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Johnson R, Conley C, Jeter E, Randolph SD. PrEP-aring stylists: Development of a stylist educational workshop to increase PrEP awareness and knowledge among Black women in the US south . Public Health Nurs 2024; 41:57-66. [PMID: 37720933 DOI: 10.1111/phn.13253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/20/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Black cis-gender women are disparately affected by HIV and require prioritization in prevention efforts, including pre-exposure prophylaxis (PrEP). Preparing trusted community leaders such as salon stylists as health-based opinion leaders may be promising to increasing awareness, knowledge, and uptake of PrEP among Black women. We sought to develop training and better understand stylists who may participate in a salon-based PrEP intervention for Black women. METHODS A community-research partnership designed a stylist training workshop for stylists with a majority Black women clientele. A two-session workshop focused on HIV knowledge, HIV prevention including PrEP, and the role of an opinion leader to influence community social and health norms. An exploratory research design and analysis was conducted to examine stylists and provide training feedback. CONCLUSIONS Stylists showed a high level of knowledge and willingness to serve as an opinion leader in their salons and with their communities. Stylists also verified medical mistrust in the healthcare system that makes community-based interventions attractive. This article discusses how the training was piloted and accepted by stylists.
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Affiliation(s)
- Ragan Johnson
- Division of Health in Adult Populations, Duke University School of Nursing, Durham, North Carolina, USA
| | - Cherie Conley
- Department of Systems, Population, and Leadership, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth Jeter
- Division of Health in Adult Populations, Duke University School of Nursing, Durham, North Carolina, USA
| | - Schenita D Randolph
- Division of Health in Adult Populations, Duke University School of Nursing, Durham, North Carolina, USA
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Arnold T, Whiteley L, Elwy RA, Ward LM, Konkle-Parker DJ, Brock JB, Giorlando KK, Barnett AP, Sims-Gomillia C, Craker LK, Lockwood KR, Leigland A, Brown LK. Mapping Implementation Science with Expert Recommendations for Implementing Change (MIS-ERIC): Strategies to Improve PrEP Use among Black Cisgender Women Living in Mississippi. J Racial Ethn Health Disparities 2023; 10:2744-2761. [PMID: 36396922 PMCID: PMC9672575 DOI: 10.1007/s40615-022-01452-x] [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] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Black women are disproportionately affected by the HIV epidemic. Strategies to increase Black women's use of pre-exposure prophylaxis (PrEP) are needed. METHODS Interviews were conducted in Mississippi (MS) with Black, cisgender women at risk for HIV, and community healthcare clinic (CHC) staff who work directly with this population. Reflexive thematic analysis was used to identify barriers and select appropriate implementation strategies to increase PrEP care. RESULTS Twenty Black women and twelve CHC staff were interviewed. PrEP use barriers resulted from low HIV risk awareness, lack of PrEP knowledge, and structural and stigma-related barriers. Methods for PrEP education and motivation included normalizing PrEP in public communications, providing education at places where women congregate, and tailoring PrEP content with Black women as educators. The Expert Recommendations for Implementing Change (ERIC) project provides a way for implementation scientists to select strategies that are consistent within research and practice across studies. Strategies from the ERIC project were selected to address implementation barriers. CONCLUSIONS Tailoring PrEP implementation protocols to increase Black women's access, engagement, and adherence to PrEP is needed. This is one of the first implementation studies to incorporate these four implementation concepts into a single study: (1) implementation outcomes, (2) i-PARIHS, (3) ERIC's strategy list, and (4) operationalizing the strategies using the Proctor et al., guidelines. Results provide an in-depth comprehensive list of implementation strategies to increase PrEP uptake for Black women in MS.
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Affiliation(s)
- Trisha Arnold
- Brown University Warren Alpert Medical School, Providence, RI, USA.
- Department of Psychiatry, Rhode Island Hospital, Providence, USA.
| | - Laura Whiteley
- Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Rani A Elwy
- Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Lori M Ward
- Departments of Nursing, Medicine, and Population Health Sciences, University of Mississippi Medical Center, Jackson, USA
| | - Deborah J Konkle-Parker
- Departments of Nursing, Medicine, and Population Health Sciences, University of Mississippi Medical Center, Jackson, USA
| | - James B Brock
- Departments of Nursing, Medicine, and Population Health Sciences, University of Mississippi Medical Center, Jackson, USA
| | | | - Andrew P Barnett
- Brown University Warren Alpert Medical School, Providence, RI, USA
- Department of Psychiatry, Rhode Island Hospital, Providence, USA
| | - Courtney Sims-Gomillia
- Departments of Nursing, Medicine, and Population Health Sciences, University of Mississippi Medical Center, Jackson, USA
| | - Lacey K Craker
- Division of Prevention Science and Community Health, University of Miami, Miami, USA
| | - Khadijra R Lockwood
- Departments of Nursing, Medicine, and Population Health Sciences, University of Mississippi Medical Center, Jackson, USA
| | - Avery Leigland
- Department of Psychiatry, Rhode Island Hospital, Providence, USA
| | - Larry K Brown
- Brown University Warren Alpert Medical School, Providence, RI, USA
- Department of Psychiatry, Rhode Island Hospital, Providence, USA
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Randolph SD, Johnson R, Jeter E, McGee K, Johnson A. UPDOs Protective Styles, a Multilevel Intervention to Improve Pre-exposure Prophylaxis Uptake Among Black Cisgender Women: Pretest-Posttest Evaluation. J Assoc Nurses AIDS Care 2023; 34:459-468. [PMID: 37651624 DOI: 10.1097/jnc.0000000000000424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
ABSTRACT In the United States, Black cisgender women account for one in five new HIV infections with Black Americans, accounting for 57% of new diagnoses in the South. Pre-exposure prophylaxis (PrEP) is 99% effective at preventing HIV. Still, Black women's uptake remains at 2% due to multiple documented barriers, including lack of awareness and knowledge, mistrust, stigma, and low perceived risk. Culturally relevant interventions leveraging trusted venues, such as beauty salons, can overcome these barriers. This article reports preliminary results of an intervention to improve PrEP knowledge and awareness, PrEP stigma, PrEP trust, and uptake among Black cisgender women. This multilevel, mixed-methods study used a community-engagement approach to develop and pilot a salon-based intervention, Using PrEP and Doing it for Ourselves (UPDOs) Protective Styles. The intervention improved knowledge, awareness, and trust around PrEP among Black cisgender women. PrEP use stigma within interpersonal relationships decreased, but low perceived risk and social stigma remained constant. Culturally and socially acceptable interventions like UPDOs Protective Styles can model health care delivery to improve trust, thus improving uptake over time for this population.
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Affiliation(s)
- Schenita D Randolph
- Schenita D. Randolph, PhD, MPH, RN, FAAN, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA. Ragan Johnson, DNP, FNP-BC, CNE, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA. Elizabeth Jeter, PhD, is a Research Associate, Duke University School of Nursing, Durham, North Carolina, USA. Kara McGee, DMS, MSPH, PA-C, AAHIVS, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA. Allison Johnson is a Clinical Research Coordinator, Duke University School of Nursing, Durham, North Carolina, USA
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Morehead-Gee A, Üsküp DK, Omokaro U, Shoptaw S, Harawa NT, Heilemann MV. Relating 'to her Human Side': a Grounded Theory analysis of cosmetologists' and aestheticians' relationships with clients in Black American beauty salons to inform sexual health interventions. CULTURE, HEALTH & SEXUALITY 2023; 25:1180-1197. [PMID: 36377185 PMCID: PMC10183050 DOI: 10.1080/13691058.2022.2141331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/25/2022] [Indexed: 05/15/2023]
Abstract
Due to the elevated incidence of HIV among Black American women, effective sexual health interventions are needed. To explore beauty salons as settings for such interventions, we examined Black American women stylists' experiences discussing sex-related topics with Black American women clients. Constructivist Grounded Theory methodology guided data collection and analysis. Individual intensive interviews were conducted in 2019 with 16 Black women cosmetologists and/or aestheticians who served Black women in Southern California. Analyses generated grounded theory which we refer to as Relating 'to her Human Side': Black American cosmetologist-client relationship building model. The model highlights the importance of three sets of practices: 1) playing different roles to appeal to clients' varying wants and needs, 2) creating a comfortable atmosphere, and 3) establishing a judgement-free zone. Stylists put clients at ease and consequently, clients shared stories regarding sex and relationships freely. Stylists' actions built trusting relationships with clients, thus crafting beauty salons as atmospheres favourable for sex-related conversations and potential sexual health interventions.
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Affiliation(s)
- Alicia Morehead-Gee
- National Clinician Scholars Program, University of California (UCLA), Los Angeles, CA, USA
- Department of Internal Medicine, Charles Drew University, Los Angeles, CA, USA
- Institute for Health Equity, AltaMed Health Services, Los Angeles, CA, USA
| | - Dilara K Üsküp
- Department of Internal Medicine, Charles Drew University, Los Angeles, CA, USA
- Center for HIV Identification, Prevention, and Treatment Services, University of California (UCLA), Los Angeles, CA, USA
| | - Uwaila Omokaro
- Center for HIV Identification, Prevention, and Treatment Services, University of California (UCLA), Los Angeles, CA, USA
| | - Steve Shoptaw
- Center for HIV Identification, Prevention, and Treatment Services, University of California (UCLA), Los Angeles, CA, USA
- Department of Family Medicine, David Geffen School of Medicine, University of California (UCLA), Los Angeles, CA, USA
| | - Nina T Harawa
- Department of Internal Medicine, Charles Drew University, Los Angeles, CA, USA
- Center for HIV Identification, Prevention, and Treatment Services, University of California (UCLA), Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, University of California (UCLA), Los Angeles, CA, USA
| | - MarySue V Heilemann
- National Clinician Scholars Program, University of California (UCLA), Los Angeles, CA, USA
- School of Nursing, University of California (UCLA), Los Angeles, CA, USA
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Dixon A, Earls E, Handberry M, Moon B, Smith L, Mincey K. Using Nail Salons, Beauty Spas, and Hair Salons for Health Education with Black Women. JOURNAL OF AFRICAN AMERICAN STUDIES (NEW BRUNSWICK, N.J.) 2023; 27:1-5. [PMID: 37361611 PMCID: PMC10186277 DOI: 10.1007/s12111-023-09626-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 06/28/2023]
Abstract
A historical lack of access to healthcare and the mistreatment of Black women among those in the medical field have contributed to the health disparities against this group today. Based on existing health disparities affecting Black women, this study examined the feasibility of using nail salons, beauty salons, and hair salons as an avenue for health education efforts for Black women. An online survey was used to reach Black-owned salon workers. A total of 20 female participants completed the survey. Most participants preferred sharing health information with their clients through one-on-one conversations. Eighty percent of participants were willing to receive training on health topics so they could educate their clients. Findings suggest that it is feasible to utilize beauty stylists as lay health workers to promote positive health education among Black women. Further studies are needed to address health topics that clients would be willing to discuss with their stylists.
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Affiliation(s)
- Ashlee Dixon
- Department of Community Medicine, Mercer University School of Medicine, 1550 College Street, Macon, GA 31207 USA
| | - Eldria Earls
- Department of Public Health, Mercer University, 3001 Mercer University Drive, Atlanta, GA 30341 USA
| | - Maya Handberry
- Department of Community Medicine, Mercer University School of Medicine, 1550 College Street, Macon, GA 31207 USA
| | - Brianna Moon
- Department of Community Medicine, Mercer University School of Medicine, 1550 College Street, Macon, GA 31207 USA
| | - Lindsay Smith
- Department of Community Medicine, Mercer University School of Medicine, 1550 College Street, Macon, GA 31207 USA
| | - Krista Mincey
- Department of Community Medicine, Mercer University School of Medicine, 1550 College Street, Macon, GA 31207 USA
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Randolph SD, Johnson R, Johnson A, Keusch L. Using PrEP and Doing it for Ourselves (UPDOs Protective Styles), a Web-Based Salon Intervention to Improve Uptake of Pre-exposure Prophylaxis Among Black Women: Protocol for a Pilot Feasibility Study. JMIR Res Protoc 2022; 11:e34556. [PMID: 36040785 PMCID: PMC9472057 DOI: 10.2196/34556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/06/2022] [Accepted: 06/30/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Multilevel interventions are necessary to address the complex social contributors to health that limit pre-exposure prophylaxis use among Black women, including medical distrust, pre-exposure prophylaxis stigma, and access to equitable health care. Strategies to improve knowledge, awareness, and uptake of pre-exposure prophylaxis among Black women will be more successful if information-sharing and implementation take place within trusted environments. Providing women with information through trusted cultural and social channels can effectively support informed decision-making about pre-exposure prophylaxis for themselves and members of their social networks who are eligible for pre-exposure prophylaxis. OBJECTIVE The goal of this project is to improve knowledge, awareness, uptake, and trust of pre-exposure prophylaxis, as well as reduce pre-exposure prophylaxis stigma, among Black women living in the US South. METHODS This multilevel, mixed methods study uses a community-engagement approach to develop and pilot test a salon-based intervention. There are three components of this intervention: (1) stylist training, (2) women-focused entertainment videos and modules, and (3) engagement of a pre-exposure prophylaxis navigator. First, stylist training will be provided through two 2-hour training sessions delivered over 2 consecutive weeks. We will use a pre- and posttest design to examine knowledge and awareness improvement of pre-exposure prophylaxis among the stylists. Upon full completion of training, the stylists will receive a certificate of completion and "Ask Me about PrEP" signage for their beauty salons. Second, together with the community, we have codeveloped a 4-part entertainment series (The Wright Place) that uses culturally and socially relevant stories to highlight key messages about (1) HIV, (2) pre-exposure prophylaxis, and (3) Black women's social contributors to health. Quantitative and qualitative measures will be used in a pre- and posttest design to examine pre-exposure prophylaxis knowledge, awareness, risk, stigma, trust, intentions, and women's perceptions of the usability and acceptability of the overall intervention and its implementation strategies. A video blog will be provided after each video. Third, participants will have access through an email or text message link to a pre-exposure prophylaxis navigator, who will respond to them privately to answer questions or make referrals for pre-exposure prophylaxis as requested. RESULTS This project was funded in October 2020 by Gilead Sciences and was approved by the Duke University School of Nursing institutional review board in April 2021 (Pro00106307). Intervention components were developed in partnership with community partners in the first year. Data collection for phase 1 began in April 2022. Data collection for phase 2 began in May 2022. The study will be complete by October 2022. CONCLUSIONS Multilevel interventions that consider the assets of the community have promise for promoting health among Black women who have influence within their social networks. The findings of this study have the potential to be generalizable to other populations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/34556.
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Affiliation(s)
- Schenita D Randolph
- Duke University School of Nursing, Duke University, Durham, NC, United States
| | - Ragan Johnson
- Duke University School of Nursing, Duke University, Durham, NC, United States
| | - Allison Johnson
- Duke University School of Nursing, Duke University, Durham, NC, United States
| | - Lana Keusch
- Duke University School of Nursing, Duke University, Durham, NC, United States
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