. Adolescents and young adults are priority populations in the U.S. Sexually Transmitted Infections National Strategic Plan, but there is a lack of research examining CT/NG retesting among these populations. This study describes retesting following CT/NG diagnosis among adolescent and young adult patients at Title X and non-Title X clinics and measures the association of patient-level factors with CT/NG retesting. METHODS We evaluated electronic medical records from 2014 to 2020 from an academic urban-suburban primary care network. The primary outcome was retesting, defined as a diagnostic test for CT or NG ordered 8-16 weeks after index diagnosis. Mixed effects logistic regression modeling stratified by Title X funding was conducted to evaluate the association of patient-level factors with CT/NT retesting. RESULTS Overall, 23.5% (n = 731) of patients were retested within 8-16 weeks following index CT/NG diagnosis. A significantly greater proportion of Title X patients were retested compared to non-Title X patients. Males were significantly less likely to be retested compared to females, and the proportion of patients retested decreased significantly over the study period. DISCUSSION Guideline-recommended retesting following CT/NG diagnosis was low in this young primary care cohort, especially among male and non-Title X clinic patients. Decreases in CT/NG retesting over the study period may be contributing to worsening of the STI epidemic. Our results provide insights into CT/NG retesting that can inform efforts to end the STI epidemic.
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Affiliation(s)
- Daniel Teixeira da Silva
- National Clinician Scholars Program, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Danielle Petsis
- Department of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tatiane Santos
- The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anjali Mahajan
- Department of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stephen Bonett
- Department of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sarah Wood
- Department of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Bergam S, Kuo C, Atujuna M, Pellowski JA, Mtukushe B, Ndevu-Qwabe N, Matiwane M, Rencken CA, Belsky M, Hoare J, Bekker LG, Harrison AD. “We Should Be Taught Self-Respect, Self-Confidence and Self-Love”: Youth Perspectives of Adult Influences on Their Sexuality and Relationships Among South African Adolescents Living With HIV. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:913170. [PMID: 36303635 PMCID: PMC9580667 DOI: 10.3389/frph.2022.913170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Of the 1.75 million adolescents aged 10–19 years living with HIV globally, 84% reside in sub-Saharan Africa. This problem is most acute in South Africa, where there are 720,000 adolescents living with HIV (ALHIV). ALHIV navigate the same challenges as other adolescents—such as puberty and first relationships—as well as challenges specific to their HIV-status—including stigma, disclosure, and concerns about HIV transmission. This dual burden calls for tailored sexual and reproductive health (SRH) programs. Here, we qualitatively explore the reflections of South African ALHIV on SRH education, communication, and discussion provided by adults in schools, clinics, and the home related to their unique SRH needs. Methods This paper reports on qualitative data from a mixed-methods study to inform interventions that meet the SRH needs of ALHIV. In-depth interviews (N = 20) were conducted with ALHIV recruited from two clinics in Cape Town, South Africa. Nine males and 11 females aged 16–19 participated in semi-structured in-depth interviews to discuss their sexual health as ALHIV. The interview guide explored 1) perceived SRH needs; 2) healthy living with HIV; 3) future goals; 4) intimate relationships; 5) psychosocial challenges; and 6) preferred interventions. Data were thematically applied to an iteratively-developed codebook and analyzed by the cross-cultural research team using NVivo 12. Results These qualitative data reveal the pressing needs among ALHIV for open communication and accurate information about sexuality and HIV, given the risk to themselves and their partners as they enter intimate relationships. Three themes emerged from the data: 1) Intergenerational pressures coming from caregivers, clinicians, and teachers often stigmatize the sexual heath behaviors of ALHIV; 2) When present, open intergenerational communication can provide ALHIV with crucial information, resources, and social support that supports healthy decisions, and 3) ALHIV offer specific ideas about how adults can support their decision-making in the transition to adulthood. Conclusions Findings highlight adolescents' recommendations for programs involving open communication, stigma-reduction around sexuality, and support from both peer and adult mentors. This study lays the foundation for strategies to improve intergenerational communication about sexual health to promote positive approaches to sexuality for ALHIV.
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Affiliation(s)
- Scarlett Bergam
- Brown University School of Public Health, Providence, RI, United States
| | - Caroline Kuo
- Brown University School of Public Health, Providence, RI, United States
| | | | | | - Bulelwa Mtukushe
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Mluleki Matiwane
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Mikaela Belsky
- Department of Health and Human Biology, Brown University, Providence, RI, United States
| | - Jacqueline Hoare
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Linda-Gail Bekker
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Abigail D. Harrison
- Brown University School of Public Health, Providence, RI, United States
- *Correspondence: Abigail D. Harrison
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Lung SLM, Wincentak J, Gan C, Kingsnorth S, Provvidenza C, McPherson AC. Are healthcare providers and young people talking about sexuality? A scoping review to characterize conversations and identify barriers. Child Care Health Dev 2021; 47:744-757. [PMID: 34240445 DOI: 10.1111/cch.12892] [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: 10/08/2020] [Revised: 01/25/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Conversations about sexuality with healthcare providers (HCPs) are critical to youth's positive development, including youth with disabilities or chronic conditions. Yet, little is known about the characteristics of sexuality conversations with youth in healthcare settings. This scoping review examined the nature and extent of sexuality conversations between HCPs and youth (with and without a disability or chronic condition) and aimed to identify barriers to these conversations. METHODS Scoping review methodology using rapid review principles was employed. INCLUSION CRITERIA studies published between 2009 and 2019; examined conversations between HCPs and youth aged 21 and below; addressed sexuality; and took place in a healthcare setting. Study characteristics were described and clustered into thematic groups. RESULTS Of the 5543 identified, 32 articles were included. Articles addressed (i) the content of sexuality conversations, (ii) prevalence of sexuality conversations and (iii) barriers to discussing sexuality. The content of sexuality discussions was largely biologically focused. The prevalence of sexuality discussions varied, with some discrepancy between youth-reported and HCP-reported rates. Seven barriers (three personal and four systemic) were identified. Youth with disabilities or chronic conditions were vastly under-represented in the published literature. CONCLUSIONS This study highlighted that sexuality is an underexplored topic between HCPs and young people, especially young people with disabilities and/or chronic conditions. Given the importance of sexuality to young people's mental and physical health, research addressing barriers to these discussions and development of evidence-informed resources to support HCPs and youth to engage in conversations about sexuality should be a priority.
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Affiliation(s)
- Stephanie Lock Man Lung
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Joanne Wincentak
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Therapy, University of Toronto, Ontario, Canada
| | - Caron Gan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Shauna Kingsnorth
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Therapy, University of Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
| | - Christine Provvidenza
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
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9
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Chlamydia and Gonorrhea Screening Among Women Aged 15-24 Years Undergoing a Long-Acting Reversible Contraceptive Insertion. J Adolesc Health 2021; 69:121-126. [PMID: 33280976 PMCID: PMC10140757 DOI: 10.1016/j.jadohealth.2020.10.024] [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: 06/18/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE This study aimed to evaluate the receipt of chlamydia and gonorrhea screening among women aged 15-24 years undergoing long-acting reversible contraception (LARC) insertion. METHODS We used the 2016-2017 MarketScan commercial claims data set to identify sexually active women aged 15-24 years with LARC insertion in 2017 and had ≥12 months of insurance coverage before the date of LARC insertion. Sexual activity (defined by Healthcare Effectiveness Data and Information Set chlamydia testing measure) and LARC insertion, including intrauterine device (IUD) and implant insertion, were identified by applicable International Classification of Disease, Tenth Revision, Healthcare Common Procedure Coding System, and Current Procedural Terminology codes. We evaluated chlamydia and gonorrhea testing performed in the preceding 12 months or at the time of LARC insertion among sexually active women aged 15-24 years. RESULTS We identified 37,331sexually active women aged 15-24 years with LARC insertion. Among these women, overall chlamydia testing was more frequent among women initiating an IUD (77.8%) than implant initiators (67.8%), p < .001. A similar pattern was seen for gonorrhea testing (80.0% for IUD users, 71.1% for implant users), p < .001. Among sexually active women without chlamydia and gonorrhea testing within the 12 months before the date of insertion, IUD users were more frequently tested for chlamydia (1,410 [20.9%] vs. 433 [9.2%]; p < .001) and for gonorrhea (1,206 [20.0%] vs. 374 [8.9%]; p < .001) than implant users on the day of LARC insertion. CONCLUSIONS Our results showed that approximately one in four sexually active women undergoing LARC insertion had not received recommended chlamydia and gonorrhea screening past year. Health care providers may use LARC-related visits as an opportunity to educate patients about, and to offer, chlamydia and gonorrhea screening if they had not been screened in the past 12 months.
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10
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Aronson ID, Zhang J, Rajan S, Bugaighis M, Marsch LA, Ibitoye M, Chernick LS, Des Jarlais DC. Mobile Augmented Screening to Increase HIV Testing Among Emergency Department Patients as Young as 13 Years. Cureus 2021; 13:e15829. [PMID: 34327070 PMCID: PMC8301293 DOI: 10.7759/cureus.15829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 12/02/2022] Open
Abstract
Because adolescents and emerging adults are frequently not offered HIV testing, and often decline tests when offered, we developed and tested a tablet-based intervention to increase HIV test rates among emergency department (ED) patients aged 13-24 years. Pediatric and adult ED patients in a high volume New York City hospital (N = 295) were randomized to receive a face-to-face HIV test offer, or to complete a tablet-based intervention that contained an HIV test offer delivered via computer. Test rates in both conditions were then compared to historic test rates in the same ED during the previous six months. Among participants aged 19 years and younger who were offered HIV testing and declined before enrollment in the study, participants in the tablet-based condition were 1.7 times more likely to test for HIV compared to participants in the face-to-face condition. Participants aged 19 years and younger were three times as likely to test for HIV compared to patients the same age who were treated in the previous six months (26.39%, n = 71 study participants vs. 10.29%, n = 189 prior patients, OR = 3.13, \begin{document}\chi\end{document}2 = 54.76, p < 0.001). Protocols designed to offer HIV testing to all eligible patients can significantly increase adolescent test rates compared to standard practice. Because tablets are equally effective compared to face-to-face offers, and in some cases more so, EDs may consider tablet-based interventions that require fewer staff resources and may integrate more easily into high-volume workflows.
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Affiliation(s)
- Ian D Aronson
- Research, Digital Health Empowerment, Brooklyn, USA.,Social and Behavioral Sciences, New York University School of Global Public Health, New York, USA
| | - Jingru Zhang
- Measurement and Evaluation, Teachers College, Columbia University, New York, USA
| | - Sonali Rajan
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, USA
| | - Mona Bugaighis
- Emergency Medicine, Columbia University Irving Medical Center, New York, USA
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Dartmouth College, Lebanon, USA
| | - Mobolaji Ibitoye
- Institute for Population Research, The Ohio State University, Columbus, USA
| | - Lauren S Chernick
- Emergency Medicine, Columbia University Irving Medical Center, New York, USA
| | - Don C Des Jarlais
- Epidemiology, New York University School of Global Public Health, New York, USA
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11
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Lowenthal E, Matesva M, Marukutira T, Bayani O, Chapman J, Tshume O, Matshaba M, Hickson M, Gross R. Psychological Reactance is a Novel Risk Factor for Adolescent Antiretroviral Treatment Failure. AIDS Behav 2021; 25:1474-1479. [PMID: 32754779 DOI: 10.1007/s10461-020-02986-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Psychological reactance is an aversive response to perceived threats against personal agency. For adolescents receiving HIV treatment in Botswana, we utilized a two-question, medication-specific reactance tool to assess whether: (1) verbal reminders to take medicines made adolescents want to avoid taking them, and, (2) whether adolescents felt anger when reminded to take medicines. Reactant adolescents had 2.05-fold (95% CI 1.23, 3.41) greater odds of treatment failure than non-reactant adolescents (p = 0.03). Adjusted risk of treatment failure was 14% (95% CI 3%, 28%) greater for each point elevation in reactance score (p = 0.016). Autonomy over medication-taking did not modify the association between reactance and treatment failure. Psychological reactance may be a useful interventional target for improving adolescent adherence.
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12
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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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13
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Petsis D, Min J, Huang YSV, Akers AY, Wood S. HIV Testing Among Adolescents With Acute Sexually Transmitted Infections. Pediatrics 2020; 145:peds.2019-2265. [PMID: 32179661 PMCID: PMC7579673 DOI: 10.1542/peds.2019-2265] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/02/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Rates of sexually transmitted infections (STIs) have increased over the decade. Guidelines recommend HIV testing with incident STIs. Prevalence and factors associated with HIV testing in acute STIs are unknown in adolescents. Our objective was to determine the prevalence of completed HIV testing among adolescents with incident STIs and identify patient and health care factors associated with HIV testing. METHODS Retrospective study of STI episodes (gonorrhea, Chlamydia, trichomoniasis, or syphilis) of adolescents between 13 and 24 years old from July 2014 to December 2017 in 2 urban primary care clinics. We performed mixed effects logistic regression modeling to identify patient and health care factors associated with HIV testing within 90 days of STI diagnosis. RESULTS The 1313 participants contributed 1816 acute STI episodes. Mean age at STI diagnosis was 17.2 years (SD = 1.7), 75% of episodes occurred in females, and 97% occurred in African Americans. Only half (55%) of acute STI episodes had a completed HIV test. In the adjusted model, female sex, previous STIs, uninsured status, and confidential sexual health encounters were associated with decreased odds of HIV testing. Patients enrolled in primary care at the clinics, compared with those receiving sexual health care alone, and those with multipathogen STI diagnoses were more likely to have HIV testing. CONCLUSIONS HIV testing rates among adolescents with acute STIs are suboptimal. Patient and health care factors were found to be associated with receipt of testing and should be considered in clinical practice.
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Affiliation(s)
- Danielle Petsis
- Craig Dalsimer Division of Adolescent Medicine and .,PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jungwon Min
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | - Aletha Y Akers
- Craig A. Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA,,PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA,,University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Sarah Wood
- Craig A. Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA,,PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA,,University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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14
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Cordova D, Mendoza Lua F, Muñoz-Velázquez J, Street K, Bauermeister JA, Fessler K, Adelman N, Neilands TB, Boyer CB. A multilevel mHealth drug abuse and STI/HIV preventive intervention for clinic settings in the United States: A feasibility and acceptability study. PLoS One 2019; 14:e0221508. [PMID: 31437240 PMCID: PMC6705861 DOI: 10.1371/journal.pone.0221508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 08/08/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Drug abuse and sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV), remain significant public health concerns in the United States. Youth are at disproportionate risk of drug use and STIs/HIV, yet interventions aimed at improving STI and HIV testing and reducing STI/HIV risk behaviors through technology-based engagement in clinic settings are limited. The purpose of this study was to examine the feasibility and acceptability of Storytelling 4 Empowerment (S4E), a multilevel mobile-health drug abuse and STI/HIV preventive application (app) for clinic settings. We also explored uptake of STI/HIV testing among youth immediately post-intervention. METHOD Employing community-based participatory research principles and a multi-method research design, we developed a clinician-facing app, and examined the feasibility and acceptability of S4E among clinicians (n = 6) and youth (n = 20) in an urban youth-centered community health clinic. S4E aimed to improve clinician-youth risk communication and youths' drug use and STI/HIV knowledge, self-efficacy, and refusal skills. We also explored youths' uptake of STI and HIV testing. Quantitative data were analyzed by computing mean scores and proportions, and qualitative analyses followed the tenets of content analysis. RESULTS Among eligible participants, 86.9% of youth and 85.7% of clinicians enrolled in the study, suggesting the feasibility of recruiting participants from the targeted clinic. Most clinicians identified as non-Hispanic white (83%) and female (66.7%). Among the youth, 70% identified as non-Hispanic white, followed by 30% African American, and 50% identified as female with a mean age of 19.6 (SD = 1.5, Range = 16-21). The quantitative findings suggest that the acceptability of S4E is high, as indicated by the Client Satisfaction Questionnaire (mean score = 25.2, SD: 4.8). Immediately post-intervention, all youth who reported past 90-day condomless sex or having never been tested for STIs or HIV in their lifetime, were tested for both STIs and HIV. Qualitative themes revealed four overarching themes, including S4E: (1) faciliated timely, targeted, and tailored prevention and risk reduction strategies; (2) shaped clinician and youth communication and interaction during the clinic visit; (3) may have improved uptake of STI/HIV testing and increased STI/HIV knowledge and self-efficacy; and (4) had high feasibiliy and acceptability among youth and clninicans. CONCLUSIONS Findings suggest the feasibility and acceptability of S4E in an urban community-based health clinic setting. A next important step is to examine the efficacy of S4E in a randomized controlled trial design.
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Affiliation(s)
- David Cordova
- University of Michigan School of Social Work, Ann Arbor, Michigan, United States of America
| | - Frania Mendoza Lua
- University of Chicago School of Social Service Administration, Chicago, Illinois, United States of America
| | - Jaime Muñoz-Velázquez
- University of Michigan School of Social Work, Ann Arbor, Michigan, United States of America
| | - Katie Street
- University of Michigan School of Social Work, Ann Arbor, Michigan, United States of America
| | - Jose A. Bauermeister
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America
| | - Kathryn Fessler
- The Corner Health Center, Ypsilanti, Michigan, United States of America
| | - Nicole Adelman
- The Corner Health Center, Ypsilanti, Michigan, United States of America
| | | | - Torsten B. Neilands
- University of California, San Francisco, California, United States of America
| | - Cherrie B. Boyer
- University of California, San Francisco, California, United States of America
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15
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Blevins CE, Anderson BJ, Caviness CM, Herman DS, Stein MD. Emerging Adults' Discussion of Substance Use and Sexual Behavior with Providers. JOURNAL OF HEALTH COMMUNICATION 2019; 24:121-128. [PMID: 30806172 PMCID: PMC6459691 DOI: 10.1080/10810730.2019.1583700] [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: 06/09/2023]
Abstract
Emerging adulthood (ages 18-25) is a time of increased autonomy and associated with a high rate of risky substance use and sexual behavior. As emerging adults (EA) increasingly have more independence, they have the ability to make health decisions, including whether to see a provider (primary care (PCP) and/or gynecologist (GYN)) and whether to discuss substance use and sexual behavior. The current study aimed to determine: (1) factors associated with PCP and GYN health-care seeking by sexually active EA who use alcohol and/or marijuana; (2) gender differences in substance use and sexual risk topics initiated by providers; (3) whether PCPs compared to GYNs discuss different topics with women. Alcohol and/or marijuana-using, sexually active EA (n = 500) were recruited as part of a health behaviors study. Among participants, 39% did not see a PCP in the previous year. Women, White individuals, and EA with health insurance were most likely to attend a PCP appointment. Even among participants who saw a provider, many participants reported that providers did not initiate a discussion about substance use (approximately half discussed substance use) and sexual behavior (about half discussed STI history, two-thirds discussed condom use, and three-quarters discussed sexual partners). Among women with a PCP and GYN provider, discussions on substance use were more likely to be initiated by a PCP while sexual issues were more likely to be initiated by a GYN. Thus, even among sexually active, substance-using EA, central topics - specifically substance use and sexual behavior - are not routinely brought up by providers.
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Affiliation(s)
- Claire E Blevins
- a Alpert Medical School of Brown University , Butler Hospital , Providence , RI , USA
| | - Bradley J Anderson
- b Behavioral Medicine and Addictions Research Lab , Butler Hospital , Providence , RI , USA
| | - Celeste M Caviness
- b Behavioral Medicine and Addictions Research Lab , Butler Hospital , Providence , RI , USA
| | - Debra S Herman
- a Alpert Medical School of Brown University , Butler Hospital , Providence , RI , USA
| | - Michael D Stein
- c Boston University School of Public Health , Butler Hospital , Boston , MA , USA
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16
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Johnson KE, Salas-Wright CP, Córdova D, Ugalde J, Todic J, Mendoza Lua F. The Acceptability of Biobehavioral Research With Latino Youth in the United States. JOURNAL OF ADOLESCENT RESEARCH 2018. [DOI: 10.1177/0743558418765397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, we explored Latinx adolescents’ knowledge and perceptions of biobehavioral research and their willingness to participate in such studies. We conducted four focus groups in the summer of 2014 with Latinx adolescents in Texas between the ages of 12 and 17 years ( n = 17; 53% male; M age = 14.6 years [ SD = 1.66]) who were recruited from a community-based clinic. Five themes emerged from our content analysis: (a) protection of human subjects is important to participants, (b) comfort with providing different types of biological data varies depending on different factors, (c) engagement in biobehavioral research should be grounded in a cultural lens, (d) providing bilingual research staff is essential, and (e) adolescents have various motivations for participating. Findings highlighted how various factors could serve as both barriers and facilitators to participation. Our study provides insight into strategies for conducting biobehavioral research with Latinxs, who are the fastest growing group of adolescents in the United States and experience disparities in health-risk behaviors that can be better understood through research approaches that integrate biological and psychological measures. Without considering the perspectives of historically marginalized or understudied populations, we jeopardize the quality and validity of research findings, and risk harming participants.
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Affiliation(s)
| | | | | | - Jenny Ugalde
- Northwest Center Against Sexual Assault, Arlington Heights, IL, USA
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17
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Córdova D, Mendoza Lua F, Ovadje L, Hong E, Castillo B, Salas-Wright CP. Randomized Controlled Trials of Technology-Based HIV/STI and Drug Abuse Preventive Interventions for African American and Hispanic Youth: Systematic Review. JMIR Public Health Surveill 2017; 3:e96. [PMID: 29237577 PMCID: PMC5745352 DOI: 10.2196/publichealth.7129] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 10/12/2017] [Accepted: 10/30/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND HIV/sexually transmitted infections (STIs) and drug abuse remain significant public health concerns in the United States, and African American and Hispanic youth are disproportionately affected. Although technology-based interventions are efficacious in preventing and reducing HIV/STI and licit/illicit drug use behaviors, relatively little is known regarding the state of the science of these interventions among African American and Hispanic youth. OBJECTIVE The aim of this review is to identify and examine randomized controlled trials (RCTs) of technology-based HIV/STI and/or drug abuse preventive interventions for African American and Hispanic youth. METHODS We searched electronic databases (ie, PubMed, Proquest, PsycINFO, Ebscohost, Google Scholar) to identify studies between January 2006 and October 2016. RCTs of technology-based interventions targeting African American and Hispanic youth HIV/STI risk behaviors, including sexual risk, licit and illicit drug use, and HIV/STI testing were included. RESULTS Our search revealed a total of three studies that used an RCT design and included samples comprised of >50% African American and/or Hispanic youth. The follow-up assessments ranged from two weeks to six months and the number of participants in each trial ranged from 72 to 141. The three interventions were theory-driven, interactive, and tailored. The long-term effects of the interventions were mixed, and outcomes included reductions in sex partners, licit drug use, and condomless anal sex acts. CONCLUSIONS Although technology-based interventions seem promising in the prevention of HIV/STI and drug abuse among African American and Hispanic youth, more research is needed.
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Affiliation(s)
- David Córdova
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Frania Mendoza Lua
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Lauretta Ovadje
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Ethan Hong
- College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, United States
| | - Berenice Castillo
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
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