Predictors of Hepatitis Knowledge Improvement Among Methadone Maintained Clients Enrolled in a Hepatitis Intervention Program

This randomized, controlled study (n = 256) was conducted to compare three interventions designed to promote hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination completion, among clients undergoing methadone maintenance treatment (MMT) in Los Angeles and Santa Monica. The participants were randomized into three groups: Motivational Interviewing-Single Session (MI-Single), Motivational Interviewing-Group (MI-Group), or Nurse-Led Hepatitis Health Promotion (HHP). All three treatment groups received the 3-series HAV/HBV vaccine. The MI sessions were provided by trained therapists, the Nurse-Led HHP sessions were delivered by a research nurse. The main outcome variable of interest was improvement in HBV and HCV knowledge, measured by a 6-item HBV and a 7-item HCV knowledge and attitude tool that was administered at baseline and at 6-month follow-up. The study results showed that there was a significant increase in HBV- and HCV-related knowledge across all three groups (p < 0.0001). There were no significant differences found with respect to knowledge acquisition among the groups. Irrespective of treatment group, gender (P = 0.008), study site (P < 0.0001) and whether a participant was abused as a child (P = 0.017) were all found to be predictors of HCV knowledge improvement; only recruitment site (P < 0.0001) was found to be a predictor of HBV knowledge. The authors concluded that, although MI-Single, MI-Group and Nurse-Led HHP are all effective in promoting HBV and HCV knowledge acquisition among MMT clients, Nurse-Led HHP may be the method of choice for this population as it may be easier to integrate and with additional investigation may prove to be more cost efficient

Development of nursing theory and science in vulnerable populations research.

Inequalities with respect to the distribution of societal resources can predispose people to vulnerability, which has led to a growing concern across America. The Federal Government has taken a leadership role and has launched several initiatives to combat health inequalities experienced by vulnerable populations. The National Institute of Health and all of its institutes, including the National Institute of Nursing Research, have written strategic plans to reduce, and ultimately, eliminate such health disparities. Nursing research has been conducted in the setting of vulnerable populations; several theoretical models for studying vulnerability have been created; and interventional studies designed to reduce health disparities have been implemented. This introduction includes the following: (a) a definition of the concept of vulnerability and health disparities; (b) a discussion of the conceptual models of vulnerability and health disparity and their applications; (c) a description of the impact of federal funding on vulnerable populations research; (d) a synopsis of the contributions made by nurse researchers in the field of vulnerable populations research; and (e) an overview of the volume

Perceptions and health care needs of HIV-positive mothers in India.

BackgroundAn estimated 2.5 million Indians live with HIV/AIDS. Spread primarily through heterosexual contact, the epidemic is shifting toward women, 29% of whom are currently infected, with still more cases going unreported. As the primary caregivers for their families, women face many challenges when it comes to accessing care; these include dealing with discrimination from family, community, and health care providers, and a general lack of education, social support, and nutrition guidance and sustenance.ObjectivesThe purpose of this study was to explore the perceptions and experiences of a group of HIV-positive mothers living in India to learn about the challenges they face in terms of assessing health care services, dealing with mental health stressors, and giving them a voice in designing the structure of a culturally sensitive and tailored intervention for women like themselves.MethodsThis study used a qualitative approach using focus groups consisting of a convenience sample of 60 HIV-infected mothers recruited from a large maternity hospital and sexually transmitted disease clinic in Chennai, India. Using a semi-structured interview guide, information was solicited from participants and qualitative content analysis conducted to determine common themes discussed among the groups.ResultsParticipants described challenges they face on a day-to-day basis, living with HIV and factors that prevent or help them to seek, obtain, and maintain care. The women also provided recommendations for future intervention plans, to include counseling, nutritional support, psychological support, and educational services for women living with HIV.ConclusionsFindings of this study provided a rich backdrop upon which a community-based AIDS program for HIV-positive mothers in India can now be designed

Perceptions and health care needs of HIV-Positive mothers in India.

BackgroundAn estimated 2.5 million Indians live with HIV/AIDS. Spread primarily through heterosexual contact, the epidemic is shifting toward women, 29% of whom are currently infected, with still more cases going unreported. As the primary caregivers for their families, women face many challenges when it comes to accessing care; these include dealing with discrimination from family, community, and health care providers, and a general lack of education, social support, and nutrition guidance and sustenance.ObjectivesThe purpose of this study was to explore the perceptions and experiences of a group of HIV-positive mothers living in India to learn about the challenges they face in terms of assessing health care services, dealing with mental health stressors, and giving them a voice in designing the structure of a culturally sensitive and tailored intervention for women like themselves.MethodsThis study used a qualitative approach using focus groups consisting of a convenience sample of 60 HIV-infected mothers recruited from a large maternity hospital and sexually transmitted disease clinic in Chennai, India. Using a semi-structured interview guide, information was solicited from participants and qualitative content analysis conducted to determine common themes discussed among the groups.ResultsParticipants described challenges they face on a day-to-day basis, living with HIV and factors that prevent or help them to seek, obtain, and maintain care. The women also provided recommendations for future intervention plans, to include counseling, nutritional support, psychological support, and educational services for women living with HIV.ConclusionsFindings of this study provided a rich backdrop upon which a community-based AIDS program for HIV-positive mothers in India can now be designed

Correlates of depressive symptoms among homeless young adults.

Adolescent homelessness has received increasing attention because of its fast growth throughout the United States and the poor mental outcomes experienced by homeless young people. This cross-sectional study (N = 156) identified correlates of depressive symptomatology among homeless young adults and investigated how depressive symptoms are influenced by the coping strategies these young adults use. The findings are based on analysis of baseline data collected for a hepatitis vaccination intervention pilot study conducted in partnership with a young adult's drop-in center in Santa Monica, California. Standardized tools assessed drug use history, coping ability, and psychiatric symptomatology. Linear regression modeling was used to identify correlates of depressive symptom severity. Poor perceived physical health, recent crack cocaine use, and recent use of tranquilizers were significantly associated with increased severity of depressive symptoms. Self-destructive escape, nondisclosure/avoidance, passive problem solving, and thoughts of harming self were also associated with increased severity of depressive symptoms

Development of nursing theory and science in vulnerable populations research.

Inequalities with respect to the distribution of societal resources can predispose people to vulnerability, which has led to a growing concern across America. The Federal Government has taken a leadership role and has launched several initiatives to combat health inequalities experienced by vulnerable populations. The National Institute of Health and all of its institutes, including the National Institute of Nursing Research, have written strategic plans to reduce, and ultimately, eliminate such health disparities. Nursing research has been conducted in the setting of vulnerable populations; several theoretical models for studying vulnerability have been created; and interventional studies designed to reduce health disparities have been implemented. This introduction includes the following: (a) a definition of the concept of vulnerability and health disparities; (b) a discussion of the conceptual models of vulnerability and health disparity and their applications; (c) a description of the impact of federal funding on vulnerable populations research; (d) a synopsis of the contributions made by nurse researchers in the field of vulnerable populations research; and (e) an overview of the volume

Correlates of depressive symptoms among homeless young adults.

Adolescent homelessness has received increasing attention because of its fast growth throughout the United States and the poor mental outcomes experienced by homeless young people. This cross-sectional study (N = 156) identified correlates of depressive symptomatology among homeless young adults and investigated how depressive symptoms are influenced by the coping strategies these young adults use. The findings are based on analysis of baseline data collected for a hepatitis vaccination intervention pilot study conducted in partnership with a young adult's drop-in center in Santa Monica, California. Standardized tools assessed drug use history, coping ability, and psychiatric symptomatology. Linear regression modeling was used to identify correlates of depressive symptom severity. Poor perceived physical health, recent crack cocaine use, and recent use of tranquilizers were significantly associated with increased severity of depressive symptoms. Self-destructive escape, nondisclosure/avoidance, passive problem solving, and thoughts of harming self were also associated with increased severity of depressive symptoms