Condom Use among Young African American Men: Implications for Planning Interventions

Condom Use among Young African American Men: Implications for Planning Interventions Sexually transmitted diseases, including HIV, continue to present significant public health problems affecting young people in the United States, especially African Americans. While African Americans make up about 12% of the U.S. population, in 2010 they accounted for 44% of new HIV infections in 2010 and 48% of all persons living with AIDS in 2007. The 2010 data shows that of these new cases, 38% occurred among African American males ages 13-24 years old. Correct condom use remains a challenge in this population and efforts to increase condom use among minority males has been a formidable challenge. This paper reports the results of formative research conducted in order to guide the development of an intervention to increase consistent, effective condom use for young African American males. Methods: A snowball sampling approach was used to recruit participants. African American males, ages 18-24, who self-reported as sexually active were eligible to participate in one of four focus groups or one of six individual interviews. All study events were conducted at community locations. Each event was audiotaped and notes were taken. Analysis was performed using using NVivo-9. The coding strategy included emic and etic codes and a coding tree was developed which was used to identify themes. Results: A total of 36 African American males between the ages of 18-24 (mean 20.7 years) took part. In general, participants felt condom use was highly influenced by contextual factors including partner interest, partner communication, length of relationship and trust. Condom use was also influenced by a sense of invincibility and being caught up in the moment. Notably, most sexual activity occurred outside of a relationship, most often within the party scene or as quickly arranged hook-ups. Analysis: In order to ensure maximum impact on the development of the intervention, the results from this formative phase were viewed through the Transtheoretical Model of Behavior Change (TTM) and most participants would be described as being in the pre-contemplation or contemplation stages of behavioral change. While all participants expressed some understanding of the risks of unprotected sex, many did not connect risks to consequences. While the data did not indicate that condom use behavior was likely to change in the short-term (less than 6 months), several participants were contemplating making a change. Discussion: The snowball sampling approach allowed us to understand the participants’ social network and allowed us to consider social influences as well as about individual attitudes and beliefs. In the TTM frame, interventions designed for this population need to include contemplators and pre-contemplators and should focus on modification of cognition, affect and behaviors. Our research also shows that several of the underlying assumptions of TTM are at odds with the framework within which sex often occurs for this population and condom use decisions are highly influenced by the social context. In light of the results, the intervention placed condom use into a health promotion context. It combines group activities and one-on-one interaction. Group activities can impact shared values and beliefs and, thus, the intervention builds social support for behavior changes while addressing individual capacity

Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings.

BackgroundThis study examines sustainment of an EBI implemented in 11 United States service systems across two states, and delivered in 87 counties. The aims are to 1) determine the impact of state and county policies and contracting on EBI provision and sustainment; 2) investigate the role of public, private, and academic relationships and collaboration in long-term EBI sustainment; 3) assess organizational and provider factors that affect EBI reach/penetration, fidelity, and organizational sustainment climate; and 4) integrate findings through a collaborative process involving the investigative team, consultants, and system and community-based organization (CBO) stakeholders in order to further develop and refine a conceptual model of sustainment to guide future research and provide a resource for service systems to prepare for sustainment as the ultimate goal of the implementation process.MethodsA mixed-method prospective and retrospective design will be used. Semi-structured individual and group interviews will be used to collect information regarding influences on EBI sustainment including policies, attitudes, and practices; organizational factors and external policies affecting model implementation; involvement of or collaboration with other stakeholders; and outer- and inner-contextual supports that facilitate ongoing EBI sustainment. Document review (e.g., legislation, executive orders, regulations, monitoring data, annual reports, agendas and meeting minutes) will be used to examine the roles of state, county, and local policies in EBI sustainment. Quantitative measures will be collected via administrative data and web surveys to assess EBI reach/penetration, staff turnover, EBI model fidelity, organizational culture and climate, work attitudes, implementation leadership, sustainment climate, attitudes toward EBIs, program sustainment, and level of institutionalization. Hierarchical linear modeling will be used for quantitative analyses. Qualitative analyses will be tailored to each of the qualitative methods (e.g., document review, interviews). Qualitative and quantitative approaches will be integrated through an inclusive process that values stakeholder perspectives.DiscussionThe study of sustainment is critical to capitalizing on and benefiting from the time and fiscal investments in EBI implementation. Sustainment is also critical to realizing broad public health impact of EBI implementation. The present study takes a comprehensive mixed-method approach to understanding sustainment and refining a conceptual model of sustainment

The Faculty Notebook, September 2011

The Faculty Notebook is published periodically by the Office of the Provost at Gettysburg College to bring to the attention of the campus community accomplishments and activities of academic interest. Faculty are encouraged to submit materials for consideration for publication to the Associate Provost for Faculty Development. Copies of this publication are available at the Office of the Provost

FOOD ASSISTANCE AND NUTRITION RESEARCH SMALL GRANTS PROGRAM: EXECUTIVE SUMMARIES OF 2001 RESEARCH GRANTS

This report summarizes research findings from the Food Assistance and Nutrition Research Small Grants Program. The Economic Research Service created the program in 1998 to stimulate new and innovative research on food assistance and nutrition issues and to broaden the participation of social science scholars in these issues. The report includes summaries of the research projects that were awarded 1-year grants in summer and fall 2000. The results of these research projects were presented at the 2001 Small Grants Program conference. The projects focus on food insecurity and hunger, nutritional outcomes, and the causes and consequences of food assistance program participation. Some projects focus on specific populations,such as people living in the rural South and on American Indian reservations.Food assistance, nutrition, vulnerable populations, food security, food insecurity, hunger, hungry, food assistance, food spending, well-being, Food Stamp Program, food stamps, National School Lunch Program, WIC, Food Assistance and Nutrition Research Program, Food Security and Poverty,

Pay for Success: The First Generation - A Comparative Analysis of the First 10 Pay for Success Projects in the United States

Nonprofit Finance Fund (NFF) has released a comprehensive free report on the first 10 Pay for Success (PFS) projects that have launched in the United States. This report details how and why communities have applied this new approach to address critical social issues including early childhood education, homelessness, and criminal justice and recidivism. Pay for Success is an approach to contracting that ties payment for service delivery to the achievement of measurable outcomes. In the U.S., all of the current PFS projects have been accompanied by a form of social innovation financing, often referred to as a Social Impact Bond, in which investors provide upfront financing for the delivery of services and are repaid only if the services achieve a pre-agreed upon set of positive outcomes. The report includes a series of comparative graphics and observations on the market's development to-date. It examines project goals and project design; the partners and stakeholders involved; the underlying data, evidence, and evaluation plans; the governance and investment structures, including repayment terms and investor profiles; and project costs. To create the report, NFF drew on experience as a PFS educator, partner, and investor and conducted research using project documentation, publically available information, and stakeholder interviews. Over the past five years, NFF has conducted more than 200 PFS trainings, presentations, webinars, workshops, and convenings across the country for service providers, governments, and investors. NFF also manages the Pay for Success Learning Hub, www.payforsuccess.org, the leading national repository for education and information on Pay for Success. NFF's work on the report was made possible with the support of the Corporation for National and Community Service's Social Innovation Fund (SIF)

Models for Change: Building Momentum for Juvenile Justice Reform

Models for Change: Building Momentum for Juvenile Justice Reform tells the story of how innovative state leaders from across the country are creating a new path toward fair, rational, effective and developmentally appropriate models for juvenile justice reform. Pennsylvania, Illinois, Louisiana and Washington are already moving to reform and reshape their juvenile justice systems. These states have demonstrated strong leadership in juvenile justice policy, value collaboration and engagement and, because of their efforts, have changed the political climate to make deeper systems reform possible. Models for Change, a new initiative from the John D. and Catherine T. MacArthur Foundation, is seeking to build on their efforts in the hope that these states develop new model policies, practices and procedures that will strengthen their reform work, and possibly represent changes that could be replicated in other states

Cure Violence: A Public Health Model to Reduce Gun Violence

Scholars and practitioners alike in recent years have suggested that real and lasting progress in the fight against gun violence requires changing the social norms and attitudes that perpetuate violence and the use of guns. The Cure Violence model is a public health approach to gun violence reduction that seeks to change individual and community attitudes and norms about gun violence. It considers gun violence to be analogous to a communicable disease that passes from person to person when left untreated. Cure Violence operates independently of, while hopefully not undermining, law enforcement. In this article, we describe the theoretical basis for the program, review existing program evaluations, identify several challenges facing evaluators, and offer directions for future research

Recommendations for The Conduct of Economic Evaluations in Osteoporosis: Outcomes of An Experts’ Consensus Meeting Organized by The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) And the US Branch of The International Osteoporosis Foundation

Summary Economic evaluations are increasingly used to assess the value of health interventions, but variable quality and heterogeneity limit the use of these evaluations by decision-makers. These recommendations provide guidance for the design, conduct, and reporting of economic evaluations in osteoporosis to improve their transparency, comparability, and methodologic standards. Introduction This paper aims to provide recommendations for the conduct of economic evaluations in osteoporosis in order to improve their transparency, comparability, and methodologic standards. Methods A working group was convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis to make recommendations for the design, conduct, and reporting of economic evaluations in osteoporosis, to define an osteoporosis-specific reference case to serve a minimum standard for all economic analyses in osteoporosis, to discuss methodologic challenges and initiate a call for research. A literature review, a face-to-face meeting in New York City (including 11 experts), and a review/approval by a larger group of experts worldwide (including 23 experts in total) were conducted. Results Recommendations on the type of economic evaluation, methods for economic evaluation, modeling aspects, base-case analysis and population, excess mortality, fracture costs and disutility, treatment characteristics, and model validation were provided. Recommendations for reporting economic evaluations in osteoporosis were also made and an osteoporosis-specific checklist was designed that includes items to report when performing an economic evaluation in osteoporosis. Further, 12 minimum criteria for economic evaluations in osteoporosis were identified and 12 methodologic challenges and need for further research were discussed. Conclusion While the working group acknowledges challenges and the need for further research, these recommendations are intended to supplement general and national guidelines for economic evaluations, improve transparency, quality, and comparability of economic evaluations in osteoporosis, and maintain methodologic standards to increase their use by decision-makers

A Development Evaluation Study of a Professional Development Initiative to Strengthen Organizational Conditions in Early Education Settings

High quality instruction is essential to producing developmental gains for young children and can mitigate risk factors such as family poverty and low parental education. Even in programs with highly qualified teachers, teacher-child interactions often do not provide the level of instructional support that children need to be well-prepared for success in kindergarten. In order to improve instructional quality, an emerging focus on early childhood professional development involves supporting leaders in creating a web of supports for teacher learning and child growth. The purpose of the 3-year evaluation study was to assess the effectiveness of an Early Childhood Education Professional Development Initiative (ECE PDI) in advancing the knowledge, skills, and dispositions of community-based early childhood leaders and teachers in relation to creating the conditions for superior developmental outcomes for low-income students served by these community-based centers. Findings from the implementation and impact studies are reported

Groups, social influences and inequality : a memberships theory perspective on poverty traps

poverty;education;inequality