Development and pilot evaluation of a home-based palliative care training and support package for young children in southern Africa

Background The leading cause of death among young children in southern Africa is complications due to HIV infection and, in South Africa, over a third of all deaths of children younger than five are associated with HIV infection. There is a great and urgent need for children’s palliative care in Africa, whether HIV-related or not. It is often not possible for sick children and their carers to attend clinics and hospitals cannot accommodate children for long periods of time. As a result children are often cared for in their own homes where caregivers require support to provide informed and sensitive care to reduce children’s suffering. Home-care places a heavy burden on families, communities and home- and community-based care workers. Methods This project involved the development and pilot evaluation of a training and support package to guide home and community-based care workers to help caregivers of seriously ill young children at home in southern Africa. A number of research methods were used, including a cross-sectional survey of content experts using the Delphi technique, participatory action research with photo elicitation and qualitative thematic analysis. Results Because the palliative care needs of these children are complex, the package focuses on delivering 9 key messages essential to improving the quality of care provided for young children. Once the key messages were developed, culturally relevant stories were constructed to enhance the understanding, retention and enactment of the messages. The various research methods used, including literature reviews, the Delphi technique and photo-elicitation ensured that the content included in the package was medically sound and culturally relevant, acceptable, feasible, and comprehensive. The end product is a home-based paediatric palliative care training and support package in English designed to help train community workers who are in a position to support families to care for very sick young children at home as well as to support families in looking after a very sick child. Conclusion A pilot study to assess the training and support package found it to be useful in delivering the key messages to caregivers. The training component was found to be feasible. It is concluded that the package offers a practical means of integrating palliative care with home-based care. Further implementation and evaluation is needed to establish its utility and impact

The Impact of the SEERs Project on HIV Testing in Kenya

Compared to other key populations, adolescents living in sub-Saharan Africa experience a high HIV disease burden. To address this, organizations have implemented a variety of youth-oriented HIV prevention strategies, including the HIV SEERs Project. SEERs is an innovative, community-based program designed with and for youth in Kenya to reduce HIV stigma (a known barrier to HIV testing), and increase treatment and retention in care. While preliminary research has demonstrated SEERs efficacy for increasing HIV knowledge and decreasing stigma, information about its efficacy as a means to increase HIV testing has been limited to assessing behavioral intentions. To address this limitation, SEERs facilitators partnered with 20 local HIV agencies in 2018 to offer on-site HIV testing during SEERs programming. The purpose of this article is to examine the impact, as well as the benefits and challenges of SEERs programming on HIV testing and linkage to care. SEERs facilitators collected and reported the following data monthly over the course of the year: number of locations for SEERs programming, number and age range of SEERs attendees, number of attendees who screened for HIV and, among those, the number who tested positive and were linked to care. Facilitators also provided written descriptions of the benefits and challenges of implementing the SEERs programming. We analyzed HIV testing data using descriptive statistics and used qualitative data to describe facilitators’ perceptions of the benefits and challenges of implementing the SEERs program. We discuss the contributions of these findings to the existing literature and explore future directions

Exploring the impact of religion, superstition, and professional cultural competence on access to HIV and mental health treatment among Black Sub-Sahara African communities in the English city of Birmingham

HIV and mental health are sensitive subjects among Black Sub-Saharan African (BSSA) communities despite the disproportionate impact of HIV among this population and high comorbidity between HIV and mental disorders. This study explored the impact of religion, superstition, and professional cultural competence on access to HIV and mental health services among BSSA communities in the English city of Birmingham. Researchers utilised explorative qualitative methods. Specifically, 12 focus groups were conducted followed by a semi-structured interview with a member from each focus group. Data were analysed using a thematic approach guided by the four phases of the silences framework. Results suggest that religion, superstition, and professional cultural competence affect access to HIV and mental health services among BSSA communities. Findings indicate a need to educate religious leaders on the impact of HIV and mental health stigma as well as a need for cultural competence training among health professionals

Civic engagement in the field of psychology.

The purpose of this article is to describe the importance of, and recommendations for how best to promote, civic engagement among undergraduate psychology majors. In this article, we will describe how the goals of civic engagement are consistent with the specific curricular goals of undergraduate psychology programs. We also will (a) review the empirical support for civic engagement in the field of psychology and describe the implications of this method for teaching students about diversity; (b) discuss some of the challenges associated with incorporating civic engagement in psychology courses as well as provide strategies for overcoming these challenges; (c) discuss some of the unique ethical issues related to civic engagement in the field of psychology; and (d) provide recommendations, using specific examples, for how to incorporate service-learning activities as a means of encouraging civic engagement in psychology courses

Civic engagement in the field of psychology.

The purpose of this article is to describe the importance of, and recommendations for how best to promote, civic engagement among undergraduate psychology majors. In this article, we will describe how the goals of civic engagement are consistent with the specific curricular goals of undergraduate psychology programs. We also will (a) review the empirical support for civic engagement in the field of psychology and describe the implications of this method for teaching students about diversity; (b) discuss some of the challenges associated with incorporating civic engagement in psychology courses as well as provide strategies for overcoming these challenges; (c) discuss some of the unique ethical issues related to civic engagement in the field of psychology; and (d) provide recommendations, using specific examples, for how to incorporate service-learning activities as a means of encouraging civic engagement in psychology courses

HIV/AIDS in Kenyan schools: Neuropsychological and psychoeducational implications

Kenya has the twelfth largest HIV/AIDS epidemic in the world. In 2016, there was an estimated 1.6 million people living with HIV in Kenya. Youth ages 15–24 accounted for over half (51%) of the HIV incidence reported in 2015, a significant increase from 2013 where youth accounted for 29% of all new cases. The purpose of this paper is to review HIV prevalence and incidence among youth and other key populations in Kenya and to discuss the cultural attitudes and practices that impact the HIV epidemic including relevant laws, policies, and initiatives with a focus on the role of school psychologists in neuropsychological interventions for children and adolescents living with HIV. A broad range of biomedical, behavioral, and structural approaches for addressing the HIV-related needs among youth in Kenya are discussed as is the importance of addressing the psychosocial needs of youth living with HIV by acknowledging the relationship between physical health, mental health, and academic outcomes. The critical role of school psychologists and other school professionals in implementing these strategies is highlighted

An Exploratory Study of COVID-19’s Impact on Psychological Distress and Antisocial Behavior Among Justice-Involved Youth

Little is known about how justice-involved youth are coping with stress related to COVID-19. This study examined changes in psychological distress and antisocial behavior indicators among 557 youths on probation who completed two assessments during pre-COVID-19 conditions and two assessments during post-COVID-19 conditions. Drawing from Agnew’s General Strain Theory, the study used multivariate latent growth models to examine: (a) changes in psychological distress and antisocial behavior over time, (b) the associations of the changes, and (c) differences across sex, race, and ethnicity regarding changes in psychological distress. In support of General Strain Theory, results highlight that indicators of psychological distress and antisocial behavior increased during post-COVID-19 conditions when compared to pre-COVID-19 conditions for the full sample and for subsamples of youth categorized by sex, race, and ethnicity

Destabilizing anti-gay environments through gay-straight alliances: Possibilities and limitations through shifting discourses.

Drawing upon research with Gay-Straight Alliance (GSA) advisors, high-school principals, and two district-level administrators, we examine the potential and limits of the safe-space discourse that encompasses the aims of GSAs. We argue that this discourse conceals heteronormative school environments, which supplies the groundwork for hostility perpetrated against LGBT students. We then delineate three strategies- organizational, pedagogical, and systemic-toward altering the safe-space discourse to a forward-looking, social-justice discourse that fosters the eradication of heteronormative school processes