Community-Academic Partnerships: Addressing Health Inequities Through Community-Engaged Service Learning.

In Chicago, Black men who have sex with men (MSM) and transgender and gender nonconforming (TGNC) individuals experience higher rates of HIV diagnoses. The Southside of Chicago has a thriving house ball culture powered by MSM and TGNC individuals who are disproportionately impacted by HIV. While this community has a history of facilitating health promotion at their events, gaps exist in community-empowered education specific to this community. Through partnership between nursing students from University of Illinois Chicago (UIC) and leaders from the Southside Health Advocacy Resource Partnership (SHARP) and the University of Chicago Center for HIV Elimination (CCHE), we aimed to reduce health disparities experienced by the Black MSM/TGNC community in Chicago. We promoted COVID-19 vaccinations and obtained funding for a community-led project to reduce HIV-related stigma. Our team consisted of two community leaders, seven students, and two professors. We met weekly during the development stages and detailed notes were maintained by students and updated with next steps. Four months of collaboration demonstrated how nursing coursework can facilitate community-academic partnership and yielded a COVID-19 viral vaccination promotion video, community administration of vaccines, and SHARP's procurement of funding to implement a project to reduce HIV-related stigma. Students learned the importance of community leaders' presence when bringing health care to communities. Community leaders learned to communicate population needs and best utilize students as a resource. Enriching nursing curriculum using an integrated service-learning format offers the opportunity for student development while simultaneously serving the community.

A Smartphone-Based Self-management Intervention for Individuals With Bipolar Disorder (LiveWell): Empirical and Theoretical Framework, Intervention Design, and Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Bipolar disorder is a severe mental illness with high morbidity and mortality rates. Even with pharmacological treatment, frequent recurrence of episodes, long episode durations, and persistent interepisode symptoms are common and disruptive. Combining psychotherapy with pharmacotherapy improves outcomes; however, many individuals with bipolar disorder do not receive psychotherapy. Mental health technologies can increase access to self-management strategies derived from empirically supported bipolar disorder psychotherapies while also enhancing treatment by delivering real-time assessments, personalized feedback, and provider alerts. In addition, mental health technologies provide a platform for self-report, app use, and behavioral data collection to advance understanding of the longitudinal course of bipolar disorder, which can then be used to support ongoing improvement of treatment. OBJECTIVE: A description of the theoretical and empirically supported framework, design, and protocol for a randomized controlled trial (RCT) of LiveWell, a smartphone-based self-management intervention for individuals with bipolar disorder, is provided to facilitate the ability to replicate, improve, implement, and disseminate effective interventions for bipolar disorder. The goal of the trial is to determine the effectiveness of LiveWell for reducing relapse risk and symptom burden as well as improving quality of life (QOL) while simultaneously clarifying behavioral targets involved in staying well and better characterizing the course of bipolar disorder and treatment response. METHODS: The study is a single-blind RCT (n=205; 2:3 ratio of usual care vs usual care plus LiveWell). The primary outcome is the time to relapse. Secondary outcomes are percentage time symptomatic, symptom severity, and QOL. Longitudinal changes in target behaviors proposed to mediate the primary and secondary outcomes will also be determined, and their relationships with the outcomes will be assessed. A database of clinical status, symptom severity, real-time self-report, behavioral sensor, app use, and personalized content will be created to better predict treatment response and relapse risk. RESULTS: Recruitment and screening began in March 2017 and ended in April 2019. Follow-up ended in April 2020. The results of this study are expected to be published in 2022. CONCLUSIONS: This study will examine whether LiveWell reduces relapse risk and symptom burden and improves QOL for individuals with bipolar disorder by increasing access to empirically supported self-management strategies. The role of selected target behaviors (medication adherence, sleep duration, routine, and management of signs and symptoms) in these outcomes will also be examined. Simultaneously, a database will be created to initiate the development of algorithms to personalize and improve treatment for bipolar disorder. In addition, we hope that this description of the theoretical and empirically supported framework, intervention design, and study protocol for the RCT of LiveWell will facilitate the ability to replicate, improve, implement, and disseminate effective interventions for bipolar and other mental health disorders. TRIAL REGISTRATION: ClinicalTrials.gov NCT03088462; https://www.clinicaltrials.gov/ct2/show/NCT03088462. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/30710.

Community-level factors and incidence of gun violence in the United States, 2014-2017.

RATIONALE AND OBJECTIVE: In the United States, gun violence claims thousands of lives each year and is a pressing public health issue. To gain a better understanding of this phenomenon, this study spatially analyzed county- and state-level predictors of yearly gun violence rates and gun-related casualty rates. METHODS: This study modeled hypothesized predictors of gun violence incidence and casualties across four years. Data sources included the Gun Violence Archive (gun violence data in the United States for 2014-2017), the U.S. Census Bureau (socioeconomic, demographic, geologic features), ICPSR (crime reports), the U.S. Geologic Survey (elevation data), and U.S. gun laws and ownership. Random forest analyses identified relevant additional interaction terms to include. RESULTS: The extent to which counties are urban was the most robust predictor of both gun violence incident and casualty rates. Similarly, places characterized by greater income disparity were also more likely to experience higher gun violence rates, especially when high income was paired with high poverty. CONCLUSIONS: Community- and state-level features are markedly associated with gun violence. Gun violence is higher in counties with both high median incomes and higher levels of poverty; poverty did not seem related to gun violence rates in counties with relatively low median incomes. Some of these findings may well be due to racial segregation and concentrated disadvantage, due to institutional racism, police-community relations, and related factors.

Same-Sex Marriage and the Assimilationist Dilemma: A Research Agenda on Marriage Equality and the Future of LGBTQ Activism, Politics, Communities, and Identities.

This special issue of the Journal of Homosexuality, examines the impact of the marriage equality movement and the resulting landmark U.S. Supreme Court decision, Obergefell v. Hodges (2015) that legalized same-sex marriage in the U.S., on lesbian, gay, bisexual, transgender, and queer (LGBTQ) activism, politics, communities, and identities. The articles in this issue examine the complicated ways in which the discourse used in same-sex marriage court cases is related to heteronormative discursive frames; the lived reality of married same-sex couples and the complex ways in which they think about marriage and heteronormativity; the ways that heteronormativity is racialized, which affects how African Americans perceive the impact of same-sex marriage on their lives; how same-sex marriage has influenced public opinion and the likelihood of anti-gay backlash; and the impact of same-sex marriage on family law. In this article, I draw on the empirical research from these articles to develop a theoretical framework that expands a multi-institutional (MIP) approach to understanding social movements and legal change. I build on and develop three conceptual tools: the assimilationist dilemma, discursive integration and cooptation, and truth regime. I conclude by laying out an agenda for future research on the impact of same-sex marriage on LGBTQ movements, politics, identities, and communities.

Gay officers in their midst: heterosexual police employees' anticipation of the consequences for coworkers who come out.

While fear among gay men and lesbians about being out in a masculinist environment is not surprising, this article examines what heterosexuals expect will happen when gay men and lesbians come out. We draw on a unique dataset from a police department in the southwest United States to examine the consequences anticipated by heterosexual police department employees if a gay or lesbian officer's sexual orientation became known in the workplace. We test four main sets of factors: individual-level demographic characteristics and religious background; homophobia; organizational tolerance for discrimination; and intergroup contact theory to explain how heterosexuals expect gay and lesbian coworkers to be treated. Using ordinary least squares regression, we find that characteristics of workplaces, measured by tolerance of discrimination, as well as contact with gay men and lesbians on the job are more significant predictors of anticipated outcomes than are individual-level traits and homophobic attitudes. We conclude by discussing the policy implications of our research.