Brothers leading healthy lives: outcomes from the pilot testing of a culturally and contextually congruent HIV prevention intervention for black male college students

We used a treatment group-only design to pilot test a newly developed intervention to increase condom use among higher risk heterosexually active African American/black male college students. A community-based participatory research partnership developed the intervention called Brothers Leading Healthy Lives. Following an initial screening of 245 men, 81 eligible men were contacted for participation. Of the 64 men who agreed to participate, 57 completed the intervention and 54 of those completed the 3-monthfollow-up assessment, for a 93% completion rate. Results show significant changes between the baseline and 3-month follow-up assessments in behavioral outcomes, including reductions in unprotected sex, increase in protection during last intercourse, and fewer condom use errors. Most potential mediators (knowledge, attitudes, intentions, and condom use self-efficacy) also changed significantly in the expected direction. These demonstrated changes provide good evidence that men exposed to this intervention will see changes that reduce their risk for HIV

Race, Socioeconomic Status, and Age: Exploring Intersections in Preterm Birth Disparities among Teen Mothers

Few studies have examined disparities in adverse birth outcomes and compared contributingsocioeconomic factors specifically between African-American and White teen mothers. Thisstudy examined intersections between neighborhood socioeconomic status (as defined by censustractmedian household income), maternal age, and racial disparities in preterm birth (PTB)outcomes between African-American and White teen mothers in North Carolina. Using a linkeddataset with state birth record data and socioeconomic information from the 2010 US Census,disparities in preterm birth outcomes for 16,472 teen mothers were examined through bivariateand multilevel analyses. African-American teens had significantly greater odds of PTB outcomesthan White teens (OR = 1.38, 95% CI 1.21, 1.56). Racial disparities in PTB rates significantlyvaried by neighborhood income; PTB rates were 2.1 times higher for African-American teens inhigher income neighborhoods compared to White teens in similar neighborhoods. Disparities inPTB did not vary significantly between teens younger than age 17 and teens ages 17–19,although the magnitude of racial disparities was larger between younger African-American andWhite teens. These results justify further investigations using intersectional frameworks to testthe effects of racial status, neighborhood socioeconomic factors, and maternal age on birthoutcome disparities among infants born to teen mothers

Laying the Groundwork for Evidence-Based Public Health: Why Some Local Health Departments Use More Evidence-Based Decision-Making Practices Than Others

We examined variation in the use of evidence-based decision-making (EBDM) practices across local health departments (LHDs) in the United States and the extent to which this variation was predicted by resources, personnel, and governance. We analyzed data from the National Association of County and City Health Officials Profile of Local Health Departments, the Association of State and Territorial Health Officials State Health Departments Profile, and the US Census using 2-level multilevel regression models. We found more workforce predictors than resource predictors. Thus, although resources are related to LHDs’ use of EBDM practices, the way resources are used (e.g., the types and qualifications of personnel hired) may be more important

An Intervention for the Transition From Pediatric or Adolescent to Adult-Oriented HIV Care: Protocol for the Development and Pilot Implementation of iTransition

Background: In the United States, adolescents and young adults are disproportionately affected by HIV and have poorer HIV-related health outcomes than adults. Health care transition (HCT) from pediatric or adolescent to adult-oriented HIV care is associated with disruptions to youths' care retention, medication adherence, and viral suppression. However, no evidence-based interventions exist to improve HCT outcomes for youth living with HIV. Objective: There are 2 phases of this project. Phase 1 involves the iterative development and usability testing of a Social Cognitive Theory-based mobile health (mHealth) HIV HCT intervention (iTransition). In phase 2, we will conduct a pilot implementation trial to assess iTransition's feasibility and acceptability and to establish preliminary efficacy among youth and provider participants. Methods: The iterative phase 1 development process will involve in-person and virtual meetings and a design team comprising youth living with HIV and health care providers. The design team will both inform the content and provide feedback on the look, feel, and process of the iTransition intervention. In phase 2, we will recruit 100 transition-eligible youth across two clinical sites in Atlanta, Georgia, and Philadelphia, Pennsylvania, to participate in the historical control group (n=50; data collection only) or the intervention group (n=50) in a pilot implementation trial. We will also recruit 28 provider participants across the pediatric or adolescent and adult clinics at the two sites. Data collection will include electronic medical chart abstraction for clinical outcomes as well as surveys and interviews related to demographic and behavioral characteristics; Social Cognitive Theory constructs; and intervention feasibility, acceptability, and use. Analyses will compare historical control and intervention groups in terms of HCT outcomes, including adult care linkage (primary), care retention, and viral suppression (secondary). Interview data will be analyzed using content analysis to understand the experience with use and acceptability. Results: Phase 1 (development) of iTransition research activities began in November 2019 and is ongoing. The data collection for the phase 2 pilot implementation trial is expected to be completed in January 2023. Final results are anticipated in summer 2023. Conclusions: The development and pilot implementation trial of the iTransition intervention will fill an important gap in understanding the role of mHealth interventions to support HCT outcomes for youth living with HIV

Laying the Groundwork for Evidence-Based Public Health: Why Some Local Health Departments Use More Evidence-Based Decision-Making Practices Than Others

We examined variation in the use of evidence-based decision-making (EBDM) practices across local health departments (LHDs) in the United States and the extent to which this variation was predicted by resources, personnel, and governance. We analyzed data from the National Association of County and City Health Officials Profile of Local Health Departments, the Association of State and Territorial Health Officials State Health Departments Profile, and the US Census using 2-level multilevel regression models. We found more workforce predictors than resource predictors. Thus, although resources are related to LHDs’ use of EBDM practices, the way resources are used (e.g., the types and qualifications of personnel hired) may be more important