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Black/African American and Hispanic Americans experience significant HIV-related disparities. Substance use might be a contributing factor to these disparities, but there is limited research on this topic. This study investigated various substance use risks by HIV status and race/ethnicity (Black, Hispanic, White) among U.S. adults. We used data from the 2005-2019 National Survey on Drug Use and Health (N = 541,921). In each racial/ethnic group, the prevalence rates of past-year and past-month tobacco, alcohol, cannabis, and cocaine use, and past-year alcohol and illicit drug use disorders were estimated by HIV status. A series of logistic regressions with the interaction term of HIV x race/ethnicity were performed to examine race/ethnicity's moderating effect on the HIV-substance use associations, while controlling for sociodemographic factors and survey year. Moderation analysis showed that HIV status's association with the risks of past-year tobacco use (AOR = 1.67, 95% CI = 1.01-2.75), past-year cocaine use (AOR = 3.80, 95% CI = 1.91-7.57), past-month cocaine use (AOR = 5.34, 95% CI = 2.10-13.60), and past-year alcohol use disorder (AOR = 2.52, 95% CI = 1.29-4.92) differed significantly between Black and White adults. Between the Hispanic and White groups, HIV status's association with the risks of past-year alcohol use (AOR = 2.00, 95% CI = 1.09-3.69), past-year cocaine use (AOR = 2.40, 95% CI = 1.06-5.39), and past-month cocaine use (AOR = 3.69, 95% CI = 1.36-10.02) also differed significantly. It is well-established that individuals with HIV face an elevated risk of substance use. Our study added valuable insights by highlighting that this phenomenon is particularly more significant among Black and Hispanic adults for several substances when compared to White adults. Implications for practice are discussed.
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Negro ou Afro-Americano , Infecções por HIV , Hispânico ou Latino , Transtornos Relacionados ao Uso de Substâncias , Brancos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Negro ou Afro-Americano/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Etnicidade/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Hispânico ou Latino/estatística & dados numéricos , Infecções por HIV/etnologia , Infecções por HIV/epidemiologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricosRESUMO
Effective recruitment strategies are pivotal for informatics-based intervention trials success, particularly for people living with HIV (PLWH), where engagement can be challenging. Although informatics interventions are recognized for improving health outcomes, the effectiveness of their recruitment strategies remains unclear. We investigated the application of a social marketing framework in navigating the nuances of recruitment for informatics-based intervention trials for PLWH by examining participant experiences and perceptions. We used qualitative descriptive methodology to conduct semi-structured interviews with 90 research participants from four informatics-based intervention trials. Directed inductive and deductive content analyses were guided by Howcutt et al.'s social marketing framework on applying the decision-making process to research recruitment. The majority were male (86.7%), living in the Northeast United States (56%), and identified as Black (32%) or White (32%). Most participants (60%) completed the interview remotely. Sixteen subthemes emerged from five themes: motivation, perception, attitude formation, integration, and learning. Findings from our interview data suggest that concepts from Howcutt et al.'s framework informed participants' decisions to participate in an informatics-based intervention trial. We found that the participants' perceptions of trust in the research process were integral to the participants across the four trials. However, the recruitment approach and communication medium preferences varied between older and younger age groups. Social marketing framework can provide insight into improving the research recruitment process. Future work should delve into the complex interplay between the type of informatics-based interventions, trust in the research process, and communication preferences, and how these factors collectively influence participants' willingness to engage.
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BACKGROUND: While there is no cure for HIV, adherence to antiretroviral therapy can extend the lifespan and improve the quality of life of people with HIV. Despite the global reduction of HIV infection rates in recent years, New York City and La Romana, Dominican Republic, continue to report high infection rates among Latino populations. Many people with HIV remain virally unsuppressed in these geographic hotspots, suggesting a need for additional interventions to overcome medication adherence barriers. Tailored and culturally appropriate mobile health (mHealth) technology can be an engaging way to improve adherence. The primary objective of this trial is to test the effectiveness of an mHealth tool to improve HIV medication adherence among Spanish-speaking people living in New York City and the Dominican Republic. METHODS: The WiseApp study is a two-arm randomized controlled trial among 248 people with HIV across the New York and Dominican Republic sites over the course of 12 months. Participants are randomly assigned to either receive a CleverCap pill bottle that is linked to the WiseApp (intervention) or standard of care (control). All participants complete surveys at baseline, 3-month, 6-month, and 12-month follow-up visits and the study team obtains HIV-1 viral load and CD4 count results through blood draw at each study timepoint. DISCUSSION: The use of mHealth technologies to improve medication adherence among people with HIV has been implemented in recent years. Although some studies have found improvement in adherence to antiretroviral therapy in the short term, there is limited information about how these interventions improve adherence among Spanish-speaking populations. Disproportionate rates of HIV infection among Latinos in New York City suggest an existing inequitable approach in reaching and treating this population. Due to a lack of mHealth studies with Latino populations, and apps tailored to Spanish-speakers, the WiseApp study will not only demonstrate the effectiveness of this particular mHealth app but will also contribute to the mHealth research community as a whole. TRIAL REGISTRATION: This trial was registered with Clinicaltrials.gov (NCT05398185) on 5/31/2022.
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Infecções por HIV , Aplicativos Móveis , Telemedicina , Humanos , Infecções por HIV/tratamento farmacológico , Qualidade de Vida , Telemedicina/métodos , Cidade de Nova Iorque , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUND: Chronic stress causes harmful physiologic responses that yield increased inflammation and subsequent health conditions. Stress is an important measure among minoritized populations who face social situations that predispose risk to developing mental health problems. Hair and fingernail cortisol have been studied as retrospective measures of chronic stress and to demonstrate biological response to social situations. OBJECTIVES: The objective of this study was to compare the Perceived Stress Scale (PSS) with hair and nail cortisol concentrations and assess the risk factors associated with stress levels among heterosexual and sexual and gender-minoritized adolescent males. METHODS: We recruited a cohort of adolescents who were assigned male sex at birth. Approximately half of our cohort consisted of sexual and gender-minoritized people, and half consisted of heterosexual cisgender males. Participants provided hair and nail samples and completed a survey that included demographic and hair hygiene questions, and the PSS. Hair and nail samples were processed in a lab and survey results were analyzed descriptively. RESULTS: Several samples were not provided or received, and some survey data was missing. Hair and nail cortisol values were significantly correlated. There was no significant relationship between the PSS and hair and nail cortisol values. No significant differences were found between the heterosexual and sexual minoritized groups. Black participants reported lower perceived stress scores compared to White participants. Participants whose gender was non-binary or genderqueer had higher hair cortisol values compared to those who identified as male. Older participants had higher hair cortisol values compared to younger participants. DISCUSSION: Previous researchers have similarly found no correlation between self-report stress scales and cortisol values, increased stress experience among non-binary or genderqueer individuals compared to cisgender individuals, and a positive correlation between aging and stress. Yet, our finding that Black participants reported lower stress levels than White participants is unexpected. Our study demonstrates a high correlation between hair and nail cortisol values, suggeting the potential to interchange these markers as needed.
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BACKGROUND: There has been a rapid expansion of digital health care services, making the need for measuring and improving digital health readiness a priority. In response, our study team developed the Mobile-Centered Digital Health Readiness: Health Literacy and Equity Scale (mDiHERS) to measure digital health readiness. OBJECTIVE: We aim to develop and validate a scale that assesses digital health readiness, encompassing literacy and equity, and to ensure the effective use of mobile-centered digital health services. METHODS: This study was conducted from October 2021 to October 2022 to develop and validate the mDiHERS. Participants included patients with inflammatory bowel disease, which is a chronic condition requiring continuous management, and experts in medical and nursing informatics. The scale development involved a literature review, focus group interviews, and content validity evaluations. A total of 440 patients with inflammatory bowel disease were recruited for the validation phase, with 403 completing the survey. The scale's validity and reliability were assessed through exploratory factor analysis and Cronbach α. The scale was translated into English by translators and bilingual and native researchers, ensuring its applicability in diverse settings. RESULTS: The mDiHERS consists of 36 items across 6 domains, with a 5-point Likert scale for responses. The validation process confirmed the scale's construct validity, with 4 factors explaining 65.05% of the total variance. The scale's reliability was established with Cronbach α values ranging from 0.84 to 0.91. The scale's development considered the technical proficiency necessary for engaging with health mobile apps and devices, reflecting the importance of subjective confidence and objective skills in digital health literacy. CONCLUSIONS: The mDiHERS is a validated tool for measuring patients' readiness and ability to use digital health services. The mDiHERS assesses user characteristics, digital accessibility, literacy, and equity to contribute to the effective use of digital health services and improve accessibility. The development and validation of the mDiHERS emphasize the importance of confidence and competence in managing health digitally. Continuous improvements are necessary to ensure that all patients can benefit from digital health care.
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Letramento em Saúde , Telemedicina , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários , Doenças Inflamatórias Intestinais/terapia , Psicometria , Aplicativos Móveis , Grupos Focais , Saúde DigitalRESUMO
OBJECTIVES: Hemoglobin (Hgb) is associated with cognitive function, with low and high levels of Hgb leading to impaired cerebral oxygenation and perfusion. Yet, current studies focused on understanding the association between Hgb and cognitive function without consideration for each cognitive domain. Thus, this study aims to identify and visualize potentially interactive associations between Hgb and specific cognitive domains among older adults. METHOD: This is a secondary data analysis using Wave II data from the National Social Life, Health, and Aging Project (NSHAP) and included 1022 older adults aged between 65 and 85 years. The network structure of three different models was estimated to understand the association between specific cognitive domains and Hgb in a mixed graphical model using the R-package 'mgm'. Model 1 did not adjust for any covariates, Model 2 adjusted for age and gender, and Model 3 adjusted for all covariates. RESULTS: Among all cognitive domains, the visuospatial (edge weight = 0.06-0.10) and memory domains (0.04-0.07) were associated with Hgb in all three models Though not present in Model 3, the attention domain was associated with Hgb in Model 1 and Model 2 (0.08-0.11). In addition, the predictability of Hgb was the highest (8.1%) in Model 3. CONCLUSION: Findings from this study suggest that cognition should be considered as a multidimensional construct, and its specific cognitive domain should be carefully assessed and managed in relation to Hgb among older adults.
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BACKGROUND: Nursing science is essential for generating a unique body of knowledge that is foundational to the academic discipline of nursing. PURPOSE: The goal of this analysis is to detail the education and licensing of faculty and leadership in research-intensive schools of nursing and to present the current data on the National Institute of Health (NIH) funding patterns in schools of nursing. METHODS: The faculty composition analysis focused on the 40 U.S. schools of nursing receiving the most NIH funding through faculty serving as PIs on grants awarded in 2023. For the NIH funding patterns analysis, data were extracted from the NIH RePORTER database. DISCUSSION: Of the top 30 NIH-funded Schools of Nursing, all the Deans and Associate Deans of Academic Affairs are educated or licensed as nurses; whereas only 55% of Associate Deans of Research are educated or licensed as nurses. In 2022, nearly half of the top-ranked schools of nursing had less than half of their NIH funding awarded to faculty who are trained and licensed as nurses CONLUSION: The current trends in the research enterprise in schools of nursing implore us to assess if we are adequately training nurses to advance nursing science and more importantly to serve as leaders of nursing science.
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Pesquisa Biomédica , Organização do Financiamento , Humanos , Estados Unidos , Docentes , Instituições Acadêmicas , Escolaridade , Fundações , National Institutes of Health (U.S.)RESUMO
PURPOSEOF REVIEW: Young people face the highest number of new HIV infections globally. With today's increasing access to smartphones, serious games have been viewed as an effective means of improving knowledge and behavioral outcomes. This systematic review describes current HIV prevention serious games and their relationship with HIV-related knowledge and behavioral outcomes. RECENT FINDINGS: A search of HIV prevention serious games was conducted using PubMed, CINAL, IEEE, Web of Science, and Google Scholar. A total of 31 papers were identified, which consist of 20 studies and 11 protocols. Results for knowledge, attitudes, intentions, and behaviors were mixed. Two interventions reported improvement in PrEP usage and optimal dosing. Gaming appears to be a viable and engaging method to improve knowledge, attitudes, and behavioral outcomes to promote HIV prevention among diverse groups of adolescents and young adults globally. However, additional research is needed to understand how to implement this modality effectively.
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Infecções por HIV , Jogos de Vídeo , Adolescente , Adulto Jovem , Humanos , Infecções por HIV/prevenção & controleRESUMO
Depressive symptoms can affect health outcomes in people living with HIV (PLWH) including adherence to treatment and disease prognosis. Self-management interventions targeting depressive symptoms have been effective in preventing these negative sequelae of depressive symptoms. The processes of self-management include learning skills related to living with the illness needs, accessing resources to manage the illness, and coping with the illness. A systematic literature review was conducted to appraise and synthesize the current evidence of self-management interventions targeting depressive symptoms in PLWH. Following the PRISMA guidelines, an electronic search of 4 databases was conducted. Original studies written in English that used a randomized controlled trial design to test the effect of self-management intervention on depressive symptoms were included. Studies were selected that were published on/before April 19, 2022, thus yielding 13 relevant articles. Risk of bias was assessed using the NIH Quality Assessment Tool for Controlled Intervention Studies and narrative synthesis was used to synthesize the results. 40 to 755 participants were included in the studies, with each using various measures to assess depressive symptoms pre-and post-intervention, and timepoints for assessing depressive symptoms post-intervention varied. While 12 studies showed a significant reduction in depressive symptoms post-intervention, only 4 studies that used individual coaching or technology showed lower depressive symptoms in intervention groups in comparison to the control groups. This review can be used to inform scale-up and dissemination of these interventions to improve depressive symptoms in PLWH.
RESUMEN: Los síntomas depresivos pueden afectar el estado de salud en personas que viven con el VIH (PLWH, por sus siglas en inglés), incluyendo la adherencia al tratamiento y el pronóstico de la enfermedad. Las intervenciones de autocuidado enfocadas a los síntomas depresivos han sido eficaces para prevenir estas secuelas negativas de los síntomas depresivos. Los procesos de autogestión incluyen habilidades de aprendizaje relacionadas con enfocarse a vivir con la enfermedad necesidades, acceder a recursos para manejar la enfermedad y afrontar a la enfermedad. Se realizó una revisión sistemática de la literatura para evaluar y sintetizar la evidencia actual de las intervenciones de autocuidado dirigidas a los síntomas depresivos en personas que viven con el VIH. Siguiendo las directrices PRISMA, se realizó una búsqueda electrónica en 4 bases de datos. Se incluyeron estudios originales escritos en inglés que utilizaron un diseño de ensayo controlado aleatorio para evaluar el efecto de la intervención de autocuidado sobre los síntomas depresivos. Se seleccionaron estudios que se publicaron el 19 de abril de 2022 o antes, obteniendo 13 artículos relevantes. El riesgo de sesgo se evaluó mediante la herramienta de evaluación de la calidad de los NIH para estudios de intervención controlados y se utilizó la síntesis narrativa para sintetizar los resultados. Se incluyeron de 40 a 755 participantes en los estudios. Los estudios utilizaron diversas medidas para evaluar los síntomas depresivos antes y después de la intervención, y los puntos temporales para evaluar los síntomas depresivos después de la intervención variaron. Mientras que 12 estudios mostraron una reducción significativa en los síntomas depresivos después de la intervención, solo 4 estudios que usaron entrenamiento individual o tecnología mostraron síntomas depresivos más bajos en los grupos de intervención en comparación con los grupos de control. Esta revisión se puede utilizar para informar la ampliación y difusión de estas intervenciones para mejorar los síntomas depresivos en las personas que viven con el VIH.
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Infecções por HIV , Autogestão , Humanos , Depressão/prevenção & controle , Infecções por HIV/complicações , Infecções por HIV/terapia , Adaptação Psicológica , Aprendizagem , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
The COVID-19 pandemic has disrupted sexual health services among those most vulnerable to HIV acquisition, such as adolescent men who have sex with men (AMSM). We sought to characterize the changes in sexual-risk behaviors, HIV and other STI testing, and pre-exposure prophylaxis (PrEP) use among a longitudinal cohort of AMSM aged 13 to 18 years before and during the COVID-19 pandemic. We observed a significant decline in HIV testing and a marginal decrease in other STI testing since the pandemic began in March 2020. Outreach efforts and innovative remote delivery of sexual health services are needed to support access to healthcare services among AMSM as the pandemic persists.
RESUMEN: La pandemia de COVID-19 ha afectado la prestación de servicios de salud sexual para los más vulnerables, tales como los hombres adolescentes que tienen relaciones sexuales con hombres (AMSM; por sus siglas en ingles). En una cohorte longitudinal de AMSM de 13 a 18 años, examinamos los cambios en comportamientos sexuales de alto riesgo, la prueba de VIH, las pruebas de otras enfermedades de transmisión sexual, y el uso de Profilaxis Preexposición (PrEP) para el VIH antes y durante la pandemia. Desde el inicio de la pandemia en marzo de 2020, observamos una disminución significativa en la frecuencia de pruebas de VIH y una disminución marginal en la frecuencia de pruebas de otras enfermedades de transmisión sexual. Mientras persista la pandemia, serán necesarios más esfuerzos de divulgación e innovaciones en la prestación remota de servicios de salud sexual para apoyar el acceso a dichos servicios por parte de AMSM.
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COVID-19 , Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Masculino , Humanos , Adolescente , Estados Unidos/epidemiologia , Homossexualidade Masculina , Pandemias/prevenção & controle , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , COVID-19/epidemiologia , COVID-19/prevenção & controle , Comportamento SexualRESUMO
Studies on HIV self-testing (HIV-ST) have been limited to adults (age 18+). The study assessed use of HIV-ST among a diverse group of young men who have sex with men (YMSM) in the United States (US) and assessed differences in uptake by demographic characteristics and requirements for parental consent. This study demonstrated feasibility of HIV-ST for YMSM as young as 14 years of age, which suggests potential for increasing HIV testing in this young age group and promoting health equity.
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Infecções por HIV , Minorias Sexuais e de Gênero , Masculino , Adulto , Humanos , Estados Unidos , Adolescente , Homossexualidade Masculina , Estudos de Viabilidade , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Teste de HIVRESUMO
BACKGROUND: Many studies have reported reduced brain white matter fractional anisotropy (FA) and increased mean diffusivity (MD) on diffusion tensor imaging (DTI) of people with HIV (PWH). Few, however, have linked individual blood inflammatory markers with white matter tract-specific FA and MD. METHODS: PWH 50 years old or older from New York, NY, USA, were invited to a cross-sectional study. Demographic data, blood samples, and brain DTI were obtained. Least absolute shrinkage and selection operator (LASSO) regression was used to examine associations between biomarkers and white matter tract-specific FA and MD. All models included age, sex, race, ethnicity, diabetes, hypertension, smoking, and viral load as control variables. RESULTS: Seventy-two cases were analyzed. Mean age was 60 ± 6 years, 47% were women, 21% were Hispanic, and 78% were black. All had asymptomatic HIV infection and were on antiretroviral therapy. Eighty-nine percent had CD4 count >200 cell/mm3 and 78% were virally suppressed. Vascular endothelial growth factor (VEGF) and macrophage inflammatory proteins (MIP) 1ß and 1α were consistently associated with lower FA and higher MD across white matter tracts. CONCLUSIONS: Elevated serum VEGF, MIP-1α, and MIP-1ß were associated with altered white matter microstructure. These blood biomarkers may help predict HIV-associated white matter damage.
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Infecções por HIV , Substância Branca , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Masculino , Substância Branca/diagnóstico por imagem , Fator A de Crescimento do Endotélio Vascular , Imagem de Tensor de Difusão/métodos , Infecções por HIV/complicações , Infecções por HIV/diagnóstico por imagem , Infecções por HIV/tratamento farmacológico , Estudos Transversais , Encéfalo/diagnóstico por imagem , Inflamação/diagnóstico por imagem , AnisotropiaRESUMO
BACKGROUND: Persons with HIV (PWH) can now achieve a near-normal life expectancy due to antiretroviral therapy (ART). Despite widespread availability of ART in the United States (US), many of the country's approximate 1.1 million PWH are not achieving viral suppression due to poor ART adherence. Viral suppression rates are particularly low in Alabama (AL, 62%) and New York City (NYC, 67%). There is mixed evidence on the efficacy of community health workers (CHW) and mHealth interventions for improving ART adherence and viral suppression in PWH thus, we sought to combine these interventions and test the efficacy for improving health outcomes in PWH. METHODS: The CHAMPS study is a two-arm randomized controlled trial among 300 PWH with suboptimal primary care appointment adherence (n = 150 in AL and 150 in NYC) over the course of 12 months. Participants are randomly assigned to CHAMPS (intervention) or a standard-of-care (control) arm. Participants in the intervention arm are given a CleverCap pill bottle that syncs to the WiseApp to track medication adherence, reminds users to take their medication at a set time, and enables communication with CHW. All participants complete baseline, 6-month, and 12-month follow-up visits where surveys are administered and, CD4 and HIV-1 viral load are obtained through blood draw. DISCUSSION: Maintaining ART adherence has significant implications in HIV management and transmission. mHealth technologies have been shown to optimize the provision of health services, produce positive changes in health behavior, and significantly improve health outcomes. CHW interventions also provide personal support to PWH. The combination of these strategies may provide the necessary intensity to increase ART adherence and clinic attendance among PWH at highest risk for low engagement. Delivering care remotely enables CHW to contact, assess, and support numerous participants throughout the day, reducing burden on CHW and potentially improving intervention durability for PWH. The adoption of the WiseApp coupled with community health worker sessions in the CHAMPS study has the potential to improve HIV health outcomes, and will add to the growing knowledge of mHealth and CHW efforts to improve PWH medication adherence and viral suppression. TRIAL REGISTRATION: This trial was registered with Clinicaltrials.gov (NCT04562649) on 9/24/20.
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Agentes Comunitários de Saúde , Aplicativos Móveis , Humanos , Adesão à Medicação , Alabama , Instituições de Assistência Ambulatorial , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
It is critical to understand health care engagement and utilization among older persons living with HIV (OPWH) who may have greater burden for non-communicable diseases. Following the PRISMA guidelines, a systematic review using 5 electronic databases was conducted to appraise and synthesize the current literature on the relationship of non-communicable diseases on engagement in care and health care utilization among OPWH. Original studies published in English between 2009 and 2019 were included, yielding 16 relevant articles. Overall, having co-morbid non-communicable diseases was associated with a decreased likelihood of initiating and adhering to ART. Being on ART and viral suppression were associated with better engagement in non-communicable disease care. Findings also suggest that an increasing number of co-morbidities is associated with higher health care utilization and financial burden. This review underscores the need for preventing and managing co-morbidities to enhance engagement in HIV care and that health care practitioners need to ensure that OPWH are engaged in care for both HIV and their co-morbid conditions by providing coordinated and integrated care.
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Infecções por HIV , Doenças não Transmissíveis , Idoso , Idoso de 80 Anos ou mais , Atenção à Saúde , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/terapia , Instalações de Saúde , Humanos , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/terapia , Aceitação pelo Paciente de Cuidados de SaúdeRESUMO
Infographics (visualizations that present information) can assist clinicians to offer health information to patients with low health literacy in an accessible format. In response, we developed an infographic intervention to enhance clinical, HIV-related communication. This study reports on its feasibility and acceptability at a clinical setting in the Dominican Republic. We conducted in-depth interviews with physicians who administered the intervention and patients who received it. We conducted audio-recorded interviews in Spanish using semi-structured interview guides. Recordings were professionally transcribed verbatim then analyzed using descriptive content analysis. Physician transcripts were deductively coded according to constructs of Bowen et al.'s feasibility framework and patient transcripts were inductively coded. Three physicians and 26 patients participated. Feasibility constructs endorsed by physicians indicated that infographics were easy to use, improved teaching, and could easily be incorporated into their workflow. Coding of patient transcripts identified four categories that indicated the intervention was acceptable and useful, offered feedback regarding effective clinical communication, and recommended improvements to infographics. Taken together, these data indicate our intervention was a feasible and acceptable way to provide clinical, HIV-related information and provide important recommendations for future visualization design as well as effective clinical communication with similar patient populations.
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Infecções por HIV , Médicos , Humanos , Comunicação , Estudos de ViabilidadeRESUMO
Little is known about how demographic, employment and meteorological factors impact physical activity. We conducted an analysis to explore these associations from participants (N = 447) from six cities in the United States and matched their activity data with abstracted local meteorological data from National Oceanic and Atmospheric Administration (NOAA) weather reports. Participants were purposively recruited in 3-month blocks, from December 2015 to October 2017, to reflect physical activity engagement across the seasons. We calculated total physical activity (minutes/week) based on 7-day physical activity recall. Mild correlations were observed between meteorological factors and correlated with lower physical activity. Participants were least active in autumn (Median = 220 min/week) and most active in spring (Median = 375 min/week). In addition to level of education and total hours of work, maximum temperature, relative humidity, heating degree day, precipitation and sunset time together explained 17.6% of variance in total physical activity. Programs assisting in employment for PLHIV and those that promote indoor physical activity during more strenuous seasons are needed. Additional research to better understand the selection, preferences, and impact of indoor environments on physical activity is warranted.
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Infecções por HIV , Cidades , Exercício Físico , Infecções por HIV/epidemiologia , Humanos , Estações do Ano , Tempo (Meteorologia)RESUMO
BACKGROUND: The training and mentoring of pre- and post-doctoral trainees in nursing research is essential to feed the pipeline of nurses prepared to launch an independent program of research. PURPOSE: The purpose of this report is to describe a one-on-one grant writing Partnership developed in a school of nursing targeting pre- and post-doctoral trainees and quantify its impact on funding rates. METHODS: The Partnership includes four key elements: regular meetings, setting a timeline with milestones, writing and editing support, and attention to administrative documents. Forty grant applications by pre- and post-doctoral trainees were developed and submitted from 2011 to 2020. FINDINGS: Among Partnership participants, 81.0% (17/21) received funding as compared with 42.1% (8/19) who did not participate, p = .02. DISCUSSION: Schools of nursing and other disciplines should consider investing in a Partnership to provide grant writing support their pre- and post-doctoral trainees and increase their overall research capacity.
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Educação de Pós-Graduação em Enfermagem , Tutoria , Pesquisa em Enfermagem , Humanos , Mentores , RedaçãoRESUMO
The purpose of this study was to evaluate the efficacy of the VIP-HANA application (app) for improving symptom burden in a randomized control trial of 100 people living with HIV (PLWH) who have non-AIDS conditions associated with HIV. The intervention group received the VIP-HANA app which allowed them to report their symptoms every week and receive self-management strategies tailored to their symptoms. The control arm received an app to report their symptoms every week but did not receive any strategies. The results of our study suggest that symptom burden improved in the participants of both study arms. Although these findings do not support the efficacy of VIP-HANA in improving symptom burden in PLWH who have HIV-associated non-AIDS (HANA) conditions, this could be a function of the study design. Findings suggest that PLWH are interested in monitoring their symptoms, which could have implications for the wider use of digital health for patient surveillance.
RESUMEN: El propósito de este estudio fue evaluar la eficacia de la aplicación VIP-HANA para mejorar la carga de síntomas en una prueba controlada aleatorizada de 100 personas que viven con VIH con condiciones no de SIDA asociadas al VIH. El grupo de intervención recibió la aplicación VIP-HANA que les permitió reportar sus síntomas cada semana y recibir estrategias de autogestión personalizadas. El brazo de control recibió una aplicación para reportar sus síntomas cada semana, pero no recibió ninguna estrategia. Los resultados de nuestro estudio sugieren que la carga general de los síntomas mejoro entre los participantes en ambos brazos del estudio. Aunque estos hallazgos no apoyan la eficacia de la aplicación VIP-HANA para mejorar la carga de síntomas en PVVS con condiciones de HANA, esto puede ser una función del diseño del estudio. Estos hallazgos sugieren que PVVS están interesados en monitorear sus síntomas, lo que puede tener implicaciones para el uso más amplio de salud digital para la vigilancia de pacientes.
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Infecções por HIV , Aplicativos Móveis , Autogestão , Telemedicina , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Projetos de PesquisaRESUMO
Long-acting injectable cabotegravir (CAB-LA) is in advanced stages of clinical trials. Under the standard protocol, CAB-LA is injected into the gluteal muscle by a healthcare provider every eight weeks. To explore transgender women's barriers and facilitators to tailored delivery strategies-including self-injection and injection in "drop-in" centers-we completed in-depth interviews with N = 15 transgender women in New York City. Participants endorsed the alternative delivery methods and the corresponding features we proposed, and expressed likes and dislikes about each. These fell into the following categories: competence (e.g., the person delivering CAB-LA must have skills to do so), convenience (e.g., CAB-LA must be easy to obtain), and privacy or fear of judgement (e.g., participants did not want to feel judged for using CAB-LA by providers or other service consumers). Findings suggest the need to offer CAB-LA to transgender women through multiple delivery protocols.
Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Pessoas Transgênero , Fármacos Anti-HIV/uso terapêutico , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Humanos , PiridonasRESUMO
We designed an infographic intervention to help clinicians provide health information to persons living with HIV. In this study, we assessed the extent to which our intervention may improve objectively and subjectively measured health outcomes (CD4 count, viral load, and engagement with clinician among others) when integrated into routine visits in the Dominican Republic. In this pretest-posttest study, we followed participants for 9 months at 3-month intervals. Physicians administered the intervention during participants' first 3 visits. Outcome measures, selected using a conceptual model, were assessed at 4 time points. We assessed changes in outcomes over time with general linear regressions and Wilcoxon Signed-Rank tests. Participants (N = 50) were mostly female (56%) and had been living with HIV for a mean of 6.3 years (SD = 6.1). All outcomes, except CD4 count, demonstrated statistically significant improvements by study end. This provides preliminary evidence our intervention may improve outcomes, but further testing is needed.
RESUMEN: Diseñamos una intervención infográfica para ayudar a los médicos brindar información médica a personas viviendo con el VIH. En este estudio, evaluamos en qué medida nuestra intervención puede mejorar los resultados de salud (conteo de CD4, carga viral, y compromiso con el médico entre otros), medidos de una manera objetiva y subjetiva, cuando se incorpora en las visitas médicas de rutina en la República Dominicana. En este estudio de prueba previo y posterior, seguimos los participantes durante 9 meses a intervalos de 3 meses. Los médicos administraron la intervención durante las primeras 3 visitas de los participantes. Seleccionamos las medidas de resultado utilizando un marco conceptual y las evaluamos en los 4 puntos de tiempo. Evaluamos cambios a lo largo del tiempo usando regresiones lineales generales y pruebas de asociación de Wilcoxon Signed-Rank. Los participantes (N = 50) fueron mayormente mujeres (56%) y habían estado viviendo con el VIH durante una media de 6,3 años (DE = 6,1). Todos los resultados, aparte del conteo de CD4, demostraron mejoras estadísticamente significativas al final del estudio. Esto proporciona evidencia preliminar de que nuestra intervención puede mejorar los resultados de la salud, pero se justifican pruebas adicionales.