Community Health and Preventive Medicine Commons^™

Implementation Science Research Examining The Integration Of Evidence-Based Practices Into Hiv Prevention And Clinical Care: Protocol For A Mixed-Methods Study Using The Exploration, Preparation, Implementation, And Sustainment (Epis) Model, April Idalski Carcone, Karin Coyle, Sitaji Gurung, Demetria Cain, Rafael E. Dilones, Laura Jadwin-Cakmak, Jeffrey T. Parsons, Sylvie Naar

Publications and Research

BACKGROUND: The Exploration, Preparation, Implementation, and Sustainment (EPIS) model is an implementation framework for studying the integration of evidence-based practices (EBPs) into real-world settings. The EPIS model conceptualizes implementation as a process starting with the earliest stages of problem recognition (Exploration) through the continued use of an EBP in a given clinical context (Sustainment). This is the first implementation science (IS) study of the integration of EBPs into adolescent HIV prevention and care settings.

OBJECTIVE: This protocol (ATN 153 EPIS) is part of the Scale It Up program, a research program administered by the Adolescent Medicine Trials Network for HIV/AIDS …

Adolescent Trials Network For Hiv-Aids Scale It Up Program: Protocol For A Rational And Overview, Sylvie Naar, Jeffrey T. Parsons, Bonita F. Stanton

Publications and Research

Background: The past 30 years have witnessed such significant progress in the prevention and treatment of HIV/AIDS that an AIDS-free generation and the end to the global AIDS epidemic are ambitious, but achievable, national and global goals. Despite growing optimism, globally, youth living with HIV are markedly less likely to receive antiretroviral therapy than adults (23% vs 38%). Furthermore, marked health disparities exist regarding HIV infection risk, with young men of color who have sex with men disproportionately affected. A large body of research has identified highly impactful facilitators of and barriers to behavior change. Several efficacious interventions have been …

Model-Based Methods To Translate Adolescent Medicine Trials Network For Hiv/Aids Interventions Findings Into Policy Recommendations: Rationale And Protocol For A Modeling Core (Atn 161), Anne M. Neilan, Kunjal Patel, Allison L. Agwu, Ingrid V. Bassett, K. Rivet Amico, Catherine M. Crespi, Aditya H. Gaur, Keith J. Horvath, Kimberly A. Powers, H. Jonathon Rendina, Lisa B. Hightow-Weidman, Xiaoming Li, Sylvie Naar, Sharon Nachman, Jeffrey T. Parsons, Kit N. Simpson, Bonita F. Stanton, Kenneth A. Freedberg, Audrey C. Bangs, Michael G. Hudgens, Andrea L. Ciaranello

Publications and Research

BACKGROUND: The United States Centers for Disease Control and Prevention estimates that approximately 60,000 US youth are living with HIV. US youth living with HIV (YLWH) have poorer outcomes compared with adults, including lower rates of diagnosis, engagement, retention, and virologic suppression. With Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) support, new trials of youth-centered interventions to improve retention in care and medication adherence among YLWH are underway.

OBJECTIVE: This study aimed to use a computer simulation model, the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-Adolescent Model, to evaluate selected ongoing and forthcoming ATN interventions to improve viral load suppression …

Youth Study Recruitment Using Paid Advertising On Instagram, Snapchat, And Facebook: Cross-Sectional Survey Study, Kelsey Lynett Ford, Tashuna Albritton, Tara A. Dunn, Kacy Crawford, Jessica Neuwirth, Sheana Bull

Publications and Research

Background:The use of paid social media advertising for targeted study recruitment is an effective strategy in health research and evaluation, specifically to reach diverse youth participants. Although the literature adequately describes the utility of Facebook in recruitment, limited information exists for social media platforms that are more popular with youth, specifically Instagram and Snapchat.

Objective:This paper outlines a paid advertising approach using Instagram, Snapchat, and Facebook to evaluate a statewide youth marijuana prevention campaign. The objective of this study was to compare recruitment metrics across Instagram, Snapchat, and Facebook for two surveys documenting youth knowledge, attitudes, and behaviors related to …

Assessing Participants’ Feedback To Dental Screening Provided By New York City College Of Technology’S Dental Hygiene Students, Dirien Santos, Roseanna M. Torres, Nazrin Akbarova, Susan Davide

Publications and Research

The purpose of this research is to determine if CUNY students, faculty and staff are aware of the Dental Hygiene Program and services located at New York City College of Technology (NYCCT). Dental Hygiene students at NYCCT provide educational, clinical and therapeutic services to the public in accordance with individual state Dental Hygiene practice acts. Prevention and treatment of oral disease are recognized as important factors in a patient's overall health and well-being. Dental hygienists are important members of the dental health care team providing these services. The first phase of the project consisted of a free dental screening event …

Empowering With Prep (E-Prep), A Peer-Led Social Media–Based Intervention To Facilitate Hiv Preexposure Prophylaxis Adoption Among Young Black And Latinx Gay And Bisexual Men: Protocol For A Cluster Randomized Controlled Trial, Viraj V. Patel, Zoë Ginsburg, Sarit A. Golub, Keith J. Horvath, Nataly Rios, Kenneth H. Mayer, Ryunh S. Kim, Julia H. Arnsten

Publications and Research

Background: Young black and Latinx, gay, bisexual, and other men who have sex with men (YBLGBM, aged 18-29 years) have among the highest rates of new HIV infections in the United States and are not consistently reached by existing prevention interventions. Preexposure prophylaxis (PrEP), an oral antiretroviral regimen taken daily by HIV-uninfected individuals to prevent HIV acquisition, is highly efficacious in reducing HIV acquisition and could help stop the HIV epidemic in YBLGBM. Use of social media (eg, Facebook, Twitter, online dating sites) is ubiquitous among young people, providing an efficient avenue to engage YBLGBM to facilitate PrEP adoption.

Objective: …

Supermarket Retailers’ Perspectives On Healthy Food Retail Strategies: In-Depth Interviews, Olivia Martinez, Noemi Rodriguez, Allison Mercurio, Marie Bragg, Brian Elbel

Publications and Research

Background

Excess calorie consumption and poor diet are major contributors to the obesity epidemic. Food retailers, in particular at supermarkets, are key shapers of the food environment which influences consumers’ diets. This study seeks to understand the decision-making processes of supermarket retailers—including motivators for and barriers to promoting more healthy products—and to catalogue elements of the complex relationships between customers, suppliers, and, supermarket retailers.

Methods

We recruited 20 supermarket retailers from a convenience sample of full service supermarkets and national supermarket chain headquarters serving low- and high-income consumers in urban and non-urban areas of New York. Individuals responsible for making …

Obesity Inequalities According To Place Of Birth: The Role Of Education, Elena Rodriguez-Alvarez, Nerea Lanborena, Luisa N. Borrell

Publications and Research

This study examined obesity inequalities according to place of birth and educational attainment in men and in women in Spain. A cross-sectional study was conducted using data from the Spanish National Health Survey 2011–2012 and from the European Health Survey in Spain 2014. We used data for 27,720 adults aged 18–64 years of whom 2431 were immigrants. We used log-binomial regression to quantify the association of place of birth with obesity before and after adjusting for the selected characteristics in women and in men. We found a greater probability of obesity in immigrant women (PR: 1.42; 95% CI: 1.22–1.64) and …

To Switch Or Not To Switch: Intentions To Switch To Injectable Prep Among Gay And Bisexual Men With At Least Twelve Months Oral Prep Experience, Kathrine Meyers, Yumeng Wu, Atrina Brill, Theodorus Sandfort, Sarit A. Golub

Publications and Research

Background: Phase III trials of long-acting injectable (LAI) PrEP, currently underway, have great potential for expanding the menu of HIV prevention options. Imagining a future in which multiple PrEP modalities are available to potential users of biomedical HIV prevention, we investigated which factors might help direct a patient-physician shared-decision making process to optimize the choice of biomedical HIV prevention method.

Methods: Participants (n = 105; ages 19–63; 46.7% men of color) were former participants in a PrEP demonstration project and had taken daily oral PrEP for 12 months. Participants were given information about LAI PrEP and asked whether they would …

The Impact Of Comorbidities, Depression, And Substance Use Problems On Quality Of Life Among Older Adults Living With Hiv, Brett M. Millar, Tyrel Starks, Sitaji Gurung, Jeffrey T. Parsons

Publications and Research

Older adults living with HIV (OALWH) comprise a growing population with a range of complex and interconnecting medical and psychosocial needs. Based on the biopsychosocial model with its emphasis on a holistic approach to various aspects of people’s lives, the current study explored associations between physical health, psychological health, substance use, and overall quality of life. Drawing on data from 114 substance-using OALWH (aged 50 or older), we employed linear regression to show associations between the number of current comorbid health conditions on quality of life, over and above depression, substance use problems, and demographic characteristics (age, race/ethnicity, gender, sexual …

Thrive With Me: Protocol For A Randomized Controlled Trial To Test A Peer Support Intervention To Improve Antiretroviral Therapy Adherence Among Men Who Have Sex With Men, Keith J. Horvath, K. Rivet Amico, Darin Erickson, Alexandra M. Ecklund, Aldona Martinka, James Dewitt, Jeffrey Mclaughlin, Jeffrey T. Parsons

Publications and Research

Background: The suboptimal rate of viral suppression among persons aged 13 years and older and residing in 37 states and the District of Columbia leaves considerable opportunities for onward transmission and contributes to poor health outcomes. Men who have sex with men (MSM) represent one of the most at-risk groups in the United States. There is a clear and continued need for innovative adherence support programs to optimize viral suppression. To address this gap, we designed and are implementing a randomized controlled trial (RCT) to test the efficacy of the Thrive with Me intervention for MSM living with HIV. Critical …

Understanding The New Blood Pressure Guidelines, Susan H. Davide, Anty Lam

Publications and Research

Oral health professionals who are well versed in the new guidelines will be best prepared to handle the implications on patient care.

Adolescent Medicine Trials Network For Hiv/Aids Interventions Data Harmonization: Rationale And Development Of Guidelines, Micah Mccumber, Demetria Cain, Sara Legrand, Kenneth H. Mayer, Debra A. Murphy, Matthew A. Psioda, Arlene C. Seña, Tyrel J. Starks, Michael Hudgens

Publications and Research

Background: The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) research program aims to defeat the rising HIV epidemic among adolescents and young adults in the United States.

Objective: This study aims to optimize cross-study analyses and comparisons of standardized measures (variables) collected in the ATN. Methods: Guidelines were developed for harmonizing measures to be collected across ATN studies.

Results: Eight domains were identified for harmonization—Demographics and Socioeconomic Characteristics, Sexual Behavior and Risk, Substance Use and Abuse, HIV-Positive Cascade, HIV-Negative Cascade, Mental Health, Social Support and Isolation, and Pre-exposure Prophylaxis Cascade.

Conclusions: The collection of selected key measures in a …

Patients’ Willingness To Participate In Rapid Hiv Testing: A Pilot Study In Three New York City Dental Hygiene Clinics, Susan H. Davide, Anthony J. Santella, Winnie Furnari, Petal Leuwaisee, Marilyn Cortell, Bhuma Krishnamachari

Publications and Research

Purpose: One in eight people living with an HIV infection in the United States is unaware of their status. Rapid HIV testing (RHT) is an easily used and accepted screening tool that has been introduced in a limited number of clinical settings. The purpose of this study was to investigate patient acceptability, certainty of their decision, and willingness to pay for screening if RHT was offered in university-based dental hygiene clinics.

Methods: A cross-sectional survey was administered to 426 patients at three dental hygiene clinics in New York City over a period of four months. The survey questionnaire was based …

Hepatitis C Serosorting Among People Who Inject Drugs In Rural Puerto Rico, Ian Duncan, Ric Curtis, Juan Carlos Reyes, Roberto Abadie, Bilal Khan, Kirk Dombrowski

Publications and Research

Due to the high cost of treatment, preventative measures to limit Hepatitis C (HCV) transmission among people who inject drugs (PWID) are encouraged by many public health officials. A key one of these is serosorting, where PWID select risk partners based on concordant HCV status. Research on the general U.S. population bySmith et al. (2013) found that knowledge of one's own HCV status facilitated serosorting behaviors among PWID, such that respondents with knowledge of their own status were more likely to ask potential partners about their status prior to sharing risk. Our objective was to see if this held true …

Characteristics Of Hiv-Infected Children At Enrollment Into Care And At Antiretroviral Therapy Initiation In Central Africa, Adebola Adedimeji, Andrew Edmonds, Donald Hoover, Qiuhu Shi, Jean D'Amour Sinayobye, Martin Nduwinmana, Patricia Lelo, Denis Nash, Kathryn Anastos, Marcel Yotebieng

Publications and Research

Background Despite the World Health Organization (WHO) regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART) in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described.

Materials and Methods Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) pediatric cohort of 3,426 children (0±15 years) entering HIV care at 15 sites in Burundi, DRC, and Rwanda. Measures include CD4 count, WHO clinical stage, age, and …

Creating Integrated Strategies For Increasing Access To Healthy Affordable Food In Urban Communities: A Case Study Of Intersecting Food Initiatives, Michele Silver, Afia Bediako, Tracey Capers, Aysu Kirac, Nicholas Freudenberg

Publications and Research

In New York and other cities, substantial evidence documents that community food environments interact with inequitable allocation of power, wealth and services to shape the distribution of diet-related diseases and food insecurity. This case study shows how one Central Brooklyn community organization, Bedford Stuyvesant Restoration Corporation, has launched multiple coordinated food initiatives in order to reduce the burden of food-related health problems and boost community development. The report used standard case study methods to document the implementation of the New York City Food and Fitness Partnership in Central Brooklyn. The case study shows how two distinct strands of activities, a …

Burnout Or Depression: Both Individual And Social Issue, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In view of the profound problems attached to the construct of burnout, we recommended that occupational health specialists focus on (job-related) depression rather than burnout to help workers more effectively. Epstein and Privitera (April 8, 1398) rejected our recommendation on the grounds that burnout is not a “purely individual syndrome”. Problematically, Epstein and Privitera attributed to us an idea that is not ours. In these authors’ view, equating burnout with depression is synonymous with mistakenly individualising a social problem. For two reasons, the argument that depression cannot replace burnout because burnout is a social problem whereas depression is an individual …

The Expert Advice: Dental Patient Compliance Hinges On Effective Communication Strategies, Diana V. Macri

Publications and Research

Most dental hygienists would agree that motivating patients to adopt good oral health behaviors-often referred to as compliance-is the most challenging aspect of practice. This critical component of patient care is not unique to dentistry and dental hygiene. In 2010, the costs of health care in the United States exceeded $2.7 trillion with "between $100 and $300 billion of avoidable health-care costs [attributable] to nonadherence in the US annually."1 Nonadherence (a term used in the medical literature, which is synonymous with noncompliance) is associated with progression of disease and, subsequently, poor health outcomes resulting in an additional burden of billions …

Reducing The Role Of The Food, Tobacco, And Alcohol Industries In Noncommunicable Disease Risk In South Africa, Peter Delobelle, David Sanders, Thandi Puoane, Nicholas Freudenberg

Publications and Research

Noncommunicable diseases (NCDs) impose a growing burden on the health, economy, and development of South Africa. According to the World Health Organization, four risk factors, tobacco use, alcohol consumption, unhealthy diets, and physical inactivity, account for a significant proportion of major NCDs. We analyze the role of tobacco, alcohol, and food corporations in promoting NCD risk and unhealthy lifestyles in South Africa and in exacerbating inequities in NCD distribution among populations. Through their business practices such as product design, marketing, retail distribution, and pricing and their business practices such as lobbying, public relations, philanthropy, and sponsored research, national and transnational …

Diabetes Training For Community Health Workers, Judith Aponte

Publications and Research

Background: A 2.5-month diabetes education training for community health workers (CHWs) was developed, implemented, and evaluated.

Methods: Training methods used included case studies, role-playing, and lectures. Exams were used throughout the training for its evaluation. Teaching was delivered by different ways: a one day American Diabetes Association (ADA) course; a five day Diabetes Self-Management Program (DSMP); Conversation Maps; and a series of seven National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) diabetes education booklets.

Results: Qualitative and quantitative evaluative methods were used during and after the training. The CHWs' diabetes knowledge was evaluated by a pre- and post-test …

The Impact Of Dentures On The Nutritional Health Of The Elderly, Michelle Gellar, Daniel Alter

Publications and Research

No abstract provided.

Motivational Interviewing Targeting Risky Sex In Hiv-Positive Young Thai Men Who Have Sex With Men, Chokechai Rongkavilit, Bo Wang, Sylvie Naar-King, Torsak Bunupuradah, Jeffrey T. Parsons, Apirudee Panthong, Juline Koken, Pichai Saengcharnchai, Praphan Phanuphak

Publications and Research

Motivational interviewing (MI) has been shown to reduce sexual risks among HIV-positive men who have sex with men (HMSM) in the US. We conducted a randomized trial of Healthy Choices, a 4-session MI intervention, targeting sexual risks among 110 HIV-positive youth ages 16–25 years in Thailand. Risk assessments were conducted at baseline, 1 month, and 6 months post-intervention. This report presents the analysis of 74 HMSM in the study. There were 37 HMSM in the Intervention group and 37 in the control group. The proportions of participants having anal sex and having sex with either HIV-uninfected or unknown partners in …

Patterns Of Client Behavior With Their Most Recent Male Escort: An Application Of Latent Class Analysis, Christian Grov, Tyrel J. Starks, Margaret Wolff, Michael D. Smith, Juline Koken, Jeffrey T. Parsons

Publications and Research

Research examining interactions between male escorts and clients has relied heavily on data from escorts, men working on the street, and behavioral data aggregated over time. In the current study, 495 clients of male escorts answered questions about sexual behavior with their last hire. Latent class analysis identified four client sets based on these variables. The largest (n = 200, 40.4 %, labeled Typical Escort Encounter) included men endorsing behavior prior research found typical of paid encounters (e.g., oral sex and kissing). The second largest class (n = 157, 31.7 %, Typical Escort Encounter + Erotic Touching) included men reporting …

Exploring Social Networking Technologies As Tools For Hiv Prevention For Men Who Have Sex With Men, Jorge Ramallo, Thomas Kidder, Tashuna Albritton, Gary Blick, John Pachankis, Valen Grandeleski, Trace Kershaw

Publications and Research

Social networking technologies are influential among men who have sex with men (MSM) and may be an important strategy for HIV prevention. We conducted focus groups with HIV positive and negative participants. Almost all participants used social networking sites to meet new friends and sexual partners. The main obstacle to effective HIV prevention campaigns in social networking platforms was stigmatization based on homosexuality as well as HIV status. Persistent stigma associated with HIV status and disclosure was cited as a top reason for avoiding HIV-related conversations while meeting new partners using social technologies. Further, social networking sites have different social …

Assessing The Burden Of Crime And The Criminal Sanction: A Public Health Perspective On Critical Issues In Criminal Justice, Jeremy Travis

Publications and Research

No abstract provided.

Ambiguity, Ambivalence, And Apprehensions Of Taking Hiv-1 Pre-Exposure Prophylaxis Among Male Couples In San Francisco: A Mixed Methods Study, Parya Saberi, Kristine Elizabeth Gamarel, Torsten B. Neilands, Megan Comfort, Nicolas Sheon, Lynae A. Darbes, Mallory O. Johnson

Publications and Research

Objective: We conducted a mixed-methods study to examine serodiscordant and seroconcordant (HIV-positive/HIVpositive) male couples’ PrEP awareness, concerns regarding health care providers offering PrEP to the community, and correlates of PrEP uptake by the HIV-negative member of the couple.

Design: Qualitative sub-study included one-on-one interviews to gain a deeper understanding of participants’ awareness of and experiences with PrEP and concerns regarding health care providers offering PrEP to men who have sex with men (MSM). Quantitative analyses consisted of a cross-sectional study in which participants were asked about the likelihood of PrEP uptake by the HIV-negative member of the couple and level …

The Manufacture Of Lifestyle: The Role Of Corporations In Unhealthy Living, Nicholas Freudenberg

Publications and Research

Recently, researchers have debated two views on the connection between lifestyle and health. In the first, health-related lifestyles including tobacco and alcohol use, diet, and physical activity are seen as primary influences on health. In the second, social stratification is the dominant influence with lifestyles simply markers of social status. Neither approach leads to interventions that can reverse the world's most serious health problems. This article proposes that corporate practices are a dominant influence on the lifestyles that shape patterns of health and disease. Modifying business practices that promote unhealthy lifestyles is a promising strategy for improving population health. Corporations …

Culture Ontogeny: Lifespan Development Of Religion And The Ethics Of Spiritual Counselling, Glen Milstein, Amy Manierre

Publications and Research

The counsellor has an ethical obligation to treat the whole person. Humans are cultural beings and the foundation of most cultures is religion. Religion and culture are received from our early relation~ ships and modified through later relationships across the lifespan. The paper introduces the term "culture ontogeny" to emphasize that this is a biological process wherein abstract ideas of culture and religion become material in the developing neurophysiology of each brain. A framework and methods are offered to examine the changing roles of religion in clients' emotional self~ structure, inclusive of those who describe themselves as spiritual, not religious. …

Dual Testing Algorithm Of Bed-Ceia And Axsym Avidity Index Assays Performs Best In Identifying Recent Hiv Infection In A Sample Of Rwandan Sex Workers, Sarah L. Braunstein, Denis Nash, Andrea A. Kim, Ken Ford, Lambert Mwambarangwe, Chantal M. Ingabire, Joseph Vyankandondera, Janneke H. H. M. Van De Wijgert

Publications and Research

Background

To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidence among female sex workers (FSW) in Kigali, Rwanda.

Methodology and Findings

Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing at baseline and ≥12 months later to estimate assay false-recent rates (FRR). STARHS-based HIV incidence was estimated using the McWalter/Welte formula, and adjusted with locally derived FRR and CD4 results. HIV incidence and local assay window periods were estimated from a prospective cohort of FSW. At baseline, 190 HIV-positive women were BED and Ax-AI …