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Griffith DM. Antiracism and Health Equity Science: Overcoming Scientific Obstacles to Health Equity. Public Health Rep 2024; 139:288-293. [PMID: 38504480 PMCID: PMC11037222 DOI: 10.1177/00333549241236089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Affiliation(s)
- Derek M. Griffith
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
- Racial Justice Institute, Georgetown University, Washington, DC, USA
- Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC, USA
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Dale SK, Etienne K, Hall S, Lazarus K, Nunnally K, Gibson G, Bolden R, Gardner N, Sanders J, Reid R, Phillips A. Five point initiative: a community-informed bundled implementation strategy to address HIV in Black communities. BMC Public Health 2023; 23:1625. [PMID: 37626315 PMCID: PMC10463742 DOI: 10.1186/s12889-023-16525-7] [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: 05/19/2022] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Black individuals in the U.S. remain the most disproportionately impacted by new HIV diagnoses, represent the highest portion of individuals living with HIV, and have the highest morbidity rates. Structural inequities and historical oppression are the primary drivers. Such drivers limit access to HIV prevention tools that need to be delivered with culturally congruent and community-informed approaches. METHODS The Five Point Initiative (FPI) is a community-informed bundled implementation strategy developed and piloted between September 2019 and March 2020 in Miami, Florida in communities heavily impacted by HIV. Key components of the strategy included community consultants/experts, five categories (hence the "Five Point") of community businesses (e.g., corner stores, beauty supply stores, laundromats, mechanics, barbershops), local health organizations, an academic research program engrossed in community engaged research, and community residents who provided ongoing feedback throughout. Outcomes of FPI included (a) survey information (e.g., knowledge of and access to PrEP, barriers to care) and pilot data (acceptability and feasibility), (b) expansion of reach to Black individuals in HIV high impact zip codes in Miami, (c) insights on our bundled implementation strategy, (d) condom distribution, and (e) HIV testing. RESULTS Over the course of six months FPI carried out 10 outreach events, partnered with 13 community businesses and 5 health organizations, engaged 677 community residents, collected health information via a survey, distributed 12,434 condoms, provided information on PrEP, and offered voluntary HIV testing (131 completed). FPI's ability to reach residents who are not being reached (e.g., 68.8% never heard of PrEP, 8% no HIV testing ever, 65.9% no primary care provider), positive feedback from residents (e.g., 70% very satisfied, 21% satisfied; 62% strongly agree and 25% agree they would participate again) and qualitative interviews with businesses provide evidence of acceptability and feasibility. Further, survey data provided insights on factors such as socio-demographics, discrimination experiences, barriers to care, social-structural factors, physical and sexual health, and mental health and substance use. CONCLUSIONS The FPI bundled implementation strategy shows promise to deliver health prevention/intervention for HIV and other health conditions to communities facing health inequities and for whom the current system for delivering care is insufficient.
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Affiliation(s)
- Sannisha K Dale
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA.
| | - Kayla Etienne
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Sidny Hall
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
- New College of Florida, Sarasota, FL, USA
| | - Kimberly Lazarus
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | | | | | - Roxana Bolden
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
- A Sister with A Testimony, Miami, FL, USA
| | - Nadine Gardner
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Jasmyn Sanders
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Rachelle Reid
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Arnetta Phillips
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
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Abad N, Messinger SD, Huang Q, Hendrich MA, Johanson N, Fisun H, Lewis Z, Wilhelm E, Baack B, Bonner KE, Kobau R, Brewer NT. A qualitative study of behavioral and social drivers of COVID-19 vaccine confidence and uptake among unvaccinated Americans in the US April-May 2021. PLoS One 2023; 18:e0281497. [PMID: 36763680 PMCID: PMC9917274 DOI: 10.1371/journal.pone.0281497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 01/24/2023] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION Around one-third of Americans reported they were unwilling to get a COVID-19 vaccine in April 2021. This focus group study aimed to provide insights on the factors contributing to unvaccinated adults' hesitancy or refusal to get vaccinated with COVID-19 vaccines. METHOD Ipsos recruited 59 unvaccinated US adults who were vaccine hesitant (i.e., conflicted about or opposed to receiving a COVID-19 vaccination) using the Ipsos KnowledgePanel. Trained facilitators led a total of 10 focus groups via video-conference in March and April 2021. Two coders manually coded the data from each group using a coding frame based on the focus group discussion guide. The coding team collaborated in analyzing the data for key themes. RESULTS Data analysis of transcripts from the focus groups illuminated four main themes associated with COVID-19 vaccine hesitancy: lack of trust in experts and institutions; concern about the safety of COVID-19 vaccines; resistance towards prescriptive guidance and restrictions; and, despite personal reluctance or unwillingness to get vaccinated, acceptance of others getting vaccinated. DISCUSSION Vaccine confidence communication strategies should address individual concerns, describe the benefits of COVID-19 vaccination, and highlight evolving science using factural and neutral presentations of information to foster trust.
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Affiliation(s)
- Neetu Abad
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | | | - Qian Huang
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | | | - Nataly Johanson
- Ipsos US Public Affairs, Washington, DC, United States of America
| | - Helen Fisun
- Ipsos US Public Affairs, Washington, DC, United States of America
| | - Zachary Lewis
- Ipsos US Public Affairs, Washington, DC, United States of America
| | - Elisabeth Wilhelm
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Brittney Baack
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Kimberly E. Bonner
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Rosemarie Kobau
- US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Noel T. Brewer
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States of America
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McCuistian C, Peteet B, Burlew K, Jacquez F. Sexual Health Interventions for Racial/Ethnic Minorities Using Community-Based Participatory Research: A Systematic Review. HEALTH EDUCATION & BEHAVIOR 2023; 50:107-120. [PMID: 33870765 PMCID: PMC9004606 DOI: 10.1177/10901981211008378] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Racial/ethnic minorities (REMs) continue to carry the burden of sexual health disparities in the United States, including increased health risks and lower proportions of preventative care. Community-based participatory research (CBPR) has been useful in developing interventions aimed at reducing these disparities. Specifically, partnership with the target group members has resulted in more culturally relevant intervention strategies. AIM The purpose of this systematic review was to analyze the existing research on sexual health interventions targeting U.S. REMs that were developed using CBPR, to highlight the role target group members played in the development of these interventions, and to explore the benefits and outcomes of these partnerships. METHOD Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guided the search of 46 thesauri terms for CBPR, sexual health, and REMs across six databases. RESULTS The initial search yielded 805 identified studies. After applying limiters, reviewing abstracts, and doing a full-text review, 24 appropriate studies were retained. The key findings indicated significant intervention outcomes such as increased health knowledge, attitude change, and behavioral intention that could reduce sexual risk-taking behaviors. Twelve studies detailed the methods for partnering with target group members to formulate interventions, highlighting the benefits related to recruitment, retention, and cultural relevance. DISCUSSION CBPR is well-positioned to address sexual health disparities among REMs. While community partnership strategies vary, the findings yield evidence that CBPR addressing sexual health disparities is achievable, can influence the effectiveness of interventions, and should be considered as an orientation in future sexual health research.
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Pichon LC, Jewell EN, Williams Stubbs A, Jones D, Campbell B, Kimble KM, Stewart GM, Hurd-Sawyer L, Carroll L, Powell TW. An Engaged Community of Faith to Decrease HIV Stigma in the U.S. South. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2100. [PMID: 36767467 PMCID: PMC9915988 DOI: 10.3390/ijerph20032100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Community members from a city in the U.S. Deep South identified root causes of HIV racial disparities, including stigma. This meeting report describes how we developed and implemented a conference series to address HIV stigma. We used community feedback and bidirectional learning to host two meetings in observance of National HIV Testing Day (June 2021) and National Southern HIV/AIDS Awareness Day (August 2021). We established a 10-member organizing committee workgroup that met monthly to plan the Faith Summit in honor of National Black HIV Awareness Day (February 2022). Lessons learned include (a) the effectiveness of different community engagement strategies, including participatory evaluative approaches, and (b) strategies to maintain engagement and increase participation, such as reliance on personal and professional networks and prompting the community about forthcoming interventions. Sustaining a conference series to end HIV stigma requires commitment and inclusive participation. This collaborative project offers additional evidence that faith communities can be a part of the solution to ending the HIV epidemic and related health disparities.
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Affiliation(s)
- Latrice C. Pichon
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | - Erin N. Jewell
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | - Andrea Williams Stubbs
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | | | | | | | | | | | - Lacretia Carroll
- University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Terrinieka W. Powell
- Department of Population, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Sanusi A, Elsey H, Golder S, Sanusi O, Oluyase A. Cardiovascular health promotion: A systematic review involving effectiveness of faith-based institutions in facilitating maintenance of normal blood pressure. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001496. [PMID: 36962921 PMCID: PMC10022319 DOI: 10.1371/journal.pgph.0001496] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/17/2022] [Indexed: 01/21/2023]
Abstract
Globally, faith institutions have a range of beneficial social utility, but a lack of understanding remains regarding their role in cardiovascular health promotion, particularly for hypertension. Our objective was assessment of modalities, mechanisms and effectiveness of hypertension health promotion and education delivered through faith institutions. A result-based convergent mixed methods review was conducted with 24 databases including MEDLINE, Embase and grey literature sources searched on 30 March 2021, results independently screened by three researchers, and data extracted based on behaviour change theories. Quality assessment tools were selected by study design, from Cochrane risk of bias, ROBINS I and E, and The Joanna Briggs Institute's Qualitative Assessment and Review Instrument tools. Twenty-four publications contributed data. Faith institution roles include cardiovascular health/disease teaching with direct lifestyle linking, and teaching/ encouragement of personal psychological control. Also included were facilitation of: exercise/physical activity as part of normal lifestyle, nutrition change for cardiovascular health, cardiovascular health measurements, and opportunistic blood pressure checks. These demand relationships of trust with local leadership, contextualisation to local sociocultural realities, volitional participation but prior consent by faith / community leaders. Limited evidence for effectiveness: significant mean SBP reduction of 2.98 mmHg (95%CI -4.39 to -1.57), non-significant mean DBP increase of 0.14 mmHg (95%CI -2.74 to +3.01) three months after interventions; and significant mean SBP reduction of 0.65 mmHg (95%CI -0.91 to -0.39), non-significant mean DBP reduction of 0.53 mmHg (95%CI -1.86 to 0.80) twelve months after interventions. Body weight, waist circumference and multiple outcomes beneficially reduced for cardiovascular health: significant mean weight reduction 0.83kg (95% CI -1.19 to -0.46), and non-significant mean waist circumference reduction 1.48cm (95% CI -3.96 to +1.00). In addressing the global hypertension epidemic the cardiovascular health promotion roles of faith institutions probably hold unrealised potential. Deliberate cultural awareness, intervention contextualisation, immersive involvement of faith leaders and alignment with religious practice characterise their deployment as healthcare assets.
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Affiliation(s)
- Abayomi Sanusi
- Department of Health Sciences, University of York, York, United Kingdom
| | - Helen Elsey
- Department of Health Sciences, University of York, York, United Kingdom
| | - Su Golder
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Adejoke Oluyase
- Cicely Saunders Institute of Palliative Care & Rehabilitation, King's College London, London, United Kingdom
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Shannon C, Dwyre C, Grafton K. Faith Community Nurses Key to Promoting Health in At-Risk Communities: An Integrative Review. J Christ Nurs 2022; 39:228-235. [PMID: 36048595 DOI: 10.1097/cnj.0000000000001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT An integrative literature review was conducted to identify recommendations to implement culturally congruent and spiritually connected approaches to health promotion in at-risk faith communities. Five themes emerged from an analysis of 48 articles meeting criteria for the review. Review results repeatedly highlighted the impact nurses-more specifically faith community nurses (FCNs)-can have on at-risk population outcomes and bridging the gap between minority communities and the healthcare establishment. Five recommended action steps provide program guidance to FCNs for promoting faith-based health in at-risk minority communities.
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Rapid Implementation of a Community-Academic Partnership Model to Promote COVID-19 Vaccine Equity within Racially and Ethnically Minoritized Communities. Vaccines (Basel) 2022; 10:vaccines10081364. [PMID: 36016251 PMCID: PMC9415044 DOI: 10.3390/vaccines10081364] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has highlighted inequities in mortalities and associated illnesses among non-Hispanic Black and Hispanic/Latino individuals. Immunization against COVID-19 is critical to ending the pandemic, especially within racial and ethnically minoritized communities. However, vaccine hesitancy and institutional mistrust in these communities, resulting from decades of mistreatment, structural racism, and barriers to vaccination access, have translated into low vaccination uptake. Trustworthy relationships with healthcare professionals and partnerships with faith and community leaders are critical to increasing vaccination rates within these minoritized communities. Loma Linda University researchers collaborated with local faith and community organizations in San Bernardino County, CA, to rapidly implement a three-tiered approach to increase the vaccination rates within non-Hispanic Black and Hispanic/Latino communities. This community–academic partnership model provided over 1700 doses of the COVID-19 vaccine within these vaccine-hesitant, targeted minoritized communities. As over 100,000 individuals are diagnosed with COVID-19 daily and updated vaccines targeting variants of the Omicron strain are expected to rollout in the coming months, the development of sustainable programs aimed at increasing vaccine uptake within vulnerable communities are of the utmost importance.
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Husbands W, Kerr J, Calzavara L, Tharao W, Greenspan N, Muchenje-Marisa M, Luyombya H, Nakamwa J, Arnold K, Nakiweewa S, Browne O. Black PRAISE: engaging Black congregations to strengthen critical awareness of HIV affecting Black Canadian communities. Health Promot Int 2021; 36:303-312. [PMID: 32617568 DOI: 10.1093/heapro/daaa057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In Canada, HIV disproportionately affects Black communities. Though Black faith leaders play an influential role engaging Black communities around social care and social justice, their response to HIV has been somewhat muted. Black PRAISE is a novel intervention for Black churches to strengthen congregants' critical awareness of HIV affecting Black communities. A multi-stakeholder team developed and tested the intervention in 2016 - 17 among six churches in the province of Ontario, where more than half of Black Canadians reside, using a community-based participatory approach. Specifically, the intervention aimed to strengthen how congregants understand HIV among Black communities and reduce their level of stigma toward people living with HIV. We addressed critical awareness among the participating congregations through (i) disseminating a booklet with validated information that promoted critical health literacy related to HIV; (ii) enabling pastors to deliver a sermon on love, compassion and social justice; and (iii) developing and screening a short film that featured Black Canadians discussing their experiences of HIV-related stigma. We assessed changes in knowledge and stigma by surveying congregants (N = 173) at baseline and two follow-ups using validated instruments and other measures. Through Black PRAISE, congregants significantly increased their HIV-related knowledge; moreover, exposure to all the intervention components was associated with a significantly reduced level of stigma. A likely strategic outcome of Black PRAISE is that churches are empowered to help strengthen Black people's community-based response to HIV and join efforts to eliminate the structural conditions that increase Black people's vulnerability to HIV.
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Affiliation(s)
- Winston Husbands
- Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON M4T 1X3, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Jelani Kerr
- School of Public Health and Information Sciences, University of Louisville, 485 E. Gray St., Room 209, Louisville, KY 40202, USA
| | - Liviana Calzavara
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Wangari Tharao
- Women's Health in Women's Hands Community Health Centre, 2 Carlton Street, Suite 500, Toronto, ON M5B 1J3, Canada
| | - Nicole Greenspan
- Toronto Public Health, 277 Victoria Street, Toronto, ON M5B 2L6, Canada
| | - Marvelous Muchenje-Marisa
- Women's Health in Women's Hands Community Health Centre, 2 Carlton Street, Suite 500, Toronto, ON M5B 1J3, Canada
| | - Henry Luyombya
- Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON M4T 1X3, Canada
| | - Joanita Nakamwa
- Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON M4T 1X3, Canada
| | - Keresa Arnold
- African and Caribbean Council on HIV/AIDS in Ontario, 20 Victoria Street, 4th Floor, Toronto, ON M5C 2N8, Canada
| | - Susan Nakiweewa
- Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON M4T 1X3, Canada
| | - Orville Browne
- Meritus Medical Centre, Inc., 11116 Medical Campus Road, Suite 2904, Hagerstown, MD 21742, USA
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Senteio CR, Montague KE, Campbell B, Campbell TR, Seigerman S. Enhancing racial equity in LIS research by increasing representation of BIPOC. EDUCATION FOR INFORMATION 2021. [DOI: 10.3233/efi-211530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The escalation of discourse on racial injustice prompts novel ideas to address the persistent lack of racial equity in LIS research. The underrepresentation of BIPOC perspectives contributes to the inequity. Applying the Community Based Participatory Research (CBPR) approach meaningfully engages BIPOC to help guide LIS investigations that identify evolving needs and concerns, such as how systematic racism may contribute to social justice issues like environmental and health inequity. Engaging with BIPOC, using the CBPR approach, can help address racial equity in LIS because it will result in increased racial representation which enables incorporation of the perspectives and priorities of BIPOC. This shift to greater engagement is imperative to respond to escalating attention to social injustice and ensure that these central issues are adequately reflected in LIS research. The discipline is positioned to help detail the drivers and implications of inequity and develop ways to address them. We underscore the importance of working across research disciplines by describing our CBPR experience engaging with BIPOC in LIS research. We highlight the perspectives of community partners who have over two decades of experience with community-based LIS research. We offer lessons learned to LIS researchers by describing the factors that make these initiatives successful and those which contribute to setbacks.
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Affiliation(s)
- Charles R. Senteio
- Rutgers University School of Communication and Information, New Brunswick, New Jersey, USA
| | - Kaitlin E. Montague
- Rutgers University School of Communication and Information, New Brunswick, New Jersey, USA
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Codjoe L, Barber S, Ahuja S, Thornicroft G, Henderson C, Lempp H, N'Danga-Koroma J. Evidence for interventions to promote mental health and reduce stigma in Black faith communities: systematic review. Soc Psychiatry Psychiatr Epidemiol 2021; 56:895-911. [PMID: 33866378 PMCID: PMC8053235 DOI: 10.1007/s00127-021-02068-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 03/10/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE There are significant documented inequalities for the Black community in the UK in relation to mental health care. Research has also indicated that cultural difference exists in pathways into, and engagement with, mental health services. To reduce inequalities and improve engagement with mental health services, it is important that professionals utilise culturally appropriate community networks to increase mental health awareness and reduce stigma. This systematic review considers research in Black faith settings, with two linked aims to review the evidence for the effectiveness of (i) mental health interventions, and (ii) other health stigma interventions as the latter have been implemented in Black faith settings. The review identified 'active ingredients' of interventions for this population that can be applied in future work. The authors seek to draw from the mental health and wider health stigma literature to inform the design of the ON TRAC project, a collaborative partnership between King's College London, South London and Maudsley NHS Foundation Trust and Black faith community groups in Southwark and Lambeth, London, in this currently under-researched area. METHODS A systematic search of ten major medical and social sciences databases was conducted in 2019, for studies on mental health or other health stigma interventions in Black faith settings. PRISMA guidelines were followed and search terms and search strategy ensured all possible studies were identified for review. RESULTS The review identified sixteen studies for inclusion. Ten were quantitative studies, four qualitative studies and two systematic reviews. Active ingredients of interventions included utilisation of 'bottom up' development of approaches and mental health champions. Multiple factors were found to influence effective implementation. Co-production and partnership working are key to ensure that an acceptable and accessible intervention is agreed. CONCLUSION Evidence for the effectiveness of interventions focused on mental health awareness and stigma reduction in the Black faith community is limited due to the low quality of studies. This review sheds light on the lessons learnt and necessary key requirements for interventions that can guide future projects. STUDY REGISTRATION PROSPERO registration number: CRD42018110068.
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Affiliation(s)
- Louisa Codjoe
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Sarah Barber
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Shalini Ahuja
- Centre for Implementation Science and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Graham Thornicroft
- Centre for Implementation Science and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Claire Henderson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Heidi Lempp
- Centre for Rheumatic Diseases, Department of Inflammation Biology, King's College London, Weston Education, 10, Cutcombe Rd, London, SE5 9RJ, UK
| | - Joelyn N'Danga-Koroma
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
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Mpofu E, Ntinda K, Levers LL, van Rensberg A, Nkomazana F. Pathways to sexual decision making by Pentecostal church youths in Botswana. BMC Public Health 2021; 21:659. [PMID: 33823835 PMCID: PMC8025555 DOI: 10.1186/s12889-021-10645-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/17/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The ways church youth make sexual decisions are incompletely understood and yet important for public health interventions. This study aimed to examine personal religiosity influences on the sexual decisions by church youth from the country of Botswana, taking into account their sense of personal agency. METHOD Participants were 235 Botswana Pentecostal faith church youth (females = 67.2%, male = 32.8%; age range 12-23 years). They completed measures of personal religiosity, personal agency, sexual abstinence, and contraception use predisposition. We analysed the data applying Structural Equation Modelling to test five paths - personal religiosity to personal agency, personal agency to abstinence, personal religiosity to abstinence, personal agency to contraceptive use, and personal religiosity to contraceptive use. RESULTS Results suggest that personal religiosity influences the youth in their sexual abstinence and contraception decisions through personal agency. High personal agency, but not personal religiosity, was associated with pro-sexual abstinence, and contraception use was associated with religiosity. Personal agency augmented the likelihood of both abstinence and contraception use decisions among the older church youth and with church youth with higher levels of formal education. CONCLUSION Church youth likely adopt discretionary sexual behaviours over the developmental period from early to older adolescents, which would make them more receptive to public sexual health messages. Personal agency appears to be an important resource for public health interventions aimed at influencing church youth's sexual decisions.
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Affiliation(s)
- Elias Mpofu
- Rehabilitation and Health Services Department, College of Health and Public Services, University of North Texas, 1151 Union Circle #, Denton, TX, 311456, USA.
- University of Sydney, Australia, Camperdown, Australia.
- University of Johannesburg, South Africa, Johannesburg, South Africa.
| | - Kayi Ntinda
- University of Eswatini, Kwaluseni, Eswatini
- University of Botswana, Gaborone, Botswana
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Griffith DM, Jaeger EC. Mighty men: A faith-based weight loss intervention to reduce cancer risk in African American men. Adv Cancer Res 2020; 146:189-217. [PMID: 32241389 DOI: 10.1016/bs.acr.2020.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
According to the American Cancer Society's guidelines on nutrition and physical activity for cancer prevention, weight control, eating practices and physical activity are second only to tobacco use as modifiable determinants of cancer risk. However, no evidence-based interventions have been targeted to African American men or tailored to individual African American men's preferences, needs or identities. The goal of this chapter is to describe the rationale for the components, aims and setting of Mighty Men: A Faith-Based Weight Loss Intervention for African American Men. We begin by discussing the rationale for focusing on weight loss in the context of cancer prevention, and argue that obesity and obesogenic behaviors are important yet modifiable determinants of cancer risk. Next, we briefly review the scarce literature on interventions to promote healthy eating, physical activity and weight loss in our population of interest, and then discuss the rationale for conducting the intervention in faith- based organizations rather than other common settings for recruiting African American men. We conclude with a discussion of the conceptual foundations and components of Mighty Men, and discuss our focus and goals in the context of the larger literature in this area.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, United States; Center for Medicine, Health and Society, Vanderbilt University, Nashville, TN, United States.
| | - Emily C Jaeger
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, United States
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14
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Religiosity, Social Support, and Ethnic Identity: Exploring "Resilience Resources" for African-American Women Experiencing HIV-Related Stigma. J Acquir Immune Defic Syndr 2020; 81:175-183. [PMID: 30865171 DOI: 10.1097/qai.0000000000002006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION African-American women living with HIV report substantial HIV-related stigma and depression. Resilience resources are strength-based resources that may moderate the effects of HIV-related stigma on poor psychosocial outcomes such as depression. OBJECTIVE To evaluate whether religiosity, social support, and ethnic identity moderate the effects of HIV-related stigma on depression among African-American women living with HIV. METHODS We used baseline data (May 2013-October 2015) from a randomized controlled trial testing the efficacy of an HIV-related stigma-reduction intervention among African-American women living with HIV in Chicago, IL, and Birmingham, AL, who were older than 18 years and currently receiving HIV services. To assess whether religiosity (7-item Religious Beliefs and Behaviors survey), social support (select subscales from the Medical Outcomes Study Social Support Survey), and ethnic identity (Commitment subscale from the Multigroup Ethnic Identity Measure) modified the relationship between HIV-related stigma (Stigma Scale for Chronic Illness) and depression (8-item Patient Health Questionnaire), we conducted 3 separate moderation analyses using linear regression with interactions between HIV-related stigma and each moderator of interest, adjusted for study site, age, time since diagnosis, and education. RESULTS Among 226 African-American women living with HIV, greater levels of HIV-related stigma were associated with greater depression in all 3 models (P < 0.05). Only religiosity modified this association (P = 0.04), with a weaker association among women reporting higher levels of religiosity. CONCLUSIONS The protective effects of religiosity may be leveraged in interventions for African-American women living with HIV struggling with HIV-related stigma.
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Mendel P, Green HD, Palar K, Kanouse DE, Bluthenthal RN, Mata MA, Oden CW, Derose KP. Congregational involvement in HIV: A qualitative comparative analysis of factors influencing HIV activity among diverse urban congregations. Soc Sci Med 2020; 246:112718. [PMID: 31931449 PMCID: PMC7027958 DOI: 10.1016/j.socscimed.2019.112718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022]
Abstract
Religious congregations can potentially reach disproportionately affected populations with HIV programming, however, factors that influence congregational involvement in HIV are not well-studied. Utilizing comparative case methods and in-depth qualitative data from a diverse sample of 14 urban congregations, we examine a range of attitudinal, organizational, resource, and demographic factors to systematically identify different case scenarios-i.e., combinations of characteristics-associated with the level and types of HIV activities in which the congregational cases tended to be involved. For example, White or mixed race congregations with active gay constituencies and an African-American congregation with a strong lay HIV champion were among the high HIV involvement case scenarios, compared to African-American congregations with a health emphasis but no lay HIV champion among the medium HIV involvement scenarios, and fundamentalist African-American and Latino congregations among the low HIV involvement scenarios. Two key factors that appeared influential across case scenarios included the existence of lay champions for HIV activities and the general theological orientation of the congregation.
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Affiliation(s)
| | - Harold D Green
- RAND Corporation, Santa Monica, CA, USA; Indiana University, Bloomington, IN, USA
| | - Kartika Palar
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Ricky N Bluthenthal
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Clyde W Oden
- Bethel Oxnard African Methodist Episcopal Church, Oxnard, CA, USA
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16
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Dangerfield DT, Williams JE, Bass AS, Wynter T, Bluthenthal RN. Exploring Religiosity and Spirituality in the Sexual Decision-Making of Black Gay and Bisexual Men. JOURNAL OF RELIGION AND HEALTH 2019; 58:1792-1802. [PMID: 31161470 DOI: 10.1007/s10943-019-00845-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Many Black gay and bisexual men (BGBM) practice consistent religious worship and spirituality in order to cope with social challenges. This study utilized data from in-depth qualitative interviews conducted to explore personal meanings of religiosity and spirituality and how these constructs affect partner choices and sexual behaviors among BGBM. Interviews were conducted with 26 BGBM in Los Angeles, California, from September to November 2015. In-depth interviews yielded themes related to BGBM's understanding of religiosity and spirituality and how their personal beliefs influenced their partner choices and sexual risks. Implications for church-based and community-based interventions are discussed.
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Affiliation(s)
- Derek T Dangerfield
- Johns Hopkins School of Nursing, 855 N. Wolfe St Suite 601, Baltimore, MD, 21205, USA.
| | - Jeffery E Williams
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alágra S Bass
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Timothy Wynter
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ricky N Bluthenthal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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17
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Wright LS, Branscum P, Maness S, Larson D, Taylor EL, Mayeux L, Cheney MK. Parents' beliefs of the Black Church's role in teen pregnancy prevention. J Adolesc 2019; 72:52-63. [PMID: 30825754 DOI: 10.1016/j.adolescence.2019.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 02/15/2019] [Accepted: 02/16/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Parents are important decision makers in black churches. The objective of this qualitative study was to identify African American parents' beliefs of the Black Church's role in preventing teen pregnancy and promoting healthy teen relationships. METHODS Parent members (n = 36) of 27 predominately Black churches in two southwestern US cities participated in semi-structured interviews from February-June 2017. A question path was developed based on literature searches, key informant interviews, and a previous study with local pastors, and questions focused on parents' knowledge/beliefs about 1) sexuality education, 2) the church's role in preventing teen pregnancy, and 3) implementation obstacles. Interviews were transcribed verbatim, coded using NVivo, and open-coded for themes to investigate patterns across codes and participants. Transcripts were then reviewed for quotes to represent each theme. RESULTS Five themes were identified, with multiple subthemes. Most parents said there should be no boundaries on the type of sexuality information shared by their church, but later changed their minds after reviewing a list of potential topics. Parents listed 'parent-child communication', 'goals and dreams', and 'relationships' as the most important topics for teen pregnancy prevention intervention. Parents said information shared during workshops should be judgement-free and realistic. Parents most often said pastors and/or youth pastors/directors should deliver sexual health information. Parents believed older adults and other parents may oppose sexual education. CONCLUSIONS By understanding parents' beliefs of teen pregnancy prevention programs, public health practitioners can understand concerns, modify implementation strategies, and utilize parental support to gain buy-in before planning and implementing programs.
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18
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Payán DD, Flórez KR, Bogart LM, Kanouse DE, Mata MA, Oden CW, Derose KP. Promoting Health from the Pulpit: A Process Evaluation of HIV Sermons to Reduce HIV Stigma and Promote Testing in African American and Latino Churches. HEALTH COMMUNICATION 2019; 34:11-20. [PMID: 29053386 PMCID: PMC5927848 DOI: 10.1080/10410236.2017.1384352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Embedding health messages into sermons is a potentially valuable strategy to address HIV and other health disparities in churches that predominantly serve racial and ethnic minorities. This study explores implementation of an HIV sermon as part of a multi-component intervention in three churches (Latino Catholic, Latino Pentecostal, and African American Baptist) in high HIV prevalence areas of Los Angeles County, California. Clergy were given an HIV sermon guide that included local public health data, stigma reduction cues, HIV testing messages, and a sample sermon. Findings are based on a process evaluation (i.e., reach, dose delivered, fidelity, and implementation) and in-depth content analysis to explore HIV frames and messages used by clergy. Sermons were audio-recorded, transcribed verbatim, and coded using an inductive approach. Complementary data were collected through systematic observation. Overall, five clergy delivered nine HIV sermons to majority African American or Latino audiences. On average, 174 congregants were reached per sermon. We found large variation in fidelity to communicating key HIV messages from the sermon guide. While promoting HIV testing from the pulpit seemed viable and acceptable to all the participating clergy, fewer embedded explicit stigma reduction cues. Most spoke about HIV using compassionate and non-judgmental terms, however, issue framing varied across clergy. Structured training of clergy may be necessary to implement the more theoretically driven stigma reduction cues included in the sermon guide. More research is needed on the viability and acceptability of embedding specific health promotion messages into sermons.
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Affiliation(s)
- Denise D. Payán
- School of Social Sciences, Humanities and Arts, University of California, Merced
- Health Program, RAND Corporation
| | - Karen R. Flórez
- Health Program, RAND Corporation
- Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, City University of New York
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19
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Bradley ELP, Sutton MY, Cooks E, Washington-Ball B, Gaul Z, Gaskins S, Payne-Foster P. Developing FAITHH: Methods to Develop a Faith-Based HIV Stigma-Reduction Intervention in the Rural South. Health Promot Pract 2018; 19:730-740. [PMID: 29383967 PMCID: PMC6211576 DOI: 10.1177/1524839917754044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human immunodeficiency virus (HIV) disproportionately affects Blacks/African Americans, particularly those residing in the southern United States. HIV-related stigma adversely affects strategies to successfully engage people in HIV education, prevention, and care. Interventions targeting stigma reduction are vital as additional tools to move toward improved outcomes with HIV prevention and care, consistent with national goals. Faith institutions in the South have been understudied as partners in HIV stigma-reduction efforts, and some at-risk, Black/African American communities are involved with southern faith institutions. We describe the collaborative effort with rural, southern faith leaders from various denominations to develop and pilot test Project Faith-based Anti-stigma Initiative Towards Healing HIV/AIDS (FAITHH), an HIV stigma-reduction intervention that built on strategies previously used with other nonrural, Black/African American faith communities. The eight-module intervention included educational materials, myth-busting exercises to increase accurate HIV knowledge, role-playing, activities to confront stigma, and opportunities to develop and practice delivering a sermon about HIV that included scripture-based content and guidance. Engaging faith leaders facilitated the successful tailoring of the intervention, and congregation members were willing participants in the research process in support of increased HIV awareness, prevention, and care.
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Affiliation(s)
- Erin L P Bradley
- 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Madeline Y Sutton
- 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Cooks
- 2 University of Alabama, Tuscaloosa, AL, USA
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20
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Pingel ES, Bauermeister JA. 'Church hurt can be the worst hurt': community stakeholder perceptions of the role of Black churches in HIV prevention among young Black gay and bisexual men. CULTURE, HEALTH & SEXUALITY 2018; 20:218-231. [PMID: 28662610 DOI: 10.1080/13691058.2017.1338756] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Black gay and bisexual men aged 15-29 are disproportionately represented among new cases of HIV in the USA. Researchers have argued that community-based prevention cannot succeed without the participation of faith-based organisations, particularly given the salience of religion and spirituality in the lives of young Black gay and bisexual men. Yet some Black churches may be hesitant to engage in HIV prevention efforts given their beliefs about same-sex behaviour. It is less clear, however, whether and how public health practitioners in the field of HIV prevention have approached church inclusion. We therefore explored how community stakeholders describe the involvement of Black churches with the HIV continuum of care. We draw on a qualitative dataset of 50 in-depth semi-structured interviews conducted in Detroit, USA. Participants offered multiple perspectives on the response of Black churches to the HIV epidemic, from overt stigma to gradual acceptance and action. Nevertheless, participants agreed that when stigma was present in the pews and the pulpit, young Black gay and bisexual men were at potential risk of social isolation. Furthermore, tensions may exist between Black churches and secular community-based organisations that are attributable to histories of mistrust. These findings have important implications for future community-based intervention strategies among young Black gay and bisexual men.
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Affiliation(s)
- Emily S Pingel
- a Department of Health Behavior & Health Education, School of Public Health , University of Michigan , Ann Arbor , USA
- b Department of Sociology , Emory University , Atlanta , USA
| | - José A Bauermeister
- a Department of Health Behavior & Health Education, School of Public Health , University of Michigan , Ann Arbor , USA
- c Department of Family and Community Health , University of Pennsylvania , Philadelphia , USA
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21
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Stephens TM. The Role of Faith-Based Organizations in the Education, Support, and Services for Persons Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome. Nurs Clin North Am 2017; 53:25-33. [PMID: 29362058 DOI: 10.1016/j.cnur.2017.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Faith-based organizations are in a unique position to provide resilience-enhancing efforts for persons living with human immunodeficiency virus/AIDS. Many persons living with human immunodeficiency virus/AIDS report having a strong faith or religious affiliation, with a large percentage attending church services on a regular basis. Faith-based organizations can use these factors to reach out to these individuals and effectively promote health, well-being, education, and support. Faith-based organizations can contribute to the reduction of stigma and isolation for persons living with human immunodeficiency virus/AIDS.
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Affiliation(s)
- Teresa M Stephens
- College of Nursing, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, USA.
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22
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Abstract
One of the four national HIV prevention goals is to incorporate combinations of effective, evidence-based approaches to prevent HIV infection. In fields of public health, techniques that alter environment and affect choice options are effective. Structural approaches may be effective in preventing HIV infection. Existing frameworks for structural interventions were lacking in breadth and/or depth. We conducted a systematic review and searched CDC's HIV/AIDS Prevention Research Synthesis Project's database for relevant interventions during 1988-2013. We used an iterative process to develop the taxonomy. We identified 213 structural interventions: Access (65%), Policy/Procedure (32%), Mass Media (29%), Physical Structure (27%), Capacity Building (24%), Community Mobilization (9%), and Social Determinants of Health (8%). Forty percent targeted high-risk populations (e.g., people who inject drugs [12%]). This paper describes a comprehensive, well-defined taxonomy of structural interventions with 7 categories and 20 subcategories. The taxonomy accommodated all interventions identified.
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23
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Orrego Dunleavy V, Chudnovskaya E, Phillips J, McFarlane SJ. Applying the PEN-3 Cultural Model to Address HIV/AIDS Prevention in Rural Guatemala. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17475759.2017.1398178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Elena Chudnovskaya
- Department of Communication, Western Illinois University, Macomb, IL, USA
| | - Jasmine Phillips
- Department of Social Sciences, Nevada State College, Henderson, NV, USA
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24
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Berman M, Berkley-Patton J, Booker A, Bowe-Thompson C, Bradley-Ewing A. Exploring HIV Risk and Ex-Offender Status Among African American Church Populations: Considerations for Faith-Based Settings. JOURNAL OF CORRECTIONAL HEALTH CARE 2017; 23:230-242. [PMID: 28358230 DOI: 10.1177/1078345817700615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Studies with the general population indicate that involvement in the correctional system is strongly associated with the risk of contracting HIV and other sexually transmitted infections. However, limited studies have examined ex-offender status and HIV risk among African Americans-a population disproportionately impacted by incarceration and HIV-and even fewer have examined these risks among African American church-affiliated populations. This study examined ex-offender status, HIV risks, and perceptions of church involvement in HIV prevention strategies among 484 participants affiliated with African American churches. Findings indicate ex-offender participants were more likely to have been tested for HIV and believed the church should be involved in HIV prevention strategies. Future research, practice, and recommendations on the design of culturally and religiously tailored interventions for ex-offender HIV prevention, screening, and linkage to care in African American church settings are discussed.
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Affiliation(s)
- Marcie Berman
- 1 Psychology Department, University of Missouri, Kansas City, MO, USA
| | | | - Alexandria Booker
- 1 Psychology Department, University of Missouri, Kansas City, MO, USA
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25
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Ross L, Johnson J, Smallwood SW, Luque JS, Tedders SH, Airhihenbuwa CO, Alford T, Underwood W. Using CBPR to Extend Prostate Cancer Education, Counseling, and Screening Opportunities to Urban-Dwelling African-Americans. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:702-708. [PMID: 25948412 PMCID: PMC5393453 DOI: 10.1007/s13187-015-0849-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Community-based participatory research (CBPR) is becoming one of the dominant approaches for bringing evidence- and consensus-based cancer prevention and control practices to medically underserved communities. There are many examples of how CBPR has been useful for generating culturally specific solutions for different health issues that affect African-Americans. However, few examples exist in the literature on how the CBPR approach can be applied to address prostate cancer. This paper describes a collaborative process for linking inner-city, African-American men to free prostate cancer education, physician counseling, and screening opportunities (prostate-specific antigen (PSA) testing and digital rectal examination (DRE)). The site of this community-based participatory project was the city of Buffalo, located in Erie County, New York. The collaborative, community-academic process that is described includes the following: (1) planning and conducting a community needs assessment to contextualize local prostate cancer issues, (2) organizing town and gown event planning, and (3) manipulating aspects of the built environment to build an infrastructure within the community to address disparities in screening opportunities. This paper concludes with a description of lessons learned that can help others develop and implement similar activities in other communities.
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Affiliation(s)
- Levi Ross
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA, 30460-8015, USA.
| | - Jarrett Johnson
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA, 30460-8015, USA
| | - Stacy W Smallwood
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA, 30460-8015, USA
| | - John S Luque
- Medical University of South Carolina, Department of Public Health Sciences, Hollings Cancer Center, Charleston, SC, 29445, USA
| | - Stuart H Tedders
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA, 30460-8015, USA
| | - Collins O Airhihenbuwa
- College of Health and Human Development, Pennsylvania State University, 219D Biobehavioral Health Building, University Park, PA, 16802, USA
| | - Terry Alford
- Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Willie Underwood
- Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
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26
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Derose KP, Griffin BA, Kanouse DE, Bogart LM, Williams MV, Haas AC, Flórez KR, Collins DO, Hawes-Dawson J, Mata MA, Oden CW, Stucky BD. Effects of a Pilot Church-Based Intervention to Reduce HIV Stigma and Promote HIV Testing Among African Americans and Latinos. AIDS Behav 2016; 20:1692-705. [PMID: 27000144 PMCID: PMC4945375 DOI: 10.1007/s10461-015-1280-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
HIV-related stigma and mistrust contribute to HIV disparities. Addressing stigma with faith partners may be effective, but few church-based stigma reduction interventions have been tested. We implemented a pilot intervention with 3 Latino and 2 African American churches (4 in matched pairs) in high HIV prevalence areas of Los Angeles County to reduce HIV stigma and mistrust and increase HIV testing. The intervention included HIV education and peer leader workshops, pastor-delivered sermons on HIV with imagined contact scenarios, and HIV testing events. We surveyed congregants at baseline and 6 month follow-up (n = 1235) and found statistically significant (p < 0.05) reductions in HIV stigma and mistrust in the Latino intervention churches but not in the African American intervention church nor overall across matched African American and Latino pairs. However, within matched pairs, intervention churches had much higher rates of HIV testing (p < 0.001). Stigma reduction and HIV testing may have synergistic effects in community settings.
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Affiliation(s)
- Kathryn P Derose
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | | | - David E Kanouse
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Laura M Bogart
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Malcolm V Williams
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | | | - Karen R Flórez
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | | | | | | | - Clyde W Oden
- Bryant Temple African Methodist Episcopal Church, Los Angeles, CA, USA
| | - Brian D Stucky
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
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Medved Kendrick H. Are religion and spirituality barriers or facilitators to treatment for HIV: a systematic review of the literature. AIDS Care 2016; 29:1-13. [PMID: 27410058 DOI: 10.1080/09540121.2016.1201196] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Much attention has been given to the relationship between religion/spirituality (R/S) and HIV in recent years, but comparatively little has been explored in regard to R/S and HIV testing, retention in care, and adherence to medication. Religious views concerning HIV risk behavior pose challenges to communication and education about sexual health in religious communities and may serve as barriers to HIV treatment and care. Conversely, religious coping and spiritual well-being, as well as social support could serve as facilitators to HIV treatment and care. This study aims to fill a gap in the literature by addressing the following questions: (1) what dimensions of R/S have been found to be factors associated with HIV outcomes?; (2) which R/S factors function as barriers or facilitators to care among people living with HIV (PLWH)?; and (3) which R/S factors, if any, vary across socio-demographic groups? Thirty-three empirical articles were identified for systematic review. Of the 33 empirical studies included, 24 studies found that at least one measure of R/S was associated with better adherence and clinical health outcomes. Twelve studies found at least one measure of R/S to be associated with poorer adherence and clinical health outcomes. Seven of the studies found at least one R/S measure to have no significant association with outcomes. Though all of the studies included in this review focused on R/S experiences of PLWH, there was very little consistency in regard to measurement of R/S. Studies in this review included a wide range of R/S measures, including beliefs, religious/spiritual practices, R/S coping, organizational religion, and many more. Of the 33 studies reviewed, only 9 focused on unique populations such as women, people with histories of substance abuse, immigrants, etc. Findings from this review highlight opportunities for more studies in various populations using standardized R/S measures.
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Affiliation(s)
- Haley Medved Kendrick
- a Department of Sociology , University of Alabama at Birmingham , Birmingham , AL , USA
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28
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Pichon LC, Powell TW, Ogg SA, Williams AL, Becton-Odum N. Factors Influencing Black Churches' Readiness to Address HIV. JOURNAL OF RELIGION AND HEALTH 2016; 55:918-927. [PMID: 26345680 DOI: 10.1007/s10943-015-0117-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study employed a community-based participatory research approach to understand factors that influence church readiness to engage in HIV prevention and treatment activities. A convenience sample of twenty-six Black faith leaders participated in four focus groups. Data analysis was done through qualitative content analysis. Three themes emerged. First, the pastor's blessing and authority as the church's decision-maker determines readiness to engage in HIV prevention. Second, the church's purview of sexual health as part of a holistic ministry facilitates faith leader's readiness. Lastly, securing financial and human resources makes it feasible for faith leaders to implement activities. Findings suggest HIV-related stigma alone does not explain readiness to address HIV. Participants also discussed activities their churches are equipped to handle, including HIV testing events and health fairs.
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Affiliation(s)
- Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3820 Desoto Ave, Robison Hall Room 209, Memphis, TN, USA.
| | | | - Siri A Ogg
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3820 Desoto Ave, Robison Hall Room 209, Memphis, TN, USA
| | - Andrea L Williams
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
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29
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Derose KP, Kanouse DE, Bogart LM, Griffin BA, Haas A, Stucky BD, Williams MV, Flórez KR. Predictors of HIV-related stigmas among African American and Latino religious congregants. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2016; 22:185-95. [PMID: 26213890 PMCID: PMC4729667 DOI: 10.1037/cdp0000062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To inform church-based stigma interventions by exploring dimensions of HIV stigma among African American and Latino religious congregants and determining how these are related to drug addiction and homosexuality stigmas and knowing someone HIV-positive. METHOD In-person, self-administered surveys of congregants 18+ years old across 2 African American and 3 Latino churches (n = 1,235, response rate 73%) in a western U.S. city with high HIV prevalence. Measures included 12 items that captured dimensions of HIV stigma, a 5-item scale that assessed attitudes toward people who are addicted to drugs, a 7-item scale assessing attitudes toward homosexuality, and questions regarding sociodemographics and previous communication about HIV. RESULTS Of the survey participants, 63.8% were women, mean age was 40.2 years, and 34.4% were African American, 16.8% were U.S.-born Latinos, 16.0% were foreign-born, English-speaking Latinos, and 32.9% were foreign-born, Spanish-speaking Latinos. Exploratory and confirmatory factor analyses identified 4 dimensions of HIV stigma: discomfort interacting with people with HIV (4 items, α = .86), feelings of shame "if you had HIV" (3 items, α = .78), fears of rejection "if you had HIV" (3 items, α = .71), and feelings of blame toward people with HIV (2 items, α = .65). Across all dimensions, after controlling for sociodemographic characteristics and previous communication about HIV, knowing someone with HIV was associated with lower HIV stigma, and greater stigma concerning drug addiction and homosexuality were associated with higher HIV stigma. CONCLUSIONS Congregation-based HIV stigma reduction interventions should consider incorporating contact with HIV-affected people. It may also be helpful to address attitudes toward drug addiction and sexual orientation. (PsycINFO Database Record
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Affiliation(s)
| | | | - Laura M. Bogart
- Department of Pediatrics, Children’s Hospital Boston and Harvard Medical School, Boston, MA
| | | | - Ann Haas
- RAND Corporation, Pittsburgh, PA
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Coleman JD, Tate AD, Gaddist B, White J. Social Determinants of HIV-Related Stigma in Faith-Based Organizations. Am J Public Health 2016; 106:492-6. [PMID: 26794158 PMCID: PMC4815751 DOI: 10.2105/ajph.2015.302985] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine the association between social factors in faith-based settings (including religiosity and proximity to people living with HIV/AIDS) and HIV stigma. METHODS A total of 1747 congregants from primarily African American faith-based organizations of Project FAITH (Fostering AIDS Initiatives That Heal), a South Carolina statewide initiative to address HIV-related stigma, completed a survey. RESULTS Female gender (P = .001), higher education (P < .001), knowing someone with HIV/AIDS (P = .01), and knowing someone who is gay (P < .001), but not religiosity, were associated with lower levels of stigma and with lower odds of stigmatizing attitudes (P < .05). CONCLUSIONS Opportunities for connection with people living with HIV/AIDS tailored to the social characteristics of faith-based organizations may address HIV stigma in African American communities.
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Affiliation(s)
- Jason D Coleman
- Jason D. Coleman is with School of Health, Physical Education, and Recreation, University of Nebraska at Omaha. Allan D. Tate is with Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis. Bambi Gaddist and Jacob White are with South Carolina HIV/AIDS Council, Columbia
| | - Allan D Tate
- Jason D. Coleman is with School of Health, Physical Education, and Recreation, University of Nebraska at Omaha. Allan D. Tate is with Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis. Bambi Gaddist and Jacob White are with South Carolina HIV/AIDS Council, Columbia
| | - Bambi Gaddist
- Jason D. Coleman is with School of Health, Physical Education, and Recreation, University of Nebraska at Omaha. Allan D. Tate is with Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis. Bambi Gaddist and Jacob White are with South Carolina HIV/AIDS Council, Columbia
| | - Jacob White
- Jason D. Coleman is with School of Health, Physical Education, and Recreation, University of Nebraska at Omaha. Allan D. Tate is with Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis. Bambi Gaddist and Jacob White are with South Carolina HIV/AIDS Council, Columbia
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Cornelius JB, Appiah JA. A 5-Year Review of Faith-Based Sexuality Education and HIV Prevention Programs. CURRENT SEXUAL HEALTH REPORTS 2016. [DOI: 10.1007/s11930-016-0062-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Obong'o CO, Pichon LC, Powell TW, Williams AL. Strengthening partnerships between Black Churches and HIV service providers in the United States. AIDS Care 2016; 28:1119-23. [PMID: 26830679 DOI: 10.1080/09540121.2016.1139666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Across the United States, Black Churches play a significant role among the Black community and are increasingly being used to deliver Human Immunodeficiency Virus (HIV) prevention services. This study sought to investigate HIV service providers' strategies for strengthening partnerships with churches to deliver HIV prevention services. Using a community-based participatory research approach, an HIV coalition and an academic institution formed a partnership to address the study aim. Individual interviews (n = 16) were conducted with providers from medical institutions and HIV social support agencies. A thematic analysis focusing on recommendations for addressing the challenges and benefits of partnership with churches for HIV services was conducted. Participants' interest in and intention to work with churches, as well as their comfort level discussing sexual health-related topics with religious congregations, was high. Four themes emerged to highlight the different perspectives of service providers' recommendations for addressing challenges and strengthening partnerships with churches to deliver HIV services including: (1) carefully selecting churches and HIV services to provide, (2) gaining "buy-in" and support of church leadership, (3) taking advantage of conflict with church doctrine, and (4) choosing appropriate delivery strategies. Study findings demonstrate that although challenges exist, heath service providers in this region of the United States may be interested in addressing HIV among faith communities. Study findings also provide concrete solutions to previously documented barriers to HIV prevention in Black Churches. Such information will benefit researchers and practitioners seeking to expand effective HIV prevention efforts with Black Churches in communities who bear a disproportionate burden of HIV infections.
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Affiliation(s)
| | - Latrice C Pichon
- a School of Public Health , The University of Memphis , Memphis , TN , USA
| | - Terrinieka W Powell
- b Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA
| | - Andrea L Williams
- c Department of Infectious Diseases , St. Jude Children's Research Hospital , Memphis , TN , USA
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Saunders DR, Holt CL, Le D, Slade JL, Muwwakkil B, Savoy A, Williams R, Whitehead TL, Wang MQ, Naslund MJ. Recruitment and Participation of African American Men in Church-Based Health Promotion Workshops. J Community Health 2015; 40:1300-10. [PMID: 26089253 DOI: 10.1007/s10900-015-0054-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Health promotion interventions in African American communities are frequently delivered in church settings. The Men's Prostate Awareness Church Training (M-PACT) intervention aimed to increase informed decision making for prostate cancer screening among African American men through their churches. Given the significant proportion and role of women in African American churches, the M-PACT study examined whether including women in the intervention approach would have an effect on study outcomes compared with a men-only approach. The current analysis discusses the men's participation rates in the M-PACT intervention, which consisted of a series of 4 bimonthly men's health workshops in 18 African American churches. Data suggest that once enrolled, retention rates for men ranged from 62 to 69 % over the workshop series. Among the men who were encouraged to invite women in their lives (e.g., wife/partner, sister, daughter, friend) to the workshops with them, less than half did so (46 %), suggesting under-implementation of this "health partner" approach. Finally, men's participation in the mixed-sex workshops were half the rate as compared to the men-only workshops. We describe recruitment techniques, lessons learned, and possible reasons for the observed study group differences in participation, in order to inform future interventions to reach men of color with health information.
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Affiliation(s)
- Darlene R Saunders
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 2369 School of Public Health Building (255), College Park, MD, 20742, USA.
| | - Cheryl L Holt
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 2369 School of Public Health Building (255), College Park, MD, 20742, USA.
| | - Daisy Le
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 2369 School of Public Health Building (255), College Park, MD, 20742, USA
| | - Jimmie L Slade
- Community Ministry Prince of George's County, Upper Marlboro, MD, USA
| | - Bettye Muwwakkil
- Access to Wholistic and Productive Living Institute, Inc., Lanham, MD, USA
| | - Alma Savoy
- Community Ministry Prince of George's County, Upper Marlboro, MD, USA
| | - Ralph Williams
- Access to Wholistic and Productive Living Institute, Inc., Lanham, MD, USA
| | - Tony L Whitehead
- Department of Anthropology, University of Maryland, College Park, MD, USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 2369 School of Public Health Building (255), College Park, MD, 20742, USA
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Chin JJ, Neilands TB. Chinese Immigrant Religious Institutions' Variability in Views on Preventing Sexual Transmission of HIV. Am J Public Health 2015; 106:110-8. [PMID: 26562121 DOI: 10.2105/ajph.2015.302924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined Chinese immigrant religious institutions' views on teaching about preventing sexual transmission of HIV and the consistency of their views with public health best practices in HIV prevention. METHODS We used 2009 to 2011 survey data from 712 members of 20 New York City-based Chinese immigrant religious institutions to analyze their views on (1) teaching adolescents about condoms, (2) discussing homosexuality nonjudgmentally, and (3) promoting abstinence until marriage. RESULTS Religion type was a significant predictor of views in the 3 domains, with Evangelical Protestants in least agreement with public health best practices, Buddhists in most agreement, and mainline Protestants between them. Greater HIV knowledge was significantly associated with agreement with best practices in all 3 domains. The frequency of prayer, meditation, or chanting and the level of acculturation were significant predictors of views on teaching adolescents about condoms and promoting abstinence until marriage. CONCLUSIONS The best practice messages about HIV prevention that Chinese immigrant religious institutions find acceptable vary according to religion type and several other key factors, including HIV knowledge; frequency of prayer, meditation, or chanting; and level of acculturation.
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Affiliation(s)
- John J Chin
- John J. Chin is with the Department of Urban Policy and Planning, Hunter College, City University of New York, New York, NY. Torsten B. Neilands is with the Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco
| | - Torsten B Neilands
- John J. Chin is with the Department of Urban Policy and Planning, Hunter College, City University of New York, New York, NY. Torsten B. Neilands is with the Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco
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Killawi A, Heisler M, Hamid H, Padela AI. Using CBPR for Health Research in American Muslim Mosque Communities. Prog Community Health Partnersh 2015; 9:65-74. [PMID: 25981426 DOI: 10.1353/cpr.2015.0007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND American Muslims are understudied in health research, and there are few studies documenting community-based participatory research (CBPR) efforts among American Muslim mosque communities. OBJECTIVES We highlight lessons learned from a CBPR partnership that explored the health care beliefs, behaviors, and challenges of American Muslims. METHODS We established a collaboration between the University of Michigan and four Muslim-focused community organizations in Michigan. Our collaborative team designed and implemented a two-phase study involving interviews with community stakeholders and focus groups and surveys with mosque congregants. LESSONS LEARNED Although we were successful in meeting our research goals, maintaining community partner involvement and sustaining the project partnership proved challenging. CONCLUSIONS CBPR initiatives within mosque communities have the potential for improving community health. Our experience suggests that successful research partnerships with American Muslims will utilize social networks and cultural insiders, culturally adapt research methods, and develop a research platform within the organizational infrastructures of the American Muslim community.
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Woods-Jaeger BA, Carlson M, Taggart T, Riggins L, Lightfoot AF, Jackson MR. Engaging African American Faith-Based Organizations in Adolescent HIV Prevention. JOURNAL OF RELIGION AND HEALTH 2015; 54:1358-1374. [PMID: 25169052 DOI: 10.1007/s10943-014-9932-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
To reduce current HIV disparities among African American youth, it is imperative to find effective ways to extend the reach of evidence-based HIV prevention. One promising community resource to support this effort is faith-based organizations (FBOs), a credible and respected resource in the African American community. This paper describes the experiences, perceptions, and challenges that African American FBOs and faith leaders face in engaging in adolescent HIV prevention and highlights facilitators and barriers to implementing HIV prevention in African American FBOs. The findings suggest that African American FBOs and faith-based leaders are uniquely positioned to be instrumental resources in reducing African American youth HIV disparities.
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Affiliation(s)
- Briana A Woods-Jaeger
- Developmental and Behavioral Sciences, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA,
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Pichon LC, Powell TW. Review of HIV Testing Efforts in Historically Black Churches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:6016-26. [PMID: 26030470 PMCID: PMC4483684 DOI: 10.3390/ijerph120606016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 05/25/2015] [Accepted: 05/25/2015] [Indexed: 11/16/2022]
Abstract
This paper aims to critically assess the state of HIV testing in African American churches. A comprehensive review of peer-reviewed publications on HIV testing in church-based settings was conducted by two independent coders. Twenty-six papers published between 1991 and 2015, representing 24 unique projects, were identified addressing at least one dimension of HIV testing. Thirteen faith-based projects have implemented HIV testing events or had clergy promote the importance of testing and knowing one's HIV status, but empirical data and rigorous study designs were limited. Only eight papers reported onsite HIV testing in churches. Less than 5% of the studies reported the percentage of congregants who returned for their test results. Finally, no study has examined at baseline or post-intervention behavioral intentions to be screened for HIV. Future research is needed to evaluate the effectiveness of HIV testing in churches and to explore the possibilities of the role of the church and leadership structure in the promotion of HIV treatment and care.
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Affiliation(s)
- Latrice Crystal Pichon
- School of Public Health, University of Memphis, 209 Robison Hall, Memphis, TN 38152, USA.
| | - Terrinieka Williams Powell
- Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, E4614 Baltimore, MD 21205, USA.
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Altman L, Kuhlmann AKS, Galavotti C. Understanding the black box: a systematic review of the measurement of the community mobilization process in evaluations of interventions targeting sexual, reproductive, and maternal health. EVALUATION AND PROGRAM PLANNING 2015; 49:86-97. [PMID: 25615599 DOI: 10.1016/j.evalprogplan.2014.11.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 11/08/2014] [Accepted: 11/19/2014] [Indexed: 06/04/2023]
Abstract
Community mobilization (CM) interventions are often used to improve sexual, reproductive, and maternal health (SRMH). This systematic review provides an overview of CM indicators used in evaluation and then focuses on the use of linking constructs-those measures of the process of CM between programmatic outputs and outcomes. We identified 108 English-language articles evaluating 86 CM interventions that target SRMH. Content analysis was used to code CM indicators into five categories: qualitative descriptions of CM; participation, diffusion and community action indicators that measure tangible, programmatic outputs; and linking constructs that capture the process of moving from participation to empowerment. Fifty-five (64.0%) interventions include a CM indicator. Diffusion indicators are most common (56.4%); linking constructs are least common (20.0%). We found 23 linking constructs used in evaluations of 11 interventions, with limited information on psychometric properties available. Three evaluations report positive relationships between linking constructs and condom use, one of which was significant in multivariate analysis. To better understand how CM leads to improved outcomes, we recommend increasing the measurement of linking constructs in evaluations of CM interventions. Research should focus on developing and validating new linking construct indicators and better disseminating existing measurement tools.
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Affiliation(s)
- Lara Altman
- MANILA Consulting Group, Inc., 1420 Beverly Road Suite 220, McLean, VA 22101, USA; CARE USA, 51 Ellis Street, Atlanta, GA 30303, USA.
| | - Anne K Sebert Kuhlmann
- MANILA Consulting Group, Inc., 1420 Beverly Road Suite 220, McLean, VA 22101, USA; George Warren Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA.
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Mendel P, Derose KP, Werber L, Palar K, Kanouse DE, Mata M. Facilitators and barriers to HIV activities in religious congregations: perspectives of clergy and lay leaders from a diverse urban sample. JOURNAL OF RELIGION AND HEALTH 2014; 53:1472-1486. [PMID: 23990037 PMCID: PMC3938977 DOI: 10.1007/s10943-013-9765-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This paper examines facilitators and barriers to HIV activities within religious congregations, the relative internal or external sources of these influences, and suggestive differences across congregational types. Results are based on in-depth interviews with clergy and lay leaders (n = 57) from 14 congregations in Los Angeles County, California, purposively selected to reflect diversity in racial-ethnic composition, denomination, size, and HIV activity level. Many common facilitators and barriers were related to norms and attitudes, only a few of which appeared overtly associated with theological orientations. Clergy support was a facilitator particularly prevalent among congregations having higher HIV activity levels, indicating its importance in sustaining and expanding HIV programs. Resource issues were also prominent, with material resource barriers more frequently mentioned by smaller congregations and human resource barriers more among larger congregations. Organizational structure issues were mostly centered on external linkages with various social service, public health, and faith-based entities. Analysis of internal versus external sources highlights the roles of different stakeholders within and outside congregations in promoting HIV activities. Potential differences across congregational types represent fruitful areas for future research.
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Rasmus SM. Indigenizing CBPR: evaluation of a community-based and participatory research process implementation of the Elluam Tungiinun (towards wellness) program in Alaska. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2014; 54:170-9. [PMID: 24756887 PMCID: PMC4119544 DOI: 10.1007/s10464-014-9653-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The process that community based participatory research (CBPR) implementation takes in indigenous community contexts has serious implications for health intervention outcomes and sustainability. An evaluation of the Elluam Tungiinun (Towards Wellness) Project aimed to explore the experience of a Yup'ik Alaska Native community engaged within a CBPR process and describe the effects of CBPR process implementation from an indigenous community member perspective. CBPR is acknowledged as an effective strategy for engaging American Indian and Alaska Native communities in research process, but we still know very little about the experience from a local, community member perspective. What are the perceived outcomes of participation in CBPR from a local, community member perspective? Qualitative methods were used to elicit community member perspectives of participation in a CBPR process engaged with one Yup'ik community in southwest Alaska. Results focus on community member perceptions of CBPR implementation, involvement in the process and partnership, ownership of the project with outcomes observed and perceived at the community, family and individual levels, and challenges. A discussion of findings demonstrates how ownership of the intervention arose from a translational and indigenizing process initiated by the community that was supported and enhanced through the implementation of CBPR. Community member perspectives of their participation in the research reveal important process points that stand to contribute meaningfully to implementation science for interventions developed by and for indigenous and other minority and culturally diverse peoples.
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Affiliation(s)
- Stacy M Rasmus
- Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks, P.O. Box 757000, Fairbanks, AK, 99775, USA,
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Young S, Patterson L, Wolff M, Greer Y, Wynne N. Empowerment, Leadership, and Sustainability in a Faith-Based Partnership to Improve Health. JOURNAL OF RELIGION AND HEALTH 2014; 54:2086-2098. [PMID: 25015127 DOI: 10.1007/s10943-014-9911-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Community-based participatory research is a noted approach for improving community health and reducing health disparities. Community partnerships can serve as a catalyst for change in public health efforts. This article will apply empowerment theory and sustainability principles to an existing faith-based partnership. BRANCH Out is a partnership among 13 African American churches, the City of Milwaukee Health Department-Community Nutrition, and the Medical College of Wisconsin. The partnership goal was to change inaccurate perceptions, knowledge and negative attitudes, and behaviors about chronic disease and promote healthy youth leadership. Faith-based empowerment can occur at the individual, organizational, and community level. BRANCH Out demonstrates how partnerships can be sustained in multiple ways. The partnership also highlights the unique contributions of churches to community health outcomes.
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Affiliation(s)
- Staci Young
- Department of Family and Community Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA,
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Derose KP, Bogart LM, Kanouse DE, Felton A, Collins DO, Mata MA, Oden CW, Domínguez BX, Flórez KR, Hawes-Dawson J, Williams MV. An intervention to reduce HIV-related stigma in partnership with African American and Latino churches. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2014; 26:28-42. [PMID: 24450276 PMCID: PMC3947594 DOI: 10.1521/aeap.2014.26.1.28] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
HIV-related stigma negatively affects prevention and care, and community-based interventions are needed. Here we describe the development of a multi-ethnic, faith-based intervention to reduce HIV stigma that included: educational workshops on HIV, testing, and stigma; peer leader workshops using role plays and drawing on principles of motivational interviewing; a pastor-delivered sermon on HIV that incorporated theological reflection and an imagined contact scenario; and congregation-based HIV testing events. Lessons learned include: partnership development is essential and requires substantial investment; tailoring intervention components to single race-ethnic groups may not be preferable in diverse community settings; and adapting testing processes to be able to serve larger numbers of people in shorter time frames is needed for congregational settings. This development process successfully combined the rigorous application of social science theory and community engagement to yield a multifaceted HIV stigma reduction intervention appropriate for Protestant and Catholic churches in African American and Latino communities.
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DiStefano A, Peters R, Tanjasiri SP, Quitugua L, Dimaculangan J, Hui B, Barrera-Ng A, Vunileva 'I, Tui'one V, Takahashi L. A community-based participatory research study of HIV and HPV vulnerabilities and prevention in two Pacific Islander communities: ethical challenges and solutions. J Empir Res Hum Res Ethics 2013; 8:68-78. [PMID: 23485672 DOI: 10.1525/jer.2013.8.1.68] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We describe ethical issues that emerged during a one-year CBPR study of HIV and human papillomavirus (HPV) vulnerabilities and prevention in two Pacific Islander (PI) communities, and the collaborative solutions to these challenges reached by academic and community partners. In our project case study analysis, we found that ethical tensions were linked mainly to issues of mutual trust and credibility in PI communities; cultural taboos associated with the nexus of religiosity and traditional PI culture; fears of privacy breaches in small, interconnected PI communities; and competing priorities of scientific rigor versus direct community services. Mutual capacity building and linking CBPR practice to PI social protocols are required for effective solutions and progress toward social justice outcomes.
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Pichon LC, Williams TT, Campbell B. An exploration of faith leaders' beliefs concerning HIV prevention: thirty years into the epidemic. FAMILY & COMMUNITY HEALTH 2013; 36:260-268. [PMID: 23718961 DOI: 10.1097/fch.0b013e318292eb10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Despite the growing body of research on faith-based human immunodeficiency virus (HIV) initiatives, there are few studies exploring the perspective of faith leaders involved in HIV prevention efforts. This exploratory study examined how 29 faith leaders conceptualized key aspects of HIV prevention. Sexual health beliefs, perspectives on condom distribution, and facilitating factors and barriers to implementing an HIV program were explored. Seventy-six percent of participants agreed with the statement "they would be willing to make condoms available to adolescents." These findings highlight the importance of reconciling any differences between religious doctrine, leadership role, and beliefs of faith leaders in addressing HIV in churches.
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Affiliation(s)
- Latrice C Pichon
- The University of Memphis, School of Public Health, Memphis, TN, USA.
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Veinot TC, Campbell TR, Kruger DJ, Grodzinski A. A question of trust: user-centered design requirements for an informatics intervention to promote the sexual health of African-American youth. J Am Med Inform Assoc 2013; 20:758-65. [PMID: 23512830 PMCID: PMC3721161 DOI: 10.1136/amiajnl-2012-001361] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 02/14/2013] [Accepted: 02/24/2013] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We investigated the user requirements of African-American youth (aged 14-24 years) to inform the design of a culturally appropriate, network-based informatics intervention for the prevention of HIV and other sexually transmitted infections (STI). MATERIALS AND METHODS We conducted 10 focus groups with 75 African-American youth from a city with high HIV/STI prevalence. Data analyses involved coding using qualitative content analysis procedures and memo writing. RESULTS Unexpectedly, the majority of participants' design recommendations concerned trust. Youth expressed distrust towards people and groups, which was amplified within the context of information technology-mediated interactions about HIV/STI. Participants expressed distrust in the reliability of condoms and the accuracy of HIV tests. They questioned the benevolence of many institutions, and some rejected authoritative HIV/STI information. Therefore, reputational information, including rumor, influenced HIV/STI-related decision making. Participants' design requirements also focused on trust-related concerns. Accordingly, we developed a novel trust-centered design framework to guide intervention design. DISCUSSION Current approaches to online trust for health informatics do not consider group-level trusting patterns. Yet, trust was the central intervention-relevant issue among African-American youth, suggesting an important focus for culturally informed design. Our design framework incorporates: intervention objectives (eg, network embeddedness, participation); functional specifications (eg, decision support, collective action, credible question and answer services); and interaction design (eg, member control, offline network linkages, optional anonymity). CONCLUSIONS Trust is a critical focus for HIV/STI informatics interventions for young African Americans. Our design framework offers practical, culturally relevant, and systematic guidance to designers to reach this underserved group better.
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Affiliation(s)
- Tiffany C Veinot
- School of Information, University of Michigan, Ann Arbor, Michigan 48109-1285, USA.
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Simonds VW, Christopher S. Adapting Western research methods to indigenous ways of knowing. Am J Public Health 2013; 103:2185-92. [PMID: 23678897 DOI: 10.2105/ajph.2012.301157] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Indigenous communities have long experienced exploitation by researchers and increasingly require participatory and decolonizing research processes. We present a case study of an intervention research project to exemplify a clash between Western research methodologies and Indigenous methodologies and how we attempted reconciliation. We then provide implications for future research based on lessons learned from Native American community partners who voiced concern over methods of Western deductive qualitative analysis. Decolonizing research requires constant reflective attention and action, and there is an absence of published guidance for this process. Continued exploration is needed for implementing Indigenous methods alone or in conjunction with appropriate Western methods when conducting research in Indigenous communities. Currently, examples of Indigenous methods and theories are not widely available in academic texts or published articles, and are often not perceived as valid.
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Affiliation(s)
- Vanessa W Simonds
- Vanessa W. Simonds is with the Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City. Suzanne Christopher is with the Department of Health and Human Development at Montana State University, Bozeman
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Teti M, Murray C, Johnson L, Binson D. Photovoice as a Community-Based Participatory Research Method among Women Living with HIV/AIDS: Ethical Opportunities and Challenges. J Empir Res Hum Res Ethics 2012; 7:34-43. [DOI: 10.1525/jer.2012.7.4.34] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Photovoice is a method in which participants use photography to identify, express, and disseminate their experiences. We conducted photovoice projects with women living with HIV/AIDS ( N=21) to explore opportunities and challenges associated with the method. Photovoice provided a means to achieve two key principles of ethical public health practice: It gives participants opportunities to define their health priorities, and facilitates participant empowerment. Ethical challenges that were encountered related to exposing, through photographs, one's identity as living with HIV/AIDS, illicit activities, and other people. We discuss lessons learned for future practice to maximize the ethical opportunities and manage the challenges associated with using photovoice as an HIV-related CBPR strategy.
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Coleman JD, Lindley LL, Annang L, Saunders RP, Gaddist B. Development of a framework for HIV/AIDS prevention programs in African American churches. AIDS Patient Care STDS 2012; 26:116-24. [PMID: 22149766 DOI: 10.1089/apc.2011.0163] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Churches and other faith-based organizations (FBOs) are a vital resource for HIV prevention and education efforts in African American communities. Few models describe how churches and FBOs have implemented such efforts within their congregations or communities, the challenges they faced, or the changes that resulted from such efforts. This article presents a framework for implementing HIV/AIDS prevention programs in African American churches based upon a qualitative investigation of Project FAITH (Fostering AIDS Initiatives that Heal), an HIV education and stigma reduction demonstration project conducted in South Carolina. Between 2007-2008 in-depth interviews were conducted with 8 pastors, 4 technical assistance providers, and 2 project champions; 22 care team members also participated in focus groups to identify domains associated with project implementation. Data analysis was conducted using a grounded theory approach and inputs, enablers, inhibitors, mediators, and outputs associated with HIV/AIDS prevention programs conducted as part of Project FAITH were identified. Furthermore, the framework includes the influences of public policy and stigma on the faith-based HIV/AIDS prevention programs in this study. The framework calls for the identification of individuals (members of the congregation and church leadership) who are passionate about and devoted to addressing HIV/AIDS, and provides specific mechanisms (i.e., health ministries) through which these individuals can organize, strategies for HIV/AIDS implementation, and areas of technical assistance and capacity building to maximize effectiveness of such efforts.
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Affiliation(s)
- Jason D. Coleman
- School of Health, Physical Education, & Recreation, University of Nebraska at Omaha, Omaha, Nebraska
| | - Lisa L. Lindley
- Department of Global and Community Health, George Mason University, Fairfax, Virginia
| | - Lucy Annang
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Ruth P. Saunders
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Bambi Gaddist
- South Carolina HIV/AIDS Council, Columbia, South Carolina
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Derose KP, Mendel PJ, Palar K, Kanouse DE, Bluthenthal RN, Castaneda LW, Corbin DE, Domínguez BX, Hawes-Dawson J, Mata MA, Oden CW. Religious congregations' involvement in HIV: a case study approach. AIDS Behav 2011; 15:1220-32. [PMID: 20953903 PMCID: PMC3087861 DOI: 10.1007/s10461-010-9827-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Comparative case studies were used to explore religious congregations' HIV involvement, including types and extent of activities, interaction with external organizations or individuals, and how activities were initiated and have changed over time. The cases included 14 congregations in Los Angeles County representing diverse faith traditions and races-ethnicities. Activities fell into three broad categories: (1) prevention and education; (2) care and support; and (3) awareness and advocacy. Congregations that engaged early in the epidemic focused on care and support while those that became involved later focused on prevention and education. Most congregations interacted with external organizations or individuals to conduct their HIV activities, but promoting abstinence and teaching about condoms were conducted without external involvement. Opportunities exist for congregations to help address a variety of HIV-related needs. However, activities that are mission-congruent, such as providing pastoral care for people with HIV, raising HIV awareness, and promoting HIV testing, appear easier for congregations to undertake than activities aimed at harm reduction.
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