1
|
Osei Baah F, Brawner BM, Teitelman AM, Ruger JP, Riegel B. A Mixed-Methods Study of Social Determinants and Self-care in Adults With Heart Failure. J Cardiovasc Nurs 2023; 38:555-567. [PMID: 37816083 PMCID: PMC10593982 DOI: 10.1097/jcn.0000000000000999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND The burden of heart failure (HF) is unequally distributed among population groups. Few study authors have described social determinants of health (SDoH) enabling/impeding self-care. AIM The aim of this study was to explore the relationship between SDoH and self-care in patients with HF. METHODS Using a convergent mixed-methods design, we assessed SDoH and self-care in 104 patients with HF using the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE) and the Self-Care of HF Index v7.2 with self-care maintenance, symptom perception, and self-care management scales. Multiple regression was used to assess the relationship between SDoH and self-care. One-on-one in-depth interviews were conducted in patients with poor (standardized score ≤ 60, n = 17) or excellent (standardized score ≥ 80, n = 20) self-care maintenance. Quantitative and qualitative results were integrated. RESULTS Participants were predominantly male (57.7%), with a mean age of 62.4 ± 11.6 years, with health insurance (91.4%) and some college education (62%). Half were White (50%), many were married (43%), and most reported adequate income (53%). The money and resources core domain of PRAPARE significantly predicted self-care maintenance ( P = .019), and symptom perception ( P = .049) trended significantly after adjusting for other PRAPARE core domains (personal characteristics, family and home, and social and emotional health) and comorbidity. Participants discussed social connectedness, health insurance coverage, individual upbringing, and personal experiences as facilitators of self-care behavior. CONCLUSION Several SDoH influence HF self-care. Patient-specific interventions that address the broader effects of these factors may promote self-care in patients with HF.
Collapse
|
2
|
Lanier Y, Cornelius T, Morillo C, Lavarin C, Brawner BM, Kershaw T. A Dyadic Analysis Exploring the Mediating Role of Relationship Quality on Discrimination and HIV/STI Risk Among Young Black and Latino Expecting Couples. AIDS Behav 2023; 27:1269-1276. [PMID: 36156173 PMCID: PMC10038914 DOI: 10.1007/s10461-022-03863-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 11/25/2022]
Abstract
Encounters with discrimination are a normative experience for many Black and Latino adolescents and young adults (AYAs); these experiences may be even more common for expecting AYAs. While the harmful effects of discriminatory experiences on mental and physical health have been well explored, relatively little is known regarding the impact of discrimination on relationship quality and sexual health-specifically HIV/STI risk.Using the Actor Partner Interdependence Model, we examined both actor and partner effects of discrimination on relationship quality and willingness to be non-monogamous in a sample of 259 pregnant adolescent and young adult couples. There was a significant indirect actor effect, such that one's own discrimination was associated with a decrease in their own relationship quality which, in turn, was associated with their own greater willingness to be non-monogamous. The partner effect for the association of one's partner's discrimination on one's own relationship quality was not significant. Findings highlight the need for more attention to the implications of discrimination on relational and sexual health.
Collapse
Affiliation(s)
- Yzette Lanier
- Rory Meyers College of Nursing, New York University, New York, US.
| | | | - Cheyenne Morillo
- School of Global Public Health, New York University, New York, US
| | | | - Bridgette M Brawner
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, US
| | - Trace Kershaw
- School of Public Health, Yale University , New Haven, US
| |
Collapse
|
3
|
Opara I, Lardier DT, Boyd D, Boateng ACO, Brawner BM. The Association Between Racial Attitudes, Alcohol Use and Mood Disorders Among Black Adolescents. J Prev (2022) 2023; 44:85-104. [PMID: 36156761 PMCID: PMC9892305 DOI: 10.1007/s10935-022-00706-y] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 02/04/2023]
Abstract
Alcohol is the most widely used substance among adolescents. Although Black adolescents use alcohol at lower rates than White adolescents, Black adolescents tend to have worse outcomes. This includes higher rates of mood disorders and criminal justice involvement associated with alcohol use and misuse compared to any other racial group. Black adolescents are also more likely to experience racial discrimination and be exposed to traumatic events within their communities, which may increase their chances of using substances. Understanding the relationship between racial attitudes (towards one's own group and others) and substance use and mental health can provide unique and meaningful insight into prevention programming for Black adolescents. Yet, these concepts have been understudied. To fill this gap, we examined the association between racial attitudes and alcohol use and mood disorders in Black adolescents in Philadelphia, PA (N = 154). We used the revised Adolescent Survey of Black Life to measure pro-Black (positive attitudes toward being Black and factors related to Black people), anti-White (negative attitudes toward White people due to experiences of racism and discrimination) and racism awareness (recognition of racism) domains. Logistic regression analyses were conducted to test the associations. Results showed that: higher pro-Black attitudes were associated with a lower odds of mood disorder (odds ratio [OR] = 0.72, 95% CI = 0.55, 0.89); and higher racism awareness was associated with an increased odds of alcohol use (OR = 1.18, 95% confidence interval [CI] = 1.06, 1.29). Findings provide preliminary support for interventions and policies for Black adolescents that bolster positive racial identity and eliminate experiences of racism as alcohol use and mood disorder prevention strategies.
Collapse
Affiliation(s)
- Ijeoma Opara
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, USA.
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, USA.
| | - David T Lardier
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, USA
| | - Donte Boyd
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, USA
- School of Social Work, Ohio State University, Columbus, USA
| | | | - Bridgette M Brawner
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, USA
| |
Collapse
|
4
|
Brawner BM, Talley LM, Baker JL, Bowleg L, Dominique TB, Robinson DY, Riegel B. A Convergent Mixed Methods Study of Cardiovascular Disease Risk Factors among Young Black Men in the United States. Ethn Dis 2022; 32:169-184. [PMID: 35909645 PMCID: PMC9311303 DOI: 10.18865/ed.32.3.169] [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: 02/04/2023] Open
Abstract
Background An understanding of the factors that influence cardiovascular (CVD) risk among young Black men is critically needed to promote cardiovascular health earlier in the life course and prevent poor outcomes later in life. Purpose To explore how individual (eg, depression, racial discrimination) and environmental factors (eg, neighborhood resources) are associated with CVD risk factors among young Black men. Methods We conducted a convergent mixed methods study (qualitative/quantitative, QUAL+quant) with Black men aged 18 to 30 years (N = 21; 3 focus groups). Participants completed a self-administered electronic survey immediately prior to the focus groups. Results Participants (M age = 23) reported: two or more CVD risk factors (75%; eg, high blood pressure); racial discrimination (32%); and depressive symptoms in the past 2 weeks (50%). Five themes emerged: 1) emergence and navigation of Black manhood stressors; 2) high expectations despite limited available resources; 3) heart disease socialization: explicit and vicarious experiences; 4) managing health care needs against fear, avoidance and toughing it out; and 5) camaraderie and social support can motivate or deter. The integrated qualitative and quantitative analyses highlight race, gender, and class intersectionality factors that are relevant to what it means to be young, Black, male and of lower socioeconomic status in the United States. Conclusion Our findings help to identify modifiable, culturally specific and contextually relevant factors that relate to CVD risk factors among young Black men. Such work is crucial to inform interventions, primary prevention efforts, policies, and social-structural changes to thwart the development of CVD and advanced disease stages.
Collapse
Affiliation(s)
- Bridgette M. Brawner
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, Address correspondence to Bridgette M. Brawner, PhD, MDiv, APRN, M. Louise Fitzpatrick College of Nursing, Villanova University, PA.
| | | | - Jillian L. Baker
- Center for Parent and Teen Communication, Division of Adolescent Medicine, Children’s Hospital of Philadelphia, PA
| | - Lisa Bowleg
- The George Washington University Columbian College of Arts and Sciences, Department of Biological and Brain Sciences, Washington, DC
| | - Tiffany B. Dominique
- University of Pennsylvania Perelman School of Medicine, Center for AIDS Research, Philadelphia, PA
| | - Daiquiri Y. Robinson
- University of Pennsylvania Perelman School of Medicine, Center for AIDS Research, Philadelphia, PA
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health and Science, Philadelphia, PA
| | | |
Collapse
|
5
|
Abboud S, Flores DD, Bond K, Chebli P, Brawner BM, Sommers MS. Family Sex Communication Among Arab American Young Adults: A Mixed-Methods Study. J Fam Nurs 2022; 28:115-128. [PMID: 34694172 PMCID: PMC9795851 DOI: 10.1177/10748407211053931] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There is a significant gap in understanding the sexual health of Arab Americans. The purpose of this study is to explore family sex communication among Arab American young adults and its association with gender and sexual attitudes. We used a parallel mixed methods design and administered an electronic survey (N = 100); a subsample of 24 participants participated in five focus groups. We observed convergence in the findings. Participants reported rare occurrences of family sex communication, with women reporting less comfort than men. Family sex communication was often "unspoken," and reinforced prevailing social norms. Gender differences were reported based on sex communication topics. The most common source of sex information was peers/friends. Focus group participants perceived their parents to be more conservative and less knowledgeable about sex than they were. Future research on strategies to bridge generational differences is needed to promote family-based sex communication, given the multiple teachable moments at home.
Collapse
Affiliation(s)
| | | | - Keosha Bond
- The City University of New York, New York City, USA
| | | | | | | |
Collapse
|
6
|
Jackson GY, Darlington CK, Tieu HV, Brawner BM, Flores DD, Bannon JA, Davis A, Frye V, Chittamuru D, Gugerty P, Koblin BA, Teitelman AM. Women's views on communication with health care providers about pre-exposure prophylaxis (PrEP) for HIV prevention. Cult Health Sex 2022; 24:642-656. [PMID: 33535887 PMCID: PMC8567214 DOI: 10.1080/13691058.2021.1877824] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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] [Indexed: 05/03/2023]
Abstract
Since the beginning of the HIV epidemic in the USA, effective interventions to reduce HIV risk among cisgender women have been lacking. Although oral HIV pre-exposure prophylaxis (PrEP) is effective in pharmacologically preventing HIV infection, there is a gap between the recommended use of PrEP and PrEP uptake among eligible women. This study aimed to identify the role of patient-provider communication in PrEP decision-making among women considering PrEP. Semi-structured in-depth interviews were conducted with 41 PrEP-eligible women in Philadelphia and New York City. A thematic analysis of the responses was conducted, and a conceptual model developed and confirmed as analysis continued. Of the women interviewed, 53.6% were African American and 29.3% were Latina. Women noted that having a trusting relationship with their health care provider, receiving a tailored recommendation for PrEP based upon their specific needs and using their health care provider as support were crucial facilitators of PrEP decision-making. Lack of provider knowledge about PrEP, perceived health care provider stigma about their drug use and sexual activity, and lack of care continuity were all identified as barriers to effective communication. Study findings can inform future interventions to enhance patient-provider communication about PrEP and increase PrEP uptake among women.
Collapse
Affiliation(s)
| | - Caroline K. Darlington
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Corresponding Author: Caroline K. Darlington
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | | | | | | | - Annet Davis
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Victoria Frye
- School of Medicine, The City University of New York, New York, NY, USA
| | - Deepti Chittamuru
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Paige Gugerty
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Anne M. Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
7
|
Paidipati CP, Deatrick JA, Eiraldi RB, Ulrich CM, Lane JM, Brawner BM. Caregivers' perspectives on the contextual influences within family management for ethnically diverse children with ADHD. J SPEC PEDIATR NURS 2022; 27:e12365. [PMID: 34962094 DOI: 10.1111/jspn.12365] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/15/2021] [Accepted: 12/08/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder affecting over 9% of children in the United States. Family caregivers are often responsible for the management of their child's ADHD. Contextual influences, such as healthcare providers, systems, and resources, are factors contributing to the ease or difficulty of family management. The purpose of this article is to qualitatively describe the major contextual influences that impact family management for ethnically diverse children with ADHD. DESIGN AND METHODS This analysis is part of a mixed methods study using a concurrent nested design (QUAL + quant) to understand the phenomenon of family management from a contextual and socioecological perspective. In this analysis, cross-sectional data from caregivers of children with ADHD (N = 50) within a large northeastern city in the United States were collected, analyzed, and interpreted in the qualitative descriptive tradition. Semistructured interviews were conducted with participants to understand the contextual influences within family management. Conventional content analysis resulted in the emergence of barrier and facilitator domains and subdomains. RESULTS Caregivers were predominantly female (98%) and between 24 and 61 years with a mean age of 37.54 (SD = 1.18). Caregivers identified their children as Black or African American (56%), White (26%), Multi-Racial (16%), Hispanic or Latinx (8%), and Asian (2%). Contextual influences within family management emerged as barrier or facilitator domains. Barrier domains included: (1) family, (2) healthcare systems, (3) educational systems, (4) stigma, and (5) financial, insurance, and policy issues. Facilitator domains included: (1) family and community, (2) healthcare providers, and (3) educational providers. Subdomains within each domain are expanded in the article. PRACTICE IMPLICATIONS Specialists in pediatric nursing should consider contextual influences within family management for ethnically diverse children with ADHD. As healthcare providers, it is important to recognize system-level barriers or facilitators for caregivers and their children and find creative ways to overcome obstacles and leverage strengths within families, communities, and care systems. Another important area for pediatric specialists to consider is understanding how stigma impacts children with ADHD. Policy-level engagement and advocacy should maximize the political will of nurses, families, and educators to create change within communities.
Collapse
Affiliation(s)
- Cynthia P Paidipati
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, Illinois, USA
| | - Janet A Deatrick
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ricardo B Eiraldi
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Connie M Ulrich
- School of Nursing, Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jamil M Lane
- Warner Graduate School of Education and Human Development, University of Rochester, Rochester, New York, USA
| | - Bridgette M Brawner
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
8
|
Brooks Carthon JM, Perez GA, Brawner BM. Health equity and social determinants of health. Res Nurs Health 2022; 45:139-141. [DOI: 10.1002/nur.22222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 11/08/2022]
Affiliation(s)
- J. Margo Brooks Carthon
- Department of Family & Community Health University of Pennsylvania School of Nursing Philadelphia Pennsylvania USA
| | - G. Adriana Perez
- Leonard Davis Institute of Health Economics University of Pennsylvania School of Nursing Philadelphia Pennsylvania USA
| | - Bridgette M. Brawner
- M. Louise Fitzpatrick College of Nursing Villanova University Villanova Pennsylvania USA
| |
Collapse
|
9
|
Brawner BM, Kerr J, Castle BF, Bannon JA, Bonett S, Stevens R, James R, Bowleg L. A Systematic Review of Neighborhood-Level Influences on HIV Vulnerability. AIDS Behav 2022; 26:874-934. [PMID: 34480256 PMCID: PMC8415438 DOI: 10.1007/s10461-021-03448-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 12/27/2022]
Abstract
A better understanding of the social-structural factors that influence HIV vulnerability is crucial to achieve the goal of ending the HIV epidemic by 2030. Given the role of neighborhoods in HIV outcomes, synthesis of findings from such research is key to inform efforts toward HIV eradication. We conducted a systematic review to examine the relationship between neighborhood-level factors (e.g., poverty) and HIV vulnerability (via sexual behaviors and substance use). We searched six electronic databases for studies published from January 1, 2007 through November 30, 2017 (PROSPERO CRD42018084384). We also mapped the studies' geographic distribution to determine whether they aligned with high HIV prevalence areas and/or the "Ending the HIV Epidemic: A Plan for the United States". Fifty-five articles met inclusion criteria. Neighborhood disadvantage, whether measured objectively or subjectively, is one of the most robust correlates of HIV vulnerability. Tests of associations more consistently documented a relationship between neighborhood-level factors and drug use than sexual risk behaviors. There was limited geographic distribution of the studies, with a paucity of research in several counties and states where HIV incidence/prevalence is a concern. Neighborhood influences on HIV vulnerability are the consequence of centuries-old laws, policies and practices that maintain racialized inequities (e.g., racial residential segregation, inequitable urban housing policies). We will not eradicate HIV without multi-level, neighborhood-based approaches to undo these injustices. Our findings inform future research, interventions and policies.
Collapse
Affiliation(s)
- Bridgette M Brawner
- M. Louise Fitzpatrick College of Nursing, Villanova University, 800 E. Lancaster Avenue, Office 212, Villanova, PA, 19085, USA.
| | - Jelani Kerr
- Department of Health Promotion and Behavioral Sciences, School of Public Health & Information Sciences, University of Louisville, Louisville, KY, USA
| | - Billie F Castle
- Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA
| | - Jaqueline A Bannon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephen Bonett
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Robin Stevens
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
| | - Richard James
- Biomedical Library, University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa Bowleg
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| |
Collapse
|
10
|
Teitelman AM, Tieu HV, Flores D, Bannon J, Brawner BM, Davis A, Gugerty P, Koblin B. Individual, social and structural factors influencing PrEP uptake among cisgender women: a theory-informed elicitation study. AIDS Care 2022; 34:273-283. [PMID: 33719816 PMCID: PMC8426410 DOI: 10.1080/09540121.2021.1894319] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 10/21/2022]
Abstract
The underutilization of pre-exposure prophylaxis (PrEP) among cisgender women in the U.S. limits this population's ability to reduce their risk for HIV infection, especially within the unique individual, social and structural systems they navigate. There is a need to identify the relevant multi-level barriers and facilitators to PrEP use among cisgender women to inform theory-guided efforts that address HIV disparities by race/ethnicity among cisgender women. Guided by the Integrated Behavioral Model and the Behavioral Model of Vulnerble Populations we conducted 41 interviews with PrEP eligible cisgender women in New York City and Philadelphia. Directed content analysis identified 11 modal behavioral beliefs crucial to PrEP uptake, including anticipated negative social consequences, 5 normative beliefs centered on available social supports, and 9 control beliefs such as anticipated barriers such as cost. Awareness and knowledge of PrEP as a biobehavioral HIV prevention method is limited for this sample. Through conventional content analysis we identified interpersonal and structural barriers to PrEP uptake including lack of partner support, transportation, mental health challenges, and challenges in accessing PrEP care. Potential solutions to structural barriers were enumerated along with implications for future intervention work and public health programming.
Collapse
Affiliation(s)
- Anne M. Teitelman
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Hong-Van Tieu
- Lab of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center; Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center
| | - Dalmacio Flores
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Jacqueline Bannon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bridgette M. Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Annet Davis
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Paige Gugerty
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Beryl Koblin
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA,Independent Consultant, Metuchen, NJ
| |
Collapse
|
11
|
Abboud S, Flores D, Redmond L, Brawner BM, Sommers MS. Sexual attitudes and behaviours among Arab American young adults in the USA. Cult Health Sex 2021; 23:1591-1607. [PMID: 32744471 DOI: 10.1080/13691058.2020.1788163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
While the sexual behaviours of different racial and ethnic groups have been studied extensively in the USA, Arab Americans are relatively understudied. The purpose of our study is to describe sexual attitudes and behaviours of Arab American young adults, to explore gender differences and the factors associated with five primary sexual behaviours (solo and partnered masturbation, oral, vaginal and anal sex). We conducted a cross-sectional quantitative study using a self-administered survey, which included measures of Arab ethnic identity, religiosity and sexual attitudes and behaviours. The survey was completed by 100 Arab American young adults (18-25 years old). Almost half of the sample reported being engaged in at least one of the five primary sexual behaviours in the past six months. In bivariate analysis, there were significant gender differences in sexual attitudes and all the primary sexual behaviours except for anal sex. Sexual attitudes and religiosity were significant predictors of partnered masturbation, oral and vaginal sex. Our findings challenge Arab societal assumptions that unmarried Arab American young adults do not engage in sexual behaviours, including risky behaviours, warranting further research to prevent unintended sexual health outcomes.
Collapse
Affiliation(s)
- Sarah Abboud
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Dalmacio Flores
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Leni Redmond
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, College of Nursing, Chicago, IL, USA
| | - Bridgette M Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Marilyn S Sommers
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| |
Collapse
|
12
|
Weissinger GM, Brooks Carthon JM, Ahmed C, Brawner BM. Experiences of Hospitalization of Patients With Psychotic Disorders on Medical-Surgical Units: A Thematic Analysis. J Am Psychiatr Nurses Assoc 2021; 27:306-321. [PMID: 31795792 PMCID: PMC9254133 DOI: 10.1177/1078390319892313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/24/2023]
Abstract
BACKGROUND:Individuals with psychotic disorders are more likely to have nonpsychiatric hospitalizations than the general population. Moreover, they experience worse outcomes in terms of rehospitalization, adverse events, in-hospital mortality, and longer length of stay. AIM: A patient-centered understanding of inpatient medical-surgical hospitalization experiences could shed light on disparities in hospital outcomes among individuals with psychotic disorders. METHOD: This article reports findings from Phase 1 (Qualitative) of a mixed methods, exploratory sequential study of nonpsychiatric hospitalizations of patients with psychotic disorders. Patients on medical-surgical units with diagnosed psychotic disorders (n = 20) were interviewed about their experiences of hospitalization, and a thematic analysis was conducted of transcripts, case notes, and setting notes. RESULTS: Five themes emerged from analysis: (1) managing through hard times (subthemes: intense emotions, medically complex with many symptoms, strategies for self-management), (2) ignored and treated unfairly, (3) actively involved in health (subthemes: seeking health education, suggesting changes), (4) appreciation of caring providers, and (5) violence: expected and enacted. Participants connected the difficult nature of their hospitalization experiences with a variety of sources and outcomes, including strong emotions, variable relationships with providers and a struggle to receive health education. CONCLUSIONS: Nurses who care for patients with psychotic disorders in medical-surgical settings can better meet patients' needs by concentrating on relationship building, especially during initial interactions, and helping patients better manage their medical and psychiatric symptoms through both pharmaceutical and nursing interventions.
Collapse
Affiliation(s)
- Guy M Weissinger
- Guy M. Weissinger II, MPhil, PhD, RN, Drexel University, Philadelphia, PA, USA
| | - J Margo Brooks Carthon
- J. Margo Brooks Carthon, PhD, RN, FAAN, University of Pennsylvania, Philadelphia, PA, USA
| | - Charisse Ahmed
- Charisse Ahmed, BSN, University of Pennsylvania, Philadelphia, PA, USA
| | - Bridgette M Brawner
- Bridgette M. Brawner, MDiv, PhD, APRN, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
13
|
Brawner BM, Jemmott LS, Hanlon AL, Lozano AJ, Abboud S, Ahmed C, Wingood G. Results from Project GOLD: A pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention for black youth. AIDS Care 2021; 33:767-785. [PMID: 33550841 PMCID: PMC8494072 DOI: 10.1080/09540121.2021.1874273] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
Black youth face significant disparities in HIV/sexually transmitted infection (STI) disease burden. Mental illness and emotion regulation are ontributors to HIV/STI risk, yet many HIV/STI prevention interventions do not address these factors. Project GOLD was a pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention designed to address the role of mental illness and emotion regulation in HIV/STI risk among heterosexually active Black youth aged 14-17 (N = 108). Participants were recruited from outpatient mental health treatment programs and general community settings via community partner referrals, face-to-face encounters, flyers and social media. Assessments were conducted pretest, immediate posttest, and at 3-, 6-, and 12-month follow-up. Although there were no statistically significant differences in behavior change from baseline, there were practically significant effect sizes among HIV condition participants when compared to the general health condition (e.g., fewer sexual partners at 6 months). An increase in theoretical mediators (e.g., condom use negotiation beliefs) was sustained at 12 months. HIV condition participants also reported lower depressive symptom severity, with statistical significance noted at immediate post and at 3 months. The findings highlight the importance and challenges of engaging Black youth in culturally and contextually relevant, developmentally and psychologically appropriate HIV/STI prevention interventions.
Collapse
Affiliation(s)
- Bridgette M. Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America; Twitter: @DrBMBrawnerhttps://twitter.com/DrBMBrawner; Facebook: Dr. Bridgette M. Brawner https://www.facebook.com/DrBMBrawner/; LinkedIn: Bridgette M. Brawner, PhD, MDiv, APRN https://www.linkedin.com/in/bridgette-m-brawner-phd-mdiv-aprn-754a24109/
| | - Loretta Sweet Jemmott
- Department of Nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, United States of America; Twitter: https://twitter.com/Dr_SweetJ
| | - Alexandra L. Hanlon
- Center for Biostatistics and Health Data Science, Department of Statistics, College of Science, Virginia Tech, Roanoke, Virginia, United States of America; Twitter: @al_hanlonhttps://twitter.com/al_hanlon
| | - Alicia J. Lozano
- Center for Biostatistics and Health Data Science, Department of Statistics, College of Science, Virginia Tech, Roanoke, Virginia, United States of America; Twitter: @aliciajlozanohttps://twitter.com/aliciajlozano
| | - Sarah Abboud
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, College of Nursing, Chicago, Illinois, United States of America; Twitter: @SarahAbboud78https://twitter.com/sarahabboud78
| | - Charisse Ahmed
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America; LinkedIn: https://www.linkedin.com/in/charisse-ahmed-2b341866/
| | - Gina Wingood
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| |
Collapse
|
14
|
Threats M, Brawner BM, Montgomery TM, Abrams J, Jemmott LS, Crouch PC, Freeborn K, Kamitani E, Enah C. A Review of Recent HIV Prevention Interventions and Future Considerations for Nursing Science. J Assoc Nurses AIDS Care 2021; 32:373-391. [PMID: 33929980 PMCID: PMC8715511 DOI: 10.1097/jnc.0000000000000246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT As our knowledge of HIV evolved over the decades, so have the approaches taken to prevent its transmission. Public health scholars and practitioners have engaged in four key strategies for HIV prevention: behavioral-, technological-, biomedical-, and structural/community-level interventions. We reviewed recent literature in these areas to provide an overview of current advances in HIV prevention science in the United States. Building on classical approaches, current HIV prevention models leverage intimate partners, families, social media, emerging technologies, medication therapy, and policy modifications to effect change. Although much progress has been made, additional work is needed to achieve the national goal of ending the HIV epidemic by 2030. Nurses are in a prime position to advance HIV prevention science in partnership with transdisciplinary experts from other fields (e.g., psychology, informatics, and social work). Future considerations for nursing science include leveraging transdisciplinary collaborations and consider social and structural challenges for individual-level interventions.
Collapse
Affiliation(s)
- Megan Threats
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Bridgette M. Brawner
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Tiffany M. Montgomery
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Jasmine Abrams
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Loretta Sweet Jemmott
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Pierre-Cedric Crouch
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Kellie Freeborn
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Emiko Kamitani
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Comfort Enah
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| |
Collapse
|
15
|
Brawner BM. #SendHelpNow: Mental wellness and virtual connection in the age of coronavirus. J Psychiatr Ment Health Nurs 2021; 28:121-122. [PMID: 32406591 PMCID: PMC7272808 DOI: 10.1111/jpm.12651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Bridgette M Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| |
Collapse
|
16
|
Teitelman AM, Koblin BA, Brawner BM, Davis A, Darlington C, Lipsky RK, Iwu E, Bond KT, Westover J, Fiore D, Tieu HV. Just4Us: Development of a Counselor-Navigator and Text Message Intervention to Promote PrEP Uptake Among Cisgender Women at Elevated Risk for HIV. J Assoc Nurses AIDS Care 2021; 32:188-204. [PMID: 33427767 PMCID: PMC10375596 DOI: 10.1097/jnc.0000000000000233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT In the United States, pre-exposure prophylaxis (PrEP) uptake among eligible cisgender women has been slow, despite the availability of oral PrEP since 2012. Although women make up nearly 20% of those living with HIV, there are currently few PrEP uptake interventions for cisgender women at elevated risk for acquiring HIV. Here we describe the process used to design and pre-pilot test Just4Us, a theory-based behavioral intervention to promote PrEP initiation and adherence among PrEP-eligible cisgender women. This work was part of a multiphase study conducted in New York City and Philadelphia, two locations with HIV rates higher than the national average. The counselor-navigator component of the intervention was designed to be delivered in a 60- to 90-min in-person session in the community, followed by several phone calls to support linkage to care. An automated text messaging program was also designed for adherence support. Just4Us addressed personal and structural barriers to PrEP uptake using an empowerment framework by building on women's insights and resources to overcome barriers along the PrEP cascade. Usability pre-pilot testing results were favorable and provided valuable feedback used to refine the intervention.
Collapse
Affiliation(s)
- Anne M Teitelman
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Beryl A Koblin
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Bridgette M Brawner
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Annet Davis
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Caroline Darlington
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Rachele K Lipsky
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Emilia Iwu
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Keosha T Bond
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Julie Westover
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Danielle Fiore
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Hong-Van Tieu
- Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Beryl A. Koblin, PhD, is an Independent Consultant, Metuchen, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Annet Davis, RN, MSW, CCRC, is a Coordinator of Community Engagement & Project Director for the Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Caroline Darlington, MSN, WHNP-BC, is a PhD Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Rachele K. Lipsky, PhD, CRNP, PMHNP-BC, is a Postdoctoral Scholar, National Clinical Scholars Program, Duke University, Durham, North Carolina, USA, and a Former Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Emilia Iwu, PhD, RN, APNC, FWACN, is an Assistant Professor, Rutgers University School of Nursing, Division of Nursing Science and Center for Global Health, Newark, New Jersey, USA. Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Julie Westover, BS, is a Medical Student, University of California San Diego, School of Medicine, San Diego, California, USA, and a Former Innovation Technology Fellow, Penn Medicine Center for Health Care Innovation, Philadelphia, Pennsylvania, USA. Danielle Fiore, BS, is a Data Manager, Just4Us Study, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Hong-Van Tieu, MD, MS, is Head of the Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| |
Collapse
|
17
|
Opara I, Weissinger GM, Lardier DT, Lanier Y, Carter S, Brawner BM. Mental Health Burden among Black Adolescents: The Need for Better Assessment, Diagnosis and Treatment Engagement. Soc Work Ment Health 2021; 19:88-104. [PMID: 34248423 PMCID: PMC8262091 DOI: 10.1080/15332985.2021.1879345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study examines mental health symptoms among Black adolescents who were currently in mental health treatment and those who were not in treatment. The study uses a sample of Black adolescents (N=154) and logistic regression was performed to determine which psychological factors were associated with exhibiting mental health symptoms. Both groups experienced high amounts of trauma exposure history, recent suicidality, substance use, and depressive symptoms. Nearly one in four adolescents in the out of treatment group met diagnostic criteria for anxiety disorders. Implications include better screening for mental health symptoms to ensure Black adolescent have access to mental health treatment.
Collapse
|
18
|
Weissinger GM, Carthon JMB, Brawner BM. Non-psychiatric hospitalization length-of-stay for patients with psychotic disorders: A mixed methods study. Gen Hosp Psychiatry 2020; 67:1-9. [PMID: 32866772 PMCID: PMC7722147 DOI: 10.1016/j.genhosppsych.2020.07.007] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Patients with psychotic disorders experience higher rates of chronic and acute non-psychotic diseases and have frequent non-psychiatric hospitalizations which result in both longer and more varied length-of-stay (LoS) than other patients. This study seeks to use a patient-centered perspective to examine LoS. METHODS This article reports Phase Two of a mixed methods, exploratory sequential study on non-psychiatric hospitalizations for individuals with psychotic disorders. Patients' experiences were used to guide a quantitative analysis of LoS using a general linear model. RESULTS Medical comorbidities were the patient characteristics which had the largest effect on LoS. Certain processes of care highlighted by patients from Phase One were also associated with longer LoS, including: physical restraints (105%), psychiatric consults (20%) and continuous observation (133%). Only recent in-system outpatient appointments were associated with shorter LoS. Data integration highlighted that factors which were important to patients such as partner support, were not always quantitatively significant, while others like medical comorbidities and use of physical restraints were points of congruence. CONCLUSIONS Medical comorbidities were highly associated with LoS but processes relating to longer LoS are those that are used to manage symptoms of acute psychosis. Clinicians should develop policies and procedures that address psychosis symptoms effectively during non-psychiatric hospitalizations. Further research is needed to understand which patients with psychotic disorders are at highest risk of extended length-of-stay.
Collapse
Affiliation(s)
- Guy M Weissinger
- Drexel University, College of Nursing and Health Professions, 3020 Market Street, Suite 510, Philadelphia, PA 19104, United States of America; University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, United States of America.
| | - J Margo Brooks Carthon
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, United States of America
| | - Bridgette M Brawner
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, United States of America
| |
Collapse
|
19
|
Teitelman AM, Chittamuru D, Koblin BA, Davis A, Brawner BM, Fiore D, Broomes T, Ortiz G, Lucy D, Tieu HV. Beliefs Associated with Intention to Use PrEP Among Cisgender U.S. Women at Elevated HIV Risk. Arch Sex Behav 2020; 49:2213-2221. [PMID: 32270399 PMCID: PMC7321894 DOI: 10.1007/s10508-020-01681-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 04/26/2019] [Revised: 02/26/2020] [Accepted: 03/07/2020] [Indexed: 05/16/2023]
Abstract
Women comprise 19% of those newly diagnosed with HIV in the U.S. There is a wide gap between recommended use of pre-exposure prophylaxis (PrEP) and actual uptake among women who are eligible for PrEP. In order to identify women's beliefs and intentions about starting PrEP, a survey, informed by the reasoned action approach, was administered to 160 cisgender PrEP-eligible women, age 18-55, in Philadelphia and New York City. The mean age was 40.2 years (SD = 11.78), 44% had completed high school, 75% were unemployed, and 85% experienced financial instability in the past 3 months. Multivariate linear regression analyses identified sets of behavioral and normative beliefs associated with intention to start PrEP in the next 3 months. Behavioral beliefs reflected views about PrEP benefits such as preventing HIV, and normative beliefs reflected perceptions of support or lack thereof from others including partners, friends, mother, and children. These findings can be used to inform interventions to foster greater PrEP uptake among women.
Collapse
Affiliation(s)
- Anne M Teitelman
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Fagin Hall, Room 483L, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA.
| | - Deepti Chittamuru
- Public Health Department, University of California-Merced, Merced, CA, USA
| | | | - Annet Davis
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Fagin Hall, Room 483L, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Bridgette M Brawner
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Fagin Hall, Room 483L, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Danielle Fiore
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Fagin Hall, Room 483L, 418 Curie Blvd., Philadelphia, PA, 19104-4217, USA
| | - Tarashon Broomes
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Geneva Ortiz
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Debbie Lucy
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| |
Collapse
|
20
|
Stevens RC, Brawner BM, Kranzler E, Giorgi S, Lazarus E, Abera M, Huang S, Ungar L. Exploring Substance Use Tweets of Youth in the United States: Mixed Methods Study. JMIR Public Health Surveill 2020; 6:e16191. [PMID: 32213472 PMCID: PMC7146240 DOI: 10.2196/16191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Substance use by youth remains a significant public health concern. Social media provides the opportunity to discuss and display substance use-related beliefs and behaviors, suggesting that the act of posting drug-related content, or viewing posted content, may influence substance use in youth. This aligns with empirically supported theories, which posit that behavior is influenced by perceptions of normative behavior. Nevertheless, few studies have explored the content of posts by youth related to substance use. OBJECTIVE This study aimed to identify the beliefs and behaviors of youth related to substance use by characterizing the content of youths' drug-related tweets. Using a sequential explanatory mixed methods approach, we sampled drug-relevant tweets and qualitatively examined their content. METHODS We used natural language processing to determine the frequency of drug-related words in public tweets (from 2011 to 2015) among youth Twitter users geolocated to Pennsylvania. We limited our sample by age (13-24 years), yielding approximately 23 million tweets from 20,112 users. We developed a list of drug-related keywords and phrases and selected a random sample of tweets with the most commonly used keywords to identify themes (n=249). RESULTS We identified two broad classes of emergent themes: functional themes and relational themes. Functional themes included posts that explicated a function of drugs in one's life, with subthemes indicative of pride, longing, coping, and reminiscing as they relate to drug use and effects. Relational themes emphasized a relational nature of substance use, capturing substance use as a part of social relationships, with subthemes indicative of drug-related identity and companionship. We also identified topical areas in tweets related to drug use, including reference to polysubstance use, pop culture, and antidrug content. Across the tweets, the themes of pride (63/249, 25.3%) and longing (39/249, 15.7%) were the most popular. Most tweets that expressed pride (46/63, 73%) were explicitly related to marijuana. Nearly half of the tweets on coping (17/36, 47%) were related to prescription drugs. Very few of the tweets contained antidrug content (9/249, 3.6%). CONCLUSIONS Data integration indicates that drugs are typically discussed in a positive manner, with content largely reflective of functional and relational patterns of use. The dissemination of this information, coupled with the relative absence of antidrug content, may influence youth such that they perceive drug use as normative and justified. Strategies to address the underlying causes of drug use (eg, coping with stressors) and engage antidrug messaging on social media may reduce normative perceptions and associated behaviors among youth. The findings of this study warrant research to further examine the effects of this content on beliefs and behaviors and to identify ways to leverage social media to decrease substance use in this population.
Collapse
Affiliation(s)
- Robin C Stevens
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, United States
| | - Bridgette M Brawner
- University of Pennsylvania School of Nursing, Philadelphia, PA, United States
| | - Elissa Kranzler
- Wharton Risk Management and Decision Processes Center, Philadelphia, PA, United States
| | - Salvatore Giorgi
- Department of Computer and Information Science, Philadelphia, PA, United States
| | - Elizabeth Lazarus
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Maramawit Abera
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Sarah Huang
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Lyle Ungar
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| |
Collapse
|
21
|
Bradley ELP, Lanier Y, Ukuku Miller AM, Brawner BM, Sutton MY. Successfully Recruiting Black and Hispanic/Latino Adolescents for Sexually Transmitted Infection and HIV Prevention Research. J Racial Ethn Health Disparities 2019; 7:36-44. [PMID: 31520322 DOI: 10.1007/s40615-019-00631-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/10/2019] [Accepted: 08/15/2019] [Indexed: 11/29/2022]
Abstract
Disparities in rates of sexually transmitted infections (STIs) and HIV between Black/African American and Hispanic/Latino adolescents and their white counterparts are well documented. Researchers may encounter notable challenges recruiting Black/African American and Hispanic/Latino adolescents for sexual risk reduction studies. In this article, we present information to assist with planning, implementing, and evaluating recruitment and retention strategies. We also provide practical examples of challenges and solutions from three STI/HIV epidemiologic or prevention intervention studies with different study purposes and populations. Researchers can use this information to aid proposal development, create or refine a recruitment/retention protocol before implementation, and troubleshoot challenges during implementation.
Collapse
Affiliation(s)
- Erin L P Bradley
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30329, USA.
| | - Yzette Lanier
- New York University Rory Meyers College of Nursing, 433 First Ave, Room 406, New York, NY, 10003, USA
| | - Afekwo M Ukuku Miller
- Department of Health Promotion and Physical Education, Kennesaw State University, 290 Kennesaw State University Road, MD 0301, Kennesaw, GA, 30144, USA
| | - Bridgette M Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, 418 Curie Blvd., Room 419, Philadelphia, PA, 19104-4217, USA
| | - Madeline Y Sutton
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30329, USA.,Department of Obstetrics and Gynecology, Morehouse School of Medicine, 720 Westview Dr, Atlanta, GA, 30310, USA
| |
Collapse
|
22
|
Brawner BM, Jemmott LS, Wingood G, Lozano AJ, Hanlon AL. Project GOLD: A pilot randomized controlled trial of a novel psychoeducational HIV/STI prevention intervention for heterosexually-active black youth. Res Nurs Health 2019; 42:8-28. [PMID: 30730043 PMCID: PMC6913528 DOI: 10.1002/nur.21930] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/24/2018] [Indexed: 11/08/2022]
Abstract
Black youth account for the largest number of new HIV infections among heterosexual youth. Mental illness and difficulties in emotion regulation contribute to increased reports of HIV/sexually transmitted infection (STI) risk-related sexual behaviors in this group. Yet limited interventions exist to address this affective component of the sexual decision-making process. The purpose of this paper was to describe the trial design, research challenges, and baseline characteristics from a study designed to fill this gap. Project GOLD was a pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention designed to address the role of mental illness and emotion regulation in HIV/STI risk among heterosexually-active Black youth aged 14 to 17 (N = 108). Challenges encountered in the research process warrant further attention in future research (e.g., disagreement among the regulatory bodies on parental permission requirements). The most common mental health diagnoses were Recurrent Major Depressive Disorder (15.7%) and current substance abuse (7.4%). Participants reported higher levels of emotional suppression, and adaptive methods of emotion management, than culturally inappropriate expressions of anger or sadness. They also reported a mean age of 13.6 at first vaginal sex, used condoms 66% of the time for vaginal sex, and had an average of three sexual partners in the past 6 months. More than one-quarter (26.9%) had sex with more than one person in the same day. These findings indicate intervention is crucial for this population. The forthcoming trial evaluation will indicate the promise of such interventions in reducing HIV/STI infections in this key population.
Collapse
Affiliation(s)
- Bridgette M. Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America
| | - Loretta Sweet Jemmott
- Department of Nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Gina Wingood
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Alicia J. Lozano
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America
| | - Alexandra L. Hanlon
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, United States of America
| |
Collapse
|
23
|
Brawner BM, Abboud S, Reason J, Wingood G, Jemmott LS. The development of an innovative, theory-driven, psychoeducational HIV/STI prevention intervention for heterosexually active black adolescents with mental illnesses. Vulnerable Child Youth Stud 2019; 14:151-165. [PMID: 31687041 PMCID: PMC6826258 DOI: 10.1080/17450128.2019.1567962] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 12/20/2018] [Indexed: 06/09/2023]
Abstract
Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), continue to disproportionately affect Black adolescents. Those experiencing the psychological sequelae of mental illnesses are at increased risk. Here, we outline the development of an HIV/STI prevention intervention for heterosexually-active Black adolescents with mental illnesses. This research was guided by a psychosocial expansion of the Theory of Planned Behavior, nested within a broader social determinants of health framework. A youth community advisory board provided study oversight. Heterosexually-active Black adolescents aged 14 to 17 were recruited from community-based outpatient mental health providers for focus groups, surveys and two "dress rehearsals" of the intervention protocol (N = 68). The qualitative and quantitative findings indicated that knowledge, attitudes and skills related to consistent condom use, reduced number of sexual partners, routine HIV/STI testing, abstinence and emotion regulation were important areas to target. These elicitation data provided insight on the context of HIV/STI risk for the study population, and were used to develop the intervention content. "Project GOLD: We are Kings and Queens" was designed to be delivered over two days (three hours per day), with eight, 45-minute modules. The activities address behaviors, as well as cognitive, emotional, psychological and social processes associated with HIV/STI risk. Alongside evidence-based HIV/STI prevention strategies (e.g., sexual partner communication skills), the intervention activities are rooted in principles of Cognitive Behavioral Therapy. Dress rehearsal participants were in favor of the intervention and provided feedback on activity length, gender and cultural relevance, and strategies to sustain attention; this information was used to finalize the curriculum. In partnership with the community, we developed a theoretically-driven, gender and culturally relevant, developmentally and psychologically appropriate HIV/STI prevention program. Our ultimate goal is to standardize sexual health assessment and intervention in outpatient mental health treatment settings to meet sexual health needs in this underserved population.
Collapse
Affiliation(s)
- Bridgette M. Brawner
- Department of Family and Community Health, University of
Pennsylvania School of Nursing, 418 Curie Blvd., 4th Floor, Room 419, Philadelphia,
PA 19104-4217, USA; Twitter: @DrBMBrawner; 215-898-0715 (office), 215-746-3374
| | - Sarah Abboud
- Department of Women, Children and Family Health Science,
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA, Twitter:
@SarahAbboud78
| | - Janaiya Reason
- Department of Family and Community Health, University of
Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Gina Wingood
- Mailman School of Public Health, Columbia University, New
York, NY, USA
| | | |
Collapse
|
24
|
Ha YP, Seifu LD, Lewis LM, Dupuis R, Brawner BM, Cannuscio CC. Partnering Medical Students With Barbers to Cut Hypertension in Black Men. Am J Public Health 2018; 108:785-787. [PMID: 29741952 DOI: 10.2105/ajph.2018.304374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Yoonhee P Ha
- Yoonhee P. Ha, Roxanne Dupuis, and Carolyn C. Cannuscio are with the Center for Public Health Initiatives, University of Pennsylvania, Philadelphia. Leah D. Seifu is with The Children's Hospital of Philadelphia. Lisa M. Lewis and Bridgette M. Brawner are with the Department of Family and Community Health, School of Nursing, University of Pennsylvania
| | - Leah D Seifu
- Yoonhee P. Ha, Roxanne Dupuis, and Carolyn C. Cannuscio are with the Center for Public Health Initiatives, University of Pennsylvania, Philadelphia. Leah D. Seifu is with The Children's Hospital of Philadelphia. Lisa M. Lewis and Bridgette M. Brawner are with the Department of Family and Community Health, School of Nursing, University of Pennsylvania
| | - Lisa M Lewis
- Yoonhee P. Ha, Roxanne Dupuis, and Carolyn C. Cannuscio are with the Center for Public Health Initiatives, University of Pennsylvania, Philadelphia. Leah D. Seifu is with The Children's Hospital of Philadelphia. Lisa M. Lewis and Bridgette M. Brawner are with the Department of Family and Community Health, School of Nursing, University of Pennsylvania
| | - Roxanne Dupuis
- Yoonhee P. Ha, Roxanne Dupuis, and Carolyn C. Cannuscio are with the Center for Public Health Initiatives, University of Pennsylvania, Philadelphia. Leah D. Seifu is with The Children's Hospital of Philadelphia. Lisa M. Lewis and Bridgette M. Brawner are with the Department of Family and Community Health, School of Nursing, University of Pennsylvania
| | - Bridgette M Brawner
- Yoonhee P. Ha, Roxanne Dupuis, and Carolyn C. Cannuscio are with the Center for Public Health Initiatives, University of Pennsylvania, Philadelphia. Leah D. Seifu is with The Children's Hospital of Philadelphia. Lisa M. Lewis and Bridgette M. Brawner are with the Department of Family and Community Health, School of Nursing, University of Pennsylvania
| | - Carolyn C Cannuscio
- Yoonhee P. Ha, Roxanne Dupuis, and Carolyn C. Cannuscio are with the Center for Public Health Initiatives, University of Pennsylvania, Philadelphia. Leah D. Seifu is with The Children's Hospital of Philadelphia. Lisa M. Lewis and Bridgette M. Brawner are with the Department of Family and Community Health, School of Nursing, University of Pennsylvania
| |
Collapse
|
25
|
Brawner BM, Jemmott LS, Wingood G, Reason J, Mack N. HIV/STI Prevention Among Heterosexually Active Black Adolescents With Mental Illnesses: Focus Group Findings for Intervention Development. J Assoc Nurses AIDS Care 2018; 29:30-44. [PMID: 29037602 PMCID: PMC6913525 DOI: 10.1016/j.jana.2017.09.008] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 09/22/2017] [Indexed: 10/18/2022]
Abstract
Heterosexually active Black adolescents with mental illnesses are at increased risk for sexually transmitted infections (STIs), including HIV. However, few HIV/STI prevention interventions exist for this demographic. We held seven focus groups (N = 33) to elucidate social, cultural, and psychological factors that influence HIV/STI risk-related sexual behaviors in this understudied population. Seven themes emerged: (a) Blackness and media portrayals, (b) Blackness as a source of cultural resilience and pride, (c) psychosocial determinants of condom use, (d) consequences of engaging in sexual activity, (e) attitudes and beliefs toward sexual behaviors, (f) benefits of sexual activity, and (g) coping mechanisms. Participants also supported the feasibility of and interest in HIV/STI prevention programs integrated with mental health treatment. Transportation, potential breaches of confidentiality, and time were noted barriers to participation. Psychoeducational, skills-based programs are needed to address the sequelae of mental illnesses as they relate to the sexual decision-making process in adolescents.
Collapse
Affiliation(s)
- Bridgette M. Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | | | | | - Janaiya Reason
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Niya Mack
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| |
Collapse
|
26
|
Abboud S, De Penning E, Brawner BM, Menon U, Glanz K, Sommers MS. Cervical Cancer Screening Among Arab Women in the United States: An Integrative Review. Oncol Nurs Forum 2017; 44:E20-E33. [PMID: 27991600 DOI: 10.1188/17.onf.e20-e33] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Arab American women are an ethnic minority and immigrant population in the United States with unique and nuanced sociocultural factors that influence preventive health behaviors. The aims of this article are to evaluate and synthesize the existing evidence on cervical cancer screening behaviors, as well as determine factors that influence these behaviors, among Arab American women.
. LITERATURE SEARCH Extensive literature searches were performed using PubMed, CINAHL®, Scopus, Embase, and Cochrane databases; articles published through October 2015 were sought.
. DATA EVALUATION Of 17 articles, 14 explicitly identified Arab and/or Muslim women and cervical cancer screening in either the title or the abstract; the remaining three focused on cancer attitudes and behaviors in Arab Americans in general but measured cervical cancer screening. Eleven articles reported different aspects of one intervention. Because of methodologic heterogeneity, the current authors synthesized results narratively.
. SYNTHESIS Key factors influencing cervical cancer screening were identified as the following. CONCLUSIONS Cervical cancer screening rates among Arab American women are comparable to other ethnic minorities and lower than non-Hispanic White women. Findings are inconsistent regarding factors influencing cervical cancer screening behaviors in this underrepresented group.
. IMPLICATIONS FOR RESEARCH Significant need exists for more research to better understand cervical cancer prevention behaviors in this group to inform culturally relevant interventions. Healthcare providers play a crucial role in increasing cervical cancer screening awareness and recommendations for Arab American women.
Collapse
|
27
|
Brawner BM, Guthrie B, Stevens R, Taylor L, Eberhart M, Schensul JJ. Place Still Matters: Racial/Ethnic and Geographic Disparities in HIV Transmission and Disease Burden. J Urban Health 2017; 94:716-729. [PMID: 28879489 PMCID: PMC5610132 DOI: 10.1007/s11524-017-0198-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 12/22/2022]
Abstract
Neighborhood-level structural interventions are needed to address HIV/AIDS in highly affected areas. To develop these interventions, we need a better understanding of contextual factors that drive the pandemic. We used multinomial logistic regression models to examine the relationship between census tract of current residence and mode of HIV transmission among HIV-positive cases. Compared to the predominantly white high HIV prevalence tract, both the predominantly black high and low HIV prevalence tracts had greater odds of transmission via injection drug use and heterosexual contact than male-to-male sexual contact. After adjusting for current age, gender, race/ethnicity, insurance status, and most recently recorded CD4 count, there was no statistically significant difference in mode of HIV transmission by census tract. However, heterosexual transmission and injection drug use remain key concerns for underserved populations. Blacks were seven times more likely than whites to have heterosexual versus male-to-male sexual contact. Those who had Medicaid or were uninsured (versus private insurance) were 23 and 14 times more likely, respectively, to have injection drug use than male-to-male sexual contact and 10 times more likely to have heterosexual contact than male-to-male sexual contact. These findings can inform larger studies for the development of neighborhood-level structural interventions.
Collapse
Affiliation(s)
- Bridgette M Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, 418 Curie Blvd., Room 419, Philadelphia, PA, USA.
| | - Barbara Guthrie
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Robin Stevens
- Department of Family and Community Health, University of Pennsylvania School of Nursing, 418 Curie Blvd., Room 419, Philadelphia, PA, USA
| | - Lynne Taylor
- Biostatistics Analysis Center, University of Pennsylvania, Philadelphia, PA, USA
| | | | | |
Collapse
|
28
|
Brawner BM, Sutton MY. Sexual Health Research Among Youth Representing Minority Populations: To Waive or Not to Waive Parental Consent. Ethics & Behavior 2017; 28:544-559. [DOI: 10.1080/10508422.2017.1365303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Bridgette M. Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing
| | | |
Collapse
|
29
|
Brawner BM, Reason JL, Hanlon K, Guthrie B, Schensul JJ. Stakeholder conceptualisation of multi-level HIV and AIDS determinants in a Black epicentre. Cult Health Sex 2017; 19:948-963. [PMID: 28132611 PMCID: PMC6100790 DOI: 10.1080/13691058.2016.1274428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/04/2016] [Accepted: 12/15/2016] [Indexed: 06/06/2023]
Abstract
HIV has reached epidemic proportions among African Americans in the USA but certain urban contexts appear to experience a disproportionate disease burden. Geographic information systems mapping in Philadelphia indicates increased HIV incidence and prevalence in predominantly Black census tracts, with major differences across adjacent communities. What factors shape these geographic HIV disparities among Black Philadelphians? This descriptive study was designed to refine and validate a conceptual model developed to better understand multi-level determinants of HIV-related risk among Black Philadelphians. We used an expanded ecological approach to elicit reflective perceptions from administrators, direct service providers and community members about individual, social and structural factors that interact to protect against or increase the risk for acquiring HIV within their community. Gender equity, social capital and positive cultural mores (e.g., monogamy, abstinence) were seen as the main protective factors. Historical negative contributory influences of racial residential segregation, poverty and incarceration were among the most salient risk factors. This study was a critical next step toward initiating theory-based, multi-level community-based HIV prevention initiatives.
Collapse
Affiliation(s)
- Bridgette M. Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Janaiya L. Reason
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Kelsey Hanlon
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Barbara Guthrie
- Department of Nursing, Northeastern University, Boston, Massachusetts, USA
| | | |
Collapse
|
30
|
Stevens R, Gilliard-Matthews S, Dunaev J, Woods M, Brawner BM. The Digital Hood: Social Media Use among Youth in Disadvantaged Neighborhoods. New Media Soc 2017; 19:950-967. [PMID: 28694736 PMCID: PMC5501457 DOI: 10.1177/1461444815625941] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This study examines the role of social media in the lives of youth living in disadvantaged neighborhoods. Feminist Standpoint theory, which privileges the voices of marginalized communities in understanding social phenomena, suggests that youth at the margins have specific knowledge that helps us understand social media more broadly. We conducted semi-structured interviews with 30 females and 30 males aged 13 to 24 about their social worlds and neighborhoods, both on- and offline. The findings reveal a dynamic and somewhat concerning interplay between the geographic neighborhood and the digital neighborhood, whereby negative social interactions in the geographic neighborhood are reproduced and amplified on social media.
Collapse
|
31
|
McDonald CC, Brawner BM, Fargo J, Swope J, Sommers MS. Development of a Theoretically Grounded, Web-Based Intervention to Reduce Adolescent Driver Inattention. J Sch Nurs 2017; 34:270-280. [PMID: 28553750 DOI: 10.1177/1059840517711157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 12/30/2022] Open
Abstract
Motor vehicle crashes are the leading cause of adolescent death. Inattention to the roadway contributes to crash risk and often results from distractions, such as cell phone calls, texting, and peer passengers. We report on the development of a web-based intervention based on the Theory of Planned Behavior that aims to reduce adolescent driver inattention ( Let's Choose Ourselves). In Phase I, we collected qualitative and quantitative data on adolescents' attitudes, perceived behavioral control, and subjective norms about driver inattention through focus groups with newly licensed adolescent drivers. In Phase II, we developed the content in an e-learning delivery system, performed beta- and pilot testing, and made refinements. In Phase III, we conducted a randomized controlled trial to evaluate feasibility. The development of Let's Choose Ourselves provides information for school nurses regarding intervention development strategies as well as promotion of safe adolescent driving by reducing driver inattention.
Collapse
Affiliation(s)
- Catherine C McDonald
- 1 School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.,2 Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,3 Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Jamison Fargo
- 4 Department of Psychology, Utah State University, Logan, UT, USA
| | - Jennifer Swope
- 5 The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Marilyn S Sommers
- 1 School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
32
|
Brawner BM, Jemmott LS, Wingood G, Reason J, Daly B, Brooks K, Lanier Y. Feelings Matter: Depression Severity and Emotion Regulation in HIV/STI Risk-Related Sexual Behaviors. J Child Fam Stud 2017; 26:1635-1645. [PMID: 35979202 PMCID: PMC9380447 DOI: 10.1007/s10826-017-0674-z] [Citation(s) in RCA: 8] [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: 05/30/2023]
Abstract
Human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention models may not address psychological complexities among adolescents with mental illnesses. This study examined contextual factors related to HIV/STI risk among heterosexually active Black adolescents with mental illnesses to inform the development of targeted HIV/STI prevention strategies. Black adolescent males and females (aged 14-17) were recruited from outpatient mental health programs in Philadelphia, PA to complete a computer-assisted personalized interview on sociodemographics, sexual behaviors, and emotion regulation (N = 53). Two sample t-tests, Wilcoxon Rank Sum tests and regression modeling were used to examine differences in the study measures by gender and relationship status. Reports of sexual partner concurrency were high-both while already in a sexual relationship (67.3%) and multiple sexual partners in the same day (42.3%). Boys reported significantly more risk behaviors than girls. Sadness dysregulation predicted currently being in a relationship, older age at first oral sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters. Coping difficulties predicted a greater number of vaginal and oral sexual partners, and a lower age at first vaginal sex. Increasing depression severity was related to older age at first vaginal sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters in the past 3 months. This formative work suggests that coping mechanisms should be addressed in HIV/STI prevention research through the inclusion of activities targeted toward emotion regulation and decreasing sexual risk behaviors. Psycho-education and skills building may mitigate the psychopathology that contributes to HIV/STI risk in the target demographic.
Collapse
Affiliation(s)
- Bridgette M Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, 418 Curie Blvd., 4th Floor, Room 419, Philadelphia, PA 19104-4217
| | | | - Gina Wingood
- Public Health Promotion Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Janaiya Reason
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Bridget Daly
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Kiahana Brooks
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | | |
Collapse
|
33
|
Stewart JM, Hanlon A, Brawner BM. Predictors of HIV/AIDS Programming in African American Churches: Implications for HIV Prevention, Testing, and Care. Health Educ Behav 2016; 44:385-393. [PMID: 27540035 DOI: 10.1177/1090198116663695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/16/2022]
Abstract
Using data from the National Congregational Study, we examined predictors of having an HIV/AIDS program in predominately African American churches across the United States. We conducted regression analyses of Wave II data ( N = 1,506) isolating the sample to churches with a predominately African American membership. The dependent variable asked whether or not the congregation currently had any program focused on HIV or AIDS. Independent variables included several variables from the individual, organizational, and social levels. Our study revealed that region, clergy age, congregant disclosure of HIV-positive status, permitting cohabiting couples to be members, sponsorship or participation in programs targeted to physical health issues, and having a designated person or committee to address health-focused programs significantly increased the likelihood of African American churches having an HIV/AIDS program. A paucity of nationally representative research focuses on the social-, organizational-, and individual-level predictors of having HIV/AIDS programs in African American churches. Determining the characteristics of churches with HIV/AIDS programming at multiple levels is a critical and necessary approach with significant implications for partnering with African American churches in HIV or AIDS initiatives.
Collapse
Affiliation(s)
| | - Alexandra Hanlon
- 2 University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | |
Collapse
|
34
|
Lucas MS, Brawner BM, Hardie TL, Beacham B, Paidipati C, Diaz M, Lauer A, Hobbie WL, Deatrick JA. Assessing Suicidal Ideation and Behaviors Among Survivors of Childhood Brain Tumors and Their Mothers During Sociobehavioral Research. Oncol Nurs Forum 2016; 42:E319-29. [PMID: 26302289 DOI: 10.1188/15.onf.42-05ap] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe the development and feasibility of a protocol for nonpsychiatric subspecialty research staff members to screen research participants who endorse suicidal ideations or behaviors during data collection
. DESIGN Descriptive protocol development.
. SETTING The Children's Hospital of Philadelphia and the University of Pennsylvania.
. SAMPLE 186 mother caregivers and 134 adolescent or young adult survivors of childhood brain tumors, with the protocol implemented for 5 caregivers and 11 survivors. METHODS During telephone- and home-based interviews, the interviewer assessed the participant using the Columbia-Suicide Severity Rating Scale (C-SSRS). MAIN RESEARCH VARIABLES Expressed suicidal ideation or behavior
. FINDINGS Implementation of the C-SSRS by nonpsychiatric subspecialty staff members was feasible and valid. Interviewers' conclusions based on this instrument matched those of the mental health professional who followed up with participants. Process notes contained themes about the participants, including anger and sadness in survivors and the physical and emotional demands of the survivor in caregivers. Progress notes for the interviewer included a reiteration of events, whether the assessment was successful, and whether the recommendation of the interviewer was in agreement with that of the mental health professional
. CONCLUSIONS The protocol based on the C-SSRS was useful and feasible for nonpsychiatric subspecialty staff members to use in the collection of data from survivors of childhood brain tumors and their caregivers. IMPLICATIONS FOR NURSING Survivors of childhood brain tumors and their caregivers may experience psychosocial distress. Nurses, as research assistants or in other roles, can use tools such as the C-SSRS to assist in front-line assessments.
.
Collapse
|
35
|
Brawner BM, Fannin EF, Reason JL, Weissinger G. Addressing Unmet Sexual Health Needs among Black Adolescents with Mental Illnesses. ACTA ACUST UNITED AC 2016; 3:75-91. [PMID: 29119132 DOI: 10.1353/bsr.2016.0007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Despite advances in HIV epidemiologic and prevention research, adolescents with mental illnesses remain a historically underserved group with respect to human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention resources. Black adolescents with mental illnesses in particular are a relatively underserved, hidden population in the field of sexual health. Strategies and guidelines are needed to account for underlying psychopathology among Black adolescents with mental illnesses in ways that current models have yet to address. In this paper, we propose several actionable mechanisms to better integrate HIV/STI and mental health related services and activities for sexual health promotion.
Collapse
Affiliation(s)
- Bridgette M Brawner
- Assistant Professor of Nursing, Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing, 418 Curie Blvd., Room 419, Philadelphia, PA 19104
| | - Ehriel F Fannin
- Ruth L. Kirschstein NRSA Predoctoral Fellow (T32NR007100), Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing
| | - Janaiya L Reason
- Research Coordinator, Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing
| | - Guy Weissinger
- BSN-to-PhD Hillman Scholar, Center for Health Equity Research, University of Pennsylvania School of Nursing
| |
Collapse
|
36
|
Brawner BM, Alexander KA, Fannin EF, Baker JL, Davis ZM. The Role of Sexual Health Professionals in Developing a Shared Concept of Risky Sexual Behavior as it Relates to HIV Transmission. Public Health Nurs 2015; 33:139-50. [PMID: 26184496 DOI: 10.1111/phn.12216] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
"Risky sexual behavior" accounts for the majority of new HIV infections regardless of gender, age, geographic location, or ethnicity. The phrase, however, refers to a relatively nebulous concept that hampers development of effective sexual health communication strategies. The purpose of this paper was to propose development of a shared conceptual understanding of "risky sexual behavior." We reviewed multidisciplinary HIV/AIDS literature to identify definitions of risky sexual behavior. Both the linguistic components and the social mechanisms that contribute to the concept of risky sexual behaviors were noted. Risky sexual behavior was often defined in a subjective manner in the literature, even in the scientific research. We urge a paradigm shift to focus on explicit behaviors and the social context of those behaviors in determining HIV risk. We also propose a new definition that reduces individual biases and promotes a broader discussion of the degree of sexual risk across a diversity of behavioral contexts. Sexual health professionals can strengthen practice and research initiatives by operating from a concise working definition of risky sexual behavior that is broadly transferable and expands beyond a traditional focus on identity-based groups.
Collapse
Affiliation(s)
- Bridgette M Brawner
- Department of Nursing, Center for Health Equity Research and Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Kamila A Alexander
- Johns Hopkins School of Nursing, Department of Community Public Health, Baltimore, Maryland
| | - Ehriel F Fannin
- Center for Health Equity Research and Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Jillian L Baker
- Department of Urban Public Health & Nutrition, School of Nursing & Health Sciences, La Salle University, Philadelphia, Pennsylvania
| | - Zupenda M Davis
- Department of Urban Public Health & Nutrition, School of Nursing & Health Sciences, La Salle University, Philadelphia, Pennsylvania
| |
Collapse
|
37
|
|
38
|
Abstract
Disproportionate HIV/AIDS rates among African American women have been examined extensively, primarily from an individual-centered focus. Beyond individual behaviors, factors such as the hyperincarceration of African American men and geographically concentrated disadvantage may better explain inequitable disease burden. In this article I propose a conceptual model of individual, social, and structural factors that influence HIV transmission among African American women. The model can be used to develop comprehensive assessments and guide prevention programs in African American communities.
Collapse
|
39
|
Sowicz TJ, Teitelman AM, Coleman CL, Brawner BM. Considerations for implementing oral preexposure prophylaxis: a literature review. J Assoc Nurses AIDS Care 2014; 25:496-507. [PMID: 25305026 DOI: 10.1016/j.jana.2014.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 07/21/2014] [Indexed: 10/25/2022]
Abstract
Oral preexposure prophylaxis (PrEP) is in its infancy as an approved biomedical intervention; therefore, research is needed to understand the issues surrounding its implementation. The purpose of this literature review is to report the empirical research about PrEP to identify the salient issues surrounding its implementation. PubMed, Medline, and CINAHL databases were searched, yielding 45 articles meeting inclusion criteria for the review. Overall, we found patient awareness of PrEP varied and its use was low. Awareness was higher among providers. Patients were willing to use PrEP, but both patients' and providers' concerns may have impacted implementation of this intervention. PrEP requires a prescription, yet only five of the 45 articles addressed provider-level factors. Research involving providers is needed to ensure that patient risk of becoming infected with HIV is accurately assessed, that PrEP is provided to those at high risk for HIV infection, and that frequent follow-up is conducted.
Collapse
|
40
|
Abstract
Background: Women and adolescent girls bear a significant burden of the global HIV pandemic. Both behavioral and biomedical prevention approaches have been shown to be effective. In order to foster the most effective combination HIV-prevention approaches for women and girls, it is imperative to understand the unique biological, social, and structural considerations that increase vulnerability to acquiring HIV within this population. Primary Study Objective: The purpose of this article is to propose novel ideas for personalized biobehavioral HIV prevention for women and adolescent girls. The central argument is that we must transcend unilevel solutions for HIV prevention toward comprehensive, multilevel combination HIV prevention packages to actualize personalized biobehavioral HIV prevention. Our hope is to foster transnational dialogue among researchers, practitioners, educators, and policy makers toward the actualization of the proposed recommendations. Methods: We present a commentary organized to review biological, social, and structural factors that increase vulnerability to HIV acquisition among women and adolescent girls. The overview is followed by recommendations to curb HIV rates in the target population in a sustainable manner. Results: The physiology of the lower female reproductive system biologically increases HIV risk among women and girls. Social (eg, intimate partner violence) and structural (eg, gender inequality) factors exacerbate this risk by increasing the likelihood of viral exposure. Our recommendations for personalized biobehavioral HIV prevention are to (1) create innovative mechanisms for personalized HIV risk—reduction assessments; (2) develop mathematical models of local epidemics; (3) prepare personalized, evidence-based combination HIV risk—reduction packages; (4) structure gender equity into society; and (5) eliminate violence (both physical and structural) against women and girls. Conclusions: Generalized programs and interventions may not have universal, transnational, and crosscultural implications. Personalized biobehavioral strategies are needed to comprehensively address vulnerabilities at biological, social, and structural levels.
Collapse
Affiliation(s)
- Bridgette M Brawner
- Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, United States
| | - Anne M Teitelman
- Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, United States
| | - Amanda W Bevilacqua
- Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, United States
| | - Loretta Sweet Jemmott
- Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, United States
| |
Collapse
|
41
|
Brawner BM, Volpe EM, Stewart JM, Gomes MM. Attitudes and beliefs toward biobehavioural research participation: voices and concerns of urban adolescent females receiving outpatient mental health treatment. Ann Hum Biol 2013; 40:485-95. [PMID: 23822716 PMCID: PMC4668940 DOI: 10.3109/03014460.2013.806590] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Biobehavioural research methodology can be invasive and burdensome for participants - particularly adolescents with mental illnesses. Human biological researchers should consider how methodological impositions may hinder adolescent research participation. However, literature on adolescent's voices and concerns toward biobehavioural research participation is virtually non-existent. AIM This study was designed to determine adolescents' perceptions of participation in research involving the collection of biomarkers via blood, saliva and/or urine samples. SUBJECTS AND METHODS Urban adolescent females (aged 12-19) receiving outpatient mental health treatment (n = 37) participated in focus groups with concurrent survey administration to explore attitudes, beliefs and willingness/intentions toward biobehavioural research participation. RESULTS Participants had favourable attitudes toward biobehavioural research and were amenable to provide each specimen type. Mistrust for research emerged, however, and concerns related to privacy and confidentiality were expressed. CONCLUSION Participant recruitment is a critical component in study design and implementation; this includes knowledge of population-specific recruitment barriers and facilitators. This innovative paper provides a context for the research participants' decision-making process, strategies to allay fears and concerns and concrete areas to target in research-related interventions. Although the findings are from a specific, US-based sample, the implications warrant replication of the research in other geosocial settings.
Collapse
Affiliation(s)
- Bridgette M. Brawner
- Center for Health Equity Research, Center for Global Women’s Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Ellen M. Volpe
- Center for Health Equity Research, Center for Global Women’s Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Jennifer M. Stewart
- Center for Health Equity Research, Center for Global Women’s Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Melissa M. Gomes
- Department of Family and Community Health Nursing, Virginia Commonwealth University School of Nursing, Richmond, VA, USA
| |
Collapse
|
42
|
Stewart JM, Sommers MS, Brawner BM. The Black church, sexual health, and sexuality: a conceptual framework to promote health through faith-based organizations. Fam Community Health 2013; 36:269-279. [PMID: 23718962 DOI: 10.1097/fch.0b013e318292eb2d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
There is a growing body of literature that documents the unique impact of black churches on social and health-related changes in the black community. Sexual health and sexuality, however, have long been sources of contention within the institution. The purpose of this article was to refine existing theoretical models that undergird sexual health research in faith-based organizations. The proposed conceptual model explores social-level factors (racism, homophobia, and heterosexism) and church organizational-level factors (beliefs, social trust, norms, and social support/influence). We make an argument in favor of illuminating the negative social-level barriers and affirming the internal cultural supports.
Collapse
Affiliation(s)
- Jennifer M Stewart
- Center for Health Equity Research and Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA.
| | | | | |
Collapse
|
43
|
Brawner BM, Baker JL, Stewart J, Davis ZM, Cederbaum J, Jemmott LS. "The black man's country club": assessing the feasibility of an HIV risk-reduction program for young heterosexual African American men in barbershops. Fam Community Health 2013; 36:109-18. [PMID: 23455681 PMCID: PMC3687538 DOI: 10.1097/fch.0b013e318282b2b5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [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] [Indexed: 05/23/2023]
Abstract
Despite increasing HIV/AIDS morbidity and mortality, focus on young heterosexual African American men is limited. Nontraditional community-based prevention programs may be most effective for this demographic. Barbershops are one potential venue; however, barbers' and barbershop owners' views on the concept are less known. This paper describes attitudes and beliefs among barbers and barbershop owners regarding delivering a barber-facilitated, skills-based HIV risk-reduction intervention to their clientele. Participants believed that young heterosexual African American men were at significant risk for HIV and highly regarded the intervention model. This novel work contributes a voice to the literature that is infrequently heard.
Collapse
Affiliation(s)
- Bridgette M Brawner
- Center for Health Equity Research, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104-4217, USA.
| | | | | | | | | | | |
Collapse
|
44
|
Brawner BM. Attitudes and beliefs regarding depression, HIV/AIDS, and HIV risk-related sexual behaviors among clinically depressed African American adolescent females. Arch Psychiatr Nurs 2012; 26:464-76. [PMID: 23164403 PMCID: PMC3502880 DOI: 10.1016/j.apnu.2012.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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: 12/20/2011] [Revised: 04/24/2012] [Accepted: 06/01/2012] [Indexed: 11/27/2022]
Abstract
Individuals' attitudes and beliefs toward behaviors are key indicators of behavioral performance. The purposes of this study were to elucidate attitudes and beliefs about depression, HIV/AIDS, and HIV risk-related sexual behaviors among clinically depressed African American adolescent females and to develop an understanding of their context for HIV risk. For this descriptive qualitative inquiry, semistructured interviews and surveys were employed (N = 24). The narratives reveal that behavioral sequelae of depression (i.e., loneliness) can produce risk for HIV. These findings may guide psychiatric nurse educators, scientists, and practitioners to modify HIV risk among clinically depressed African American adolescent females.
Collapse
Affiliation(s)
- Bridgette M Brawner
- Center for Health Equity Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104-4217, USA.
| |
Collapse
|
45
|
Brawner BM, Baker JL, Voytek CD, Leader A, Cashman RR, Silverman R, Peter N, Buchner BJ, Barnes CA, Jemmott LS, Frank I. The Development of a Culturally Relevant, Theoretically Driven HPV Prevention Intervention for Urban Adolescent Females and Their Parents/Guardians. Health Promot Pract 2012; 14:624-36. [DOI: 10.1177/1524839912462389] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, accounting for the large majority of cervical cancer and anogenital warts cases. Two HPV vaccines are currently licensed and recommended for women and girls. However, vaccination rates have been suboptimal, with evidence of disparities influencing both uptake and series completion among African American and Hispanic adolescents. There has been a dearth of theory-based, behavioral interventions targeted to prevent HPV infection and increase HPV vaccine uptake among urban adolescents. This article describes the development of two skills-based intervention curricula aimed to increase HPV prevention and vaccination among low-income urban adolescent females 9 to 18 years old. Guided by the theory of planned behavior, elicitation research was conducted to elucidate the social psychological factors that underlie HPV vaccination intentions ( N = 141). The findings were subsequently used to identify theoretical mediators of behavioral change to drive the intervention. Culturally relevant strategies to promote HPV vaccination were translated into the curricula content. Both curricula were designed to motivate and empower participants to reduce risk of being infected with HPV. Targeting theoretical mediators of behavioral change, derived from the voices of the community, may prove to be successful in increasing HPV vaccination and preventing HPV.
Collapse
Affiliation(s)
| | | | | | - Amy Leader
- Thomas Jefferson University, Philadelphia, PA, USA
| | | | | | - Nadja Peter
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | | | - Ian Frank
- University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
46
|
Brawner BM, Gomes MM, Jemmott LS, Deatrick JA, Coleman CL. Clinical depression and HIV risk-related sexual behaviors among African-American adolescent females: unmasking the numbers. AIDS Care 2012; 24:618-25. [PMID: 22292603 DOI: 10.1080/09540121.2011.630344] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Clinically depressed and nondepressed African-American adolescent females aged 13-19 years (N=131) were interviewed and surveyed to determine the relationship between depression and HIV risk-related sexual behaviors. Narratives indicate that the psychopathology of depression may create situations where the target population could become exposed to HIV. Specifically, depressed participants described feelings of loneliness, isolation, and wanting somebody to "comfort them" as aspects of depression that affect the decisions they make about sex and relationships. In essence, sex was viewed as a stress reliever, an anti-depressant and a way to increase self-esteem. They shared that even if they did not feel like having sex, they might just "git it over wit" so their partners would stop asking. Some also discussed financial and emotional stability offered by older, more sexually experienced partners. These age-discordant relationships often translated into trusting that their partners knew what was best for their sexual relationships (i.e., having unprotected sex). Sixty-nine percent (n=88) of the sample reported engaging in sexual activity. Given their mean age (16 ± 1.9 years) participants had been sexually active for 2 ± 1.8 years. The adolescents reported an average of 2 ± 1.8 sexual partners within the past three months. Depressed participants reported a higher frequency of having ever had sex (78% vs. 59%, χ(2)=5.236, p=0.022), and had a higher mean number of sexual partners (2 vs. 1, t=-2.023, p= 0.048) and sexual encounters under the influence of drugs and alcohol (8 vs. 2, t=-3.078, p=0.005) in the past three months. The results of this study can guide the modification and/or development of tailored HIV/sexually transmitted infection (STI) prevention programs. The findings provide explicit, psychologically and culturally relevant information regarding the interaction between depression, self-medicating behaviors and risk for HIV/STIs among clinically depressed African-American adolescent females.
Collapse
Affiliation(s)
- B M Brawner
- Center for Health Equity Research, School of Nursing, University of Pennsylvania, Philadelphia, USA.
| | | | | | | | | |
Collapse
|
47
|
Leader AE, Cashman R, Voytek CD, Baker JL, Brawner BM, Frank I. An exploratory study of adolescent female reactions to direct-to-consumer advertising: the case of the Human Papillomavirus (HPV) Vaccine. Health Mark Q 2011; 28:372-385. [PMID: 22054031 DOI: 10.1080/07359683.2011.630289] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
When the human papillomavirus (HPV) vaccine was approved in 2006, an extensive direct-to-consumer (DTC) advertising campaign raised awareness and promoted vaccination. This study explores adolescents' exposure to and understanding of the messages in these advertisements. Sixty-seven African American females participated in a focus group about DTC advertising for the HPV vaccine. Virtually all adolescents had seen an HPV vaccine DTC advertisement, but most did not understand the health information contained in it. If DTC advertising is to be an effective source of health information for adolescents in the future, it must take into account the unique features of an adolescent audience.
Collapse
Affiliation(s)
- Amy E Leader
- a Division of Population Science, Department of Medical Oncology , Thomas Jefferson University , Philadelphia , Pennsylvania
| | | | | | | | | | | |
Collapse
|
48
|
Brawner BM, Davis ZM, Fannin EF, Alexander KA. Clinical depression and condom use attitudes and beliefs among African American adolescent females. J Assoc Nurses AIDS Care 2011; 23:184-94. [PMID: 21737313 DOI: 10.1016/j.jana.2011.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 03/28/2011] [Indexed: 10/18/2022]
Abstract
Depression, HIV, and other sexually transmitted diseases (STDs) are growing concerns among African American adolescent females. Theoretical models contribute to identification of mediators of condom use; however, minimal research has addressed the explicit relationship between clinical depression and condom use in African American adolescent females. The authors report results from quantitative surveys with clinically depressed (n = 64) and nondepressed (n = 64) African American adolescent females in two large metropolitan cities in the eastern United States. Theoretical mediators of condom use in the study sample-attitudes, subjective norms, perceived behavioral control, and intentions-were investigated. Significant differences existed between the groups in condom use frequency (U = 356.5, p = .037); however, there were no statistically significant differences in condom use attitudes and beliefs. Although clinically depressed and nondepressed African American adolescent females may hold similar attitudes and beliefs about condom use, differences in condom use frequency may be a psychopathologic occurrence.
Collapse
Affiliation(s)
- Bridgette M Brawner
- Center for Health Equity Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | | | | | |
Collapse
|
49
|
Alexander KA, Dovydaitis T, Beacham B, Bohinski JM, Brawner BM, Clements CP, Everett JS, Gomes MM, Harner H, McDonald CC, Pinkston E, Sommers MS. Learning health equity frameworks within a community of scholars. J Nurs Educ 2011; 50:569-74. [PMID: 21710960 DOI: 10.3928/01484834-20110630-05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Accepted: 05/18/2011] [Indexed: 11/20/2022]
Abstract
Scholars in nursing science have long espoused the concept of health equity without specifically using the term or dialoguing about the social determinants of health and social justice. This article describes the development, implementation, and evaluation of a doctoral and postdoctoral seminar collective entitled "Health Equity: Conceptual, Linguistic, Methodological, and Ethical Issues." The course enabled scholars-in-training to consider the construct and its nuances and frame a personal philosophy of health equity. An example of how a group of emerging scholars can engage in the important, but difficult, discourse related to health equity is provided. The collective provided a forum for debate, intellectual growth, and increased insight for students and faculty. The lessons learned by all participants have the potential to enrich doctoral and postdoctoral scientific training in nursing science and may serve as a model for other research training programs in the health sciences.
Collapse
|
50
|
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.
Collapse
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.,
| | | | | | | | | |
Collapse
|