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Olakunde BO, Ujam C, Ndukwe CD, Falola-Anoemuah Y, Olaifa Y, Oladele TT, Yahaya HB, Ogundipe A. Barriers to the uptake of oral pre-exposure prophylaxis among young key populations in Nigeria. Int J STD AIDS 2024; 35:346-351. [PMID: 38105179 DOI: 10.1177/09564624231220099] [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: 12/19/2023]
Abstract
BACKGROUND Young key populations (YKP) contribute to the burden of HIV in Nigeria and are a priority population for oral pre-exposure prophylaxis (PrEP). However, their uptake of PrEP remains low. We assessed the main barriers to PrEP uptake and the variation among YKP (15-24 years) in Nigeria. METHODS This study was a secondary data analysis of the 2020 Integrated Biological & Behavioural Surveillance Survey conducted among key populations (KP), including female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), and transgender people (TG), in 12 states in Nigeria. A closed-ended question asking the main reason for not taking PrEP among KP who had never taken PrEP was included in the surveillance questionnaire. We collapsed the responses into six barrier themes. Using multinomial logistic regression analysis, we examined the association between the barriers (dependent variable) and KP group (independent variable), controlling for age, educational attainment, religion, marital status, employment status, and geopolitical zone. RESULTS A total of 1776 YKP were included in this study. The most cited barriers by KP group were: lack of access (28.3%) and fear of side effects (28.3%) by FSW; lack of interest (37.1%) by MSM; low risk perception (65.5%) by PWID; and lack of access (34.4%) by TG. The odds of reporting fear of side effects, lack of access, lack of interest, and nonspecific/others reasons were significantly different by KP group. CONCLUSIONS The barriers limiting the uptake of PrEP among YKP vary by KP group. Our results highlight the need for KP-specific interventions to improve the uptake of PrEP among YKP in Nigeria.
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Affiliation(s)
- Babayemi O Olakunde
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Chukwugozie Ujam
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Chinwedu D Ndukwe
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
- African Institute of Health Policy and Health Systems, Abakaliki, Nigeria
| | - Yinka Falola-Anoemuah
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Yewande Olaifa
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Tolulope T Oladele
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Hidayat B Yahaya
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Alex Ogundipe
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
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Liaaen JM, Söderström S. The interrelated process of becoming independent in user participation for young persons living with disabilities. Disabil Rehabil 2024; 46:714-722. [PMID: 36772814 DOI: 10.1080/09638288.2023.2175385] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 01/28/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE User participation is important in the delivery of health- and social services. Yet, our knowledge regarding how user participation is experienced from the perspective of those who use these services is limited. This study aims to develop knowledge regarding how young persons living with disabilities experience becoming independent in user participation. MATERIALS AND METHODS This qualitative study is inspired by Constructivist Grounded Theory. Nine young persons between 16 and 25 years of age and living with a disability, participated in the interviews. RESULTS The results revealed that user participation for young persons is a socially situated, relational, and skills-dependent process. User participation is characterized as a process, consisting of increasing skills, gradually reducing parental support, and responding to interactions with professionals. The three categories are strongly reciprocal and interrelated, forming the unifying core category of Striving towards independence in user participation. CONCLUSION We theorize about the Interrelated process of becoming independent in user participation for young persons with disabilities. This theory highlights the need to understand the interrelatedness of user participation, allowing for a recognition of the complexity of user participation, showing it as a process involving developing skills, and gradually becoming independent and skilled in user participation.Implications for rehabilitationYoung persons with disability rely on support from parents as well as professionals to become independent in user participationProfessionals should acknowledge that user participation is a learning process and allow for time and resources to aid this processFocusing on increasing health literacy alone is not sufficient to ensure user participation for young persons with disability.
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Affiliation(s)
- Janne Marita Liaaen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sylvia Söderström
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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3
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Olakunde BO, Folala-Anoemuah Y, Ujam C, Ndukwe CD, Olaifa Y, Yahaya HB, Bello H, Ogundipe A. Awareness and uptake of oral pre-exposure prophylaxis among adolescent and young key populations in Nigeria: a secondary data analysis of the 2020 Integrated Biological & Behavioural Surveillance Survey. AIDS Care 2024; 36:146-152. [PMID: 37683258 DOI: 10.1080/09540121.2023.2254547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 08/25/2023] [Indexed: 09/10/2023]
Abstract
Oral pre-exposure prophylaxis (PrEP) is a critical intervention for HIV prevention among key populations (KP) in Nigeria. However, little is known about its coverage among adolescent and young key populations (AYKP). Using the 2020 Integrated Biological & Behavioural Surveillance Survey conducted among KP, including female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), and transgender people (TG), we assessed the awareness and uptake of PrEP among AYKP (15-24 years) in Nigeria. We performed weighted descriptive statistics and logistic regression analyses. Of the 6882 AYKP included in this study, 36.1% were aware of PrEP, ranging from 47.9% in MSM to 19.8% in FSW. Compared with FSW, MSM (aOR = 3.7, 95%CI = 3.22-4.35) and TG (aOR = 2.6, 95%CI = 2.18-2.98) had significant higher odds of PrEP awareness. Among those aware of PrEP, 24.5% had ever taken PrEP. The uptake of PrEP varied by KP group: TG (28.1%), MSM (25.3%), PWID (18.0%), and FSW (14.4%). MSM (aOR = 2.6, 95%CI = 1.72-4.07) and TG (aOR = 2.7, 95%CI = 1.71-4.14) had significant higher odds of PrEP uptake relative to FSW. The awareness and uptake of PrEP among AYKP in Nigeria is low. This calls for more awareness creation about PrEP addressing the barriers that limit its uptake.
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Affiliation(s)
- Babayemi O Olakunde
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
- Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria
| | - Yinka Folala-Anoemuah
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Chukwugozie Ujam
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Chinwedu D Ndukwe
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
- African Institute of Health Policy and Health Systems, Abakaliki, Nigeria
| | - Yewande Olaifa
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Hidayat B Yahaya
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Hasiya Bello
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
| | - Alex Ogundipe
- Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Abuja, Nigeria
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Brown M, Lord E, John A. Adaptation of ACTivate Your Wellbeing, a Digital Health and Well-being Program for Young Persons: Co-design Approach. JMIR Form Res 2023; 7:e39913. [PMID: 37052994 PMCID: PMC10141270 DOI: 10.2196/39913] [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] [Received: 05/27/2022] [Revised: 09/09/2022] [Accepted: 10/06/2022] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND ACTivate your wellbeing is a digital health and well-being program designed to support and encourage positive lifestyle behavior change. The website includes 5 lifestyle behavior change modules and a 12-week well-being intervention based on acceptance and commitment therapy. It was timely to adapt the resource for a new audience in the wake of the COVID-19 pandemic. Young persons' mental health needs have increased substantially, and lifestyle behaviors play a critical role in both mental and physical health statuses. OBJECTIVE This study aimed to adapt an existing health and well-being website for use by young persons aged 16 to 24 years. METHODS A 3-staged participatory, co-design approach was adopted. The participants reviewed the existing program and provided feedback (stage 1) before cocreating new content (stage 2). Finally, the updated program underwent formative evaluation (stage 3). Two groups were created: one had access for 3 weeks and the other could self-select their study duration. The options were 3 weeks, 60 days, or 90 days. Outcome measures were the Warwick and Edinburgh Mental Well-being Scale, 4-item Patient Health Questionnaire, and Acceptance and Action Questionnaire version 2. RESULTS Stage 1 identified that the website was appealing to the new audience (19/24, 79%), and the 3 web-based focus group discussions explored data from the written review in more depth to identify and clarify the main areas for update and adaptation. Overall, 3 themes were developed, and the data informed the creation of 6 tasks for use in 5 web-based co-design workshops. Stage 2 led to the cocreation of 36 outputs, including a new name, new content, scenarios, images, and a new user dashboard, which included streaks and an updated color scheme. After the website update program was completed, 40 participants registered to use the website for formative evaluation (stage 3). Data analysis revealed differences in engagement, completion, and mean well-being after intervention between the 2 groups. The completion rate was 68% in the 3-week duration group, and well-being scores improved after intervention. CONCLUSIONS Young persons engaged actively with the participatory design process. The participants discussed the updates they desired during the web-based discussions, which worked well via Zoom (Zoom Video Communications Inc) when small groups were used. The participants easily cocreated new content during the web-based co-design workshops. The web-based format enabled a range of participants to take part, share their ideas, search for images, and design digital content creatively together. The Zoom software enabled screen sharing and collaborative whiteboard use, which helped the cocreation process. The formative evaluation suggested that younger users who engage more with the website for a shorter duration may benefit more.
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Affiliation(s)
- Menna Brown
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Emily Lord
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
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5
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McNamara J, Mohammadrezaei M, Griffin P. Promoting childhood farm safety in Ireland. Front Public Health 2022; 10:1055082. [PMID: 36579071 PMCID: PMC9791180 DOI: 10.3389/fpubh.2022.1055082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- John McNamara
- Teagasc - Irish Agriculture and Food Development Authority, Farm Health and Safety Knowledge Transfer Unit, Kildalton, Kilkenny, Ireland,*Correspondence: John McNamara
| | - Mohammad Mohammadrezaei
- Teagasc - Irish Agriculture and Food Development Authority, Rural Economy Development Programme, Dublin, Ireland
| | - Patrick Griffin
- Health and Safety Authority, The Metropolitan Building, Dublin, Ireland
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Cohen-Mansfield J, Muff A. Comparing Community-based Intergenerational Activities in Israel: Participants, Programs, and Perceived Outcomes. J Gerontol Soc Work 2022; 65:495-511. [PMID: 34689696 DOI: 10.1080/01634372.2021.1983683] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 03/02/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
This study investigated whether the content of different community-based intergenerational programs (IGPs) affects their perceived impact on older and younger participants. Data were collected through direct structured questionnaires administered to 84 older, and 96 younger participants, and were assessed using both quantitative and qualitative analyses. Different IGP types involved participants with differing background characteristics and were associated with different benefits and challenges. In art programs, older participants reported being more active and younger participants indicated more awareness of others, but also greater stress. Learning programs contributed to older persons' happiness, and younger persons' acquisition of new skills, but were also associated with divergent expectations between young and old, and a perception that young participants lacked commitment. Assistance programs attracted older participants with greater needs, and were associated with such benefits as alleviating older persons' loneliness, improving younger participants' satisfaction from helping, but also involved challenges pertaining to the relationship termination. Generally, older participants reported more benefits than younger persons. The results highlight the need to differentiate between IGP types, a distinction not addressed in previous studies. The combination of activity content and participant characteristics and needs may lead to different perceived program impacts.
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Affiliation(s)
- Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Igor Orenstein Chair for the Study of Geriatrics, Tel-Aviv University, Tel Aviv-Yafo, Israel
- The Herczeg Institute on Aging, Tel-Aviv University, Tel Aviv-Yafo, Israel
- Minerva Center for Interdisciplinary Study of End of Life, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Aline Muff
- Minerva Center for Interdisciplinary Study of End of Life, Tel-Aviv University, Tel Aviv-Yafo, Israel
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Kaelin VC, Valizadeh M, Salgado Z, Parde N, Khetani MA. Artificial Intelligence in Rehabilitation Targeting the Participation of Children and Youth With Disabilities: Scoping Review. J Med Internet Res 2021; 23:e25745. [PMID: 34734833 PMCID: PMC8603165 DOI: 10.2196/25745] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 05/21/2021] [Accepted: 09/07/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In the last decade, there has been a rapid increase in research on the use of artificial intelligence (AI) to improve child and youth participation in daily life activities, which is a key rehabilitation outcome. However, existing reviews place variable focus on participation, are narrow in scope, and are restricted to select diagnoses, hindering interpretability regarding the existing scope of AI applications that target the participation of children and youth in a pediatric rehabilitation setting. OBJECTIVE The aim of this scoping review is to examine how AI is integrated into pediatric rehabilitation interventions targeting the participation of children and youth with disabilities or other diagnosed health conditions in valued activities. METHODS We conducted a comprehensive literature search using established Applied Health Sciences and Computer Science databases. Two independent researchers screened and selected the studies based on a systematic procedure. Inclusion criteria were as follows: participation was an explicit study aim or outcome or the targeted focus of the AI application; AI was applied as part of the provided and tested intervention; children or youth with a disability or other diagnosed health conditions were the focus of either the study or AI application or both; and the study was published in English. Data were mapped according to the types of AI, the mode of delivery, the type of personalization, and whether the intervention addressed individual goal-setting. RESULTS The literature search identified 3029 documents, of which 94 met the inclusion criteria. Most of the included studies used multiple applications of AI with the highest prevalence of robotics (72/94, 77%) and human-machine interaction (51/94, 54%). Regarding mode of delivery, most of the included studies described an intervention delivered in-person (84/94, 89%), and only 11% (10/94) were delivered remotely. Most interventions were tailored to groups of individuals (93/94, 99%). Only 1% (1/94) of interventions was tailored to patients' individually reported participation needs, and only one intervention (1/94, 1%) described individual goal-setting as part of their therapy process or intervention planning. CONCLUSIONS There is an increasing amount of research on interventions using AI to target the participation of children and youth with disabilities or other diagnosed health conditions, supporting the potential of using AI in pediatric rehabilitation. On the basis of our results, 3 major gaps for further research and development were identified: a lack of remotely delivered participation-focused interventions using AI; a lack of individual goal-setting integrated in interventions; and a lack of interventions tailored to individually reported participation needs of children, youth, or families.
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Affiliation(s)
- Vera C Kaelin
- Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Mina Valizadeh
- Computer Science, College of Engineering, University of Illinois at Chicago, Chicago, IL, United States
- Natural Language Processing Laboratory, University of Illinois at Chicago, Chicago, IL, United States
| | - Zurisadai Salgado
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
- Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Natalie Parde
- Computer Science, College of Engineering, University of Illinois at Chicago, Chicago, IL, United States
- Natural Language Processing Laboratory, University of Illinois at Chicago, Chicago, IL, United States
| | - Mary A Khetani
- Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
- Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
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8
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Mann‐Jackson L, Alonzo J, Garcia M, Trent S, Bell J, Horridge DN, Rhodes SD. Using community-based participatory research to address STI/HIV disparities and social determinants of health among young GBMSM and transgender women of colour in North Carolina, USA. Health Soc Care Community 2021; 29:e192-e203. [PMID: 33369811 PMCID: PMC8451894 DOI: 10.1111/hsc.13268] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 06/03/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 05/04/2023]
Abstract
Sexually transmitted infections (STIs) and HIV disproportionately affect young persons; gay, bisexual and other men who have sex with men (GBMSM) and transgender women; persons of colour; and the U.S. South. Complex issues contribute to these high STI/HIV rates. Our community-based participatory research (CBPR) partnership conducted a community-driven needs assessment to inform an intervention addressing STI/HIV disparities and related social determinants of health (SDH) among young GBMSM and transgender women of colour in a high-incidence STI/HIV community in North Carolina. In 2018, in-depth interviews were conducted with 21 community members and 29 community organisation representatives to explore needs, priorities and assets. Interview data were analysed using constant comparison, an approach to grounded theory, and an empowerment theory-based planning process was used to develop multilevel intervention strategies based on findings. Thirteen themes emerged from the interviews that were organised into five domains: health (e.g., limited health services use; need for lesbian, gay, bisexual and transgender [LGBT]-friendly providers; prioritisation of mental health and gender transition and limited knowledge of and access to pre-exposure prophylaxis [PrEP] for HIV); employment (e.g., employment as a priority and relying on sex work to 'make ends meet'); education (e.g., barriers to education and needs for training to improve employment opportunities); social support (e.g., few welcoming activities and groups; strong informal support networks and little interaction between GBMSM and transgender women) and discrimination (e.g., frequent experiences of discrimination and the impact of frontline staff on services use). Three strategies - community-based peer navigation, use of social media, and anti-discrimination trainings for organisations - were identified and integrated into a new intervention known as Impact Triad. CBPR was successfully applied to identify needs, priorities and assets and develop a multilevel intervention focused on health disparities and SDH among young GBMSM and transgender women of colour in the U.S. South.
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Affiliation(s)
- Lilli Mann‐Jackson
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
| | - Jorge Alonzo
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
| | - Manuel Garcia
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
| | | | - Jonathan Bell
- University of North Carolina Chapel HillChapel HillNCUSA
| | - Danielle N. Horridge
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
| | - Scott D. Rhodes
- Department of Social Sciences and Health PolicyCTSI Program in Community‐Engaged ResearchWake Forest School of MedicineWinston‐SalemNCUSA
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9
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Mlilo P, Dziva C, Moyo VP, Ndondo NL, Ndlovu Z, Muyambo N. "Growing up and growing old with HIV": HIV+ adolescents' experiences of disclosing statuses to romantic partners in Bulawayo, Zimbabwe. Afr J AIDS Res 2021; 19:312-322. [PMID: 33337977 DOI: 10.2989/16085906.2020.1841011] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article explores the experiences of HIV-positive adolescents disclosing their status to romantic partners in Bulawayo, Zimbabwe. Disclosure of HIV status continues to be one of the most pressing issues facing adolescents, especially those in relationships, yet health care workers have minimal tailored guidance on how to approach this except to encourage full disclosure. Motives for disclosure were: guilty conscience; legal and ethical obligations; preventing partners being infected; and supportive people, honesty and trust. Disclosure was done on a one-on-one basis in public spaces such as roadsides where the adolescents usually met, or in health care facilities through the help of health care workers, and through mobile phones using WhatsApp. Results revealed that disclosure was associated with negative and positive outcomes ranging from disruption of relationships, depression, breaches of confidential information and, in some instances, relationship and marriage assurance. However, results clearly showed that adolescents living with HIV struggle with disclosure because the process is complex and loaded with emotions and the outcomes can be unpredictable and difficult to handle. Optimism towards treatment, social support, rationalisation, and social comparison through attributing new meanings to the disease were employed to deal with negative outcomes of disclosure. Therefore, the development and implementation of evidence-based initiatives to raise awareness and train the youth to disclose is recommended. Through their experiences, we can learn what works well and what needs to be strengthened.
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Affiliation(s)
- Philani Mlilo
- Department of Sociology and Social Anthropology, Great Zimbabwe University, Masvingo, Zimbabwe
| | - Cowen Dziva
- Nehanda Centre for Gender and Cultural Studies, Great Zimbabwe University, Masvingo, Zimbabwe
| | | | | | - Zanele Ndlovu
- Department of Sociology and Social Anthropology, Great Zimbabwe University, Masvingo, Zimbabwe
| | - Nkosinathi Muyambo
- School of Religion, Philosophy and Classics, University of KwaZulu-Natal, Pietermaritzburg campus, South Africa
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10
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Salerno JP, Devadas J, Pease M, Nketia B, Fish JN. Sexual and Gender Minority Stress Amid the COVID-19 Pandemic: Implications for LGBTQ Young Persons' Mental Health and Well-Being. Public Health Rep 2020; 135:721-727. [PMID: 33026972 DOI: 10.1177/0033354920954511] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- John P Salerno
- 1068 Department of Behavioral & Community Health, School of Public Health, University of Maryland, College Park, MD, USA.,LGBTQ+ Students and Allies in Public Health, University of Maryland, College Park, MD, USA.,University of Maryland Prevention Research Center, College Park, MD, USA
| | - Jackson Devadas
- LGBTQ+ Students and Allies in Public Health, University of Maryland, College Park, MD, USA.,Department of Biology, College of Computer, Math, and Natural Sciences, University of Maryland, College Park, MD, USA
| | - M Pease
- LGBTQ+ Students and Allies in Public Health, University of Maryland, College Park, MD, USA.,Department of Psychology, College of Behavioral and Social Sciences, University of Maryland, College Park, MD, USA
| | - Bryanna Nketia
- LGBTQ+ Students and Allies in Public Health, University of Maryland, College Park, MD, USA.,Department of Public Health Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Jessica N Fish
- University of Maryland Prevention Research Center, College Park, MD, USA.,Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
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11
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Santosh P, Singh J, Adams L, Mastroianni M, Heaney N, Lievesley K, Sagar-Ouriaghli I, Allibrio G, Appleton R, Davidović N, de Girolamo G, Dieleman G, Dodig-Ćurković K, Franić T, Gatherer C, Gerritsen S, Gheza E, Madan J, Manenti L, Maras A, Margari F, McNicholas F, Pastore A, Paul M, Purper-Ouakil D, Rinaldi F, Sakar V, Schulze U, Signorini G, Street C, Tah P, Tremmery S, Tuffrey A, Tuomainen H, Verhulst F, Warwick J, Wilson A, Wolke D, Fiori F, Singh S. Validation of the Transition Readiness and Appropriateness Measure (TRAM) for the Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare in Europe (MILESTONE) study. BMJ Open 2020; 10:e033324. [PMID: 32580979 PMCID: PMC7312331 DOI: 10.1136/bmjopen-2019-033324] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Young people moving from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) are faced with significant challenges. To improve this state of affairs, there needs to be a recognition of the problem and initiatives and an urgent requirement for appropriate tools for measuring readiness and outcomes at the transfer boundary (16-18 years of age in Europe). The objective of this study was to develop and validate the Transition Readiness and Appropriateness Measure (TRAM) for assessing a young person's readiness for transition, and their outcomes at the transfer boundary. DESIGN MILESTONE prospective study. SETTING Eight European Union (EU) countries participating in the EU-funded MILESTONE study. PARTICIPANTS The first phase (MILESTONE validation study) involved 100 adolescents (pre-transition), young adults (post-transition), parents/carers and both CAMHS and AMHS clinicians. The second phase (MILESTONE cohort study and nested cluster randomised trial) involved over 1000 young people. RESULTS The development of the TRAM began with a literature review on transitioning and a review of important items regarding transition by a panel of 34 mental health experts. A list of 64 items of potential importance were identified, which together comprised the TRAM. The psychometric properties of the different versions of the TRAM were evaluated and showed that the TRAM had good reliability for all versions and low-to-moderate correlations when compared with other established instruments and a well-defined factor structure. The main results of the cohort study with the nested cluster randomised trial are not reported. CONCLUSION The TRAM is a reliable instrument for assessing transition readiness and appropriateness. It highlighted the barriers to a successful transition and informed clinicians, identifying areas which clinicians on both sides of the transfer boundary can work on to ease the transition for the young person. TRIAL REGISTRATION NUMBER ISRCTN83240263 (Registered 23 July 2015), NCT03013595 (Registered 6 January 2017); Pre-results.
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Affiliation(s)
- Paramala Santosh
- Child and Adolescent Psychiatry, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker, Gillingham, UK
| | - Jatinder Singh
- Child and Adolescent Psychiatry, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK
| | - Laura Adams
- School of Psychology, University of Plymouth, Plymouth, Devon, UK
| | - Mathilde Mastroianni
- Child and Adolescent Psychiatry, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK
| | - Natalie Heaney
- Child and Adolescent Psychiatry, King's College London, London, UK
| | | | | | - Giovanni Allibrio
- Unit of Neuropsychiatry, ASST Spedali Civili di Brescia Dipartimento di Salute Mentale, Brescia, Lombardia, Italy
| | - Rebecca Appleton
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Nikolina Davidović
- Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
| | - Giovanni de Girolamo
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy
| | - Gwen Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | | | - Tomislav Franić
- Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
| | - Charlotte Gatherer
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Suzanne Gerritsen
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Elisa Gheza
- Neuropsychiatry Service of Childhood and Adolescence, Mental Health Department, ASST della Valcamonica, Breno, Lombardia, Italy
| | - Jason Madan
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, Coventry, UK
| | - Lidia Manenti
- Unit of Neuropsychiatry, ASST Spedali Civili di Brescia Dipartimento di Salute Mentale, Brescia, Lombardia, Italy
| | - Athanasios Maras
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
- Yulius Academy, Rotterdam, The Netherlands
| | - Francesco Margari
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Puglia, Italy
| | - Fiona McNicholas
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Geary Institute, University College Dublin, Dublin, Ireland
- Department of Child Psychiatry, Our Lady's Hospital For Sick Children, Crumlin, Ireland
- Lucena Clinic, Saint John of God Hospitaller Services, Dublin, Ireland
| | - Adriana Pastore
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Puglia, Italy
| | - Moli Paul
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, Coventry, UK
| | - Diane Purper-Ouakil
- Psychological Medicine for Children and Adolescents, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, Languedoc-Roussillon, France
| | - Francesco Rinaldi
- Neuropsychiatry Service of Childhood and Adolescence, Mental Health Department, ASST della Valcamonica, Breno, Lombardia, Italy
| | - Vehbi Sakar
- Department of Child and Adolescent Psychiatry/Psychotherapy, Universitatsklinikum Ulm, Ulm, Baden-Württemberg, Germany
| | - Ulrike Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, Universitatsklinikum Ulm, Ulm, Baden-Württemberg, Germany
| | - Giulia Signorini
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy
| | - Cathy Street
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Priya Tah
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sabine Tremmery
- Department of Neurosciences, Child & Adolescent Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
- Department of Child & Adolescent Psychiatry, University Hospitals Leuven, Leuven, Belgium
| | - Amanda Tuffrey
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Helena Tuomainen
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Frank Verhulst
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Jane Warwick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, Coventry, UK
| | - Anna Wilson
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Dieter Wolke
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
- Department of Psychology, University of Warwick, Warwick, UK
| | - Federico Fiori
- Child and Adolescent Psychiatry, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker, Gillingham, UK
| | - Swaran Singh
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, Coventry, UK
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12
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Ogu R, Maduka O, Alamina F, Adebiyi O, Agala V, Eke G, Porbeni I, Offor N, Abam C, Nte A, Okonofua F. Mainstreaming youth-friendly health services into existing primary health care facilities: experiences from South-South Nigeria. Int J Adolesc Med Health 2018; 32:ijamh-2017-0151. [PMID: 29369812 DOI: 10.1515/ijamh-2017-0151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 09/02/2017] [Accepted: 11/26/2017] [Indexed: 11/15/2022]
Abstract
Background Youth friendly services, an evidence based approach to overcome the barriers experienced by youths in accessing care, is poorly implemented. The Medical Women's Association of Nigeria (MWAN) Rivers State chapter, was supported by Ford Foundation to mainstream youth-friendly health services (YFHS) into existing primary health care facilities in two hard-to-reach communities. This paper presents the interventions, findings, challenges and recommendations. Methods This study project was implemented in stages: design, baseline survey, interventions and evaluation, between 2014 and 2016. Interventions included facility modifications, health worker capacity building, school and community outreaches, peer group activities, and interpersonal communication. Pre-and-post-intervention surveys were carried out among in- and out-of-school youths to determine the effects of the interventions. Results The most commonly stated barriers to uptake of youth friendly health services included: unavailability of services (154; 33.1%), unavailability of health care workers (167; 38.9%), unaffordability of services (108; 45.8%) and difficulty in communicating with health workers (85; 36.0%). Post-intervention, utilization improved across all services while the perception of barriers to utilization of services reduced (p < 0.05). The interventions implemented increased the odds of youths utilizing YFHS 1.81 times (95% CI = 1.39-2.37). Conclusion Facility modifications, capacity building of health workers, school and community outreaches, peer group activities, and interpersonal communication improved utilization across all services while the perception of barriers to utilization of services reduced. Implementation of YFHS is impacted by external factors often beyond the control of project implementers. Innovative solutions outside of routine health care delivery systems are critical for success. Further evaluation to explore the effect of these interventions is needed. Strengthening of health systems remains a vital strategy for scale-up of YFHS.
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Affiliation(s)
- Rosemary Ogu
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria.,Department of Obstetrics and Gynaecology, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Omosivie Maduka
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria.,Department of Preventive and Social Medicine, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Folusho Alamina
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria.,Department of Community Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Obelebra Adebiyi
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria.,Department of Medical and Dental Services, Rivers State Hospitals Management Board, Port Harcourt, Nigeria
| | - Vetty Agala
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria.,Free Medical Care Programme, Rivers State Ministry of Health, Port Harcourt, Nigeria
| | - Gracia Eke
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria.,Department of Paediatrics, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Ibimonye Porbeni
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria
| | - Nnesochi Offor
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria.,Free Medical Care Programme, Rivers State Ministry of Health, Port Harcourt, Nigeria
| | - Claribel Abam
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria.,Office of the Executive Secretary, Rivers State Primary Health Care Management Board, Port Harcourt, Nigeria
| | - Alice Nte
- Medical Women's Association of Nigeria, Rivers State Branch, Port Harcourt, Nigeria.,Department of Paediatrics, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Friday Okonofua
- Department of Youth Sexuality, Reproductive Health and Rights, Ford Foundation Office of West Africa, Lagos, Nigeria
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13
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Olumide A, Owoaje E. Patterns and predictors of disclosure of HIV positive status among youth living with HIV in Ibadan, Nigeria. Int J Adolesc Med Health 2018; 32:/j/ijamh.ahead-of-print/ijamh-2017-0086/ijamh-2017-0086.xml. [PMID: 29332013 DOI: 10.1515/ijamh-2017-0086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/04/2017] [Indexed: 11/15/2022]
Abstract
Background Information on disclosure of HIV status among youth is sparse in spite of the fact that they bear a significant burden of the HIV epidemic. Our objective was to determine the predictors of HIV disclosure among youth aged 18-35 years in Ibadan, Nigeria. Methods A cross-sectional study was conducted among youth with HIV attending two HIV support groups and one ARV clinic in Ibadan, Nigeria. Information was obtained with the aid of an interviewer-administered questionnaire. Descriptive and analytic statistics were conducted. Results There were 170 clients with a mean age of 29.6 ± 3.9 years; 140 (82.4%) were female and 139 (81.8%) had disclosed their status. Common people first informed included respondents' mother 49 (35.3%), spouse 39 (28.1%) or father, 38 (27.3%). Disclosure to an unmarried sexual partner was low as only six (12.0%) of the 50 single youth who had a current sexual partner had disclosed their status to him/her. Youth who were aware that their spouse/partner was HIV positive (OR = 9.87; CI = 1.09-88.83) or negative (OR = 9.98; CI = 1.18-84.70) were more likely to have disclosed their status than those unaware of their spouse/partners' status. Disclosure was also higher among members of an HIV support group (OR = 3.32; CI = 1.03-10.72). Conclusions Many respondents had disclosed their status although disclosure to an unmarried sexual partner was low. Interventions to improve HIV disclosure especially among unmarried sexually active youth could improve disclosure and overall management of HIV in our study area.
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Affiliation(s)
- Adesola Olumide
- University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Eme Owoaje
- University of Ibadan/University College Hospital, Ibadan, Nigeria
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14
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Arulogun OS, Ogbu IA, Dipeolu IO. Influence of internet exposure on sexual behaviour of young persons in an urban district of Southwest Nigeria. Pan Afr Med J 2016; 25:261. [PMID: 28293377 PMCID: PMC5337276 DOI: 10.11604/pamj.2016.25.261.2630] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 07/07/2016] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The proportion of young people exposed to pornographic materials through the internet in Nigeria is increasing. However, the influence of the exposure on their sexual behaviour has not been fully explored. This study therefore explored the effects of internet exposure on the sexual behaviour of young persons in Ibadan North Local Government Area of southwest Nigeria. METHODS A survey of 413 young persons was done using a pretested self-administered questionnaire which included questions on internet exposure and its influence on behaviour. Data were analysed using descriptive statistics, Chi-square test and logistic regression. RESULTS Mean age of males was 21.7 ± 3.4 years while that of females was 20.9 ± 3.2 years. Forty-nine percent of the respondents used the internet for the first time between the ages of 15-19 years. Main source of information about the internet was friends (63.3%) and 99.3% accessed the internet from cybercafé. Seventy-two percent had ever stumbled on pornographic sites. Reactions included glancing through before closing (45.2%), closure of the sites (38.5%), and minimizing page to view later (12.5%). Post-exposure influence on behaviour included engagement in oral sex (48.3%), body tattoo (18.3%), having multiple sexual partners (11.6%) and homosexuality (5.0%). More males (95% CI OR =1.245-6.465) and frequent users (95% CI OR =1.168-3.497) were likely to report a change in sexual behaviour. CONCLUSION Internet use was common among the young persons. Interventions aimed at reducing exposure to sexual content on internet targeting young persons especially the males and cybercafé operators are advocated.
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Affiliation(s)
- Oyedunni Sola Arulogun
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ifeyinwa Arinze Ogbu
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria; Family Health International (FHI 360), Monitoring & Evaluation Department, Plot 1073 A-1, Godab Plaza J.S. Tarka Street, Area 3, Garki Abuja, Nigeria
| | - Isaac Oluwafemi Dipeolu
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Ahlström BH, Wentz E. Difficulties in everyday life: young persons with attention-deficit/hyperactivity disorder and autism spectrum disorders perspectives. A chat-log analysis. Int J Qual Stud Health Well-being 2014; 9:23376. [PMID: 24875238 PMCID: PMC4038720 DOI: 10.3402/qhw.v9.23376] [Citation(s) in RCA: 12] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2014] [Indexed: 11/14/2022] Open
Abstract
This study focuses on the everyday life of young persons with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). There are follow-up studies describing ADHD, and ASD in adults, and residual impairments that affect life. Few qualitative studies have been conducted on the subject of their experiences of everyday life, and even fewer are from young persons' perspectives. This study's aim was to describe how young persons with ADHD and ASD function and how they manage their everyday life based on analyses of Internet-based chat logs. Twelve young persons (7 males and 5 females aged 15-26) diagnosed with ADHD and ASD were included consecutively and offered 8 weeks of Internet-based Support and Coaching (IBSC). Data were collected from 12 chat logs (445 pages of text) produced interactively by the participants and the coaches. Qualitative content analysis was applied. The text was coded and sorted into subthemes and further interpreted into themes. The findings revealed two themes: "fighting against an everyday life lived in vulnerability" with the following subthemes: "difficult things," "stress and rest," and "when feelings and thoughts are a concern"; and the theme "struggling to find a life of one's own" with the following subthemes: "decide and carry out," "making life choices," and "taking care of oneself." Dealing with the problematic situations that everyday encompasses requires personal strength and a desire to find adequate solutions, as well as to discover a role in society. This study, into the provision of support and coaching over the Internet, led to more in-depth knowledge about these young persons' everyday lives and revealed their ability to use IBSC to express the complexity of everyday life for young persons with ADHD and ASD. The implications of the findings are that using online coaching makes available new opportunities for healthcare professionals to acknowledge these young persons' problems.
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Affiliation(s)
- Britt H Ahlström
- Department of Nursing, Health and Culture, University West, Trollhättan, Sweden; The Vårdal Institute, Swedish Institute for Health Sciences, Lund, Sweden;
| | - Elisabet Wentz
- The Vårdal Institute, Swedish Institute for Health Sciences, Lund, Sweden; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Abstract
OBJECTIVE To describe the challenges to activity and participation faced by young people with visual impairment within the framework of the International Classification of Functioning (ICF). METHODS 14 young persons (aged 16-22 years) with visual impairment and their parents (n = 22) participated in the study. The Canadian Occupational Performance Measure (COPM) was used to describe challenges of participation as perceived by the young persons themselves. Individual interviews with the young persons and their parents were used to investigate in more depth the challenges the young persons face with regard to participation. RESULTS Young persons with visual impairment face challenges to participation most frequently with regard to mobility, domestic life, interpersonal interaction and relationships, major life areas, and leisure activities. The environment in which they live has a central role as a barrier or facilitator of participation. CONCLUSIONS The challenges related to activities and participation that young persons with visual impairment face are diverse. It is important that these challenges are assessed individually and with the help of subjective measures. Serving as a broad framework for classifying the data, the ICF proved to be a useful tool, but used strictly at category level it may limit the coding of data and narrow interpretation.
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