"I'll Just Pick It Up ": Women's Acceptability of Self-Sampling Methods for Sexually Transmitted Infection Screening.

BACKGROUND: Rates of sexually transmitted infection (STI) screening are suboptimal among college women. Self-sampling methods (SSMs) may improve STI screening rates, but critical gaps remain regarding the influential characteristics of SSM to prioritize in intervention development. The purpose of this study was to explore intervention characteristics influencing the decision to adopt SSM among college women. METHODS: In-depth interviews (n = 24) were conducted with sexually active college women aged 18-24 years to explore preferred intervention characteristics of SSM. Interviews were stratified by screening status (screened or not screened). The instrument was guided by constructs from the Diffusion of Innovation theory and included characteristics of SSM, such as relative advantage, compatibility, complexity, adaptability, and risk and uncertainty. RESULTS: Overall, women felt that the SSM was not complex and that the instructions were straightforward. Participants discussed their strong preference for receiving their results via text or e-mail rather than via telephone. In addition, women described their concerns about mailing their sample and described their concern about potential contamination and tampering. The most salient advantage to use of SSM was avoiding an interaction with a health care provider. CONCLUSIONS: This study contributes to an understanding of the salient intervention characteristics influencing the use of SSM for STI screening, which can be leveraged to improve the health of students and improve rates of screening. Findings can be used to inform the development of a future innovative, theory-based intervention that promotes the use of SSM to improve STI screening rates, and ultimately decrease the burden of STI-related disease.

Exploring college students' sexual and reproductive health literacy.

Objective: To assess college students' sexual and reproductive health (SRH) literacy experiences, specific to contraception use and STI prevention. Participants: In Spring 2015, participants (n = 43) from a large institution participated in six focus groups (two male and four females groups). Methods: Focus groups were guided by the health literacy domains (access; understand; appraise; apply); data were analyzed in MaxQDA using the constant comparative method. Results: The Internet was the most commonly accessed source for SRH information. Participants discussed facilitators (eg, use of visuals) and barriers (eg, medical jargon) to understanding information; and personal lifestyle, advice from family/friends, symptoms, and sexual partners as appraisal factors. Participants applied information by communicating with friends/providers and seeking healthcare. However, findings were not linear nor mutually exclusive, representing the interaction of health literacy skills. Conclusion: Findings suggest that a patient-centered intervention capitalizing on technology and trusted individuals (providers/peer educators) may facilitate college students' SRH literacy.

HPV knowledge among HPV+ women.

OBJECTIVE: To assess knowledge and information seeking among women recently receiving an HPV+ diagnosis. METHODS: A 2-phase mixed methods design was used. In both phase I (qualitative) and phase II (quantitative), women with scheduled gynecological exams and Pap smears at clinic sites were approached to participate. RESULTS: Women expressed confusion about HPV, and most could not correctly articulate the meaning of their diagnosis. Women do engage in further information seeking, especially through the Internet. CONCLUSION: Identifying gaps in knowledge among HPV+ women who need clear messages to facilitate their comprehension of the diagnosis is an important public health activity.

The psychosocial burden of HPV: a mixed-method study of knowledge, attitudes and behaviors among HPV+ women.

Despite an increased awareness and 'normalization' of Human Papillomavirus (HPV) following the release of the HPV vaccine, the psychosocial impact of an HPV infection, the most common sexually transmissible infection (STI), must not be overshadowed. This study employed in-depth interviews (N = 52) and quantitative surveys (N = 154) to assess the knowledge, emotional impact and behavioral consequences of an HPV-related diagnosis in women who had received abnormal Pap test results. Findings revealed confusion over test results and themes related to stigma, fear, self-blame, powerlessness and anger emerged. The promotion of the HPV vaccine should not obfuscate the psychosocial burden associated with an HPV diagnosis.

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program.

BACKGROUND AND OBJECTIVES: Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. METHODS: The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. RESULTS: This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. CONCLUSION: Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.

Teen parents and academic success.

The purpose of this study was to explore the personal life stories of women who became mothers while still in their teen years. The focus was on themes that evolved as important in the lives of these women, including family support, partner support, mentor support, economic opportunity, resiliency, optimism, and spirituality. Each of the 22 women in the study offered her formulas for success that are useful for consideration by school nurses. Factors the women perceived to contribute to their success in achieving a master's or doctoral degree are explored. This study helps to identify the support and community efforts necessary to improve the outcome for teen mothers today. Their unique stories are exemplars of resiliency and achievement.

The shifting sands for applicants to maternal and child health training programs.

OBJECTIVE: Anecdotal evidence suggests that fewer students today than in decades past are applying to maternal and child health (MCH) graduate training programs with previous clinical degrees. The purpose of this study was to determine the extent to which applicants accepted to an MCH training program demonstrated a shift away from the tradition of having a prior health professional degree and discuss options needed to provide responsive training. METHODS: Twenty years of demographic face sheet data (1983 through 2002) for admitted applicants to the MCH training program at the University of South Florida College of Public Health were examined. RESULTS: Quantitative analysis of admission records confirmed the anecdotal data. Today's applicants are more likely to possess undergraduate nonclinical backgrounds rather than clinical health professional training. Statistically significant differences were found between the students with clinical and without clinical degrees for ethnicity, GRE score, GPA, and the length of time needed to complete the MPH degree. CONCLUSION: Adjustments in MCH curricula may be necessary to be responsive to the "shifting sands" of clinical and public health work experience among program applicants. However, curriculum modifications need to be ones that maintain the zeal of the new generation of MCH students without diluting the rigor of traditional professional preparation. Some possible responses of training programs are suggested.