The Media and Sexual Violence Among Adolescents: Findings from a Qualitative Study of Educators Across Vietnam.

Growing access to technology and media has presented new avenues of influence on youth attitudes and norms regarding sexuality and sexual violence, as well as new technological pathways through which to perpetrate sexual violence. The aim of this research was to understand contextual influences on and needs for scale-up of sexual violence prevention programming in the media-violence context of Vietnam. We conducted 45 interviews with high school teachers (n = 15), university lecturers (n = 15), and affiliates from youth-focused community service organizations (n = 15) from across Vietnam. Additionally, we conducted four sector-specific focus groups with a sub-sample of interview participants (k = 4, n = 22). Media and technology were brought up consistently in relation to sexual violence prevention and sexual health information. Key informants noted that, in Vietnam, generational differences in acceptability of sex and lack of comprehensive sexuality education intersect with new technological opportunities for exposure to sexual information and media. This creates a complex landscape that can promote sexual violence through priming processes, instigate mimicry of violent media, and presents new opportunities for the perpetration of sexual violence though technology. Development of comprehensive sexual education, including violence prevention education, is imperative, with consideration of age-specific needs for Vietnamese youth.

Development of the Vietnamese Rape Myths Acceptance Scales: A Web-Based Survey of Young Adults.

Rape myths-false but widely held beliefs that serve to deny and justify sexual aggression-present a major barrier to reporting and prevention of sexual violence in Vietnam and globally. Based on a parent study aimed at reducing sexual violence at two universities in Hanoi, we developed and assessed a contextualized measure of rape myths among young people in Vietnam. Items from previously validated rape myth acceptance (RMA) scales and data from qualitative research informed the development of 50 items, which were administered to Vietnamese 18-24-year-olds (n = 2,756 total, n = 1,798 cisgender women) via an anonymous link in February 2021. We used factor analysis to explore and test factor structure and multi-group factor analysis to assess measurement equivalence across gender. We calculated item-level discrimination and difficulty parameters and visualized information curves using item response theory analysis, informing the development of a short form. Four hypothesized subconstructs identified in the qualitative data emerged as factors: (1) "He didn't mean to"; (2) "She asked for it"; (3) "It wasn't really rape"; and (4) "Rape is a deviant event." A fifth factor, "She didn't protect herself," included four items from formative data. Confirming formative findings and prior literature, cisgender women had lower RMA than cisgender men, particularly on items related to victim-blaming. The Vietnamese Rape Myths Acceptance Scales were internally consistent and equivalent between cisgender men and women, capturing elements specific to the Vietnamese context and providing a tool for campus climate surveys and evaluations of sexual violence prevention programs.

Preventing sexual violence in Vietnam: qualitative findings from high school, university, and civil society key informants across regions.

BACKGROUND: Sexual violence by young men against women is common, but efficacious primary prevention interventions tailored to men are limited in low- and middle-income settings like Vietnam. GlobalConsent, a web-based sexual violence prevention intervention tailored to university men in Hanoi, is efficacious. Implementation research is needed to understand facilitators and barriers to scaling GlobalConsent and prevention programs generally. We conducted qualitative research with key informants from three youth-focused organizational settings to understand the context of implementation in Vietnam. METHODS: Interviews with university (n = 15), high-school (n = 15) and non-governmental (n = 15) key informants focused on perceptions about sexual violence among young people and prevention programming. Four focus group discussions with 22 interviewed informants, following the Consolidated Framework for Implementation Research, asked about facilitators and barriers to implementing GlobalConsent. Narratives were transcribed, translated, and coded inductively and deductively to identify salient themes. RESULTS: Outer-setting influences included greater expectations for sex among young people alongside norms favoring men's sexual privilege, ostensibly ambiguous and lax laws on sexual violence, government ministries as bureaucratic but potential allies, external subject-matter experts, and the media. Inner-setting influences included variable cultures regarding openness to discuss sexual violence and equitable gender norms, variable departmental coordination, limited funding and 'red tape' especially in public institutions, inconsistent student access to technologies, and limited time and competing priorities among students and teachers. Several actors were considered influential, including institutional leaders, human-resource staff, the Youth Union, and student-facing staff. Important characteristics of individuals for implementation included subject-matter expertise, science or social science training, younger age, engagement in social justice related activities, and more open attitudes about sex. Regarding characteristics of sexual violence prevention programming, some participants preferred online formats for busy students while others suggested hybrid or in-person formats, peer education, and incentives. Participants generally accepted the content of GlobalConsent and suggested adding more content for women, ancillary support services, and adapted content for high-school students. CONCLUSIONS: Implementation of sexual violence prevention programs in youth-focused organizations in Vietnam requires multilevel strategies that connect outer-setting subject-matter experts with supportive inner-setting leaders and student-facing staff to overcome normative and organizational constraints, and thereby, to deliver institution-wide programming.

Preventing sexual violence in college men: a randomized-controlled trial of GlobalConsent.

BACKGROUND: Sexual violence-any sexual act committed against a person without freely given consent-disproportionately affects women. Women's first experiences of sexual violence often occur in adolescence. In Asia and the Pacific, 14% of sexually experienced adolescent girls report forced sexual debut. Early prevention with men that integrates a bystander framework is one way to address attitudes and behavior while reducing potential resistance to participation. METHODS: This paper describes a study protocol to adapt RealConsent for use in Vietnam and to test the impact of the adapted program-GlobalConsent-on cognitive/attitudinal/affective mediators, and in turn, on sexual violence perpetration and prosocial bystander behavior. RealConsent is a six-session, web-based educational entertainment program designed to prevent sexual violence perpetration and to enhance prosocial bystander behavior in young men. The program has reduced the incidence of sexual violence among men attending an urban, public university in the Southeastern United States. We used formative qualitative research and the Centers for Disease Control and Prevention's Map of the Adaptation Process to adapt RealConsent. We conducted semi-structured interviews with college men (n = 12) and women (n = 9) to understand the social context of sexual violence. We conducted focus group discussions with university men and stakeholders (n = 14) to elicit feedback on the original program. From these data, we created scripts in storyboard format of the adapted program. We worked closely with a small group of university men to elicit feedback on the storyboards and to refine them for acceptability and production. We are testing the final program-GlobalConsent-in a randomized controlled trial in heterosexual or bisexual freshmen men 18-24 years attending two universities in Hanoi. We are testing the impact of GlobalConsent (n = 400 planned), relative to a health-education attention control condition we developed (n = 400 planned), on cognitive/attitudinal/affective mediators, prosocial bystander behavior, and sexual violence perpetration. DISCUSSION: This project is the first to test the impact of an adapted, theoretically grounded, web-based educational entertainment program to prevent sexual violence perpetration and to promote prosocial bystander behavior among young men in a middle-income country. If effective, GlobalConsent will have exceptional potential to prevent men's sexual violence against women globally. TRIAL REGISTRATION: U.S. National Library of Medicine Clinicaltrials.gov NCT04147455 on November 1, 2019 (Version 1). Retrospectively registered. Protocol amendments will be submitted to clinicaltrials.gov .

Improving the knowledge and behavior of workplace chemical exposures in Vietnamese-American nail salon workers: a randomized controlled trial.

OBJECTIVES: We assessed the efficacy of trainings with Vietnamese nail salon owners and workers on knowledge and behaviors that could reduce exposures to toxic chemicals in nail products. METHODS: We trained Vietnamese salon owners in California (n = 77) who then trained their workers (n = 200) on best practices. In a cluster randomized controlled trial, we assessed the efficacy of the training on change in knowledge and self-reported behaviors. Data were collected from 2013 to 2016 and analyzed from 2016 to 2017. RESULTS: Compared to the control group, the intervention group had significantly greater increases in knowledge about: safer nail polishes [odds ratio (OR) 3.7 (95% confidence interval (CI) 1.9, 7.2)]; proper ventilation methods (OR 4.2; 95% CI 2.2, 8.1); recommended glove types (OR 3.4; 95% CI 1.9, 6.3); and recommended product handling and storage (OR 4.1; 95% CI 1.7, 9.9). The intervention also increased best practices: using safer nail polishes (OR 3.6; 95% CI 1.9, 6.8); reading product labels (OR 2.6; 95% CI 1.3, 5.0); and wearing long sleeves (OR 2.4; 95% CI 1.3, 4.2). CONCLUSIONS: The owner-to-worker intervention with culturally and linguistically appropriate training for salon owners who then trained workers was effective in promoting knowledge and self-reported behaviors that can reduce workplace chemical exposures.

Evaluating an owner-to-worker training intervention in California nail salons using personal air monitoring.

BACKGROUND: Chemicals in nail products have been linked to numerous health concerns. METHODS: We recruited Vietnamese-American nail salon owners and workers in California and randomized salons into an intervention or control group. Owners in the intervention group received training and then provided education to workers in their salons on best practices to reduce workplace chemical exposures. Methyl methacrylate (MMA), toluene, and total volatile organic compounds (TVOCs) were measured using personal air monitors worn by workers during the work-shift. RESULTS: We enrolled 77 salons (37 intervention and 40 control) and 200 workers. There was no significant intervention effect between the two groups. However, MMA and TVOCs were higher for workers who used gel polish and acrylic nails as well as in busy salons. CONCLUSIONS: Although the intervention did not show reductions in chemical levels, identifying worker tasks and salon characteristics that predict chemical levels can inform future interventions to reduce exposures.

Understanding Falls Risk and Impacts in Chinese American Older Patients at a Community Health Center.

While falls are highly prevalent and costly for older adults, little is known about falls for Asian Americans. Using a custom, evidence-based, bilingual fall risk assessment and management tool, our study examined the prevalence of falls among older Chinese-speaking patients at a community health center. We identified the risks for falls and explored an association of fall risk with emergency room (ER) and hospital use in this population. The setting was at a community health center in Oakland, CA. Participants included 839 older Asian American adults (ages 65-80 years) who spoke Cantonese/Mandarin. Primary care clinic staff administered a fall risk assessment and management tool at the time of clinic visits to assess patients' risk factors for falls. Of the total, 173 (20.6%) reported having fallen in the past year, with women comprising a majority (71.7%). 362 patients in the cohort (43.1%) reported fear of falling. For the subset of Medicaid managed care patients (n = 455, 54.3% of total) for whom we were able to obtain ER and hospital utilization data, 31 patients (14.5%) who reported a fall risk had an ER/hospital episode compared to 15 (6.2%) of those who did not self-report fall risks (statistically significant, p < 0.05). A targeted fall risk assessment and management tool designed by community-based primary care practitioners and utilized with linguistic and cultural competence to focus on Asian American older adults, can help establish the prevalence of falls in this understudied population and effectively identify those at higher risk for falls and subsequent ER/hospital utilization. More research is needed to understand the risk and impacts of falls in understudied populations and identify ways to prevent these costly falls.

Islet1 regulates establishment of the posterior hindlimb field upstream of the Hand2-Shh morphoregulatory gene network in mouse embryos.

How divergent genetic systems regulate a common pathway during the development of two serial structures, forelimbs and hindlimbs, is not well understood. Specifically, HAND2 has been shown to regulate Shh directly to initiate its expression in the posterior margin of the limb mesenchyme. Although the Hand2-Shh morphoregulatory system operates in both the forelimb and hindlimb bud, a recent analysis suggested that its upstream regulation is different in the forelimb and hindlimb bud. A combination of all four Hox9 genes is required for Hand2 expression in the forelimb-forming region; however, it remains elusive what genetic system regulates the Hand2-Shh pathway in the hindlimb-forming region. By conditional inactivation of Islet1 in the hindlimb-forming region using the Hoxb6Cre transgene, we show that Islet1 is required for establishing the posterior hindlimb field, but not the forelimb field, upstream of the Hand2-Shh pathway. Inactivation of Islet1 caused the loss of posterior structures in the distal and proximal regions, specifically in the hindlimb. We found that Hand2 expression was downregulated in the hindlimb field and that Shh expression was severely impaired in the hindlimb bud. In the Hoxb6Cre; Islet1 mutant pelvis, the proximal element that is formed in a Shh-independent manner, displayed complementary defects in comparison with Pitx1(-/-) hindlimbs. This suggests that Islet1 and Pitx1 function in parallel during girdle development in hindlimbs, which is in contrast with the known requirement for Tbx5 in girdle development in forelimbs. Our studies have identified a role for Islet1 in hindlimb-specific development and have revealed Islet1 functions in two distinct processes: regulation upstream of the Hand2-Shh pathway and contributions to girdle development.

Adverse birth outcomes and maternal complications in licensed cosmetologists and manicurists in California.

PURPOSE: Due to concerns around occupational chemical exposures, this study sought to examine whether women working as cosmetologists (providing hair and nail care services) and manicurists (providing only nail care services) have an elevated risk for adverse pregnancy outcomes. METHODS: In this population-based retrospective study of cosmetologists and manicurists in California, we linked cosmetology licensee and birth registry files to identify births during 1996-2009. We compared outcomes among cosmetologists and manicurists to those of the general female population and to women from other industries. We also conducted restricted analyses for Vietnamese women, who comprise a significant proportion of the workforce. RESULTS: There was little evidence of increased risk for adverse birth outcomes, but we observed an association for small for gestational age (SGA) among Vietnamese manicurists (OR 1.39; 95 % CI 1.08-1.78) and cosmetologists (OR 1.40; 95 % CI 1.08-1.83) when compared to other working women. Some maternal complications were observed, notably an increased risk for gestational diabetes (OR 1.28; 95 % CI 1.10-1.50 for manicurists; OR 1.19; 95 % CI 1.07-1.33 for cosmetologists) compared with the general population, which further elevated when restricted to Vietnamese workers (OR 1.59; 95 % CI 1.20-2.11 for manicurists; OR 1.49; 95 % CI 1.04-2.11 for cosmetologists). Additionally, we observed an association for placentia previa among manicurists (OR 1.46; 95 % CI 1.08-1.97) and cosmetologists (OR 1.22; 95 % CI 1.02-1.46) compared with the general population. CONCLUSIONS: Women in the nail and hair care industry may be potentially at increased risk for some maternal complications, although further research is warranted. Vietnamese workers may also have increased risk for SGA.

Evaluating a county-based healthy nail salon recognition program.

OBJECTIVES: The City of San Francisco, California established a recognition program for nail salons that use safer nail products and receive worker safety training. This pilot study examined whether participating salons had reduced levels of toluene, methyl methacrylate (MMA), and total volatile organic compounds (TVOC), and improved knowledge and behavior compared to control salons. METHODS: We conducted personal air monitoring and administered surveys assessing knowledge and behaviors of two workers from each of six intervention salons and five control salons. We conducted assessments before and after the worker training. RESULTS: Although non-significant, there was a reduction in toluene (-46% vs. 0%) and TVOC (-19% vs. +47%), but an increase in MMA (+113% and +72%) among intervention salons compared to control salons. Awareness of dibutyl phthalates in nail products increased (+55%) among intervention salons between surveys. CONCLUSIONS: A government-administered nail salon recognition program may reduce chemical exposures and increase work-related knowledge.

Islet1-mediated activation of the ß-catenin pathway is necessary for hindlimb initiation in mice.

The transcriptional basis of vertebrate limb initiation, which is a well-studied system for the initiation of organogenesis, remains elusive. Specifically, involvement of the ß-catenin pathway in limb initiation, as well as its role in hindlimb-specific transcriptional regulation, are under debate. Here, we show that the ß-catenin pathway is active in the limb-forming area in mouse embryos. Furthermore, conditional inactivation of ß-catenin as well as Islet1, a hindlimb-specific factor, in the lateral plate mesoderm results in a failure to induce hindlimb outgrowth. We further show that Islet1 is required for the nuclear accumulation of ß-catenin and hence for activation of the ß-catenin pathway, and that the ß-catenin pathway maintains Islet1 expression. These two factors influence each other and function upstream of active proliferation of hindlimb progenitors in the lateral plate mesoderm and the expression of a common factor, Fgf10. Our data demonstrate that Islet1 and ß-catenin regulate outgrowth and Fgf10-Fgf8 feedback loop formation during vertebrate hindlimb initiation. Our study identifies Islet1 as a hindlimb-specific transcriptional regulator of initiation, and clarifies the controversy regarding the requirement of ß-catenin for limb initiation.

Structure, anticoagulant and cytotoxic activity of a sulfated polysaccharide from green seaweed Chaetomorpha linum.

In this article, chemical structure and conformation in an aqueous solution of a new sulfated polysaccharide, PCL, extracted from green seaweed Chaetomorpha linum were elucidated by SEC-MALL, IR, NMR and SAXS. The results indicated that the obtained polysaccharide is a sulfated arabinogalactan with a molecular weight of 223 kDa, and is mainly composed of →3,6)-α-D-Galp4S→ and →2)-α-L-Araf→ connecting together through 1→3 glycoside linkages. It has a broken rod-like conformation in solution with Rgc estimated as 0.43 nm from SAXS measurements. The polysaccharide exhibited a notable anticoagulant activity measured by the assays of activated partial thromboplastintime, thrombintime and prothrombine time as well as a significant cytotoxic activity against hepatocellular, human breast cancer, and cervical cancer cell lines.

Fucoidan from brown seaweed Tubinaria decurrens: Structure and structure - anticancer activity relationship.

The aims of this study are to determine the structure of a fucoidan from brown seaweed Turbinaria decurrens, to investigate its anticancer activity and structure-activity relationship. SEC-MALLS, IR, ESI-MS and NMR spectra analysis indicated that dominant structure of the fucoidan, with a Mw 122.6 KDa, has a backbone of (1 â†’ 3)- and (1 â†’ 4)-α-L-Fucp residues, branched at C-4, sulfate groups are attached at C-2, C-3 and C-4; branches are (1 â†’ 4)-ß-D-Galp residues and sulfated at C-2. The fucoidan was hydrolyzed by HCl aqueous solution to obtain hydrolyzed fucoidans. It is assumed that native and hydrolyzed fucoidans have a rod-like conformation in solution with cross-sectional radius of gyration (Rgc) ranged from 0.53 to 1.52 nm as estimated from SAXS measurements. The fucoidans show great anticancer activity against HT29 human colon cancer cell line with IC50 ranging from 5.41 ± 0.36 to 73.52 ± 2.54 µg/mL. Anticancer activity of the fucoidan could be significantly improved by lowering molecular weight, furthermore, fucoidan required small molecular weight, small molecular weight distribution and rod-like structure with a short branch length for high anticancer activity.

Reducing chemical exposures in nail salons through owner and worker trainings: an exploratory intervention study.

BACKGROUND: Nail salons represent a rapidly growing industry with mainly Vietnamese immigrant workers. Workers routinely handle nail products containing hazardous compounds, yet have limited accessible information to minimize workplace exposures. METHODS: We conducted a culturally appropriate pilot intervention on workplace chemical exposure reduction strategies. We trained eight Vietnamese owners, who then trained Vietnamese workers in their salons. We conducted pre-, mid-, and post-intervention assessments with workers, including an in-person survey and personal air monitoring of volatile compounds. RESULTS: Survey results suggested statistically significant increases for chemical knowledge and behavioral changes in glove and mask use, and a reduced prevalence of nose, throat, and skin irritations. Air monitoring results showed a net reduction for methyl methacrylate and total volatile organic compounds, but not for toluene. CONCLUSIONS: Worker education disseminated through salon owners to their workers can improve work-related knowledge, behavior, health symptoms, and exposures for select air contaminants, although more research is warranted.

Impacts of GlobalConsent, a Web-Based Social Norms Edutainment Program, on Sexually Violent Behavior and Bystander Behavior Among University Men in Vietnam: Randomized Controlled Trial.

BACKGROUND: Sexual violence against women is prevalent worldwide. Prevention programs that treat men as allies and integrate a bystander framework are emerging in lower income settings, but evidence of their effectiveness is conflicting. OBJECTIVE: This study aimed to test the impact of GlobalConsent on sexually violent behavior and prosocial bystander behavior among university men in Vietnam. METHODS: We used a double-blind, parallel intervention versus control group design with 1:1 randomization at 2 universities. A total of 793 consenting heterosexual or bisexual men aged 18-24 years who matriculated in September 2019 were enrolled and assigned randomly to GlobalConsent or an attention-control adolescent health education (AHEAD) program. GlobalConsent is an adapted, theory-based, 6-module web-based intervention with diverse behavior change techniques and a locally produced serial drama. AHEAD is a customized, 6-module attention-control program on adolescent health. Both the programs were delivered to computers and smartphones over 12 weeks. Self-reported sexually violent behaviors toward women in the prior 6 months and prosocial bystander behaviors in the prior year were measured at 0, 6, and 12 months. RESULTS: More than 92.7% (735/793) of men in both study arms completed at least 1 program module, and >90.2% (715/793) of men completed all 6 modules. At baseline, a notable percentage of men reported any sexually violent behavior (GlobalConsent: 123/396, 31.1%; AHEAD: 103/397, 25.9%) in the prior 6 months. Among men receiving GlobalConsent, the odds of reporting a high level (at least 2 acts) of sexually violent behavior at the endline were 1.3 times the odds at baseline. Among men receiving AHEAD, the corresponding odds ratio was higher at 2.7. The odds of reporting any bystander behavior at endline were 0.7 times the odds at baseline for GlobalConsent, and the corresponding odds ratio for AHEAD was lower at 0.5. CONCLUSIONS: Compared with a health attention-control condition, GlobalConsent has sustained favorable impacts on sexually violent behavior and prosocial bystander behavior among matriculating university men in Vietnam, who would otherwise face increasing risks of sexually violent behavior. GlobalConsent shows promise for national scale-up and regional adaptations. TRIAL REGISTRATION: ClinicalTrials.gov NCT04147455; https://clinicaltrials.gov/ct2/show/NCT04147455. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-020-09454-2.

Nativity and papillary thyroid cancer incidence rates among Hispanic women in California.

BACKGROUND: Overall, the incidence of papillary thyroid cancer in Hispanic women residing in the United States (US) is similar to that of non-Hispanic white women. However, little is known as to whether rates in Hispanic women vary by nativity, which may influence exposure to important risk factors. METHODS: Nativity-specific incidence rates among Hispanic women were calculated for papillary thyroid cancer using data from the California Cancer Registry (CCR) for the period 1988-2004. For the 35% of cases for whom birthplace information was not available from the CCR, nativity was statistically imputed based on age at Social Security number issuance. Population estimates were extracted based on US Census data. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were also estimated. RESULTS: In young (age <55 years) Hispanic women, the incidence of papillary thyroid cancer among US-born women (10.65 per 100,000) was significantly greater than that for foreign-born women (6.67 per 100,000; IRR, 1.60 [95% CI, 1.44-1.77]). The opposite pattern was observed in older women. The age-specific patterns showed marked differences by nativity: among foreign-born women, rates increased slowly until age 70 years, whereas among US-born women, incidence rates peaked during the reproductive years. Incidence rates increased over the study period in all subgroups. CONCLUSION: Incidence rates of papillary thyroid cancer vary by nativity and age among Hispanic women residing in California. These patterns can provide insight for future etiologic investigations of modifiable risk factors for this increasingly common and understudied cancer.

Experiences and perceptions of medical discrimination among a multiethnic sample of breast cancer patients in the Greater San Francisco Bay Area, California.

OBJECTIVES: We conducted qualitative interviews with breast cancer survivors to identify themes related to institutional, personally mediated, and internalized discrimination in the medical setting. METHODS: We conducted 7 focus groups and 23 one-on-one interviews with a multiethnic sample of breast cancer survivors randomly selected from a population-based registry covering the Greater San Francisco Bay Area, California. RESULTS: Participants reported experiencing different forms of medical discrimination related to class, race, and language. Among African Americans, participants reported experiencing internalized discrimination and personal or group discrimination discrepancy-perceiving discrimination against them as a racial/ethnic group, yet not perceiving or discussing personal experiences of discrimination. Among Asian immigrants, participants reported experiencing institutional and personally mediated overt types of discrimination, including lack of access to quality and readily available translation services. Our results also indicated well-established coping mechanisms in response to discrimination experiences in both groups. CONCLUSIONS: Participants reported experiencing medical discrimination at all 3 levels, which may have deleterious health effects through the biopsychosocial stress pathway and through active coping mechanisms that could lead to delayed- or underutilization of the health care system to avoid discrimination.

Understanding and Addressing the Digital Health Literacy Needs of Low-Income Limited English Proficient Asian American Patients.

Introduction: During the pandemic, Asian Health Services (AHS), a federally qualified health center serving patients in 14 Asian languages, transformed rapidly to provide telehealth visits, developed an intensive remote patient monitoring program, and conducted a digital health literacy survey. Method: This article describes how AHS collected and utilized descriptive data on our patient population to inform our rapid adoption of telehealth and assess our patients' response to these changes. Results: Our experiences show that audio visits are invaluable for our patients. In addition, our remote monitoring program resulted in 96% of patients improving their blood pressure control. Conclusion: Many barriers to widespread adoption of telehealth exist, including low digital literacy and the need for in-language digital training. Disaggregated data by ethnicity and language are needed to inform future work.

Rape Myths Among University Men and Women in Vietnam: A Qualitative Study.

Sexual violence is a persistent, underreported threat to the well-being of women and girls worldwide. In Vietnam, as elsewhere, myths and misconceptions around rape and other forms of sexual violence present a major barrier to reporting and prevention. Based on qualitative research from a parent study aimed at reducing sexual violence perpetration at universities in Vietnam, we sought to characterize commonly held myths among university students that may contribute to the perpetration and justification of such behaviors. Our analysis drew on focus group discussions with men (n = 69) and semi-structured interviews with men (n = 12) and women (n = 9) recruited from two universities in Hanoi. Conducted in April and May of 2018, interviews covered topics including gender norms, dating relationships, consent, and sexual violence, whereas focus groups conducted in October 2018 were designed to assess reactions to an existing sexual violence prevention program. Thematic analysis of interview and focus group transcripts revealed that myths and misconceptions about sexual violence persist among university-aged men and women. Chief among these were that rape results mainly from men's uncontrollable desire, that victims provoke rape by their "reckless" behavior, such as drinking or dressing provocatively, that "real" rape is characterized by physical force from the perpetrator and "fierce resistance" on the part of the victim, and that rape occurs only under a narrow set of circumstances. Although men and women endorsed most myths equally, justification of rape through victim blaming featured much less in women's narratives than in men's. Myths concerning false rape allegations, observed in Western populations, were not considered relevant to Vietnamese students. Findings informed the development of a contextualized rape myths acceptance scale for testing and use in Vietnam. A nuanced understanding of salient rape myths among male and female students may also inform university-based efforts to prevent sexual violence.