1
|
Conserve DF, Mathews A, Janson S, Nwaozuru U, Jennings Mayo-Wilson L, Ritchwood TD, Ahonkhai AA, Diallo H, Korede T, Dieng A, Randolph AF, Team BR. Perceptions of HIV self-testing promotion in black barbershop businesses: implications for equitable engagement of black-owned small businesses for public health programs. BMC Public Health 2024; 24:2440. [PMID: 39245719 PMCID: PMC11382491 DOI: 10.1186/s12889-024-19973-x] [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: 05/20/2024] [Accepted: 09/03/2024] [Indexed: 09/10/2024] Open
Abstract
BACKGROUND HIV self-testing (HIVST) offers an innovative and promising approach to increasing HIV testing among Black men in the United States, a population disproportionately affected by HIV. However, engaging Black men in traditional HIV prevention programs has been challenging due to stigma, medical mistrust, and limited access to preventive health services. This formative qualitative study aimed to explore the potential of utilizing barbershops as an example of a nontraditional healthcare venue to promote and distribute HIVST. METHODS Four virtual focus group discussions (FGDs) consisting of 19 participants in North Carolina were conducted with Black men, including barbershop business owners, barbers, and their customers, to assess perceptions of HIVST and the acceptability of partnering with barbershop businesses to promote HIVST. FGDs were digitally recorded, transcribed, and analyzed using a deductive coding approach to thematic analysis. RESULTS Participants reported that the trusting relationship between barbers and their customers, which may not exist between Black men and health care providers, is a facilitator of collaborating with barbershop businesses to reach Black men for HIVST distribution. Participants recommended providing education for barbers on the use of HIVST, as well as how to inform self-testers about linkage to care following HIVST to build the credibility of the barbers in delivering the intervention. Participants also raised the issue of the cost of HIVST to barbershop customers as a potential barrier to implementation, as well as the possibility that the implementation of such interventions could be seen as out of place in a barbershop business venue. Participants also expressed a strong belief that compensation to barbershops and their employees should accompany any intervention. CONCLUSION These findings suggest that barbershop business venues may provide an appropriate venue for HIVST promotion and distribution, though factors like cost, training, and incentivization of implementers are necessary to consider in implementation planning. Furthermore, partnerships between public health actors and the business community must be built on equitable engagement to ensure the long-term viability of these critical initiatives.
Collapse
Affiliation(s)
- Donaldson F Conserve
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
| | | | - Samuel Janson
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | | | | | | | | | - Hassim Diallo
- School of Public Health, University of Maryland, College Park, MD, USA
| | - Tayo Korede
- University of Central Lancashire, Preston, Lancashire, UK
| | - Arona Dieng
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | | | - Bridge Research Team
- Building Research and Implementation to Drive Growth and Equity (BRIDGE) Research Lab, Milken Institute School of Public Health, Washington, DC, USA
| |
Collapse
|
2
|
Urquhart R, Adams M, Chakraborty S, Burns JC. Real Talk: Conversations on HIV with Black Heterosexual Men in Healthcare Settings. J Community Health 2024:10.1007/s10900-024-01388-9. [PMID: 39126616 DOI: 10.1007/s10900-024-01388-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
Nearly half of heterosexually transmitted human immunodeficiency virus (HIV) infections occur among Black men in the United States. Yet Black heterosexual men (BHM) are largely ignored in HIV programming, policy implementation, and research. This study explores how masculinity, mental health, and socioeconomic factors such as income, education, and insurance (e.g., enrollment and coverage) correlate with the likelihood of BHM having important conversations surrounding HIV with their healthcare providers and family members. Conversations among social networks (e.g., peers, family, and neighbors) create an opportunity to increase comfortability while discussing HIV-related topics around condom use and testing. This study used a cross-sectional survey design and convenience sampling (N = 279) to recruit participants from a community-academic partnership involving a Federally Qualified Health Center (FQHC) in Detroit between June 1, 2020, and July 31, 2020. Descriptive statistics were used to report demographics, socioeconomic information, and sexual health-related behavior variables. Spearman's correlation test was used to report bivariate correlations between predictor and outcome variables. 49.3% of the study participants disclosed having ever talked to a healthcare provider about HIV/acquired immune deficiency syndrome (AIDS), and 40.9% disclosed having ever talked to a family member about HIV/AIDS and sexually transmitted infections (STIs). The results from this article highlight potential barriers that may inhibit BHM from engaging in conversations about HIV with their healthcare providers and family members. It is important to include BHM in future research that focuses on HIV prevention and education to support community leaders and clinicians who work to address these disparities.
Collapse
Affiliation(s)
- Rakira Urquhart
- School of Health and Human Sciences, University of North Carolina at Greensboro, 1408 Walker Ave 437 Coleman Bldg, Greensboro, NC, 27412, USA.
| | - Mackenzie Adams
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Shawtaabdee Chakraborty
- College of Human Medicine, Michigan State University, 15 Michigan St, NE Grand Rapids, MI, 49503, USA
| | - Jade C Burns
- School of Nursing, University of Michigan, 400 North Ingalls Street Room 3175, 400 NIB, Ann Arbor, MI, 48109, USA
| |
Collapse
|
3
|
Kohlbeck SA, Kant JM, Glassford R, Monroe T. Art on the skin, lifesaving within: Exploring the role of tattoo artists in suicide prevention. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:762-773. [PMID: 38949264 DOI: 10.1002/jcop.23128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/29/2024] [Accepted: 06/21/2024] [Indexed: 07/02/2024]
Abstract
Different populations experience suicide at different rates. Some studies have found an increased risk of suicide among individuals with tattoos. Studies indicate a higher prevalence of mental health disorders among individuals with one or more tattoos. These findings signal a need to explore suicide prevention in tattoo shops. The aim of this project is to determine the feasibility, acceptability, and interest of providing education on suicide prevention among tattoo artists. We conducted a cross-sectional survey with tattoo artists. Survey items assessed artists' experiences with clients expressing mental health issues or suicidal thoughts, their comfort level assisting clients, and general perceptions around suicide and stigma. Seventy-nine surveys were collected. Most artists reported that they have had at least one situation in which a client mentioned something that made them concerned about that client's mental health. Most respondents reported that a client has expressed suicidal thoughts to them at least once. Our study demonstrated that tattoo artists encounter clients who express mental health challenges as well as suicidal ideation, underscoring the potential role for tattoo artists in supporting individuals at risk for suicidal thoughts and behaviors.
Collapse
Affiliation(s)
- Sara A Kohlbeck
- Division of Suicide Research and Healing, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jacey M Kant
- Division of Suicide Research and Healing, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Rachel Glassford
- Division of Suicide Research and Healing, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Tricia Monroe
- Division of Suicide Research and Healing, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| |
Collapse
|
4
|
Khanani A, Haight D. ShopTalk - Barbers as partners in health promotion: Reviewing social determinants of health, revisiting cardiology pioneers, and moving forward. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2024; 43:100410. [PMID: 39006540 PMCID: PMC11245761 DOI: 10.1016/j.ahjo.2024.100410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 07/16/2024]
Abstract
Social Determinants of Health (SDOH) like education, economic stability, social context, neighborhood environment, and healthcare access are increasingly recognized as major drivers of persistent health disparities, particularly among minority populations. Over the past year, studies have demonstrated and quantified the impact that certain SDOH have on uncontrolled blood pressure in Black and Hispanic adults compared to white adults. This underscores the need to view chronic diseases through a SDOH lens and implement multilevel interventions targeting these underlying social factors to achieve health equity. The ShopTalk initiative, based in Lakeland, Florida, represents a promising community-based approach to addressing SDOH and health disparities. It conducts health outreach in barbershops and hair salons - trusted community hubs where meaningful dialogues occur. Key components include providing health education materials, offering screenings, and facilitating physician connections, all at no cost. By leveraging these culturally-relevant spaces, ShopTalk simultaneously targets multiple SDOH domains like health literacy, economic barriers, neighborhood familiarity, and healthcare engagement. This builds upon the pioneering work of leaders like Dr. Elijah Saunders and Dr. Ronald Victor, who previously engaged social hubs to successfully raise hypertension awareness among underserved populations. As highlighted by Healthy People 2030's emphasis on SDOH, widespread implementation of such culturally-tailored community outreach shows potential for finally reducing longstanding disparities. Specific outcome measures are planned to optimize ShopTalk, with the goal of extracting generalizable insights to guide similar initiatives nationwide.
Collapse
Affiliation(s)
- Aqeel Khanani
- Department of Internal Medicine, Lakeland Regional Health, Lakeland, FL, USA
| | - Daniel Haight
- Department of Internal Medicine, Division of Infectious Diseases and International Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| |
Collapse
|
5
|
Wippold GM, Abshire DA, Wilson DK, Woods T, Zarrett N, Griffith DM. Shop Talk: A Qualitative Study to Understand Peer Health-related Communication Among Black Men at the Barbershop. Ann Behav Med 2024; 58:498-505. [PMID: 38815252 PMCID: PMC11185087 DOI: 10.1093/abm/kaae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND While successful health promotion efforts among Black men have been implemented at barbershops, the focus has largely been on outcomes as opposed to the processes by which outcomes are produced. An understanding of processes can be leveraged in the design and implementation of future efforts to improve the health of Black men. PURPOSE The objectives of the present study were to: (i) understand peer-derived sources of health-related support at the barbershop and (ii) understand the role of the barbershop in promoting health among Black men. METHODS Seven focus groups were conducted at barbershops used predominately by Black men. Each focus group lasted between 45 and 60 min. Using a thematic approach, each focus group was independently coded by two coders using a codebook derived from an inductive and deductive approach. The results were confirmed with members of the community advisory board. RESULTS Three themes emerged: (i) dynamic and candid exchange of health-related support at the barbershop; (ii) tailored forms of health-related and judgment-free communication that provide encouragement and increase motivation; and (iii) characteristics of a supportive environment at the barbershop that facilitate health-related communication. CONCLUSIONS The findings of the present study offer a potential pathway for public health efforts seeking to improve health among Black men. Those interested in designing and implementing these efforts can create tailored programs for Black men by recognizing and leveraging the unique dynamics of health-related conversations at the barbershop.
Collapse
Affiliation(s)
- Guillermo M Wippold
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Demetrius A Abshire
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Terry Woods
- Healthy Mind, Body, and Family Foundation, Sumter, South Carolina, USA
- Main Attraction Barbershop, Sumter, South Carolina, USA
| | - Nicole Zarrett
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Derek M Griffith
- Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC, USA
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
- Racial Justice Institute, Georgetown University, Washington, DC, USA
| |
Collapse
|
6
|
Khosla P, Amin K, Doshi R. Combating Chronic Disease with Barbershop Health Interventions: A Review of Current Knowledge and Potential for Big Data. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2024; 97:239-245. [PMID: 38947107 PMCID: PMC11202109 DOI: 10.59249/otfp5065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Community-based participatory research (CBPR) using barbershop interventions is an emerging approach to address health disparities and promote health equity. Barbershops serve as trusted community settings for health education, screening services, and referrals. This narrative mini-review provides an overview of the current state of knowledge regarding CBPR employing barbershop interventions and explores the potential for big data involvement to enhance the impact and reach of this approach in combating chronic disease. CBPR using barbershop interventions has shown promising results in reducing blood pressure among Black men and improving diabetes awareness and self-management. By increasing testing rates and promoting preventive behaviors, barbershop interventions have been successful in addressing infectious diseases, including HIV and COVID-19. Barbershops have also played roles in promoting cancer screening and increasing awareness of cancer risks, namely prostate cancer and colorectal cancer. Further, leveraging the trusted relationships between barbers and their clients, mental health promotion and prevention efforts have been successful in barbershops. The potential for big data involvement in barbershop interventions for chronic disease management offers new opportunities for targeted programs, real-time monitoring, and personalized approaches. However, ethical considerations regarding privacy, confidentiality, and data ownership need to be carefully addressed. To maximize the impact of barbershop interventions, challenges such as training and resource provision for barbers, cultural appropriateness of interventions, sustainability, and scalability must be addressed. Further research is needed to evaluate long-term impact, cost-effectiveness, and best practices for implementation. Overall, barbershops have the potential to serve as key partners in addressing chronic health disparities and promoting health equity.
Collapse
Affiliation(s)
- Pavan Khosla
- Yale University School of Medicine, New Haven, CT,
USA
| | | | - Rushabh Doshi
- Yale University School of Medicine, New Haven, CT,
USA
| |
Collapse
|
7
|
Hafez S, Ismail SA, Zibwowa Z, Alhamshary N, Elsayed R, Dhaliwal M, Samuels F, Fakoya A. Community interventions for pandemic preparedness: A scoping review of pandemic preparedness lessons from HIV, COVID-19, and other public health emergencies of international concern. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002758. [PMID: 38709792 PMCID: PMC11073720 DOI: 10.1371/journal.pgph.0002758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/06/2024] [Indexed: 05/08/2024]
Abstract
Community action is broadly recognised as central to comprehensive and effective system responses to pandemics. However, there is uncertainty about how and where communities can be best supported to bolster long-term resilience and preparedness. We applied a typology of community interventions (Community Informing, Consulting, Involving, Collaborating or Empowering-or CICICE) to cover the diverse range of interventions identified across the literature and used this to structure a scoping review addressing three linked topics: (i) how CICICE interventions have been understood and applied in the literature on epidemic and pandemic preparedness; (ii) the spectrum of interventions that have been implemented to strengthen CICICE and (iii) what evidence is available on their effectiveness in influencing preparedness for current and future emergencies. We drew on peer-reviewed and grey literature from the HIV (from 2000) and COVID-19 pandemics and recent public health emergencies of international concern (from 2008), identified through systematic searches in MEDLINE, Scopus, the Cochrane Collaboration database, supplemented by keyword-structured searches in GoogleScholar and websites of relevant global health organisations. Following screening and extraction, key themes were identified using a combined inductive/deductive approach. 130 papers met the criteria for inclusion. Interventions for preparedness were identified across the spectrum of CICICE. Most work on COVID-19 focused on informing and consulting rather than capacity building and empowerment. The literature on HIV was more likely to report interventions emphasising human rights perspectives and empowerment. There was little robust evidence on the role of CICICE interventions in building preparedness. Evidence of effect was most robust for multi-component interventions for HIV prevention and control. Much of the reporting focused on intermediate outcomes, including measures of health service utilisation. We put forward a series of recommendations to help address evidence shortfalls, including clarifying definitions, organising and stratifying interventions by several parameters and strengthening evaluation methods for CICICE.
Collapse
Affiliation(s)
- Sali Hafez
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sharif A. Ismail
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Zandile Zibwowa
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nadin Alhamshary
- The Nuffield Centre for International Health and Development, School of Medicine, The University of Leeds, Leeds, United Kingdom
| | - Reem Elsayed
- The University of Western Cape, Cape Town, South Africa
| | - Mandeep Dhaliwal
- HIV and Health Group, United Nations Development Program, New York, United States of America
| | - Fiona Samuels
- Centre for Public Health and Policy, Queen Mary University of London, London, United Kingdom
| | - Ade Fakoya
- Institute for Global Health, University College London, London, United Kingdom
| |
Collapse
|
8
|
Wippold GM, Crichlow ZR, Garcia KA, Domlyn A, Sanchez S, Frank L, Mote T, Frary SG, Woods T. Assessing organizational readiness for the Clean Cuts and Sharp Minds Collective: a barbershop health promotion network. Implement Sci Commun 2024; 5:42. [PMID: 38627824 PMCID: PMC11022399 DOI: 10.1186/s43058-024-00584-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Black men have among the lowest life expectancy in the United States. Alarmingly, these men are underrepresented in health promotion efforts. There are well-documented barriers to recruiting and retaining Black men in health promotion efforts, such as exclusionary research practices - many researchers may be hesitant to reach Black men in culturally unique spaces, such as barbershops. Despite these practices, qualitative research among Black men unanimously find that Black men are interested in health promotion efforts. The Clean Cuts and Sharp Minds Collective (CCSMC) was designed to bridge this gap. The objectives of the CCSMC are to train barbers to be lay advocates for their clients, train barbers to be research partners, and serve as a nexus between barbers interested in health promotion at their shops and researchers interested in implementing such efforts. The present study sought to assess the organizational readiness of barbershops in South Carolina (SC) to participate in the CCSMC. METHODS Barbers in SC were invited to complete a modified version of the Readiness Thinking Tool to assess organizational readiness to participate in the CCSMC. RESULTS Thirty-six (36; mean age = 41.12; 94.4% identified as Black; 91.7% identified as male) barbers completed the organizational readiness assessment. Results indicated that there was a high level of motivation, innovation-specific capacity, and general capacity within barbershops to participate in the CCSMC. Additionally, many barbers indicated that there would be widespread support to join the CCSMC. CONCLUSIONS The results from the present study highlight exciting opportunities and future directions for barbershop-academic partnerships. Such partnerships have the potential to promote health equity among, and in partnership with, Black men.
Collapse
Affiliation(s)
- Guillermo M Wippold
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA.
| | - Zion R Crichlow
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA
| | - Kaylyn A Garcia
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA
| | - Ariel Domlyn
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Shane Sanchez
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA
| | - Lucina Frank
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA
| | - Thrisha Mote
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA
| | - Sarah Grace Frary
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA
| | - Terry Woods
- Main Attraction Barbershop, Sumter, SC, USA
- Healthy Mind, Body, and Family Foundation, Sumter, SC, USA
| |
Collapse
|
9
|
Johnson R, Conley C, Jeter E, Randolph SD. PrEP-aring stylists: Development of a stylist educational workshop to increase PrEP awareness and knowledge among Black women in the US south . Public Health Nurs 2024; 41:57-66. [PMID: 37720933 DOI: 10.1111/phn.13253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/20/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Black cis-gender women are disparately affected by HIV and require prioritization in prevention efforts, including pre-exposure prophylaxis (PrEP). Preparing trusted community leaders such as salon stylists as health-based opinion leaders may be promising to increasing awareness, knowledge, and uptake of PrEP among Black women. We sought to develop training and better understand stylists who may participate in a salon-based PrEP intervention for Black women. METHODS A community-research partnership designed a stylist training workshop for stylists with a majority Black women clientele. A two-session workshop focused on HIV knowledge, HIV prevention including PrEP, and the role of an opinion leader to influence community social and health norms. An exploratory research design and analysis was conducted to examine stylists and provide training feedback. CONCLUSIONS Stylists showed a high level of knowledge and willingness to serve as an opinion leader in their salons and with their communities. Stylists also verified medical mistrust in the healthcare system that makes community-based interventions attractive. This article discusses how the training was piloted and accepted by stylists.
Collapse
Affiliation(s)
- Ragan Johnson
- Division of Health in Adult Populations, Duke University School of Nursing, Durham, North Carolina, USA
| | - Cherie Conley
- Department of Systems, Population, and Leadership, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth Jeter
- Division of Health in Adult Populations, Duke University School of Nursing, Durham, North Carolina, USA
| | - Schenita D Randolph
- Division of Health in Adult Populations, Duke University School of Nursing, Durham, North Carolina, USA
| |
Collapse
|
10
|
Riccardi M, Pettinicchio V, Di Pumpo M, Altamura G, Nurchis MC, Markovic R, Šagrić Č, Stojanović M, Rosi L, Damiani G. Community-based participatory research to engage disadvantaged communities: Levels of engagement reached and how to increase it. A systematic review. Health Policy 2023; 137:104905. [PMID: 37716190 DOI: 10.1016/j.healthpol.2023.104905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/12/2023] [Accepted: 09/02/2023] [Indexed: 09/18/2023]
Abstract
Community-based participatory research (CBPR) is one of the most used community engagement frameworks to promote health changes in vulnerable populations. The more a community is engaged, the more a program can impact the social determinants of health. The present study aims to measure the level of engagement reached in randomized controlled trials (RCTs) using CBPR in disadvantaged populations, and to find out the CBPR components that better correlate with a higher level of engagement. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Embase, Web of Science, MEDLINE, Cochrane and Scopus databases were queried. Engagement level was assessed using the revised version of IAP2 spectrum, ranging from "inform" to "shared leadership" . Fifty-one RCTs were included, belonging to 36 engagement programs. Fourteen CBPR reached the highest level of engagement. According to the multivariate logistic regression, a pre-existing community intervention was associated with a higher engagement level (OR = 10.08; p<0.05). The variable "institutional funding" was perfectly correlated with a higher level of engagement. No correlation was found with income status or type of preventive programs. A history of collaboration seems to influence the effectiveness in involving communities burdened with social inequities, so starting new partnerships remains a public health priority to invest on. A strong potentiality of CBPR was described in engaging disadvantaged communities, addressing social determinants of health. The key findings described above should be taken into account when planning a community engagement intervention, to build up an effective collaborative field between researchers and population.
Collapse
Affiliation(s)
- MariaTeresa Riccardi
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Marcello Di Pumpo
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gerardo Altamura
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Mario Cesare Nurchis
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Roberta Markovic
- University of Niš, Faculty of Medicine, Niš, Serbia; Public Health Institute Niš, Niš, Serbia
| | | | - Miodrag Stojanović
- University of Niš, Faculty of Medicine, Niš, Serbia; Public Health Institute Niš, Niš, Serbia
| | - Luca Rosi
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Gianfranco Damiani
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| |
Collapse
|
11
|
Coulibaly K, Bousmah MAQ, Ravalihasy A, Taéron C, Mbiribindi R, Senne JN, Gubert F, Gosselin A, Desgrées du Loû A. Bridging the knowledge gap of biomedical HIV prevention tools among sub-saharan african immigrants in France. Results from an empowerment-based intervention. SSM Popul Health 2023; 23:101468. [PMID: 37560089 PMCID: PMC10407280 DOI: 10.1016/j.ssmph.2023.101468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/20/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction Biomedical HIV prevention tools are available in France to prevent new infections. However, evidence suggests a lack of knowledge of these tools among sub-Saharan African immigrants, who are particularly affected by HIV due to social hardship, an indirect factor of HIV acquisition. We analysed the impact of an empowerment-based intervention on the knowledge of treatment as prevention (TasP), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in a population of precarious sub-Saharan African immigrants. Methods Data were collected throughout the MAKASI project. Following an outreach approach, participants were recruited in public places based on their precarious situations and followed for six months (0, 3, 6 months) between 2018 and 2021. Participants were randomized into two groups and received an empowerment intervention sequentially (stepped wedge design). We used random-effects logistic regression models to evaluate the intervention effect on the knowledge of biomedical HIV prevention tools. ClinicalTrials.gov Identifier: NCT04468724. Results The majority of the participants were men (77.5%), and almost half of them had arrived in France within 2 years prior to inclusion (49.3%). At baseline, 56% of participants knew about TasP, 6% knew about PEP and 4% knew about PrEP. Receiving the intervention increased the odds of knowing about PEP (aOR = 2.02 [1.09-3.75]; p < 0.026). Intervention effects were observed for TasP and PrEP only after 6 months. We found significant time effects for PEP (at 3 months, aOR = 4.26 [2.33-7.80]; p < 0.001; at 6 months, aOR = 18.28 [7.39-45.24]; p < 0.001) and PrEP (at 3 months, aOR = 4.02 [2.10-7.72]; p < 0.001; at 6 months, aOR = 28.33 [11.16-71.91]; p < 0.001). Conclusions We showed that the intervention increased the knowledge of biomedical HIV prevention tools. The effect of the intervention was coupled with an important time effect. This suggested that exposure to the intervention together with other sources of information contributed to increased knowledge of biomedical HIV prevention tools among precarious sub-Saharan African immigrants.
Collapse
Affiliation(s)
- Karna Coulibaly
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
| | - Marwân-al-Qays Bousmah
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
| | - Andrainolo Ravalihasy
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
| | | | | | | | - Flore Gubert
- IRD, UMR LEDa-DIAL, PSL, Université Paris-Dauphine, CNRS, Paris, France
| | - Anne Gosselin
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
- Institut National D’Études Démographiques, Aubervilliers, France
| | - Annabel Desgrées du Loû
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
| | | |
Collapse
|
12
|
Wippold GM, Frary SG, Garcia KA, Wilson DK. Implementing barbershop-based health-promotion interventions for Black men: A systematic scoping review. Health Psychol 2023; 42:435-447. [PMID: 37227823 PMCID: PMC10330434 DOI: 10.1037/hea0001294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Health-promotion efforts among Black men in the United States have been limited in their ability to recruit, retain, and produce meaningful health-related changes. These difficulties have led to Black men being referred to as a "hard-to-reach" population-a designation that places undue blame on these men as opposed to the dissemination and implementation strategies being used by health-promotion specialists. Gender- and race-based strategies that align with the lived experiences of these men are likely to circumvent these challenges. Barbershops are cultural institutions that are uniquely positioned to promote health among Black men. There is little guidance on how to develop, implement, and evaluate barbershop-based efforts. This scoping review seeks to provide this guidance by applying the RE-AIM framework to analyze existing interventions. METHOD Information was identified by searching the following bibliographic databases: PubMed, EMBASE PsycINFO, CINAHL, and Web of Science. A grey literature search was conducted using Web of Science and ClinicalTrials.gov. Results were uploaded to Rayyan. Each article was independently and blindly assessed by two reviewers. A third reviewer blindly resolved any discrepancies. Data were then independently extracted by the two reviewers. Discrepancies were flagged and resolved collaboratively. RESULTS Results indicate that barbershop-based health-promotion efforts that prioritize community engagement and intentional alignment to the gender- and race-based lived experiences of Black men are likely to result in satisfactory recruitment, retention, and health-related changes among these men. CONCLUSIONS More intervention efforts are needed that target young Black adults, rural Black men, mental health outcomes, and which implement peer-to-peer models. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
|
13
|
Jemmott LS, Jemmott JB, Stevenson HS, Chittamuru D. Barber-Led HIV/Sexually Transmitted Infection Risk Reduction for Young African-American Men: Efficacy and Mediation in a Cluster Randomized Controlled Trial. J Adolesc Health 2023; 72:575-582. [PMID: 36690549 DOI: 10.1016/j.jadohealth.2022.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 01/22/2023]
Abstract
PURPOSE The aim of this study is to evaluate the efficacy and mediation of a culturally appropriate, theory-based HIV/STI (sexually transmitted infection) risk-reduction intervention delivered in barbershops by barbers via iPads to African-American young men in reducing sexual risk behaviors. METHODS In a cluster randomized controlled trial, 24 matched pairs of barbershops serving African-American men ages 18-24 in the 10 Philadelphia, PA zip codes with the highest HIV/AIDS prevalence were randomized to implement via iPads one of 2 interventions: "Shape Up! Barbers Building Better Brothers," an HIV/STI risk-reduction intervention based on the theory of planned behavior and formative research or an attention-matched violence-prevention control intervention. The primary outcome was self-reported consistent condom use 3, 6, and 12 months postintervention, controlling for baseline consistent condom use. RESULTS Participants were 618 men, 319 in the HIV/STI intervention and 299 in the control intervention. Generalized estimating equation analysis indicated that the direct effect of the HIV/STI intervention in increasing consistent condom use postintervention was nonsignificant (odds ratio = 1.13, 95% confidence interval: 0.73-1.75), adjusting for clustering among participants in barbershops and baseline condom use. However, mediation analysis using the product-of-coefficients approach revealed indirect effects of the intervention. Consistent with the theory of planned behavior, the intervention increased behavioral beliefs and self-efficacy regarding using condoms, which raised condom use intention, which, in turn, boosted consistent condom use. DISCUSSION Sexual risks among young African-American men can be reduced by barber-led theory-based, culturally appropriate HIV/STI risk-reduction interventions in barbershops in high HIV prevalence neighborhoods that increase behavioral beliefs and self-efficacy.
Collapse
Affiliation(s)
- Loretta S Jemmott
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.
| | - John B Jemmott
- University of Pennsylvania Annenberg School for Communication, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Howard S Stevenson
- University of Pennsylvania Graduate School of Education, Philadelphia, Pennsylvania
| | - Deepti Chittamuru
- University of Pennsylvania Annenberg School for Communication, Philadelphia, Pennsylvania; School of Social Sciences, Arts, and Humanities, University of California, Merced, California
| |
Collapse
|
14
|
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.
Collapse
|
15
|
Thomas N, Ewart C, Lewinson Roberts D, Brown A. "You Can Change the World With a Haircut": Evaluating the Feasibility of a Barber-led Intervention for Men of Black and Ethnic Minority Heritage to Manage High Blood Pressure. J Prim Care Community Health 2023; 14:21501319231168336. [PMID: 37148215 PMCID: PMC10164844 DOI: 10.1177/21501319231168336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND People of Black, Asian and minority ethnic (BAME) heritage have a higher-than-average incidence of, and mortality from hypertension and stroke. Therefore, it is important to identify new settings for engaging people at risk of high blood pressure (BP). AIM This feasibility study aimed to evaluate if barbers in a London borough can support and educate men of BAME heritage to manage their BP. Following UK Medical Research Council guidance, the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework was used to guide study objectives and feasibility outcomes. METHODS We collaborated with 8 barbers who were part of an existing BAME barber network. Barbers were trained online (1.5 h) and face-to-face (3 h) to provide BP healthcare advice and take customers BP readings. Qualitative field notes were collected to assess how best to recruit and train barbers, and to understand how to maintain motivation and retention of barbers. BP readings were recorded between June 2021 and March 2022. RESULTS Both online and face-to-face training were effective, however, greater focus on how to start conversations about BP with clients was needed. We found that motivation, incentivization and regular contact with barbers were important for recruitment, retention, and sustained BP measurement. Obtaining BP readings was challenging due to client concerns about recording their data and the impracticalities of recording results. We captured 236 BP recordings, of which 39 (16.53%) were over 140/90 mmHg; of these, 5 were over 180/100 mmHg. CONCLUSION The combined data showed that educating barbers to take BP readings and deliver healthcare advice about BP is a viable intervention for rollout in a large-scale study. It has demonstrated the need to identify strategies to motivate barbers for sustained recruitment and retention, as well as further efforts to build trust among customers for long-term BP surveillance.
Collapse
|
16
|
Nwakoby C, Pierce LJ, Crawford R, Conserve D, Perkins J, Hurt S, Ahonkhai AA. Establishing an Academic-Community Partnership to Explore the Potential of Barbers and Barbershops in the Southern United States to Address Racial Disparities in HIV Care Outcomes for Black Men Living With HIV. Am J Mens Health 2023; 17:15579883231152114. [PMID: 36757054 PMCID: PMC9943967 DOI: 10.1177/15579883231152114] [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: 08/10/2022] [Revised: 12/14/2022] [Accepted: 01/03/2023] [Indexed: 02/10/2023] Open
Abstract
Black men comprise most new HIV infections in the Southern United States and have worse HIV outcomes than their non-Black counterparts. We developed an academic-community partnership in Nashville, Tennessee, to explore opportunities to improve HIV outcomes for Black men. We recruited barbers to an HIV training and focus group discussion about prevention and potential barber/barbershop-based strategies to address HIV-related needs for Black men. We assessed HIV knowledge and stigma with validated scales and conducted thematic analysis on discussion transcripts. HIV-related stigma was low (1.8 of 15 points [SD = 1.69]) among 13 participants of unknown HIV status (12 men and one woman). HIV knowledge increased among eight (67%) participants after receiving a brief HIV didactic. Participants described general health care barriers (e.g., the social norm that Black men do not go to the doctor until they are "damn near dead"), fears about unwanted HIV disclosure when seeking HIV testing or care, and community fears about negative stereotypes associated with HIV. Participants expressed enthusiasm about receiving more HIV-related training and utilizing communication skills and client/community relationships to serve as health educators and navigators. Barbers highlighted opportunities to disseminate HIV information in barbershops and combine HIV interventions with other health issues, such as COVID-19, and suggested that these interventions may help reduce HIV-related stigma. Our findings suggest that barbers and barbershops are an underutilized resource for disseminating HIV-related health information and engaging Black men in HIV and other important prevention and care activities such as COVID-19.
Collapse
Affiliation(s)
| | - Leslie J. Pierce
- Vanderbilt Institute of Global Health,
Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Donaldson Conserve
- Department of Prevention and Community
Health, Milken Institute School of Public Health, The George Washington University,
Washington, DC, USA
| | | | | | - Aima A. Ahonkhai
- Vanderbilt Institute of Global Health,
Vanderbilt University Medical Center, Nashville, TN, USA
- Division of Infectious Diseases,
Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
17
|
Mota NP, Maia JKDO, Abreu WJCP, Galvão MTG. Tecnologias educativas para prevenção do HIV em negros: revisão de escopo. Rev Gaucha Enferm 2023. [DOI: 10.1590/1983-1447.2023.20220093.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RESUMO Objetivo: Mapear as tecnologias educativas implementadas para prevenção do HIV em negros. Método: Revisão de escopo, realizada conforme as recomendações do The Joanna Briggs Institute, nas bases de dados Medline/PubMed, Embase, LILACS, CINAHL, Scopus, Cochrane e PsycINFO, utilizando-se do instrumento Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Resultados: Encontraram-se 14 estudos publicados entre 1999 e 2020. Os principais impactos para saúde dos negros envolveram a redução das taxas de relações sexuais desprotegidas, o maior uso de preservativos, a diminuição de comportamentos de risco, a minimização do número de parceiros, a maior solicitação de testagens para HIV e o aumento do uso de Profilaxia Pré-exposição (PrEP). Conclusão: As tecnologias educativas mapeadas foram: workshops, cursos, mensagens, dramatização, vídeos, aplicativo, panfleto, campanhas de mídia e de rádio, grupos de Facebook, site, programas de computadores e softwares multimídia.
Collapse
|
18
|
Mota NP, Maia JKDO, Abreu WJCP, Galvão MTG. Educational technologies for HIV prevention in black people: scope review. Rev Gaucha Enferm 2022; 44:e20220093. [PMID: 36541949 DOI: 10.1590/1983-1447.2023.20220093.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/24/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To map the educational technologies implemented for HIV prevention in black people. METHOD Scope review, performed according to the recommendations of The Joanna Briggs Institute, in Medline/PubMed, Embase, LILACS, CINAHL, Scopus, Cochrane and PsycINFO databases, using the Preferred Reporting Items for Systematic reviews and Meta- Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS There were 14 studies published between 1999 and 2020. The main health impacts for black people involved a reduction in rates of unprotected sex, greater use of condoms, a decrease in risky behaviors, a minimization of the number of partners, a greater request for HIV testing and an increase in the use of Pre-exposure prophylaxis (PrEP). CONCLUSION The educational technologies mapped were: workshops, courses, messages, dramatization, videos, application, pamphlet, media and radio campaigns, Facebook groups, website, computer programs and multimedia software.
Collapse
Affiliation(s)
- Nikaelly Pinheiro Mota
- Universidade Federal do Ceará (UFC), Programa de Pós-Graduação em Enfermagem. Fortaleza, Ceará, Brasil
| | | | | | | |
Collapse
|
19
|
Taylor NK, Faulks M, Brown-Johnson CG, Rosas LG, Shaw JG, Saliba-Gustafsson EA, Asch SM. Pandemic Through the Lens of Black Barbershops: COVID-19's Impact and Barbers' Potential Role as Public Health Extenders. J Immigr Minor Health 2022; 25:660-665. [PMID: 36417031 PMCID: PMC9684895 DOI: 10.1007/s10903-022-01420-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/24/2022]
Abstract
We examined the impact of COVID-19 on Black barbershops and their potential role as public health extenders. A 30-item survey was distributed to predominantly Black barbershop owners and barbers across 40 different states/territories in the US between June and October 2020. The survey addressed the impact of COVID-19 on Black barbershops, and barbers' interest in engaging in health outreach programs. The majority reported that stay-at-home orders had significant to severe impact on their business; few were prepared for the financial impact and less than half thought they qualified for government assistance. The majority were already providing health education and outreach to the Black community and showed interest in continuing to provide such services, like information on COVID-19. Barbers in Black-serving barbershops, a well-documented effective place for public health outreach to the Black community, show promise as public health extenders in the response to the COVID-19 pandemic.
Collapse
Affiliation(s)
- N Kenji Taylor
- Division of Primary Care and Population Health, Stanford University School of Medicine, 291 Campus Drive, 94305, Stanford, CA, USA. .,Roots Community Health Center, Oakland, CA, USA.
| | | | - Cati G Brown-Johnson
- Division of Primary Care and Population Health, Stanford University School of Medicine, 291 Campus Drive, 94305, Stanford, CA, USA
| | - Lisa G Rosas
- Division of Primary Care and Population Health, Stanford University School of Medicine, 291 Campus Drive, 94305, Stanford, CA, USA.,Division of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Jonathan G Shaw
- Division of Primary Care and Population Health, Stanford University School of Medicine, 291 Campus Drive, 94305, Stanford, CA, USA
| | - Erika A Saliba-Gustafsson
- Division of Primary Care and Population Health, Stanford University School of Medicine, 291 Campus Drive, 94305, Stanford, CA, USA
| | - Steven M Asch
- Division of Primary Care and Population Health, Stanford University School of Medicine, 291 Campus Drive, 94305, Stanford, CA, USA.,Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, CA, USA
| |
Collapse
|
20
|
Coulibaly K, Gosselin A, Carillon S, Ravalihasy A, Melchior M, Ridde V, Desgrées du Loû A. Is empowerment in sexual health measurable? A scoping review of definitions and measurement indicators. Health Promot Int 2022; 37:6730779. [PMID: 36173607 DOI: 10.1093/heapro/daac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The concept of empowerment in sexual health is widely used in health promotion. This scoping review aims to identify how it is defined and measured. PubMed, Sage Journals, PsycInfo and the Web of Science are data sources. The inclusion criteria for studies were as follows: (1) an analysis of empowerment in sexual health, (2) quantitative evaluation and (3) publication in a peer-reviewed journal in French or English since January 1996. Data were extracted using a summary table of the definitions and indicators of empowerment in sexual health. Of the 2181 articles found, 29 met the inclusion criteria. Only 4 studies on 29 clearly defined empowerment in sexual health. Five dimensions emerged from the indicators used in the 29 studies in relation to sexual empowerment (social participation, participation in decision making, power to act, sexual health knowledge and gender norms), with two types of indicators: indicators unspecific to sexual health, which can be viewed as empowerment basic skills, and indicators specific to sexual health. Most studies concerned women and focused on individual empowerment, with a lack of measure of collective and structural levels of empowerment. Despite great heterogeneity in the definitions and indicators used, a set of core indicators emerged: participation in decision making, sexual negotiation power and sexual communication skills, knowledge and use of contraceptive methods, and HIV and sexually transmitted infections risk perception. This set could be systematically used in each study based on sexual empowerment concept, completed by supplementary indicators considering the specific context.
Collapse
Affiliation(s)
- Karna Coulibaly
- Université Paris Cité, IRD, INSERM, Ceped, F-75006 Paris, France.,French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
| | - Anne Gosselin
- Université Paris Cité, IRD, INSERM, Ceped, F-75006 Paris, France.,French Collaborative Institute on Migrations, CNRS, Aubervilliers, France.,French Institute for Demographic Studies (INED), Aubervilliers, France
| | | | - Andrainolo Ravalihasy
- Université Paris Cité, IRD, INSERM, Ceped, F-75006 Paris, France.,French Collaborative Institute on Migrations, CNRS, Aubervilliers, France.,Institute for Research on Sustainable Development (IRD), Marseille, France
| | - Maria Melchior
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France.,ERES, Social Epidemiology Unit, IPLESP, INSERM S1136, Faculté de Médecine de Saint Antoine, Paris, France
| | - Valéry Ridde
- Université Paris Cité, IRD, INSERM, Ceped, F-75006 Paris, France.,French Collaborative Institute on Migrations, CNRS, Aubervilliers, France.,Institute for Research on Sustainable Development (IRD), Marseille, France
| | - Annabel Desgrées du Loû
- Université Paris Cité, IRD, INSERM, Ceped, F-75006 Paris, France.,French Collaborative Institute on Migrations, CNRS, Aubervilliers, France.,Institute for Research on Sustainable Development (IRD), Marseille, France
| |
Collapse
|
21
|
Julian McFarlane S, Occa A, Peng W, Awonuga O, Morgan SE. Community-Based Participatory Research (CBPR) to Enhance Participation of Racial/Ethnic Minorities in Clinical Trials: A 10-Year Systematic Review. HEALTH COMMUNICATION 2022; 37:1075-1092. [PMID: 34420460 DOI: 10.1080/10410236.2021.1943978] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There has not been a significant improvement in the rate of clinical trial accrual in more than 20 years. Worse, the challenge of inadequate representation among racial and ethnic minorities also persists, deepening disparities in health. Community-Based Participatory Research (CBPR) is a participatory communication method that centers on effective dialogue between researchers and community stakeholders with the goal of creating an equitable partnership for health and social change. The objective of the current study was to provide an update since a systematic review in 2012, on the current status of the empirical research, with a particular focus on the elements of CBPR methods used to improve the rate of accrual of members of racial and ethnic minority communities for clinical trials. Our systematic review found a large increase in the number of CBPR related studies and studies related to racial and ethnic representation in research. More than 85% of studies employing CBPR methods saw statistically positive outcomes. Specifically, the elements of CBPR that are associated with these positive outcomes include community partner participation in (1) a study advisory committee, (2) data collection, (3) the development of interventions, and (4) participant recruitment. However, the results of our study indicate that researchers need to be more transparent about the extent of community participation as well as more thoroughly and accurately describe the nature of the partnership with members of minority communities in order to build upon the scientific literature on community-engaged methods.
Collapse
Affiliation(s)
| | - Aurora Occa
- Department of Communication, University of Kentucky
| | - Wei Peng
- Murrow College of Communication, Washington State University
| | | | | |
Collapse
|
22
|
Wippold GM, Frary SG, Abshire DA, Wilson DK. Improving Recruitment, Retention, and Cultural Saliency of Health Promotion Efforts Targeting African American Men: A Scoping Review. Ann Behav Med 2022; 56:605-619. [PMID: 34473823 PMCID: PMC9242543 DOI: 10.1093/abm/kaab079] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND When health promotion efforts intend to include African American men, they experience challenges with recruitment and retention, in addition to limited cultural saliency-interventions that do not align the cultural preferences and experiences of the target population produce less effective results. PURPOSE This scoping review provides an understanding of (a) how health promotion efforts among African American men are developed and implemented, in addition to the (b) main outcomes, (c) retention rates, and (d) methodological rigor of those efforts. METHODS The following databases were used: PubMed, EMBASE (Ovid), PsycINFO (EBSCO), CINAHL (EBSCO), Web of Science (Clarivate), and ProQuest. Included studies were restricted to those: (a) conducted among African American men and (b) reported the effects of a health promotion intervention. Interventions using single-group pre-post study, post-test-only study, non-randomized controlled trial, and randomized controlled trial (RCT) study designs were included. RESULTS The results indicate that varying degrees of customization in the design and implementation of health promotion efforts targeting African American can improve recruitment, retention, and health-related outcomes. Results draw attention to the need for community input when designing and implementing efforts targeting these men. CONCLUSIONS These results indicate that opportunities exist to innovate health promotion efforts among African American men, such as the intentional incorporation of the community's values, perspectives, and preferences in the effort (i.e., cultural saliency) and explicitly indicating how the efforts were culturally tailored to improve saliency. Opportunities also exist to innovate health promotion efforts among African American men based on literature-derived best practices.
Collapse
Affiliation(s)
- Guillermo M Wippold
- Department of Psychology, University of South Carolina, Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, USA
| | - Sarah Grace Frary
- Department of Psychology, University of South Carolina, Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, USA
| | | | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, USA
| |
Collapse
|
23
|
Nwaozuru U, Obiezu-Umeh C, Diallo H, Graham D, Whembolua GL, Bourgeau MJ, Ritchwood TD, Nelson LE, Shato T, Mathews A, Moise R, Ward MC, Raude J, Ahonkhai AA, Young DJ, Conserve DF. Perceptions of COVID-19 self-testing and recommendations for implementation and scale-up among Black/African Americans: implications for the COVID-19 STEP project. BMC Public Health 2022; 22:1220. [PMID: 35725400 PMCID: PMC9207861 DOI: 10.1186/s12889-022-13619-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND COVID-19 self-testing (ST) is an innovative strategy with the potential to increase the access and uptake of testing and ultimately to limit the spread of the virus. To maximize the uptake and reach of this promising strategy and inform intervention development and scale up, research is needed to understand the acceptability of and willingness to use this tool. This is vital to ensure that Black/African Americans are reached by the Biden-Harris Administration's free national COVID-19 ST program. This study aimed to explore the acceptability and recommendations to promote and scale-up the uptake of COVID-19 ST among Black/African Americans. METHODS We conducted a cross-sectional qualitative study using a semi-structured questionnaire to assess barriers and facilitators to the uptake of COVID-19 ST among a convenience sample of 28 self-identified Black/African Americans from schools, community centers, and faith-based institutions in Ohio and Maryland. Inductive content analysis was conducted to identify categories and subcategories related to acceptability and recommendations for implementing and scaling up COVID-19 ST in communities. RESULTS Participants perceived COVID-19 self-testing as an acceptable tool that is beneficial to prevent transmission and address some of the barriers associated with health facility testing, such as transportation cost and human contact at the health facility. However, concerns were raised regarding the accurate use of the kits and costs. Recommendations for implementing and scaling up COVID-19 ST included engagement of community stakeholders to disseminate information about COVID-19 self-testing and creating culturally appropriate education tools to promote knowledge of and clear instructions about how to properly use COVID-19 ST kits. Based on these recommendations, the COVID-19 STEP (Self-Testing Education and Promotion) Project is being developed and will involve engaging community partners such as barbers, church leaders, and other community-based organizations to increase the uptake and use of free COVID-19 ST kits among Black/African Americans. CONCLUSION Findings showed that most participants considered COVID-19 ST valuable for encouraging COVID-19 testing. However, cost and accuracy concerns may pose barriers. Future work should consider implementing interventions that leverage the benefits of COVID-19 ST and further assess the extent to which these identified facilitators and barriers may influence COVID-19 ST uptake.
Collapse
Affiliation(s)
- Ucheoma Nwaozuru
- Department of Implementation Science, Wake Forest School of Medicine, 475 Vine Street, Winston-Salem, NC 27101 USA
| | - Chisom Obiezu-Umeh
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave, Saint Louis, MO 63104 USA
| | - Hassim Diallo
- School of Public Health, University of Maryland, College Park, MD 20742 USA
| | - Danielle Graham
- Department of Africana Studies, University of Cincinnati, 2815 Commons Way, Cincinnati, OH 45221-0370 USA
| | - Guy-Lucien Whembolua
- Department of Africana Studies, University of Cincinnati, 2815 Commons Way, Cincinnati, OH 45221-0370 USA
| | - Marie Janeeca Bourgeau
- Department of Psychology, Queens College, City University of New York, 65-30 Kissena Blvd, Queens, New York, NY 11567 USA
| | - Tiarney D. Ritchwood
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2200 W Main St, Durham, NC 27705 USA
| | - LaRon E. Nelson
- School of Nursing, Yale University, 400 West Campus Drive, Orange, CT 06477 USA
| | - Thembekile Shato
- Washington University in Saint Louis, Brown School, 1 Brookings Drive, Saint Louis, MO 63130 USA
| | - Allison Mathews
- Gilead COMPASS Faith Coordinating Center, School of Divinity, Wake Forest University, 2596 Reynolda Rd., Suite 215C, Winston-Salem, NC 27106 USA
| | - Rhoda Moise
- Rhoda Moise, LLC, 127 Church Road, Elkins Park, PA 19027 USA
| | - Maranda C. Ward
- School of Medicine and Health Science, The George Washington University, 2600 Virginia Ave, NW, Washington, DC, 20036 USA
| | - Jocelyn Raude
- EHESP School of Public Health, Avenue du Pr Leon Bernard, F-35000 Rennes, France
| | - Aima A. Ahonkhai
- Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, USA
| | - Diane J. Young
- Prince George’s County Health Department, Family Health Services, Largo, MD 20774 USA
| | - Donaldson F. Conserve
- The George Washington University, Milken Institute School of Public Health, 950 New Hampshire Ave, NW, Washington, DC, 20052 USA
| |
Collapse
|
24
|
Gardner AJ, Fisher M, Tribit GK, Little CE, Lucas ED, Lowe MRT. Research Brief: Assessing Readiness for Barbershop-Based HIV Prevention Programs Among Rural African American Barbershop Patrons. FAMILY & COMMUNITY HEALTH 2022; 45:103-107. [PMID: 35125485 DOI: 10.1097/fch.0000000000000320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
African American men are at a greater risk for contracting HIV infection, and geography may play an important role in the spread of the virus. This study aimed to quantitatively assess the readiness of rural African American men to participate in a barbershop-based HIV prevention program. A paper-and-pencil survey was administered to rural African American male barbershop attendees to assess their readiness for barbershop-based HIV prevention programs. The results suggested that participants were amenable to this form of programming in the barbershop setting. There was no significance detected by demographic variables in readiness for barbershop-based HIV prevention programs. The results of the study give health education specialists and other public health practitioners insight into ways to effectively research, communicate to, and develop culturally appropriate programming for this priority population in a setting in which they are more likely to frequent.
Collapse
Affiliation(s)
- Antonio J Gardner
- Mississippi State University, Mississippi State (Drs Gardner and Fisher); University of Alabama at Birmingham (Ms Tribit); Marquette University, Milwaukee, Wisconsin (Ms Little); and University of Mississippi Medical Center, Jackson (Messrs Lucas and Lowe). Mr Lowe is now at Jackson State University, Jackson, Mississippi
| | | | | | | | | | | |
Collapse
|
25
|
Nwaozuru U, Obiezu-Umeh C, Diallo H, Graham D, Whembolua GL, Bourgeau MJ, Ritchwood T, Nelson LE, Shato T, Mathews A, Moise R, Ward MC, Raude J, Ahonkhai AA, Young DJ, Conserve DF. Perceptions of COVID-19 Self-Testing and Recommendations for Implementation and Scale up Among Black/African Americans: Implications for the COVID-19 STEP Project. RESEARCH SQUARE 2022:rs.3.rs-1277219. [PMID: 35194597 PMCID: PMC8863154 DOI: 10.21203/rs.3.rs-1277219/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background COVID-19 self-testing (ST) is an innovative strategy with the potential to increase the access and uptake of testing and ultimately to limit the spread of the virus. To maximize the uptake and reach of this promising strategy and inform intervention development and scale up, research is needed to understand the acceptability of and willingness to use this tool. This is vital to ensure that Black/African Americans are reached by the Biden-Harris Administration’s free national COVID-19 ST program. This study aimed to explore the acceptability and recommendations to promote and scale up the uptake of COVID-19 ST among Black/African Americans. Methods We conducted a cross-sectional qualitative study using a semi-structured survey to assess barriers and facilitators to the uptake of COVID-19 ST among a convenience sample of 28 self-identified Black/African Americans from schools, community centers, and faith-based institutions in Ohio and Maryland. Inductive content analysis was conducted to identify categories and subcategories related to acceptability and recommendations for implementing and scaling up COVID-19 ST in communities. Results Participants perceived COVID-19 self-testing as an acceptable tool that is beneficial to prevent transmission and address some of the barriers associated with health facility testing, such as transportation cost and human contact at the health facility. However, concerns were raised regarding the accurate use of the kits and costs. Recommendations for implementing and scaling up COVID-19 ST included engagement of community stakeholders to disseminate information about COVID-19 self-testing and creating culturally appropriate education tools to promote knowledge of and clear instructions about how to properly use COVID-19 ST kits. Based on these recommendations, the COVID-19 STEP (Self-Testing Education and Promotion) Project is being developed and will involve engaging community partners such as barbers, church leaders, and other community-based organizations to increase the uptake and use of free COVID-19 ST kits among Black/African Americans. Conclusion Findings showed that most participants considered COVID-19 ST valuable for encouraging COVID-19 testing. However, cost and accuracy concerns may pose barriers. Future work should consider implementing interventions that leverage the benefits of COVID-19 ST and further assess the extent to which these identified facilitators and barriers may influence COVID-19 ST uptake.
Collapse
|
26
|
Reproductive Justice, Public Black Feminism in Practice: A Reflection on Community-Based Participatory Research in Cincinnati. SOCIETIES 2022. [DOI: 10.3390/soc12010017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Research on reproductive justice has mainly, but not exclusively, appeared in academic literature in the context of grassroots social justice movements and as a theoretical framework for understanding the limitations of “reproductive choice” in the absence of social justice. But how can scholars design research to explore and understand reproductive (in)justice in the real lives of women of color? How can research partnerships between university scholars and community stewards be formed and sustained? What tensions and challenges are inherent in these efforts? And how can we find more equitable ways of sharing research findings and creating change with and not on behalf of our community? This paper reflects on the use of Community-Based Participatory Research (CBPR) in a reproductive justice research project focused on Black women residing in Cincinnati.
Collapse
|
27
|
Waryold JM, Shihabuddin C, Masciola R. Barriers to Culturally Competent Human Immunodeficiency Virus Care Among the Black, Indigenous, and People of Color Community. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2021.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
28
|
Gousse Y, Wilson TE, McFarlane D, Browne RC, Fraser M, Yusim D, Stewart M, Salifu MO, Joseph MA. HIV Testing Correlates: U.S. and Foreign Born High-Risk Black Heterosexual Men. J Immigr Minor Health 2021; 23:1145-1151. [PMID: 33507520 PMCID: PMC9796172 DOI: 10.1007/s10903-021-01140-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 12/30/2022]
Abstract
In the U.S., Black men are disproportionately affected by HIV, with some of the highest HIV incidence rates and lowest rates of HIV testing. We examined correlates of HIV testing and knowledge among participants of the Barbershop Talk with Brothers (BTWB) project, an HIV prevention program targeting high-risk sexual behaviors among Black heterosexual men in Brooklyn, New York. Specifically, we examined differences between U.S. vs. foreign-born status and HIV testing rates, HIV knowledge, and socio-demographic factors. Of the 855 men included, the mean age was 33 years and 35.0% were foreign-born. Lifetime HIV testing was reported at 84%, with greater proportion of U.S. vs foreign-born men reporting lifetime (88.6% vs. 75.0%) and recent testing (68.6% vs. 51.0%), p < 0.001. Among foreign-born men, recent HIV testing was associated with lower stigma and greater HIV transmission knowledge than those un-tested. The authors recommend tailored approaches to increasing HIV testing in Black communities, based on nativity and social factors.
Collapse
Affiliation(s)
- Yolene Gousse
- Department of Pharmacy Administration and Public Health, St. John’s University, Queens, NY, USA,Brooklyn Health Disparities Center, Brooklyn, NY, USA,Department of Pharmacy Administration and Public Health, Dr. Andrew J. Bartilucci Center, St. John’s University, 8000 Utopia Parkway, New York, NY 11439, USA
| | - Tracey E. Wilson
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Davin McFarlane
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Special Treatment and Research Program, College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Marilyn Fraser
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Arthur Ashe Institute for Urban Health, Brooklyn, NY, USA
| | - Diana Yusim
- Baystate Medical Center, Springield, MA, USA
| | - Mark Stewart
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,School of Graduate Studies, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Moro O. Salifu
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Division of Nephrology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Michael A. Joseph
- Brooklyn Health Disparities Center, Brooklyn, NY, USA,Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| |
Collapse
|
29
|
Leibowitz A, Tan D. Informing California's Plan to Enhance HIV Screening in the Ending the HIV Epidemic Initiative. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:377-394. [PMID: 34596426 PMCID: PMC9997719 DOI: 10.1521/aeap.2021.33.5.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The CDC recommends that everyone have at least one HIV test in their lifetime. However, analyses of California Health Interview Survey data showed that in 2017 only half of Californians had ever received an HIV test. Non-Hispanic Black (64.8%) and Hispanic adults (54.7%) had higher lifetime testing rates than non-Hispanic White adults (48.8%). In multivariable analyses non-Hispanic African American adults had twice and Hispanic adults 1.2 times the odds of lifetime HIV testing as non-Hispanic White adults. The CDC recommends annual HIV testing for higher-risk individuals. Independent of race/ethnicity, heterosexual men with multiple sex partners had lower annual testing rates than other high-risk individuals. Annual testing was unrelated to education level and poverty, but was related to number of doctor visits. HIV screening rates among heterosexual men with multiple partners could be increased by targeting HIV screening to non-medical settings in California's eight Ending the HIV Epidemic counties.
Collapse
Affiliation(s)
- Arleen Leibowitz
- Department of Public Policy, Luskin School of Public Affairs, University of California Los Angeles
| | - Diane Tan
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles
| |
Collapse
|
30
|
Lockhart E, Turner D, Ficek J, Livingston T, Logan RG, Marhefka SL. Understanding Technology Fit Among People with HIV Based on Intersections of Race, Sex, and Sexual Behavior: An Equitable Approach to Analyzing Differences Across Multiple Social Identities. AIDS Behav 2021; 25:2618-2629. [PMID: 33751311 PMCID: PMC7982513 DOI: 10.1007/s10461-021-03223-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 11/25/2022]
Abstract
HIV disproportionately impacts individuals based on intersecting categories (e.g. gender, race/ethnicity, behavior), with groups most at-risk deemed priority populations. Using weighted effects coding to account for differential group sizes, this study used multilevel mixed logistic models to investigate differences in eHealth use and willingness to use eHealth for HIV-related information among priority populations. Compared to the sample average, Black men who had sex with women were less likely to use all technologies except cellphones with text-messaging and less likely to be willing to use computers and tablets. White and Hispanic men who had sex with men were more likely to use all technologies. No significant differences existed for use or willingness to use cellphones with text-messaging. Future research should consider approaches used here to account for equity and multiple intersecting social identities; practitioners may use these findings or similar local data to ensure fit between eHealth programs and priority populations.
Collapse
Affiliation(s)
- Elizabeth Lockhart
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., Tampa, FL, 33612, USA
| | - DeAnne Turner
- Yale AIDS Prevention Training Program (Y-APT), Center for Interdisciplinary Research On AIDS (CIRA), Yale University, 135 College St. Suite 200, New Haven, CT, 06510, USA
| | - Joseph Ficek
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., Tampa, FL, 33612, USA
| | - Taylor Livingston
- University of Nebraska-Lincoln, 816 Oldfather Hall, Lincoln, NE, 68588-0368, USA
| | | | - Stephanie L Marhefka
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., Tampa, FL, 33612, USA.
| |
Collapse
|
31
|
Abstract
Concurrent sexual partnerships (i.e., relationships that overlap in time) contribute to higher HIV acquisition risk. Social capital, defined as resources and connections available to individuals is hypothesized to reduce sexual HIV risk behavior, including sexual concurrency. Additionally, we do not know whether any association between social capital and sexual concurrency is moderated by gender. Multivariable logistic regression tested the association between social capital and sexual concurrency and effect modification by gender. Among 1445 African Americans presenting for care at an urban STI clinic in Jackson, Mississippi, mean social capital was 2.85 (range 1-5), mean age was 25 (SD = 6), and 62% were women. Sexual concurrency in the current year was lower for women compared to men (45% vs. 55%, χ2(df = 1) = 11.07, p = .001). Higher social capital was associated with lower adjusted odds of sexual concurrency for women compared to men (adjusted Odds Ratio [aOR] = 0.62 (95% CI 0.39-0.97), p = 0.034), controlling for sociodemographic and psychosocial covariates. Interventions that add social capital components may be important for lowering sexual risk among African Americans in Mississippi.
Collapse
|
32
|
Taylor TN, DeHovitz J, Hirshfield S. Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean. Front Public Health 2020; 7:373. [PMID: 31998675 PMCID: PMC6965168 DOI: 10.3389/fpubh.2019.00373] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 11/21/2019] [Indexed: 01/08/2023] Open
Abstract
Testing is the entry point into the HIV care continuum that includes linkage to and retention in prevention services, and adherence to prevention strategies, including repeat HIV testing. Despite US policy approaches to expand HIV testing to diverse clinical care and community settings, disparities in HIV testing among Black populations persist. Foreign-born (FB) Black persons from the Caribbean have higher annual rates of HIV diagnosis and a higher percentage of late-stage HIV diagnosis, compared with US-born Black persons; and most HIV infections among FB Blacks are among men. In this article, we provide an overview of HIV testing barriers among FB Black men who engage in HIV risk-taking behaviors (e.g., condomless sex with male and/or female partners of unknown HIV serostatus). Barriers to HIV testing for both FB and US-born Black men, include HIV stigma (anticipated, perceived, internalized), low perceived HIV risk, medical or government mistrust, and perceived low access to testing resources. We examine beliefs about masculinity and gender roles that may perpetuate heteronormative stereotypes associated with perceptions of low HIV risk and barriers to HIV testing. We also discuss the impact of recent immigration policies on accessing HIV testing and treatment services and how intersectional stigmas and structural forms of oppression, such as racism, prejudice against select immigrant groups, and homophobia that may further amplify barriers to HIV testing among FB Black men. Finally, we review comprehensive prevention approaches, and suggest innovative approaches, that may improve the uptake of HIV testing among FB Black men.
Collapse
Affiliation(s)
- Tonya N. Taylor
- SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | | | | |
Collapse
|
33
|
Lee M. HIV Prevention Study for Black Heterosexual Men and Women in Other Major US Cities. Am J Public Health 2019; 110:e1. [PMID: 31800267 DOI: 10.2105/ajph.2019.305395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Missia Lee
- Missia Lee is with the Benjamin Leon School of Nursing, Miami Dade College, Miami, FL
| |
Collapse
|