Digital Commons Network^™

Patient And Provider Perceptions Of A Community-Based Accompaniment Intervention For Adolescents Transitioning To Adult Hiv Care In Urban Peru: A Qualitative Analysis, Jerome T. Galea, Milagros Wong, Brennan Ninesling, Alicia Ramos, Liz Senador, Hugo Sanchez, Lenka Kolevic, Eduardo Matos, Eduardo Sanchez, Renato A. Errea, Andrew Lindeborg, Carlos Benites, Leonid Lecca, Sonya Shin, Molly F. Franke

Social Work Faculty Publications

Introduction: Adolescents living with HIV (ALWH) experience higher mortality rates compared to other age groups, exacerbated by the suboptimal transition from paediatric to adult HIV care, during which decreased adherence to antiretroviral therapy (ART) and unsuppressed viremia are frequent. Care transition—a process lasting months or years—ideally prepares ALWH for adult care and can be improved by interventions that are youth-friendly and address psychosocial issues affecting ART adherence; however, such interventions are infrequently operationalized. Community-based accompaniment (CBA), in which laypeople provide individualized support and health system navigation, can improve health outcomes among adults with HIV. Here, we describe patient and provider …

Understanding Linkage To Biopsy And Treatment For Breast Cancer After A High-Risk Telemammography Result In Peru: A Mixed-Methods Study, Renato A. Errea, Patricia J. Garcia, Lydia E. Pace, Jerome T. Galea, Molly F. Franke

Social Work Faculty Publications

Objectives: This mixed-method study aimed to understand the effectiveness of linkage to biopsy and treatment in women with a high-risk mammography result (Breast Imaging Reporting and Data System, BI-RADS 4 and 5) in the national telemammography programme and to explore women’s experiences during this process.

Setting: Quantitative component: we collected and linked health data from the telemammography reading centre, the national public health insurance, the national centre for disease control and the national referral cancer centre. Qualitative component: we interviewed participants from different regions of the country representing diverse social and geographical backgrounds.

Participants: Quantitative: women who underwent telemammography between …

Community-Based Accompaniment For Adolescents Transitioning To Adult Hiv Care In Urban Peru: A Pilot Study, Valentina Vargas, Milagros Wong, Carly A. Rodriguez, Hugo Sanchez, Jerome T. Galea, Alicia Ramos, Liz Senador, Lenka Kolevic, Eduardo Matos, Eduardo Sanchez, Renato A. Errea, Karen Ramos, Catherine Beckhorn, Andrew Lindeborg, Carlos Benites, Leonid Lecca, Sonya Shin, Molly F. Franke

Social Work Faculty Publications

We piloted a community-based intervention to improve outcomes among adolescents living with HIV who were transitioning to adult-oriented care in Lima, Peru. We assessed feasibility and potential effectiveness, including within-person changes in self-reported adherence, psychosocial metrics (NIH Toolbox), and transition readiness (“Am I on TRAC” questionnaire, “Got Transition” checklist). From October 2019 to January 2020, we enrolled 30 adolescents (15–21 years). The nine-month intervention consisted of logistical, adherence and social support delivered by entry-level health workers and group sessions to improve health-related knowledge and skills and social support. In transition readiness, we observed within-person improvements relative to baseline. We also …

Geographic Accessibility To Health Facilities Predicts Uptake Of Community-Based Tuberculosis Screening In An Urban Setting, Helen E. Jenkins, Sally Ayuk, Daniela Puma, Meredith B. Brooks, Ana Karina Millones, Judith Jimenez, Leonid Lecca, Jerome T. Galea, Mercedes Becerra, Salmaan Keshavjee, Courtney M. Yuen

Social Work Faculty Publications

Objectives: Annually, more than 30% of individuals with tuberculosis (TB) remain undiagnosed. We aimed to assess whether geographic accessibility measures can identify neighborhoods that would benefit from TB screening services targeted toward closing the diagnosis gap.

Methods: We used data from a community-based mobile TB screening program in Carabayllo district, Lima, Peru. We constructed four accessibility measures from the geographic center of neighborhoods to health facilities. We used logistic regression to assess the association between these measures and screening uptake in one's residential neighborhood versus elsewhere, with quasi-information criterion values to assess the association.

Results: We analyzed the screening locations …

Feasibility Of A School-Based Mental Health Program Implementation To Improve The Status Of Depression And Quality Of Life Of Mothers Of Children With Autism Spectrum Disorders In Urban Bangladesh: Menthol Study, Aliya Naheed, Saimul Islam, Meredith B. Brooks, Mary C. Smith Fawzi, Mir Nabila Ashraf, Helal Uddin Ahmed, M. M. Jalal Uddin, Kamrun Nahar Koly, Jerome T. Galea, Shaheen Akhter, Charles Nelson, Saima Wazed Hossain, Kerim M. Munir

Social Work Faculty Publications

Background: We assessed the feasibility of implementing psychological counseling services (PCS) for mothers of children with autism spectrum disorders (ASD) integrated within special education settings in urban Bangladesh. Method: In two special education schools for ASD in Dhaka City, trained female psychologists screened mothers using the Patient Health Questionnaire (PHQ-9). PCS was administered to all the mothers irrespective of a diagnosis of depression. Mothers with a PHQ-9 score >4 who met criteria for a major depressive episode (MDE) based on the DSM-IV Structured Interview Axis I Disorders (SCID-I) were also administered skill-building training through monthly home visits to support ASD …

Higher Native Peruvian Genetic Ancestry Proportion Is Associated With Tuberculosis Progression Risk, Samira Asgari, Yang Luo, Chuan-Chin Huang, Zibiao Zhang, Roger Calderon, Carmen Contreras, Jerome T. Galea, Leonid Lecca, David Jones, D. Branch Moody, Megan B. Murray, Soumya Raychaudhuri

Social Work Faculty Publications

No abstract provided.

Impact Of Prolonged Isolation On Adolescents With Drug-Susceptible Tuberculosis In Lima, Peru: A Qualitative Study, Victoria Elena Rapoport, Elmer Altamirano, Liz Senador, Milagros Wong, Catherine B. Beckhorn, Julia Coit, Stephanie D. Roche, Leonid Lecca, Jerome T. Galea, Silvia S. Chiang

Social Work Faculty Publications

Objectives Patients with tuberculosis (TB) generally are instructed to isolate at the beginning of treatment in order to prevent disease transmission. The duration of isolation varies and may be prolonged (ie, lasting 1 month or more). Few studies have examined the impact of isolation during TB treatment on adolescents, who may be more vulnerable to its negative effects.

Methods This study took place from 2018 through 2019 in Lima, Peru, where the Ministry of Health mandates the exclusion of patients with TB from educational institutions for at least 2 months. Using semi-structured guides, we conducted individual in-depth interviews with adolescents …

Attitudes Toward Payment For Research Participation: Results From A U.S. Survey Of People Living With Hiv, Andrea N. Polonijo, Karine Dubé, Jerome T. Galea, Karah Yeona Greene, Jeff Taylor, Christopher Christensen, Brandon Brown

Social Work Faculty Publications

Little is known about how payment affects individuals' decisions to participate in HIV research. Using data from a U.S. survey of people living with HIV (N = 292), we examined potential research participants’ attitudes toward payment, perceived study risk based on payment amount, and preferred payment forms, and how these factors vary by sociodemographic characteristics. Most respondents agreed people should be paid for HIV research participation (96%) and said payment would shape their research participation decisions (80%). Men, less formally educated individuals, and members of some minoritized racial-ethnic groups were less likely to be willing to participate in research …

Considerations For Partnering With Ryan White Case Managers To Create Equitable Opportunities For People With Hiv To Participate In Research, Elizabeth Lockhart, Deanne Turner, Jerome T. Galea, Stephanie L. Marhefka

Social Work Faculty Publications

Many research studies focus on recruitment from one or few HIV clinics or internet-engaged populations, but this may result in inequitable representation of people with HIV (PWH), across the rural/urban/suburban continuum. Ryan White Case Managers (RWCM) meet regularly with PWH, potentially positioning them as partners in gathering research-related data from diverse groups of low-income, marginalized, PWH. Yet, data collection in partnership with RWCM, particularly over large geographic areas, has been under-explored. We partnered with RWCM and their organizations throughout Florida to administer a 10-item technology use and willingness survey to clients living with HIV; RWCMs provided process-oriented feedback. Among 382 …

A Role For Community-Level Socioeconomic Indicators In Targeting Tuberculosis Screening Interventions, Meredith B. Brooks, Helen E. Jenkins, Daniela Puma, Christine Tzelios, Ana Karina Millones, Judith Jimenez, Jerome T. Galea, Leonid Lecca, Mercedes C. Becerra, Salmaan Keshavjee, Courtney M. Yuen

Social Work Faculty Publications

Tuberculosis screening programs commonly target areas with high case notification rates. However, this may exacerbate disparities by excluding areas that already face barriers to accessing diagnostic services. We compared historic case notification rates, demographic, and socioeconomic indicators as predictors of neighborhood-level tuberculosis screening yield during a mobile screening program in 74 neighborhoods in Lima, Peru. We used logistic regression and Classification and Regression Tree (CART) analysis to identify predictors of screening yield. During February 7, 2019–February 6, 2020, the program screened 29,619 people and diagnosed 147 tuberculosis cases. Historic case notification rate was not associated with screening yield in any …