Applying the PEN-3 Cultural Model to Address HIV/AIDS Prevention in Rural Guatemala

Acceptability, Suitability, and Feasibility of an Evidence-Based Intervention to Reduce HIV Risk Behaviors: Engaging Comadronas in HIV Prevention in Rural Guatemala

This study addresses rural Guatemala's poor maternal health and HIV status by culturally adapting an evidence-based HIV intervention, SEPA (Self-Care, Education, Prevention, Self-Care), to extend the capacity of comadronas (Mayan birth attendants) as HIV prevention providers. This mixed-method study examined the acceptability, suitability, and feasibility of SEPA presented to traditional elder and a younger cohort of comadronas over three sessions. Outcome variables were reported as mean scores. Open-ended qualitative responses were categorized under central themes. Session 1, 2, and 3 acceptability (4.6/5, 4.6/5, 4.8/5), suitability (4.7/5, 4.6/5, 4.9/5), and feasibility (4.4/5, 4.7/5, 4.8/5) remained high across sessions. While comadronas reported that information was difficult, they reported high levels of understanding and comfort with SEPA content and they also found it to be culturally appropriate, increasing their confidence to discuss HIV with their community. The broader utilization of comadronas could create a pathway to enhance reproductive health among indigenous women.

Ethnic Minorities' Perceptions of COVID-19 Vaccines and Challenges in the Pandemic: A Qualitative Study to Inform COVID-19 Prevention Interventions

To inform health communication campaigns for COVID-19 prevention and vaccine promotion among racial and ethnic minorities facing disparities, we conducted formative research by interviewing Hispanic/Latino American (Latino), Black/African American (AA), and American Indian/Alaska Native (AI/AN) participants to explore their challenges during the pandemic, the barriers and facilitators to receiving COVID-19 vaccines, acceptability of using chatbots to deliver COVID-19 and vaccine information, and preferred features and suggestions for culturally tailored prevention messages. Positive perceptions of the COVID-19 vaccine were mainly derived from beliefs that the vaccine can protect oneself and families from getting infected and help stop the pandemic. Negative perceptions of the COVID-19 vaccine were driven by concerns about vaccine safety due to the rapid development process and side effects. Latino participants would like to know more information about the vaccine and evidence of its effectiveness. AA participants identified seeing others, especially government officials, get the vaccine first as a facilitator and low trust in the government and healthcare system as barriers to getting the COVID-19 vaccine. AI/AN participants emphasized the importance of equitable access to the vaccine. Participants preferred messages with the following features: informative and evidence-based messages about COVID-19 and vaccination, encouraging and motivational messages that focused on the hope to end the pandemic and return to normal, prosocial messages, and clear instructions for COVID-19 prevention strategies. Participants also suggested that messages should include different cultural practices, be translated into their native languages, and emphasize care for family members.

The Impact of Preventive Interventions on Intimate Partner Violence among Pregnant Women Resident in Hamadan City Slum Areas Using the PEN-3 Model: Control Randomized Trial Study

BACKGROUND

Intimate partner violence is a severe life-threatening criminal and public health problem affecting the well-being of individuals, families, and society. Planning interventions to reduce the burden of this persistent and criminal violence should be relevant culturally and socially.

METHODS

In this randomized control trial, 150 pregnant women residing in slum areas of Hamadan were randomly assigned to two groups (intervention group: n=50 and control group: n=100). Interventional strategies included educating the victims based on local cultural norms, culturally sensitive individual and group counseling, and educating health care providers. Data were collected via face-to-face interviews at baseline and again at 3 months after the intervention. We used a paired t-test to evaluate the effect of the intervention by comparing changes in the outcomes measured.

RESULTS

There were no statistically significant differences between the two groups at baseline in terms of sociodemographic characteristics. Post-test scores of knowledge (7.50±2.65 vs. 5.14±3.51, P=0.001), communication skills (18.38±4.25 vs. 16.2±3.83, P=0.04), and family support and social expectation of obedience (15.79±4.45 vs. 13.40±4.57, P=0.005) of the victims were statistically significantly higher in the experimental group compared to the control group. Moreover, physical (0.74±2.28 vs. 1.20±2.60, P=0.06), psychological (2.80±4.10 vs. 4.52±5.43, P=0.06), and sexual (0.11±0.58 vs. 0.61±1.22, P=0.04) violence reduced in the experimental group compared to the control group.

CONCLUSION

Culturally relevant interventions can reduce intimate partner violence.

The effect of education based on PEN-3 cultural model on students' menstrual health behaviors: a mixed method study

Menstruation is a natural process in girls, but sometimes it is accompanied by beliefs and behaviors with cultural roots that result in poor health consequences; this study aimed to consider perceptions of individual, families and community to current cultural beliefs, and to determine the effect of education based on the PEN-3 cultural model on students' menstrual health behaviors in Iran. Study had a mixed method design. In the qualitative phase, data were collected from students, their mothers and teachers through focused group discussion and in-depth interviews. In the quantitative phase, training was done in four 2-h sessions for intervention group. The data were collected immediately and 2 months after the training by a questionnaire and they were analyzed by Friedman and Wilcoxon non-parametric tests. Training was effective on all of the model structures and significantly increased mean score of the health behavior after training and 2 months later by 8.74 and 13.86, respectively, in intervention group (P<0.05). The perception and behavior of the others and access to sanitary services and products, especially cultural factors affect girls'' menstrual health behaviors, therefore, it is necessary to design the health plans regarding each of these factors, and the cultural context of each community.

Engaging the capacity of comadronas as HIV prevention providers in rural Guatemala

In this study the author address rural Guatemala's poor maternal health and HIV status by integrating an effective evidence-based HIV intervention (SEPA), with local implementing health partners to extend the capacity of comadronas (traditional Mayan birth attendants) to encompass HIV prevention. I employed a multi-method design consisting of a focus group, an interview, and participant observation to identify important factors surrounding comadrona receptivity towards expanding their capacity to HIV prevention. I analyzed data using thematic analysis and identified four categories: Project logistics, HIV knowledge and risk assessment, condom perceptions, and HIV testing perceptions. I affirm comadrona receptivity toward HIV prevention, and that will guide future cultural adaptation and tailoring of SEPA for comadrona training. I will use my results to create a prototype intervention that could be applied to other similarly underserved indigenous communities.