General and health-related Internet use among an urban, community-based sample of HIV-positive women: implications for intervention development.

Internet-based HIV interventions are increasingly common, although little focus has been on HIV-positive women. To understand the feasibility of using the Internet to deliver behavioral interventions to HIV-positive women, we sought to describe patterns of Internet use for general and health-related purposes and to explore differences between Internet-using and non-using women. From February 2014 to April 2014, 103 women were recruited at six community-based organizations in the Bronx, NY that provide services to HIV-positive persons. Women completed a 30-minute interview and answered a brief survey of socio-demographic factors, risk behavior and clinical characteristics. We performed χ(2) and Kruskal-Wallis tests to compare Internet users and non-users. Sixty-one percent of participants were current Internet users, most of whom used a personal electronic device (e.g., cellphone/smartphone) to access the Internet. While higher proportions of Internet users were passively engaged (e.g., signed up to receive email updates [42.9%] or watched an online video [58.7%] for health-related purposes), smaller proportions (12.7-15.9%) were involved in more interactive activities such as posting comments, questions, or information about health-related issues in an online discussion or a blog. A majority of Internet non-users (60.0%) expressed interest in going online. Lack of computer or Internet access (37.5%) and Internet navigation skills (37.5%) were the primary reasons for non-use. Compared with non-users, Internet users were more likely to be younger, to have higher socioeconomic status, and to report low health-related social support. Despite having a lower proportion of Internet users in our study than the general population, Internet-using women in our study had relatively high levels of online engagement and went online for both general and health-related purposes. However, Internet-based interventions targeting HIV-positive women will likely need to include providing computer and/or Internet access as well as training participants in how to navigate the Internet.

Improving the Reach of the National Diabetes Prevention Program Within a Health Disparities Population: A Bronx New York Pilot Project Crossing Health- and Community-Based Sectors.

INTRODUCTION: Diabetes affects upward of 30% of South Bronx residents. The Centers for Disease Control and Prevention's National Diabetes Prevention Program (NDPP) reduces risk of progression to diabetes, yet implementation has been elusive within health disparities populations. METHODS: This community-based, collaborative project piloted the NDPP in the South Bronx and evaluated implementation challenges and enablers. The New York State training group prepared community peer lifestyle coaches recruited by a community organization. A professional society trained academic detailers from local faculty. An interview process evaluated community needs and public health officials' beliefs. A portal managed by the New York State training group collected demographic and biometric data from the community participants and facilitated online registration. Data from interviews and observations were coded systematically using a thematic analysis framework. RESULTS: We were successful at recruiting and training 14 lifestyle coaches and 7 academic detailers, as well as recruiting members of the health disparities population in the South Bronx into the program. Fifty-two individuals completed the first 6 months of the yearlong program, attending an average of 12.7 of 16 sessions. By week 16, weight loss averaged 7.4 lbs and many had doubled their minutes of physical activity. Local electronic referral and feedback systems were developed. DISCUSSION: Health professionals, their teams, public health centers, and communities can work together to prevent diabetes by enhancing the reach of the NDPP to health disparities populations. Peer education using lifestyle coaches can provide a trustworthy process for crossing the boundaries between health teams and community support groups.

Laser epilation is a safe and effective therapy for teenagers with pilonidal disease.

UNLABELLED: Pilonidal disease (PD) is a frustrating condition because of a recurrence rate as high as 30%. Hair insertion is the essential cause of the disease. Therefore, hair removal with shaving is a part of many postoperative regimens. These methods are resource intensive and adversely impact the life-style of both patient and family. Therefore, we investigated the use of laser epilation (LE) of the intergluteal hair in adolescents with PD as a method of permanent hair removal. METHODS: A retrospective review of all patients with PD who underwent LE from 2003 to 2006 at the National Naval Medical Center, Bethesda, Md, and Walter Reed Army Medical Center, Washington, DC, was performed. Laser epilation of the intergluteal hair was carried out with a 1064 nm Nd:YAG laser (Coolglide Vantage, Altus/Cutera, Brisbane, Calif) at a standard fluence (joule/square centimeter), pulse duration, and repetition rate based on skin phototype. The patients were observed for hair regrowth and recurrence. RESULTS: Twenty-eight teenagers (17 males, 11 females; mean age, 17.2 +/- 1.4 years) underwent LE. Eight patients presented with abscess and were managed by incision and drainage followed by excision and open wound management, 17 patients presented with a cyst or sinus and underwent excision and primary closure, and 3 patients with asymptomatic sinus were managed nonoperatively. Laser epilation was performed after complete wound healing or immediately in those patients with asymptomatic sinus disease. Laser epilation was well tolerated and without complication in all patients. Intergluteal hair was completely removed in all patients. Patients required an average of 5 +/- 2 LE therapy sessions for hair removal. All patients underwent at least 3 LE sessions (range, 3 to 7 sessions) at 4-week intervals. One female developed a recurrence. The mean follow-up for the group was 24.2 +/- 9.9 months. CONCLUSIONS: Laser epilation is a safe method to remove intergluteal hair in teenagers with PD. This technique is an effective adjunctive therapy for the treatment of PD that may reduce recurrence.