The impact of signposting and group support pathways on a community-based physical activity intervention grounded in motivational interviewing.

BACKGROUND: Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental well-being after a motivational interviewing (MI) community-based PA intervention and the impact of signposting (SP) and social action (SA) (i.e. weekly group support) pathways. METHODS: Participants (n = 2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental well-being data were collected at baseline (following an initial 30-min MI appointment), 12 weeks, 6 months and 12 months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models derived point estimates and 95% confidence intervals for outcomes at each time point and change scores. RESULTS: Participants increased PA and mental well-being at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12 weeks, but the SP pathway retained more participants at 6 and 12 months. CONCLUSIONS: Both pathways produced similar improvements in PA and mental well-being; however, the addition of a control would have provided further insight as to the effectiveness. Due to lower resources yet similar effects, the SP pathway could be incorporated to support PA in primary care settings.

What African-American women know, do, and feel about AIDS: a function of age and education.

Because African-American women tend to be studied as a homogeneous group, little data exist that report differences in what they know, feel, and do about AIDS. The purpose of this study was to compare African-American women across two age groups and four educational groups to discern if differences exist. African-American women who were 20 years of age or over were recruited in a variety of settings to obtain a heterogeneous sample. The sample totaled 281 women. Participation consisted of the completion of the AIDS Knowledge, Feelings, and Behavior Questionnaire. Multivariate analysis of variance revealed that educational level influenced their knowledge and attitudes about AIDS, whereas age influenced not knowledge but attitudes and sexual behavior. Based on race alone, African-American women should not be treated as homogeneous in what they know, do, and feel about AIDS.

The long-term effectiveness of an HIV prevention intervention for low-income African American women.

The effectiveness of an HIV prevention intervention for low-income African American women between the ages of 20 and 44 years was assessed. The hypothesis was that at 3, 6, and 9 months, treatment intervention women would have significantly greater increase from baseline on self-efficacy, condom use knowledge, protective sexual behavior, prevention community behavior, and perceived HIV vulnerability compared with the control intervention women. Using an interrupted time series design, one of two geographically distinct but demographically similar communities was randomly assigned to the treatment intervention. A total of 280 women participated. Hierarchical linear modeling revealed no differences at pretest for the treatment and control women. Compared with control women, treatment women significantly increased self-efficacy, protective sexual behavior, condom knowledge, and prevention community behavior. A slight decline in protective sexual behavior at 9 months may indicate that a linear pattern of change may not be appropriate to describe sexual behavioral change.

The impact of AIDS continuing education on psychiatric and non-psychiatric nurses' knowledge.

BACKGROUND: Because an increasing number of chronically mentally ill individuals are HIV-positive, continuing education must include AIDS content to ensure psychiatric nurses provide competent care. The Fundamentals of Mental Health and HIV/AIDS Program was tested to determine its effectiveness in augmenting the AIDS knowledge of mental health professionals. METHOD: Two hundred forty RNs attended the Fundamental of Mental Health and HIV/AIDS Program. They completed pretest and posttest measures. RESULTS: The program significantly increased AIDS knowledge. The increase in AIDS knowledge was more dramatic for psychiatric nurses than for non-psychiatric nurses. CONCLUSION: This study reinforces the need for AIDS continuing education.

African American men: the ideal AIDS program.

Because designing programs based on an understanding of the target population's perceptions, expectations, and experiences is not only beneficial but feasible, a convenience sample of 17 African American men who have sex with men attended one of four focus groups to identify the needs of AIDS clients and what constitutes an ideal AIDS program. These men articulated what they needed and expected from the health care system. These needs and expectations should be incorporated into program planning to promote a more productive relationship between provider and providee and, thus, more efficacious programs. Their needs are competent comprehensive health care, adequate funds, and emotional support to enhance inner strength to cope with dying and death, dependency, and uncertainty. The ideal AIDS program would be holistic, providing health care needs as well as financial, social, emotional, and familial needs by means of both traditional and alternative treatments.

AIDS: risk behaviors and situations as perceived by adolescents in Gaborone, Botswana.

While AIDS continues to escalate in Botswana, no systematic investigation has been done of the contextual (behavioral and situational) variables important to the tailoring of AIDS educational prevention program for adolescents. A cross-sectional descriptive study identified the specific behaviors and situations placing adolescents at risk for AIDS as perceived by a convenience sample of 48 adolescents. Adolescents attended gender-specific focus groups and completed a demographic questionnaire. Content analysis revealed that gender and age could categorize the adolescents' perceptions of contextual variables. For younger adolescents AIDS-related behaviors involved sex and intravenous drug use; for older adolescents AIDS-related behaviors involved multiple sexual partners and sexual relationships between older men and adolescent girls. Though a consensus existed regarding the situational variables, gender and age influenced the situation that was most challenging to these adolescents. The data support that AIDS educational prevention programs must be tailored to the adolescents' gender and age.

PIP: This cross-sectional descriptive study was conducted to identify specific behaviors and situations placing adolescents at risk for AIDS. Research participants consisted of a convenience sample of 48 adolescents (20 males and 28 females) from a junior secondary school in Gaborone, Botswana. These participants attended gender-specific focus groups and completed a demographic questionnaire. The data revealed that gender and age could categorize adolescents' perceptions of contextual variables impacting adolescents' acquisition of AIDS. For younger adolescents AIDS-related behavior involved sex and intravenous drug use, while for older adolescents it included multiple sexual partners and sexual relationships between older men and adolescent girls. Though a consensus existed concerning the situational variables, gender and age influenced the situation that was most challenging to these adolescents. This study implies the need for AIDS educational prevention programs tailored to adolescents' gender and age.

Homeless women's perceptions of their situation.

While a plethora of data describes homeless women's demographic characteristics and health status, a paucity of data exists on homeless women's perceptions of their housing situation. This exploratory-descriptive study of 70 shelter-residing women expands knowledge of homeless women. Content analysis of focus groups revealed that homelessness meant loss of autonomy-marginal control over their lives and uncertainly about their own and their children's future. Loss of autonomy was manifested as mental strain: feeling depressed, worried, and scared. They were especially concerned about the impact of shelter-living on their children. Shelter-living was not viewed as child-friendly.

Empowerment: a view of two low-income African-Americans communities.

Field theory and empowerment were used as guiding conceptual frameworks to address empowerment issues in two low-income inner city African-Americans communities. Field theory and empowerment provided a conceptualization of these communities in terms of the possible impact of the physical environment of these communities on their residents and the health care professionals who worked with these residents. The most likely response is learned helplessness and depression that are antithetical to empowerment. These frameworks also were helpful in generating strategies to foster empowerment among these community residents. These strategies include helping residents to redefine their behavior as ways of coping with a hostile environment that confronts them with poverty and racism and to reconnect with natural supports in the community for the purpose of enhancing community coalitions and alliances.

Raising children in America: Korean parents' experiences.

This qualitative description study was designed to describe Korean American parents' perceptions of challenges and difficulties they encounter while raising their children in the USA. A convenience sampling of 21 parents of adolescents aged 11-14 years recruited from the Midwest Korean American community participated in the study. Data were collected using in-depth, face-to-face interviews, which took place in agreed-upon, convenient locations. All interviews were audiotaped and transcribed in Korean and the transcripts were translated into English. Qualitative content analysis revealed that the main stresses that parents encountered while raising their children in the USA were inability to advocate for children, feeling uneasy and insecure about incompatible American culture, ambivalence towards children's ethnic identities, and feeling alienated. In relation to these stresses, parents often felt inadequate, ashamed, guilty, regretful and powerless. The findings demonstrated the importance of understanding parents' feelings that are deeply embedded in the conflicted parent-child relationships and their perceptions of being parents in the USA. The present study highlights the need for and importance of providing intervention programmes for parents, particularly programmes that would empower parents, strengthen parent-child relationships and address ways to integrate two very different cultures while upholding ethnic identity and pride.

HIV risk behaviours and situations as perceived by Thai adolescent daughters and their mothers in Bangkok, Thailand.

The proportion of Thai women infected with HIV is rising. More than 60% of the estimated 70,000 young adults from ages 15 to 24 years who are infected with HIV are females. Furthermore, the ratio of adolescent females aged 15 to 19 years who are infected with HIV is twice that of adolescent males in the same age group (Thai Ministry of Public Health, 2005). A cross-sectional descriptive study identified the specific behaviours and situations placing Thai adolescent females at risk from HIV as perceived by Thai adolescent females aged between 12 and 14 years from public middle schools in Bangkok, Thailand and their mothers. Data were obtained from a demographic questionnaire and four different focus groups (n=40); two focus groups with Thai adolescents (n=20) and two focus groups with their mothers (n=20). Content analysis suggested that the behaviours considered most likely to result in HIV infection of Thai adolescent females were having sex without protection and drug use, and the most likely situations placing them at HIV risk were pubs/bars and boyfriends' or friends' houses when there is no parental or adult supervision. The mothers and daughters reported that HIV/AIDS-prevention programmes should provide education about the causes and dangers of sexually transmitted infections, including HIV/AIDS and prevention strategies. These data laid the foundation for the development of a culturally relevant HIV risk-reduction programme for Thai adolescent females.

HIV risk reduction strategies for low-income African American women.

Intervention strategies from the Health Education Reaching Out into the Community project that can be used in the clinical setting to assist low-income African American women adopt sexual behavior that is low risk for human immunodeficiency virus are discussed. These strategies include allocation of adequate time, the nurse practitioner's acceptance of the client, the use of adult learning principles, and active client participation through discussion, return demonstration, role play, and promotion of the client's ownership of the information learned.

The stigma of being named "AIDS carriers" on Haitian-American women.

AIDS-related stigma has impacted the lives of many individuals, including Haitians. Little, however, is known about the long-term effects AIDS-stigmatization has had on Haitian women living in the United States. A pilot study was conducted to explore Haitian-American women's perceptions of the impact of the AIDS epidemic on their lives. The long-term effects of AIDS-stigmatization fell into five categories: rejection by the dominant society, self-doubt, effect on self-esteem, effect on intimate relationships, and rejection by Haitians within their community. More extensive research is needed to explore the long-term effects of the AIDS epidemic on Haitian women. Additionally, to counter the negative effects of the AIDS epidemic, intervention strategies need to be developed and tested.

Relationship between coping strategies and depression among employed Korean immigrant wives.

Coping strategies, such as working harder and negotiation, may have an effect on depression for employed Korean immigrant wives. Additionally, income and education have been associated with depression in previous research. A cross-sectional survey research design was used to explore which coping strategies and demographic variables were significantly related to depression for employed Korean immigrant wives. The results of multiple regression analysis revealed that coping strategies and demographic variables accounted for 24% of the variance in depression. Specifically, as wives worked harder cleaning the house, their depression increased, whereas when they negotiated with their husbands, they were less likely to be depressed. To enhance negotiation among Korean wives, mental health nurses need to work within the community to foster the development of cultural and traditional norms that sanction negotiation between husbands and wives.