Novel Use of Video Logs to Deliver Educational Interventions to Black Women for Disease Prevention.

INTRODUCTION: Cisgender Black women comprise 67% of new human immunodeficiency virus (HIV) diagnoses among women in the South and are 11 times more likely to become HIV positive than White women in Texas. Optimal progress toward ending the HIV epidemic requires strategies that will interrupt transmission pathways in hotspot locations like Harris County, TX. Researchers are calling for public health interventions that can prevent HIV and sexually transmitted infections (STI) transmission; thus, we launched the first video log (vlog)-based, pilot HIV prevention intervention. METHODS: In a prospective. randomized controlled trial of two educational intervention strategies delivered as vlogs eligible participants were randomized to either 1) an interactive gaming, education-based strategy, or 2) a storytelling, education-based strategy. Eligible participants were cisgender Black women being seen in the emergency department (ED) for a non-emergent condition who reported recent condomless heterosexual sex, were ages 18-45, and had social media access. Enrolled women completed a screening assessment, informed consent, randomization, and 10-item pre-and-post assessments with true/false statements before and after viewing a brief vlog on a tablet device to identify changes in knowledge before and after being educated on HIV/STI transmission. RESULTS: Twenty-six women were randomized to the Taboo group, an interactive gaming, education-based strategy, (14 [53.8%]), or to storytelling, an education-based strategy using non-fictional and fictional case scenarios (12 [46.2%]). Taboo participants self-identified as African-American (12 [85.7%]), Black (1 [7.1%]) or "other" (1 [7.1%]), were younger (28.6% were ≥ 30 years), single (57.1%), reported a previous STI (8 [57.1%]), and were likely employed (57.2%). Storytelling participants self-identified as African-American (7 [58.3%]) or Black (5 [41.7%]), were older (49.9% were ≥ 30 years), in a relationship but not married (50%), and half were unemployed. Highest level of education and monthly income varied. The storytelling strategy increased knowledge in two areas and the Taboo strategy increased knowledge in one. No intervention effect was identified in three areas, and a significant decrease in knowledge (P < .0001) was discerned in eight areas for Taboo and six areas for storytelling. CONCLUSION: Further research is necessary to confirm whether delivery of HIV prevention interventions with vlogs is a useful approach for HIV-vulnerable populations. Findings suggest that vlogs are a feasible approach to brief behavioral interventions during an ED visit.

Study protocol for the Innovative Support for Patients with SARS-COV-2 Infections Registry (INSPIRE): A longitudinal study of the medium and long-term sequelae of SARS-CoV-2 infection.

BACKGROUND: Reports on medium and long-term sequelae of SARS-CoV-2 infections largely lack quantification of incidence and relative risk. We describe the rationale and methods of the Innovative Support for Patients with SARS-CoV-2 Registry (INSPIRE) that combines patient-reported outcomes with data from digital health records to understand predictors and impacts of SARS-CoV-2 infection. METHODS: INSPIRE is a prospective, multicenter, longitudinal study of individuals with symptoms of SARS-CoV-2 infection in eight regions across the US. Adults are eligible for enrollment if they are fluent in English or Spanish, reported symptoms suggestive of acute SARS-CoV-2 infection, and if they are within 42 days of having a SARS-CoV-2 viral test (i.e., nucleic acid amplification test or antigen test), regardless of test results. Recruitment occurs in-person, by phone or email, and through online advertisement. A secure online platform is used to facilitate the collation of consent-related materials, digital health records, and responses to self-administered surveys. Participants are followed for up to 18 months, with patient-reported outcomes collected every three months via survey and linked to concurrent digital health data; follow-up includes no in-person involvement. Our planned enrollment is 4,800 participants, including 2,400 SARS-CoV-2 positive and 2,400 SARS-CoV-2 negative participants (as a concurrent comparison group). These data will allow assessment of longitudinal outcomes from SARS-CoV-2 infection and comparison of the relative risk of outcomes in individuals with and without infection. Patient-reported outcomes include self-reported health function and status, as well as clinical outcomes including health system encounters and new diagnoses. RESULTS: Participating sites obtained institutional review board approval. Enrollment and follow-up are ongoing. CONCLUSIONS: This study will characterize medium and long-term sequelae of SARS-CoV-2 infection among a diverse population, predictors of sequelae, and their relative risk compared to persons with similar symptomatology but without SARS-CoV-2 infection. These data may inform clinical interventions for individuals with sequelae of SARS-CoV-2 infection.

Emergency medicine physician attitudes toward HPV vaccine uptake in an emergency department setting.

A physician's recommendation is the most effective published method of motivating HPV vaccination initiation. The emergency department (ED) is the 'public health safety net', and often the only access to care for underserved populations. Recommendation of the HPV vaccine in the ED is a potential avenue to improve vaccination rates among sub-populations who do not have access to routine medical care. We assessed willingness of EM physicians to recommend the vaccine, target high-risk women, and disclose perceived barriers to vaccination in the ED. A cross sectional study using an 11-item survey, was used to assess physician attitudes toward recommending the HPV vaccine in an ED setting to age eligible patients. 67.4% stated they would recommend the vaccine, 23.9% were neutral, and 8.7% would not recommend the vaccine to age eligible patients in the ED. 41% noted lack of adequate reimbursement for vaccination as a barrier to vaccination in the ED (P<0.05). Physicians were comfortable targeting women at high risk for cervical cancer for vaccination (P<0.05). EM physicians are comfortable targeting high-risk women for HPV vaccination in an ED setting. Support of EM physicians in the national effort to improve HPV vaccine uptake is an important step in eradicating a largely preventable yet lethal cancer.

The social norms and beliefs of teenage male electronic cigarette use.

Electronic cigarettes (e-cigarettes) are novel, battery-operated inhalation devices that provide warm, vaporized nicotine, and often propylene glycol, to users without the inclusion of tobacco smoke. Because men, in general, are more likely to use cigarettes and illicit drugs than women, a qualitative study was undertaken to investigate the beliefs and perceived social norms regarding this issue among 47 teenage boys who self-identified themselves as current e-cigarette smokers. The majority of respondents reported that they used e-cigarettes because of expeditious consumption and concealment. Furthermore, the most common places respondents self-reported using e-cigarettes were everywhere, in school bathrooms, at home, and in school staircases. Interestingly, respondents stated that e-cigarettes are popular because they are accessible, healthier than tobacco cigarettes, and more aesthetically pleasing. Because of the growing popularity and uncertainty regarding the social and physical consequences of e-cigarettes, this study shows a need for additional research discovery.