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Sinko L, Hah J, Manders K, Saint Arnault D, Teitelman A. A Feasibility and Acceptability Assessment of Photo-experiencing and Reflective Listening (PEARL): An Intervention to Promote Recovery Engagement After Gender-Based Harm. Violence Against Women 2024; 30:1883-1909. [PMID: 38384114 DOI: 10.1177/10778012241231775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Photo-experiencing and Reflective Listening (PEARL) is a trauma-informed intervention developed to promote recovery engagement in survivors of gender-based violence (GBV). This study aimed to understand the feasibility and acceptability of PEARL and identify potential healing elements. GBV survivors were recruited in Philadelphia through an online survey (n = 20). Participants completed the PEARL intervention, a postintervention survey, and a follow-up interview. Results revealed PEARL to be both feasible and acceptable, with thematic analysis revealing its ability to facilitate purposeful reflection, connection to the present, and progress toward healing goals. PEARL shows promise as an engaging strategy to promote healing for survivors of GBV.
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Affiliation(s)
- Laura Sinko
- Department of Nursing, Temple University College of Public Health, Philadelphia, PA, USA
| | - Julia Hah
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Khamera Manders
- Temple University College of Public Health, Philadelphia PA, USA
| | | | - Anne Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Arruda T, Sinko L, Regier P, Tufanoglu A, Curtin A, Teitelman A, Ayaz H, Cronholm P, Childress AR. Exploring Social Impairment in Those with Opioid Use Disorder: Linking Impulsivity, Childhood Trauma, and the Prefrontal Cortex. Res Sq 2024:rs.3.rs-4202009. [PMID: 38659778 PMCID: PMC11042419 DOI: 10.21203/rs.3.rs-4202009/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Challenges with social functioning, which is a hallmark of opioid use disorder (OUD), are a drawback in treatment adherence and maintenance. Yet, little research has explored the underlying mechanisms of this impairment. Impulsivity, a known risk factor for OUD, and corresponding neural alterations may be at the center of this issue. Childhood adversity, which has been linked to both impulsivity and poorer treatment outcomes, could also affect this relationship. This study aims to understand the relationship between impulsivity and social functioning in those recovering from OUD. Differences in the prefrontal cortex will be analyzed, as well as potential moderating effects of childhood trauma. Methods Participants with (N = 16) and without (N = 19) social impairment completed a survey (e.g., social functioning, Barrat's Impulsivity Scale, Adverse Childhood Experiences (ACEs) and cognitive tasks while undergoing neuroimaging. Functional near infrared spectroscopy (fNIRS), a modern, portable, wearable and low-cost neuroimaging technology, was used to measure prefrontal cortex activity during a behavioral inhibition task (Go/No-Go task). Results Those who social functioning survey scores indicated social impairment (n = 16) scored significantly higher on impulsivity scale (t(33)= -3.4, p < 0.01) and reported more depressive symptoms (t(33) = -2.8, p < 0.01) than those reporting no social impairment (n = 19). Social functioning was negatively correlated with impulsivity (r=-0.7, p < 0.001), such that increased impulsivity corresponded to decreased social functioning. Childhood trauma emerged as a moderator of this relationship, but only when controlling for the effects of depression, B=-0.11, p = 0.023. Although both groups had comparable Go/No-Go task performance, the socially impaired group displayed greater activation in the dorsolateral (F(1,100.8) = 7.89, p < 0.01), ventrolateral (F(1,88.8) = 7.33, p < 0.01), and ventromedial (F(1,95.6) = 7.56, p < 0.01) prefrontal cortex during impulse control. Conclusion In addition to being more impulsive, individuals with social impairment exhibited differential activation in the prefrontal cortex when controlling responses. Furthermore, the impact of impulsivity on social functioning varies depending on ACEs demonstrating that it must be considered in treatment approaches. These findings have implications for addressing social needs and impulsivity of those in recovery, highlighting the importance of a more personalized, integrative, and trauma-informed approach to intervention.
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Sonalkar S, Fishman J, Kete C, McAllister A, Frarey A, Short WR, Schreiber CA, Teitelman A. ORAL ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chittamuru D, Frye V, Koblin BA, Brawner B, Tieu HV, Davis A, Teitelman A. PrEP Stigma, HIV Stigma, and Intention to Use PrEP among Women in New York City and Philadelphia. Stigma Health 2019; 5:240-246. [PMID: 33184608 DOI: 10.1037/sah0000194] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Stigma is an important contributor to the continued HIV epidemic in the United States (US). In 2016, women made up nearly one in five of all new infections. Pre-exposure HIV Prophylaxis or PrEP is a medication that can be taken to prevent HIV acquisition; however, PrEP is significantly underutilized by women at risk for infection. How PrEP stigma relates to PrEP initiation among women is not well understood. Methods Surveys were completed by 160 PrEP-eligible women aged 18-55 in Philadelphia, PA and New York City, NY. Associations between PrEP stigma, HIV stigma, and PrEP initiation intention were modeled using multinomial logistic regression, controlling for sociodemographic and theoretically-relevant variables. Results Participants ranged in age from 18 to 55 years (M = 40.2; SD = 11.78). Most (79%) identified as Black or African-American and/or Latina and 36% had completed high-school or less. Higher PrEP stigma was significantly associated with lower PrEP initiation intention, while controlling for other theoretically-relevant and sociodemographic variables. HIV stigma was not related to PrEP initiation intention. Conclusions HIV prevention interventions seeking to increase PrEP initiation among PrEP-eligible, urban women need to address the role that PrEP stigma plays in PrEP uptake.
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Affiliation(s)
- Deepti Chittamuru
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California Merced, Merced, CA
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY
| | - Beryl A Koblin
- School of Nursing, University of Pennsylvania, Philadelphia, PA
| | | | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY
| | - Annet Davis
- School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Anne Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, PA
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Dichter ME, Teitelman A, Klusaritz H, Maurer DM, Cronholm PF, Doubeni CA. Trauma-Informed Care Training in Family Medicine Residency Programs Results From a CERA Survey. Fam Med 2018; 50:617-622. [PMID: 30215822 DOI: 10.22454/fammed.2018.505481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Experiences of psychological trauma are common among primary care patient populations, and adversely affect patients' health and health care utilization. Trauma-informed care (TIC) is a framework for identifying and responding to patients' experiences of psychological trauma to avoid retraumatization. The purpose of this study was to evaluate the current state of TIC training in family medicine residency programs in the United States in order to identify opportunities for and barriers to TIC training. METHODS Items addressing the four core domains of TIC were incorporated into the 2017 Council of Academy Family Medicine Educational Research Alliance (CERA) survey of program directors. The items assessed the presence, content, and sufficiency of TIC curriculum, as well as barriers to further integration of TIC training. RESULTS Approximately 50% of programs responded to the survey. Of 263 respondents, 71 (27%) reported TIC training in their curriculum, but the majority devoted less than 5 hours annually to core content. The content most commonly addressed recognizing signs of trauma, most frequently using didactic formats. Overall, just over one-half of the programs reported that their curriculum met patients' TIC needs "somewhat" (48.5%) or "a great deal" (4.6%). Lack of a champion followed by lack of time were the most commonly cited barriers to integrating TIC training. CONCLUSIONS Despite the acknowledged importance of effects of trauma in health care, this study identified insufficient exposure to training in the core TIC domains in family medicine residency programs, underscoring a need for greater integration of TIC training during residency.
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Affiliation(s)
- Melissa E Dichter
- University of Pennsylvania Perelman School of Medicine, Department of Family and Community Medicine
| | | | - Heather Klusaritz
- University of Pennsylvania Perelman School of Medicine, Department of Family and Community Medicine
| | | | - Peter F Cronholm
- Department of Family and Community Health, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Chyke A Doubeni
- University of Pennsylvania Perelman School of Medicine, Department of Family and Community Medicine
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Regier PS, Monge ZA, Franklin TR, Wetherill RR, Teitelman A, Jagannathan K, Suh JJ, Wang Z, Young KA, Gawrysiak M, Langleben DD, Kampman KM, O'Brien CP, Childress AR. Emotional, physical and sexual abuse are associated with a heightened limbic response to cocaine cues. Addict Biol 2017; 22:1768-1777. [PMID: 27654662 DOI: 10.1111/adb.12445] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/08/2016] [Accepted: 08/02/2016] [Indexed: 12/24/2022]
Abstract
Drug-reward cues trigger motivational circuitry, a response linked to drug-seeking in animals and in humans. Adverse life events have been reported to increase sensitivity to drug rewards and to bolster drug reward signaling. Therefore, we hypothesized that cocaine-dependent individuals with prior emotional, physical and sexual abuse might have a heightened mesolimbic brain response to cues for drug reward in a new brief-cue probe. Cocaine-dependent human individuals (N = 68) were stabilized in an inpatient setting and then completed an event-related blood-oxygen-level dependent functional magnetic resonance imaging task featuring 500-ms evocative (cocaine, sexual, aversive) and comparator (neutral) cues. Responses to three questions about emotional, physical and sexual abuse from the Addiction Severity Index were used to divide the patients into subgroups (history of Abuse [n = 40] versus No Abuse [n = 28]). When subjects were grouped by the historical presence or absence of emotional, physical or sexual abuse, the Abuse group showed a heightened midbrain, thalamic, caudate, and caudal orbitofrontal cortex response to cocaine cues; a similar result was found in other evocative cues, as well. These findings are the first reported for a 500-ms cocaine-cue probe, and they highlight the ability of very brief evocative cues to activate the brain's motivational circuitry. Although all participants had severe cocaine use disorders, individuals reporting prior abuse had a heightened mesolimbic response to evocative cues. To our knowledge, this is the first study in humans linking a history of abuse to a brain vulnerability (heightened mesolimbic response to drug cues) previously shown to contribute to drug-seeking.
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Affiliation(s)
- Paul S. Regier
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Zachary A. Monge
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Teresa R. Franklin
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Reagan R. Wetherill
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Anne Teitelman
- School of Nursing; University of Pennsylvania; Philadelphia PA USA
| | - Kanchana Jagannathan
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Jesse J. Suh
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Ze Wang
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Kimberly A. Young
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Michael Gawrysiak
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Daniel D. Langleben
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Kyle M. Kampman
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Charles P. O'Brien
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
| | - Anna Rose Childress
- Department of Psychiatry; University of Pennsylvania Perelman School of Medicine; Philadelphia PA USA
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Wiwattanacheewin K, Sindhu S, Teitelman A, Maneesriwongul W, Viwatwongkasem C. Predictors of Intention to Use HIV Testing Service Among Sexually Experienced Youth in Thailand. AIDS Educ Prev 2015; 27:139-152. [PMID: 25915699 DOI: 10.1521/aeap.2015.27.2.139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study examined the predictors of intention to use HIV counseling and testing (HCT) services among those who had never used HCT services in a sample of 2,536 Thai youth in Bangkok (ages 15-24). Web-based questionnaires included assessments of HIV knowledge, HIV testing attitude, AIDS stigma, and youth-friendly HCT (YFHCT) service expectation. More than 80% of the sexually experienced youth had never used HCT services but among this group 74.06% reported having intentions to do so. The significant predictors consisted of favorable expectations of YFHCT services (p < .001), positive attitude toward HIV testing (p < .005), perceived high risk for HIV infection (p < .01), having multiple sex partners while also using condoms consistently (p < .01), willingness to pay (p < .001), and being informed about HCT and knowing service locations (p < .001). Policy makers, as well as health promotion program developers and researchers can use these findings to increase intention and use of HCT services among at-risk youth.
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Jemmott JB, Stephens-Shields A, O'Leary A, Jemmott LS, Teitelman A, Ngwane Z, Mtose X. Mediation of effects of a theory-based behavioral intervention on self-reported physical activity in South African men. Prev Med 2015; 72:1-7. [PMID: 25565482 PMCID: PMC4351128 DOI: 10.1016/j.ypmed.2014.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 12/22/2014] [Accepted: 12/26/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Increasing physical activity is an important public-health goal worldwide, but there are few published mediation analyses of physical-activity interventions in low-to-middle-income countries like South Africa undergoing a health transition involving markedly increased mortality from non-communicable diseases. This article reports secondary analyses on the mediation of a theory-of-planned-behavior-based behavioral intervention that increased self-reported physical activity in a trial with 1181 men in Eastern Cape Province, South Africa. METHOD Twenty-two matched-pairs of neighborhoods were randomly selected. Within pairs, neighborhoods were randomized to a health-promotion intervention or an attention-matched control intervention with baseline, immediate-post, and 6- and 12-month post-intervention assessments. Theory-of-planned-behavior constructs measured immediately post-intervention were tested as potential mediators of the primary outcome, self-reported physical activity averaged over the 6- and 12-month post-intervention assessments, using a product-of-coefficients approach in a generalized-estimating-equations framework. Data were collected in 2007-2010. RESULTS Attitude, subjective norm, self-efficacy, and intention were significant mediators of intervention-induced increases in self-reported physical activity. The descriptive norm, not affected by the intervention, was not a mediator, but predicted increased self-reported physical activity. CONCLUSION The results suggest that interventions targeting theory-of-planned-behavior constructs may contribute to efforts to increase physical activity to reduce the burden of non-communicable diseases among South African men.
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Affiliation(s)
- John B Jemmott
- Department of Psychiatry, Perelman School of Medicine and Annenberg School for Communication, University of PA, USA.
| | - Alisa Stephens-Shields
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of PA, USA
| | - Ann O'Leary
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, USA
| | | | | | | | - Xoliswa Mtose
- Faculty of Education, University of Fort Hare, Alice, South Africa
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Jemmott JB, Jemmott LS, O'Leary A, Ngwane Z, Lewis DA, Bellamy SL, Icard LD, Carty C, Heeren GA, Tyler JC, Makiwane MB, Teitelman A. HIV/STI risk-reduction intervention efficacy with South African adolescents over 54 months. Health Psychol 2014; 34:610-21. [PMID: 25110841 DOI: 10.1037/hea0000140] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Little research has tested HIV/sexually transmitted infection (STI) risk-reduction interventions' effects on early adolescents as they age into middle and late adolescence. This study tested whether intervention-induced reductions in unprotected intercourse during a 12-month period endured over a 54-month period and whether the intervention reduced the prevalence of STIs, which increase risk for HIV. METHOD Grade 6 learners (mean age = 12.4 years) participated in a 12-month trial in Eastern Cape Province, South Africa, in which 9 matched pairs of schools were randomly selected and within pairs randomized to a theory-based HIV/STI risk-reduction intervention or an attention-control intervention. They completed 42- and 54-month postintervention measures of unprotected intercourse (the primary outcome), other sexual behaviors, theoretical constructs, and, at 42- and 54-month follow-up only, biologically confirmed curable STIs (chlamydial infection, gonorrhea, and trichomoniasis) and herpes simplex virus 2. RESULTS The HIV/STI risk-reduction intervention reduced unprotected intercourse averaged over the entire follow-up period (OR = 0.42, 95% CI [0.22, 0.84]), an effect not significantly reduced at 42- and 54-month follow-up compared with 3-, 6-, and 12-month follow-ups. The intervention caused positive changes on theoretical constructs averaged over the 5 follow-ups, although most effects weakened at long-term follow-up. Although the intervention's main effect on STIs was nonsignificant, an Intervention Condition × Time interaction revealed that it significantly reduced curable STIs at 42-month follow-up in adolescents who reported sexual experience. CONCLUSION These results suggest that theory-based behavioral interventions with early adolescents can have long-lived effects in the context of a generalized severe HIV epidemic.
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Affiliation(s)
- John B Jemmott
- Annenberg School for Communication, University of Pennsylvania
| | | | | | | | | | - Scarlett L Bellamy
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania
| | - Larry D Icard
- College of Health Professions and Social Work, Temple University
| | - Craig Carty
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - G Anita Heeren
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
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Jemmott JB, Jemmott LS, Ngwane Z, Zhang J, Heeren GA, Icard LD, O'Leary A, Mtose X, Teitelman A, Carty C. Theory-based behavioral intervention increases self-reported physical activity in South African men: a cluster-randomized controlled trial. Prev Med 2014; 64:114-20. [PMID: 24736094 PMCID: PMC4142492 DOI: 10.1016/j.ypmed.2014.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 04/04/2014] [Accepted: 04/06/2014] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To determine whether a health-promotion intervention increases South African men's adherence to physical-activity guidelines. METHOD We utilized a cluster-randomized controlled trial design. Eligible clusters, residential neighborhoods near East London, South Africa, were matched in pairs. Within randomly selected pairs, neighborhoods were randomized to theory-based, culturally congruent health-promotion intervention encouraging physical activity or attention-matched HIV/STI risk-reduction control intervention. Men residing in the neighborhoods and reporting coitus in the previous 3 months were eligible. Primary outcome was self-reported individual-level adherence to physical-activity guidelines averaged over 6-month and 12-month post-intervention assessments. Data were collected in 2007-2010. Data collectors, but not facilitators or participants, were blind to group assignment. RESULTS Primary outcome intention-to-treat analysis included 22 of 22 clusters and 537 of 572 men in the health-promotion intervention and 22 of 22 clusters and 569 of 609 men in the attention-control intervention. Model-estimated probability of meeting physical-activity guidelines was 51.0% in the health-promotion intervention and 44.7% in attention-matched control (OR=1.34; 95% CI, 1.09-1.63), adjusting for baseline prevalence and clustering from 44 neighborhoods. CONCLUSION A theory-based culturally congruent intervention increased South African men's self-reported physical activity, a key contributor to deaths from non-communicable diseases in South Africa. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01490359.
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Affiliation(s)
- John B Jemmott
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA; University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA.
| | - Loretta S Jemmott
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Zolani Ngwane
- Haverford College, Department of Anthropology, Haverford, PA, USA
| | - Jingwen Zhang
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA
| | - G Anita Heeren
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
| | - Larry D Icard
- Temple University, College of Health Professions and Social Work, Philadelphia, PA, USA
| | - Ann O'Leary
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xoliswa Mtose
- University of Fort Hare, Faculty of Education, East London, South Africa
| | - Anne Teitelman
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Craig Carty
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
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Icard LD, Jemmott JB, Teitelman A, O'Leary A, Heeren GA. Mediation effects of problem drinking and marijuana use on HIV sexual risk behaviors among childhood sexually abused South African heterosexual men. Child Abuse Negl 2014; 38:234-42. [PMID: 24041455 PMCID: PMC4075286 DOI: 10.1016/j.chiabu.2013.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 07/31/2013] [Accepted: 08/03/2013] [Indexed: 05/25/2023]
Abstract
HIV/AIDS prevalence in South Africa is one of the highest in the world with heterosexual, transmission predominantly promoting the epidemic. The goal of this study is to examine whether, marijuana use and problem drinking mediate the relationship between histories of childhood sexual, abuse (CSA) and HIV risk behaviors among heterosexual men. Participants were 1181 Black men aged, 18-45 from randomly selected neighborhoods in Eastern Cape Province, South Africa. Audio computer assisted, self-interviewing was used to assess self-reported childhood sexual abuse, problem drinking, and marijuana (dagga) use, and HIV sexual transmission behavior with steady and casual partners. Data were analyzed using multiple meditational modeling. There was more support for problem, drinking than marijuana use as a mediator. Findings suggest that problem drinking and marijuana use, mediate HIV sexual risk behaviors in men with histories of CSA. Focusing on men with histories of CSA, and their use of marijuana and alcohol may be particularly useful for designing strategies to reduce, HIV sexual transmission in South Africa.
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Affiliation(s)
- Larry D Icard
- Center for Intervention and Practice Research, Temple University, College of Health Professions and Social Work, 1301 Cecil B. Moore Avenue, Ritter Annex, Suite B10, Philadelphia, PA 19121, USA
| | | | | | - Ann O'Leary
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Davidson PM, McGrath SJ, Meleis AI, Stern P, Digiacomo M, Dharmendra T, Correa-de-Araujo R, Campbell JC, Hochleitner M, Messias DKH, Brown H, Teitelman A, Sindhu S, Reesman K, Richter S, Sommers MS, Schaeffer D, Stringer M, Sampselle C, Anderson D, Tuazon JA, Cao Y, Krassen Covan E. The health of women and girls determines the health and well-being of our modern world: A white paper from the International Council on Women's Health Issues. Health Care Women Int 2012; 32:870-86. [PMID: 21919625 DOI: 10.1080/07399332.2011.603872] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The International Council on Women's Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of women's health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girl's health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally.
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Affiliation(s)
- Patricia M Davidson
- Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Broadway, New South Wales, Australia.
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Teitelman A, Ratcliffe SJ, McDonald CC, Brawner BM, Sullivan CM. Relationships Between Physical and Non-Physical Forms of Intimate Partner Violence and Depression among Urban Minority Adolescent Females. Child Adolesc Ment Health 2011; 16:92-100. [PMID: 21617762 PMCID: PMC3100197 DOI: 10.1111/j.1475-3588.2010.00572.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND: Little is known about intimate partner violence (IPV) and depression among low income, urban African American and Hispanic adolescent females. METHOD: Interviews with 102 urban African American and Hispanic adolescent females examined physical abuse, emotional/verbal abuse, and threats, and their unique and combined associations with depression. RESULTS: One-quarter of the sample experienced all three types of abuse. Non-physical forms of IPV were significantly associated with depression. CONCLUSIONS: Some urban adolescent females from lower income households experience high rates of IPV. Physical and non-physical forms of IPV are important in understanding and responding to depression in this population.
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Affiliation(s)
- Anne Teitelman
- Center for Health Equity Research, School of Nursing, University of Pennsylvania, Fagin Hall, 2L (rm.244), 418 Curie Blvd., Philadelphia, PA 19104-4217, USA.,
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Teitelman A, McDonald CC, Wiebe DJ, Thomas N, Guerra T, Kassam-Adams N, Richmond TS. Youth's Strategies for Staying Safe and Coping with the Stress of Living in Violent Communities. J Community Psychol 2010; 38:874-885. [PMID: 21765562 PMCID: PMC3134540 DOI: 10.1002/jcop.20402] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Youth living in urban environments of pervasive violence are exposed to a variety of violence-related stressors. This qualitative descriptive study sought to ascertain how community-dwelling youth perceived exposure to violence and how these youth identified and used available resources. The intent of this community-based participatory research study was to help inform the design of a youth violence prevention center intervention. Semi-structured interviews were conducted with a purposive sample of 18 youth ages 10-16. Youth reported high levels of exposure to neighborhood violence. A theme of identifying and navigating safe and unsafe places emerged. Other stressors were more proximal and included interpersonal issues and conflicts. Youth used neighborhood and individual resources to cope with stressors. Youth maintained a high level of vigilance and developed clear strategies to safely navigate violent neighborhoods. Implications for youth due to the constant vigilance and exquisite sensitivity to stressors of chronic neighborhood violence are discussed.
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Abstract
PURPOSE To present a unified conceptual model that identifies the integral processes of nurse practitioner (NP) care delivery and that integrates major structural influences and potential outcomes. The model is further characterized to delineate the unique and "value-added" nature of NP primary care and to describe how this nature may be correlated with specific clinical outcomes. DATA SOURCES Extensive review of the literature, relevant conceptual models, clinical experiences of th authors, and two sets of qualitative dat exploring differences between NP practice an other practices. CONCLUSIONS The basis of NP primary care is the unique provider-client relationship that develops within the primary care setting. This relationship is oriented toward (a) helping client become empowered to more appropriately manage their own care in a way that will best meet their needs, (b) encouraging mutual deci sion making, (c) ensuring clients' continuity o care, and (d) providing a holistic approach to primary care. The major structural influences are NP role components, interdisciplinary practice relationships, budget resources and payer mix, and environmental characteristics. The potential outcomes are increased health promoting behaviors, improved utilization of care, higher client satisfaction levels, and improved health status. IMPLICATIONS FOR PRACTICE NPs can use this model to articulate the unique contribution of NP practice and its interrelationships within the broader primary care setting. Practicing NPs can use this framework to better understand the complexities of their current and future primary care practices. Faculty can utilize the concepts to help guide students' understanding of their prospective roles as advanced practice nurses. Finally, this conceptual framework can inform research about specific NP processes and related outcomes. A clearly delineated model that accurately depicts structures, processes, and outcomes relevant to NP primary care can strengthen NP education, distinguish NP practice, and advance evidenced-based research linking NP practice and outcomes.
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Affiliation(s)
- Katherine Dontje
- College of Nursing, Michigan State University, East Lansing, USA.
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