A White Paper On The Durham Collaboration Process Evaluation And Key Findings: A Participatory Approach To Improving Services For Immigrant Survivors Of Intimate Partner Violence

Intimate partner violence (IPV) is a complex social problem, and providing survivors with high quality services often involves a cadre of providers. This paper builds on the participatory process evaluation of a multi-agency collaboration formed to better meet the needs of immigrant Latina and South Asian survivors in Durham County, known as The Durham Multi-Agency Collaboration to Enhance Service Delivery to Immigrant Victims ( referred to as The Durham Collaboration). The Durham Collaboration is a unique collaboration comprised of four community-based organizations with diverse expertise in Durham County, North Carolina (Durham Crisis Response Center, El Centro Hispano, Kiran, and InStepp, Inc). These four organizations partnered with The School of Social Work at the University of North Carolina at Chapel Hill (UNC) to evaluate their collaborative efforts to improve domestic violence services for Latina and South Asian intimate partner violence (IPV) survivors. A toolkit will be developed from the learned lessons to disseminate to other organizations aiming to improve services for this population. This master’s paper is intended to provide context for the proposed toolkit by describing the research background, methods, and findings in detail, and discuss the translation of these finding into a product that is accessible and useful to service providers. There is a significant focus on the participatory processes, and the contributions of both academic and community researchers will be discussed in detail.Master of Science in Public Healt

Marginalisation, discrimination and the health of Latino immigrant day labourers in a central North Carolina community

The morbidity and mortality of Latino immigrants in the United States (US) stem from a complex mix of policy, culture, discrimination, and economics. Immigrants working as day labourers may be particularly vulnerable to the negative influences of these social factors due to limited access to social, financial, and legal resources. We aimed to understand how the health of male Latino day labourers in North Carolina, US is influenced by their experiences interacting with their community and perceptions of their social environment. To respond to our research questions, we conducted three focus groups (n=9, n =10, n=10) and a photovoice project (n=5) with Latino male immigrants between October 2013 and March 2014. We conducted a thematic analysis of transcripts from the discussions in the focus groups and the group of Photovoice participants. We found that men's health and well-being were primarily shaped by their experiences and feelings of discrimination and marginalization. We identified three main links between discrimination/marginalization and poor health: (1) dangerous work resulted in workplace injuries or illnesses, (2) unsteady employment caused stress, anxiety and insufficient funds for health care, and (3) exclusionary policies and treatment resulted in limited healthcare accessibility. Health promotion with Latino immigrant men in new settlement areas could benefit from community-building activities, addressing discrimination, augmenting the reach of formal health care, and building upon the informal mechanisms that immigrants rely on to meet their health needs. Reforms to immigration and labour policies are also essential to addressing these structural barriers to health for these men

AMP!: A Cross-site Analysis of the Effects of a Theater-based Intervention on Adolescent Awareness, Attitudes, and Knowledge about HIV

AMP! (Arts-based, Multiple component, Peer-education) is an HIV intervention developed for high school adolescents. AMP! uses interactive theater-based scenarios developed by trained college undergraduates to deliver messages addressing HIV/STI prevention strategies, healthy relationships, and stigma reduction towards people living with HIV/AIDS. We used a pre-test/post-test, control group study design to simultaneously assess intervention effect on ninth grade students in an urban county in California (N = 159) and a suburban county in North Carolina (N = 317). In each location, the control group received standard health education curricula delivered by teachers; the intervention group received AMP! in addition to standard health education curricula. Structural equation modeling was used to determine intervention effects. The post-test sample was 46% male, 90% self-identified as heterosexual, 32% reported receiving free or reduced lunch, and 49% White. Structural models indicated that participation in AMP! predicted higher scores on HIV knowledge (p = .05), HIV awareness (p = .01), and HIV attitudes (p = .05) at the post-test. Latent means comparison analyses revealed post-test scores were significantly higher than pre-test scores on HIV knowledge (p = .001), HIV awareness (p = .001), and HIV attitudes (p = .001). Further analyses indicated that scores rose for both groups, but the post-test scores of intervention participants were significantly higher than controls (HIV knowledge (p = .01), HIV awareness (p = .01), and HIV attitudes (p = .05)). Thus, AMP!’s theater-based approach shows promise for addressing multiple adolescent risk factors and attitudes concerning HIV in school settings

‘I learned to be okay with talking about sex and safety’: assessing the efficacy of a theatre-based HIV prevention approach for adolescents in North Carolina

Adolescents are at increased risk of HIV and sexually transmitted infections (STIs) in the Southern states of the USA, where rates among youth are higher than in the rest of the nation. This paper reports on findings from a pilot study of an HIV prevention intervention that uses interactive theatre to educate young people about sexual health. The intervention was developed in Los Angeles and adapted for testing in the South of the USA, with its legacy of abstinence-based approaches to sexual health education. This study assessed intervention effects among a sample of young people in two public high schools in North Carolina. We used a pre-test, post-test quasi-experimental evaluation design to assess changes in 317 ninth grade participants’ knowledge and attitudes about HIV. At post-test, we found statistically significant increases in participants’ HIV knowledge (t= 60.14; p=.001), as well as changes in attitudes (X2=8.23; p=.042) and awareness (X2=4.94; p=.026). Focus group data corroborated increase in HIV knowledge and reduction in HIV stigma as successful outcomes of intervention participation. The findings make an important contribution to the literature on theatre-based interventions for sexual health education. Furthermore, they highlight the importance of considering socio-cultural and political context in implementing HIV prevention interventions in schools

Prevalence and factors associated with violence and abuse of older adults in Mexico’s 2012 National Health and Nutrition Survey

Background: Factors associated with violence and the abuse of older adults are understudied and its prevalence in Mexico has not been reported. The aim of this study was to identify the prevalence and factors associated with violence and abuse of older adults in Mexico. Methods: We used Mexico’s 2012 National Health and Nutrition Survey, which included a sample of 8,894 individuals who are 60 years or older and who self-reported a negative health event related to robbery, aggression or violence in the previous 12 months. We used chi-squared test and Fisher’s exact test to analyze the variables related to violence. Adjusted estimates were completed with multiple logistic regression models for complex surveys. Results: The prevalence of violence was 1.7 % for both men and women. In 95 % of the cases, the aggression was from an unknown party. Verbal aggressions were the most prevalent (60 %). Among men, physical aggression was more common. Violence frequently occurred in the home (37.6 %); however, men were primarily assaulted in public places (42.4 %), in comparison to women (30.7 %). There were also differences in the risk factors for violence. Among men, risk was associated with younger age (60–64 years), higher education (secondary school or above) and higher socioeconomic status. Among women, risk was associated with depression, not being the head of the family, and region of the country. Conclusions: Violence against older adults presents differently for men and women, which means it is necessary to increase knowledge about the dynamics of the social determinants of violence, particularly in regards to the role of education among men. The relatively low prevalence found in this study may reflect the difficulty and fear of discussing the topic of violence. This may occur because of cultural factors, as well as by the perception of helplessness perpetuated by the scarce access to social programs that ensure protection and problem solving with regards to the complex social determinants of individual and family violence that this population group endures.publishedVersio

‘I learned to accept every part of myself’: the transformative impact of a theatre-based sexual health and HIV prevention programme

Theatre-based interventions have been used in health promotion activities among young people to address HIV and sexual health. In this study, we explored the experience of undergraduate student performers participating in a theatre-based HIV prevention and sexual health education intervention for high school students in the USA. Undergraduate students enrolled in a credit-bearing course to learn about HIV and sexual health, participatory theatre and health education techniques. We analysed students’ reflective essays written throughout the semester to identify any changes and the intervention processes that promoted these changes. Students experienced five interrelated forms of transformation: (1) increased knowledge about HIV and sexual health; (2) changes in attitude and communication about sex; (3) artistic growth; (4) emotional growth; and (5) clarification of career goals and future plans. Intervention processes that contributed to these transformations included improvisation, guided writing exercises, the creation of a close-knit cohesive group, and interactions with a group of HIV-positive speakers. Theatre-based, peer-led sexual health programmes can provide a transformative experience for undergraduate student performers. The transformative effects are linked to specific activities and processes of the intervention and require examination in future research

Carolina del Norte and the New South: Social Work Practice with New Latino Immigrant Communities

Over the past decade, the Latino population in North Carolina has increased 111%. More than half of North Carolina Latinos are foreign-born and most face issues related to immigration, acculturation, and often, discrimination. This article provides a brief overview of the historical context in which social workers engaged with immigrant communities, and argues that the profession brings strengths and unique skills to address North Carolina’s Latino immigrant population, historically, and within the current context. Key social demographics of Latino populations, sociopolitical realities, as well as theoretical and methodological issues related to the complex needs of this diverse population group are addressed. Two examples of Latino vulnerability in North Carolina, HIV/AIDS and discriminatory local immigration enforcement practices, are discussed to further highlight the unique strengths and challenges social workers in North Carolina and the New South face when working with Latino immigrants