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BACKGROUND: Most HIV cure-related studies involve interrupting antiretroviral treatment to assess the efficacy of pharmacologic interventions - also known as analytical treatment interruptions (ATIs). ATIs imply the risk of passing HIV to sexual partners due to the loss of undetectable HIV status. There has been a notable lack of attention paid to perceptions of ATIs among racial, ethnic, sex and gender minorities, and HIV serodifferent couples. These populations are among those most impacted by HIV in the United States. Future HIV cure research paradigms should equitably include considerations from these groups. METHODS: From August - October 2020, we conducted in-depth interviews with 10 racial, ethnic, sex, and gender minority HIV serodifferent couples in geographically diverse regions of the United States to understand their perspectives about ATIs and partner protection measures to prevent secondary HIV transmissions because of participation in ATI studies. We used framework analysis to analyze the qualitative data. RESULTS: Of the 10 couples recruited, four identified as a gay couple, two as a gay and bisexual couple, two as a heterosexual couple, one as a gay and queer couple, and one as a queer couple. We found that HIV serodifferent couples in our study viewed ATIs as contradicting HIV treatment adherence messages. Couples expressed discomfort around ATIs in HIV cure research. They were concerned with the return of HIV detectability and worried ATIs might result in secondary HIV transmission. Participants were strongly in favor of using a range of partner protection measures during ATIs that included PrEP, HIV risk reduction counseling, and alternatives for penetrative sex practices. Couples also recommended that sex partners be consulted or involved as part of ATI trials. CONCLUSIONS: Our findings highlight new potential opportunities and strategies to mitigate risk of HIV transmission during ATIs among key groups historically under-represented in HIV cure research. Findings also underscore the relational aspects of ATI trials. We provide preliminary considerations for planning ATI trials with diverse HIV serodifferent partners. Future studies should continue to explore these issues among other types of partnerships, cultures, and socio-cultural settings.
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Infecciones por VIH , Minorías Sexuales y de Género , Etnicidad , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Humanos , Masculino , Conducta Sexual , Parejas Sexuales , Estados UnidosRESUMEN
BACKGROUND: Low back pain (LBP) is a costly global health condition that affects individuals of all ages and genders. Physical therapy (PT) is a commonly used and effective intervention for the management of LBP and incorporates movement assessment and therapeutic exercise. A newly developed wearable, fabric-based sensor system, Motion Tape, uses novel sensing and data modeling to measure lumbar spine movements unobtrusively and thus offers potential benefits when used in conjunction with PT. However, physical therapists' acceptance of Motion Tape remains unexplored. OBJECTIVE: The primary aim of this research study was to evaluate physical therapists' acceptance of Motion Tape to be used for the management of LBP. The secondary aim was to explore physical therapists' recommendations for future device development. METHODS: Licensed physical therapists from the American Physical Therapy Association Academy of Leadership Technology Special Interest Group participated in this study. Overall, 2 focus groups (FGs; N=8) were conducted, in which participants were presented with Motion Tape samples and examples of app data output on a poster. Informed by the Technology Acceptance Model, we conducted semistructured FGs and explored the wearability, usefulness, and ease of use of and suggestions for improvements in Motion Tape for PT management of LBP. FG data were transcribed and analyzed using rapid qualitative analysis. RESULTS: Regarding wearability, participants perceived that Motion Tape would be able to adhere for several days, with some variability owing to external factors. Feedback was positive for the low-profile and universal fit, but discomfort owing to wires and potential friction with clothing was of concern. Other concerns included difficulty with self-application and potential skin sensitivity. Regarding usefulness, participants expressed that Motion Tape would enhance the efficiency and specificity of assessments and treatment. Regarding ease of use, participants stated that the app would be easy, but data management and challenges with interpretation were of concern. Physical therapists provided several recommendations for future design improvements including having a wireless system or removable wires, customizable sizes for the tape, and output including range of motion data and summary graphs and adding app features that consider patient input and context. CONCLUSIONS: Several themes related to Motion Tape's wearability, usefulness, and ease of use were identified. Overall, physical therapists expressed acceptance of Motion Tape's potential for assessing and monitoring low back posture and movement, both within and outside clinical settings. Participants expressed that Motion Tape would be a valuable tool for the personalized treatment of LBP but highlighted several future improvements needed for Motion Tape to be used in practice.
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Dolor de la Región Lumbar , Fisioterapeutas , Dispositivos Electrónicos Vestibles , Femenino , Humanos , Masculino , Grupos Focales , Investigación Cualitativa , Movimiento (Física) , Dolor de la Región Lumbar/diagnósticoRESUMEN
This field report describes the accessibility and perceived effectiveness of a free acupuncture program among a group of predominantly low-income Hispanic/Latino adults. Surveys, developed based on the Levesque Conceptual Framework of Access to Health Care, were administered to clients. Baseline (n = 245) and 6-week follow-up (n = 79) surveys were analyzed to document early program findings. A majority of clients were Hispanic/Latino (72.7%) and female (73.1%). Most reported their original pain complaint was treated very well/well (98.7%). Clients reported an average 1.2 points pain level decrease (scale 1-10) at follow-up (p < 0.0001). Early program results suggest this acupuncture program was accessible and well received by low-income Hispanics/Latinos.
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Terapia por Acupuntura , Accesibilidad a los Servicios de Salud , Hispánicos o Latinos , Manejo del Dolor , Pobreza , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Manejo del Dolor/métodos , Medicina Tradicional China , Anciano , Adulto JovenRESUMEN
PURPOSE: The objective of this cross-sectional survey-based study was to assess factors associated with patient satisfaction with physical therapy (PT) services received at a Federally Qualified Health Center (FQHC) in the United States (US) located near the US-Mexico border. METHODS: Patients > 18 years of age, English or Spanish speakers, referred to PT were invited to complete an online survey. Factors that may influence PT satisfaction were examined for patients who attended PT. Variables associated with PT satisfaction from bivariate analyses (p < .15) were included in three separate ordinal logistic regression models. RESULTS: Patients (N = 231) who reported more confidence that PT could help relieve their pain were more likely to have higher levels of satisfaction with PT communication, treatment, and outcomes than those who reported low confidence (p < .05). Patients who reported having more support from family and friends were more likely to have higher levels of satisfaction with PT communication and treatment than those with less support (p < .01). Patients with occasional or frequent pain after ending PT treatment were more likely to have lower satisfaction with PT outcomes than those reporting no pain (p < .05). CONCLUSIONS: Findings suggest that addressing confidence in PT and promoting health support from family and friends may be important for satisfaction with PT. Additionally, PTs may consider addressing gaps between expected and achieved outcomes to improve PT satisfaction.
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PURPOSE: To explore a telehealth-based lifestyle therapeutics (THBC) program on weight loss (WL) and program satisfaction in an employer population. DESIGN: This study was a collaboration between inHealth Lifestyle Therapeutics and a large national employer group including 685 participants (296 women [64% obese] and 389 men [62% obese]). MEASURES: Percent WL and subjective rating (Perceived Program Value measured by a questionnaire) were assessed. INTERVENTION: Average number of visits was 3.1 ± 0.4; each visit ranged between 20 and 45 minutes. ANALYSIS: This study utilized a 2 × 2 block design using analysis of variance techniques based on sex (male and female) and initial body mass index (BMI) category (overweight and obese) tested at P ≤ .05. RESULTS: There was no statistical difference in %WL between by sex (F1,681 = 0.398, P = .528) nor an interaction between sex and BMI (F1,681 = 0.809, P = .369). There was a statistically significant difference in %WL from pre to post program across initial BMI category (F1,681 = 13.707, P ≤ .001) with obese participants losing an average of 1.1% (0.5%-1.6%) more than overweight participants (overweight 2.5% [2.1%-3.0%] vs obese 3.6% [3.2%-3.9%]). Obese participants were 1.15 (1.07-1.25) times more likely to lose weight compared to overweight participants. Analysis of variance power analysis indicated sufficient power on minimum factor combination n = 106 ( Effect Size = 0.282). CONCLUSION: Results support the efficacy THBC in supporting WL with no reported differences between men and women, while having a high perceived value for employee participants.