Validating the Communicating Care Needs Tool for HIV (CCNT-HIV).

Health literacy has been identified as an influential factor affecting the HIV care continuum and HIV epidemic, but recent systematic reviews found mixed relationships between health literacy and HIV medication adherence. This may be partially due to discrepancies between health literacy conceptualizations, health literacy measures, and the lifeworld, day-to-day challenges that persons with HIV (PWH) face as they seek and receive care. To address these challenges, a new health literacy tool, Communicating Care Needs Tool for HIV (CCNT-HIV), was developed. With survey responses from 118 PWH, the current study compares CCNT-HIV with the Brief Health Literacy Screening Tool (BRIEF) and the All Aspects of Health Literacy Scale (AAHLS) by conducting a principal component analysis. Six principal components were identified for CCNT-HIV; one principal component was identified for BRIEF; and three principal components were identified for AAHLS. With a correlation analysis, relevance among principal components across the three tools validated CCNT-HIV. This study extended the scope of health literacy measures by emphasizing the relational, multi-variable, collaborative impacts stakeholders make on patients' health management. Practical implications for how health literacy tools, like the CCNT-HIV, can be used to directly benefit patients and their health management are also discussed.

A student-driven HIV/PrEP communication intervention using a modified social network strategy.

OBJECTIVE: The authors examined college students' experiences of providing peer-education, using the modified Social Network Strategy (SNS). PARTICIPANTS: Ninety-six college students participated this project during the 2018 academic year, drawn from a large, Mid-Southern urban university. METHODS: Students who administered the HIV-PrEP health intervention completed a cross-sectional assessment about their experiences in the project. A series of open-ended prompts garnered written narrative responses. We utilized a qualitative content analysis to identify SNS codes and their frequencies. RESULTS: Student responses were overwhelmingly supportive of the community engagement project. Student narratives featured the health communication intervention with peers most often (44.4%: counseling, testing, and referral communication), followed by influences on themselves (28.7%; what he/she learned, influences on student health and choices). CONCLUSIONS: A modified SNS demonstrated in this project reveals its utility in supporting undergraduates in the delivery of HIV/PrEP training in the 7th highest HIV transmission area in the nation.

Promoting Transformative Community Change for Equitable Health: Peer Education and Intervention for Pre-Exposure HIV Prophylaxis.

Many new HIV infections occur through individuals who are unaware of their HIV status. HIV disparities are more prevalent among underserved populations, and the number of new cases in the U.S. is highest in the Southern region. Using the Social Network Intervention, 63 undergraduate students delivered a face-to-face, communication-centered, peer education to 333 peers in the underserved communities; of those, 220 verified cases were analyzed. A baseline assessment was followed by the intervention and the second assessment, with the third assessment 2 weeks later. Assessments measured intervention impacts on health information sharing, knowledge about HIV/AIDS, and the dimensions of vested interest theory. The peer education was effective in making changes in participants' vestedness, knowledge regarding HIV/AIDS, and trust and expectation toward informational sources. Communication and tailored messages through established relationship channels were proven crucial for promoting positive behaviors about HIV sexual health, with strong evidence of change in stigma and the culture of silence.

Health Literacy and Health Communication Training for Underserved Patients and Informal Family Caregivers.

Communication training effectiveness for health care providers has been well documented, however patient and caregiver training may present a prime opportunity to mitigate communication challenges that provider-only training cannot. The aim of this study is to describe the multi-step process of adapting a national, provider, health communication training program (COMFORT) for use with underserved patients and caregivers who (1) are not regular consumers within health care systems and/or (2) do not have ready access to providers. We examine three iterations of training feedback for implementation in future training.

Providing Support for Caregiver Communication Burden: Assessing the Plain Language Planner Resource As a Nursing Intervention.

OBJECTIVE: To elicit informal caregiver feedback about an mHealth resource and it's potential as a nurse-delivered intervention for caregiver communication support. DATA SOURCES: Four focus groups with current oncology caregivers that involved caregiver use of the resource and response to a video demonstrating the resource as a nursing intervention. A brief assessment of the resource was collected for triangulation of data. CONCLUSION: Caregivers rated the resource as overwhelmingly positive and reported that use of the resource gave an increased sense of preparedness. Caregivers shared ideas for future expansion of the resource, highlighted the need for user-responsive design, and described the need for a caregiver-centered tool. IMPLICATIONS FOR NURSING PRACTICE: Communicating complex terminology relating to treatment, side effects, and symptoms requires resources to meet health literacy needs. A nursing protocol for using the resource is provided based on feedback collected from caregivers.

Conceptualizing the Pathways and Processes Between Language Barriers and Health Disparities: Review, Synthesis, and Extension.

While many may view language barriers in healthcare settings (LBHS) as a simple, practical problem, they present unique challenges to theoretical development and practice implications in healthcare delivery, especially when one considers the implications and impacts of specific contextual factors. By exploring the differences of contextual factors in the US and Japan, this review explores and highlights how such differences may entail different impacts on patients' quality of care and require different solutions. I conduct narrative review through library database, Google Scholar, and CiNii (a Japanese library database) with multiple search terms, including language barriers, healthcare, medical interpreter, and immigrant. I first present a diagram to show the pathways and process between language barriers and health disparities, using the literature reported in the US. Then, I examined the literature reported in Japan and discuss the needs for re-conceptualizing LBHS. The implications for future research will be discussed.

"Not Homeless Yet. I'm Kind of Couch Surfing": Finding Identities for People at a Homeless Shelter.

The meanings of homelessness are fluid and socially constructed, providing resources and limitations for individuals to negotiate their identities and relationships in everyday life. In this study, we examine the strategies and corresponding resources utilized by people who are homeless to cope with the labeling of a homeless identity and to redefine their identities. We used constant comparative analysis to examine in-depth interviews with 16 participants (male = 11, female = 5) who access a local homeless shelter in the southwest United States for resources. We identified three strategies that homeless people adopt to cope with the labeling of homeless identity: (a) differentiating oneself from others who are homeless, (b) prioritizing certain aspects of life, and (c) embracing the status of homelessness. Although these strategies have been identified in previous literature, the authors extend this line of research by identifying the common resources people who are homeless utilize when adopting these strategies, which entail important implications for theory development and practical implications.