Community Health Commons^™

2022 Community Needs Assessment Of Klamath County Residential Services And Housing Needs, Karen Cellarius, Aliza Tuttle, Jennifer Blakeslee

Regional Research Institute for Human Services

The PSU Regional Research Institute for Human Services (RRI) was asked by Klamath Basin Behavioral Health (KBBH) and the Oregon Health Authority (OHA) to conduct a community-wide needs assessment focusing on residential services and housing needs for populations that (1) Have behavioral health needs, and (2) Identify with a community experiencing inequities in access to health care resources.

The assessment was conducted in collaboration with KBBH and other community partners. Data sources included key informant interviews, written surveys of individuals impacted by mental health challenges and/or housing needs, and focus groups with representatives from underserved communities in Klamath County, Oregon. …

Factors Associated With The Nutritional Status Of Infants And Young Children From Rural Honduras, Ana M. Palacios, Mario Keko, Aishat Adewoye, Haresh Rochani, Asli Aslan, Dziyana Nazaruk, Ana Gisela Ramos, Weston L. Oliver, Laura Manship

Department of Health Policy and Community Health Faculty Publications

Objectives

Malnutrition is a major public health problem in children. Undernutrition and excessive weight at young ages are associated with life-long consequences. The main objective of this study was to characterize the sociodemographic and food insecurity factors associated with the nutritional status of rural children ages 6 to 24 months living in 27 rural communities in Intibucá, Honduras.

Methods

This secondary analysis of baseline data included a total of 402 children ages 6 to 24 months who were recruited to participate in a cluster-non-randomized trial of a community-based nutrition intervention. Data were collected in January 2021 through a survey that …

Research Skills Combining Microbes And Social Equity (Avs 590-0980), Sue Ishaq, School Of Food And Agriculture

General University of Maine Publications

To understand a microbiome, you must learn about the bustling community of microorganisms and the complex ecosystems they live in, because one cannot exist without the other. So, too, does microbiome research rely on understanding the lives and ecology of humans, because there is no aspect of human life which does not involve microbes in some way. To become better microbiome researchers, we must understand social and environmental contexts which affect humans and, in many cases, prevent them from making choices which result in beneficial microbial exposures. This symposium will focus on developing research skills to create transformative research, including …

Service Provider Perspectives On Exploring Social Determinants Of Health Impacting Type 2 Diabetes Management For South Asian Adults In Peel Region, Canada, Chelsea D’Silva, Nuzha Hafleen, Elizabeth Mansfield, Sara Martel, Dianne Fierheller, Ananya Banerjee, Gurpreet Malhotra, Baldev Mutta, Puneet Dhillon, Zofishan Hasan, Amish Parikh, Amish Parikh, Reza Yousefi Nooraie, Ferzana Chaze, Ian Zenlea

Publications and Scholarship

Background

Individuals from South Asian communities are known to have a higher likelihood of developing type 2 diabetes (T2D) which is often attributed to individual lifestyle and behavioral factors. This focus on individual responsibility can position communities as complicit in their illness, compounding stigmatization and systemic discrimination. This manuscript explores the social determinants of health (SDOH) that influence health behaviors among South Asian adults with T2D from a service provider perspective.

Methods

Using a qualitative descriptive design, we conducted semi-structured interviews with 12 community, social, and healthcare service providers. We used thematic analysis and the analytical concept of intersectionality to …

Resistant Maltodextrin Consumption In A Double-Blind, Randomized, Crossover Clinical Trial Induces Specific Changes In Potentially Beneficial Gut Bacteria, Volker Mai, Alyssa M Burns, Rebecca J Solch, Jennifer C Dennis-Wall, Maria Ukhanova, Bobbi Langkamp-Henken

Journal Articles

Background: We have previously reported that the addition of resistant maltodextrin (RMD), a fermentable functional fiber, to the diet increases fecal weight as well as the amount of fecal bifidobacteria. Here, we report on the targeted analysis of changes in potentially beneficial gut bacteria associated with the intervention. Objective: The primary objective of this study was to determine the effect of adding 0, 15 and 25 g RMD to the diets of healthy free-living adults on potentially beneficial gut bacteria. Methods: We expanded on our previously reported microbiota analysis in a double-blind, placebo-controlled feeding study (NCT02733263) by performing additional qPCR …

Tuned In To Communication Sounds: Neuronal Sensitivity In The Túngara Frog Midbrain To Frequency Modulated Signals, Abhilash Ponnath, Michael J. Ryan, Zhide Fang, Hamilton E. Farris

School of Public Health Faculty Publications

For complex communication signals, it is often difficult to identify the information-bearing elements and their parameters necessary to elicit functional behavior. Consequently, it may be difficult to design stimuli that test how neurons contribute to communicative processing. For túngara frogs (Physalaemus pustulosus), however, previous behavioral testing with numerous stimuli showed that a particular frequency modulated (FM) transition in the male call is required to elicit phonotaxis and vocal responses. Modeled on such behavioral experiments, we used awake in vivo recordings of single units in the midbrain to determine if their excitation was biased to behaviorally important FM parameters. Comparisons of …

Using The Whole School, Whole Child, Whole Community Approach To Improve An Urban Early Learning Center Students’ Social, Emotional, And Physical Health And Wellness, Joelle Chateauneuf

Doctor of Nursing Practice Scholarly Projects

Background: Integrating school-based health education and models of healthy lifestyles in early childhood provides a foundation for lifelong health learning. Many chronic may be prevented or mitigated through early childhood health education. Early learning centers (ELCs) may be a perfect setting to enable young children to achieve their full potential.

Problem: In Boston, Massachusetts, there are differences in health experience across population groups. Children of color and lower socioeconomic challenges experience higher rates of chronic conditions.

Available Knowledge: Search of literature showed that school-based healthy lifestyle interventions improve healthy behaviors and can be taught to children as young as preschool. …

Vikela Ekhaya: A Novel, Community-Based, Tuberculosis Contact Management Program In A High Burden Setting, Alexander W Kay, Micaela Sandoval, Godwin Mtetwa, Musa Mkhabela, Banele Ndlovu, Tara Devezin, Welile Sikhondze, Debrah Vambe, Joyce Sibanda, Gloria S Dube, Robert H Stevens, Bhekumusa Lukhele, Anna M Mandalakas

Journal Articles

BACKGROUND: The prevention of tuberculosis (TB) in child contacts of TB cases and people living with human immunodeficiency virus (HIV) is a public health priority, but global access to TB preventive therapy (TPT) remains low. In 2019, we implemented Vikela Ekhaya, a novel community-based TB contact management program in Eswatini designed to reduce barriers to accessing TPT.

METHODS: Vikela Ekhaya offered differentiated TB and HIV testing for household contacts of TB cases by using mobile contact management teams to screen contacts, assess their TPT eligibility, and initiate and monitor TPT adherence in participants' homes.

RESULTS: In total, 945 contacts from …

Associations Of Lifestyle And Sociodemographic Factors With Dietary Supplement Use In College Students, Sydney Chratian

Senior Honors Projects

Background: Dietary supplement use has been shown to be significantly prevalent in the United States, especially among the young adult population. Studies have reported increasing use of dietary supplements among college students in the US. However, little research has investigated the sociodemographic and behavioral characteristics associated with dietary supplement use in this population.

Objectives: The aim of this study was to examine the prevalence of dietary supplement use and sociodemographic and behavioral characteristics associated with dietary supplement use in college students and examine the attitudes and beliefs of college students on dietary supplements.

Methods: A cross sectional study was conducted …

Characterization Of Folic Acid, 5-Methyltetrahydrofolate And Synthetic Folinic Acid In The High-Affinity Folate Transporters: Impact On Pregnancy And Development, Ana M. Palacios, Rachel A. Feiner, Robert M. Cabrera

Department of Health Policy and Community Health Faculty Publications

Objectives:

Folates are B vitamins that are essential for several molecular, cellular, and biological processes, including nucleotide synthesis, methylation, and methionine cycling. The physiological impacts of these processes on health also extend to cell proliferation, folate deficiency anemia, and reduction of the risk of birth defects during pregnancy. The primary objective of this study was to characterize the binding affinities of different folate forms, folic acid (FA), 5-methyltetrahydrofolate (5MTHF), and folinic acid, to the folate receptors α and β, and to the bovine milk folate binding protein. These three dietary forms of folate are found in enriched grains (FA), various …

Dnp Final Report: Adolescent Support For Healthy Living, Kristin S. Hudson

DNP Final Reports

Adolescents often make decisions that negatively impact their health and wellness. They do this for many reasons including impulsivity, underdeveloped communication and coping skills, feelings of invincibility, and a perceived lack of support. In adolescents, how does education and training related to risky behaviors compared to no education affect knowledge, skills, and understanding (KSU) of high-risk behaviors three months after instruction? Thirteen peer- reviewed articles were utilized in the body of evidence. A curriculum-based intervention was implemented. Outcomes include an overall increase in KSU in six key concepts including contraception, substances abuse, sexually transmitted diseases/infections, teen pregnancy, peer pressure, and …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

Boarding Barriers For Psychiatric Patients In Emergency Departments, Emmeline B. Martin Bsn, Rn, Alison Rossano Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Objective To identify past or current literature about emergency department holds and psychiatric patients consisting of the evaluation of patient outcomes, satisfaction and equity of care. It is already known that shorter boarding times from the emergency department to a psychiatric unit have positive patient outcomes such as a decrease in readmissions, increase in patient satisfaction and efficiency in appropriate treatment.

Method A scoping review to analyze data by grouping articles into themes which included authors, date of publication, aims/purpose, methodology, sample, interventional details, and the key findings in each article. Excluded articles included those discussing COVID-19 and case management. …

Mental Health After Injury: How Neighborhoods Impact Recovery, Bryce Hruska, Maria Pacella-Labarbara, Ivan E. Castro, Richard L. George, Douglas L. Delahanty

Population Health Research Brief Series

Each year in the United States, there are over 90 million injury-related emergency department visits, resulting in $4.2 trillion in costs related to medical care, loss of work, and reduced quality of life. Nearly a quarter of injury survivors are diagnosed with a new mental health disorder within the first year of injury. This brief examines several aspects of neighborhood context and their relationship to PTSD symptom severity following an injury. Results show that survivors living in neighborhoods with higher racial segregation and lower socioeconomic status report higher PTSD symptom severity.

A Scoping Review: Trauma Informed Care For Justice Involved Youth To Decrease Recidivism, Tamika Beecham, Marissa Gray, Shelby Husband, Diana Dedmon Dnp, Fnp, Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this scoping review was to address trauma-informed care, juvenile justice systems, and recidivism rates. The literature review conducted identified key research and analysis of effective trauma-informed treatment methodologies, referrals, and accessibility of care for justice-involved youth, and the rate change of recidivism related to trauma-informed treatment and interventions.

Background The high rates of recidivism in the juvenile court systems matched with the increased prevalence of psychological trauma in justice-involved youth represent the need for implementing trauma informed care. The scoping review analyzed the research implementing the intervention of trauma informed care to determine if it resulted …

Safe Consumption Sites Are Critical To Reducing Drug Overdoses, Alexandra Punch

Population Health Research Brief Series

In 2021, over 100,000 people died from drug overdoses in the United States, resulting in the country’s deadliest year on record for drug overdoses. Much of the increase in drug overdose rates over the past several years has been due to fentanyl, a highly potent manufactured opioid with a high risk of overdose. Coupled with the risk of transmission of blood-borne diseases, such as HIV and Hepatitis C from sharing drug paraphernalia, individuals who use drugs face numerous challenges in safely consuming drugs. This issue brief advocates for the implementation of safe consumption sites across the U.S. and calls for …

Cultural Healing Practices: Incorporating Cultural Healers Into Minnesota's Mental Health Care System, Raymond Shoup, Allyson Endersbe, Nayeli Hernandez Moctezuma, Patty Balderas-Johnson

Master of Social Work Student Policy Advocacy Briefs

Minnesota’s approach to health and mental health is based on western cultural traditions of illness, help seeking behaviors, healing and wellness. This approach does not work for many of the cultural communities in Minnesota, especially those with a deep history of generational trauma, oppression, and discrimination. We need to make mental health a priority for Minnesotans by expanding the availability of holistic approaches rooted in the cultural traditions of Minnesota’s diverse cultural communities. We must address the impact of generational trauma and work to lessen the harm by incorporating cultural healing practices into our mental health care system, including the …

Children Receiving A Nutrition And High-Quality Early Childhood Education Intervention Are Associated With Greater Math And Fluid Intelligence Scores: The Guatemala City Municipal Nurseries, Ana M. Palacios, Lisa A. Villanueva, Matthew B. Flynn, Erik Parker, Stephanie Dickinson, Helen W. Bland, Greg A. Reinhart

Department of Health Policy and Community Health Faculty Publications

Background: About 47% of children < 5 years of age are stunted in Guatemala. In this study, the investigators aimed to compare growth and cognitive outcomes between children in second grade that attended five Guatemala City Municipal Nurseries (GCMN) vs. same sex, grade, and age-matched children. Methods: A cross-sectional design nested in a retrospective cohort was implemented between 2015 and 2019. Children that attended the GCMN and matched controls completed a math test and validated receptive language and fluid intelligence tests. The primary caregivers completed a sociodemographic survey. General and generalized linear mixed effect models were used to compare children that attended the GCMN vs. controls. The models were adjusted by maternal education, sex, asset score, and other relevant covariates. Results: Children that attended the GCMN exhibited greater math and fluid intelligence scores relative to the controls in the adjusted models (ß = 6.48; 95% CI (2.35–10.61)) and (ß = 1.20; 95% CI (0.12–2.29)), respectively. Lower odds of stunting were significant for children who went to any early childcare institution (AOR = 0.28; 95% CI (0.09–0.89)). Conclusions: The importance of integrating nutrition and high-quality early childhood education interventions in cognitive and growth outcomes is highlighted in this study. The GCMN model may be a scalable model in similar low-resource settings.

Medical Visits Related To Firearm Injuries Increased During Covid-19, Rachel Chernet, Margaret K. Formica

Population Health Research Brief Series

When COVID-19 began its initial wave in the United States in March 2020, gun sales surged across the country. The increase in first time gun owners, stress, anxiety, and lack of safety training courses has corresponded with a significant increase in firearm injuries, with especially large increases in the Spring and Summer of 2020 among males, non-Hispanic Blacks, ages 20 to 29, and residents of the Midwest and South. Given the especially large rise in unintentional firearm injuries, policymakers should consider interventions that increase education, training, and regulation over safe firearm access and storage.

Association Between Serum Lycopene And Lung Cancer Mortality: An 18-Year Follow-Up Study Of A National Cohort, Evans Afriyie-Gyawu, Padmini Shankar, Gulzar H. Shah, Alicia A. Brown, Shannon Cearley, Akwasi Ampofo-Yeboah, Nathaniel Abrams, Jian Zhang

Department of Health Policy and Community Health Faculty Publications

Background: Lycopene is a carotenoid found in some fruits and vegetables that is responsible for the red pigment in tomatoes and tomato products. While many studies have shown a link between lycopene and protection against the initiation and/or progression of lung cancer, data on its effect on lung cancer survivability is limited.

Objective: The primary objective of this study was to see if there was a link between lycopene levels in the blood and lung cancer mortality. A secondary goal was to see if dietary factors influence lycopene levels in the blood.

Materials and Methods: A retrospective …

The Response To Covid-19 Among Drug Retail Outlets In Indonesia: A Cross-Sectional Survey Of Knowledge, Attitudes, And Practices, Yusuf Ari Mashuri, Luh Putu Lila Wulandari, Mishal Khan, Astri Ferdiana, Ari Probandari, Tri Wibawa, Neha Batura, Marco Liverani, Richard Day, Stephen Jan

Community Health Sciences

Background: Pharmacists have been at the frontline of the COVID-19 response in Indonesia, providing medicines, advice, and referral services often in areas with limited healthcare access. This study aimed to explore their knowledge, attitudes, and practices during the pandemic, so that we can be better prepared for future emergencies.
Methods: A cross-sectional online survey of community pharmacists and pharmacy technicians in Indonesia was conducted between July and August 2020. The dataset was analysed descriptively, and logistic regression was used to explore willingness to participate in COVID-19 interventions.
Findings: 4716 respondents participated in the survey. Two-thirds (66·7%) reported knowing only "a …

Covid-19 And Social Determinants Of Health: Medicaid Managed Care Organizations’ Experiences With Addressing Member Social Needs, Samuel T. Opoku, Bettye Apenteng, Linda Kimsey, Angela H. Peden, Charles F. Owens

Department of Health Policy and Community Health Faculty Publications

Background

The significant adverse social and economic impact of the COVID-19 pandemic has cast broader light on the importance of addressing social determinants of health (SDOH). Medicaid Managed Care Organizations (MMCOs) have increasingly taken on a leadership role in integrating medical and social services for Medicaid members. However, the experiences of MMCOs in addressing member social needs during the pandemic has not yet been examined.

Aim

The purpose of this study was to describe MMCOs’ experiences with addressing the social needs of Medicaid members during the COVID-19 pandemic.

Methods

The study was a qualitative study using data from 28 semi-structured …

Factors Associated With Home Delivery In Rural Sindh, Pakistan: Results From The Global Network Birth Registry, Afreen Sadia, Shafaq Mahmood, Farnaz Naqvi, Seemab Naqvi, Zahid Soomro, Sarah Saleem

Community Health Sciences

Background: According to global estimates for 2017, nearly 295,000 maternal deaths occurred worldwide. Thus, approximately 810 women die every day due to pregnancy-related complications. This burden of maternal deaths in LMICs is primarily due to poor healthcare service utilization, as indicated by relatively low rates of institutional deliveries and skilled-birth attendance (SBA). We conducted this study with an aim to assess the factors associated with home delivery and its subsequent effect on the pregnancy outcome in rural Sindh, Pakistan.
Methods: Data for this study were taken from The Global Network's Maternal Newborn Health Registry (MNHR), which is a prospective, population-based …

Evaluating Long-Term Outcomes Of A High School-Based Impaired And Distracted Driving Prevention Program, Lindsay Buczek, Laura K. Gryder, Samantha Slinkard-Barnum, Kavita Batra, Cassandra Trummel, Allison G. Mcnickle, Douglas R. Fraser, Deborah A. Kuhls, Paul J. Chestovich

School of Medicine Faculty Publications

Motor vehicle crashes are one of the leading causes of death among teenagers. Many of these deaths are due to preventable causes, including impaired and distracted driving. You Drink, You Drive, You Lose (YDYDYL) is a prevention program to educate high school students about the consequences of impaired and distracted driving. YDYDYL was conducted at a public high school in Southern Nevada in March 2020. A secondary data analysis was conducted to compare knowledge and attitudes of previous participants with first-time participants. Independent-samples-t test and χ2 test/Fisher’s exact test with post-contingency analysis were used to compare pre-event responses between students …

Perceptions Of Drinking Water Access And Quality In Rural Indigenous Villages In Fiji, Sarah Nelson, Jacqueline Thomas, Aaron Jenkins, Kelera Naivalu, Timoci Naivalulevu, Vilisi Naivalulevu, Kinikoto Mailautoka, Shylett Anthony, Mereia Ravoka, Stacy D. Jupiter, Sangeeta Mangubhai, Pierre Horwitz, Seye Abimbola, Joel Negin

Research outputs 2022 to 2026

Poor rural water quality is a health challenge in Fiji. A mixed-methods study in six iTaukei (Indigenous Fijian) villages was conducted to understand local perceptions of drinking water access and quality, how this changes drinking water source choices, and impacts of age and gender. Seventy-two household surveys, 30 key informant interviews (KIIs) and 12 focus group discus-sions (FGDs) were conducted. Household surveys revealed 41.7% of community members perceived their water as dirty and 76.4% perceived their water as clean. Two-thirds of households reported that they always or usually had enough water. FGDs and KIIs revealed water access and quality was …

Associations Between Potential Inflammatory Properties Of The Diet And Frequency, Duration, And Severity Of Migraine Headaches: A Cross-Sectional Study, Seyed Mojtaba Ghoreishy, Gholamreza Askari, Hamed Mohammadi, Marilyn S. Campbell, Fariborz Khorvash, Arman Arab

Kinesiology and Health Promotion Faculty Publications

Despite a large body of literature on the association between the dietary inflammatory index (DII) and various chronic diseases, limited knowledge is available regarding the association between DII and migraine. Therefore, we assessed the relationship between the DII and migraine characteristics, including duration, frequency, and severity of migraine headaches, Headache Impact Test-6 (HIT-6), and serum levels of nitric oxide (NO). This population-based cross-sectional study was conducted from August 2019 to June 2020 among 262 patients (38 men and 224 women; 20-50 years). A 168-item semiquantitative food frequency questionnaire (FFQ) was gathered to evaluate dietary intake, and subsequently, an energy-adjusted DII …

Inclusive, Supportive And Dignified Maternity Care (Sdmc)-Development And Feasibility Assessment Of An Intervention Package For Public Health Systems: A Study Protocol, Bilal Iqbal Avan, Waqas Hameed, Bushra Khan, Muhammad Asim, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Introduction: Mistreatment, discrimination, and poor psycho-social support during childbirth at health facilities are common in lower- and middle-income countries. Despite a policy directive from the World Health Organisation (WHO), no operational model exists that effectively demonstrates incorporation of these guidelines in routine facility-based maternity services. This early-phase implementation research aims to develop, implement, and test the feasibility of a service-delivery strategy to promote the culture of supportive and dignified maternity care (SDMC) at public health facilities.
Methods: Guided by human-centred design approach, the implementation of this study will be divided into two phases: development of intervention, and implementing and testing …

Effects Of Nonpharmacological Interventions On Disruptive Vocalisation In Nursing Home Patients With Dementia-A Systematic Review, Saad Bilal Ahmed, Alfredo Obieta, Tamsin Santos, Saara Ahmad Muddasir, Joseph Elliot Ibrahim

Department of Biological & Biomedical Sciences

Background: Vocally disruptive behaviour is a common and difficult to treat condition in older residents with dementia. The aim of this systematic review is to evaluate the efficacy of nonpharmacological interventions in its management in persons with dementia residing in a nursing home.
Methodology: A systematic search was conducted using Ovid MEDLINE, CINAHL, and Cochrane databases and reference lists from relevant publications on various nonpharmacological approaches to manage vocally disruptive behaviour in nursing home residents. The method of appraisal was through the National Institutes of Health scoring for the Quality Assessment of controlled intervention studies. Inclusion criteria included residents of …

Medical Repatriation In Vermont: The Current Landscape And Recommendations, Olivia Dominque, Kelly Knight, Aathmika Krishnan, Kassondra Little, Clara Maxim, Sofia Toro Alvarez, Patti Smith Urie, Mark Pasanen Md, Charles Maclean Md

UVM AHEC

Background: Medical repatriation is the practice of returning patients to their country of origin when they have major medical problems_. Forced repatriation, or “medical deportation”, disproportionately affects undocumented individuals. This project aimed to assess the prevalence of medical repatriation in Vermont, identity factors that lead to it, and recommendations to prevent it.

Methods: Interviews were conducted with ten stakeholders including physicians, lawmakers, and advocates for undocumented patients. Team members then analyzed interview transcripts for major themes.

Results: This study did not uncover any occurrences of forced repatriation. Qualitative themes included: lack of awareness about medical repatriation, inability to track …

The Resilience Of Middle-Aged And Older Men Who Have Sex With Men To Hiv/Aids: Southern Nevada Stakeholder Perspectives In The 21st Century, Renato M. Liboro, Sherry Bell, Brandon Ranuschio, Jenna Despres, Trinity Puno, Aruna Sedere, Nadia Sheik Yosef, Esmeralda Villalobos, Janelle Wackens, Lianne Barnes

Psychology Faculty Research

This community report presents the findings and analysis of a survey that was part of the quantitative stage of a mixed-method Community-Based Participatory Research (CBPR) project dedicated to examine the perspectives and lived experiences of racially and ethnically diverse, middle-aged and older men who have sex with men in Southern Nevada on factors that build and promote their resilience to HIV/AIDS. The CBPR project was conducted in collaboration with community partners such as the LGBTQIA+ Community Center of Southern Nevada, Southern Nevada Health District’s Ryan White Program, Community Counseling Center of Southern Nevada, and numerous other agencies from Clark County …