Drug use and barriers to and facilitators of drug treatment for homeless youth

In the United States, homeless youth are becoming increasingly entrenched in problem substance use, including high prevalence of alcohol abuse and injection use. A total of 54 substance-using homeless youth (18–25 years) participated in focus groups in order to provide their perspectives on barriers to and facilitators of seeking treatment. Participants were recruited from shelters in Hollywood, CA, and from a street-based, drop-in site in Santa Monica, CA. Participants identified personal barriers to treatment, but reported that facilitators of treatment tended to be more systematic. Homeless youth used and abused substances to dim the psychological effects of living on the streets. They appreciated programs that facilitated treatment and rehabilitation such as mentoring, support groups, and alternative choices to substance use. Implications point to the need for further development and research on culturally-appropriate, age-sensitive programs for homeless youth. The experiences of these youth underscore the need for strategic interventions

Barriers and facilitators to salivary rapid HIV testing in African Americans

OBJECTIVE: To identify barriers and facilitators of voluntary Salivary Rapid HIV testing decisions (SRT) among African Americans in order to develop interventions to improve HIV testing rates and care entry if HIV positive. METHODS: This first phase of a two-phase study used a Comprehensive Health Seeking and Coping Paradigm-based semi-structured interview guide (SSIG) to conduct 10 focus groups of 2-5 African Americans recruited from a large STI Clinic. Content analysis of the focus group transcripts was done using line-by-line analysis, and reviewing sentences and phrases for patterns or core meanings. Patterns were refined and synthesized into descriptive statements. An iterative process of comparison was used to further analyze the data, moving between individual elements of the text specific to participant responses. Meanings that were implicit rather than explicit in the text; and of one whole account with another were used to identify overall patterns of meaning. RESULTS: Of the 38 African American adults recruited, 16 were female with ages 18-49 (M =23) and 22 were male with ages 18-49 (M=29.5). All self identified as heterosexual with most reporting low income and no health insurance. Within the context of barriers and facilitators to SRT, eight themes emerged: Familiarity, Stigma, Fear, Access, Immediacy, Ease, Degree of Responsibility, and Trust. Each theme was not seen exclusively as a barrier or facilitator but was interpreted to be one or the other depending on the aspect of HIV testing being discussed. A gender sub analysis revealed themes of health maintenance and illness management for females and males respectively. CONCLUSIONS: Since there has not been an increase in HIV testing rates in AA’s even with newer SRT technology. The findings support the need to assess barriers and facilitators to testing decisions in order to increase testing rates. The themes also suggest the need for tailored community based interventions that decrease fear, stigma and increase trust in testing methods and providers for HIV and STI screening

Associations of Partner Support and Acculturation With Physical Activity in Mexican American Women.

IntroductionInsufficient physical activity (PA) and obesity-related health conditions have reached epidemic proportions worldwide. Mexican American women (MAW) report low leisure time physical activity. Few studies examine activities beyond leisure time. Qualitative research suggests that partner support influence provides a cultural approach relevant to PA among MAW.MethodThis cross-sectional study used an ecological model to investigate community (the physical environment), interpersonal (partner support, attitudinal familism), and intrapersonal (age, health conditions, acculturation, employment, and body mass index) factors associated with PA among 112 MAW. Community-based participatory research recommendations guided the preparatory phase of the study and the face-to-face interviews. Frequencies and descriptive statistics were computed. Multivariable linear regression analyses were used to examine associations between study variables.ResultsModerate to high PA levels were found based on combined activities performed during leisure time, transportation, household tasks, and occupational duties. Women with greater partner support reported higher PA levels. Although acculturation levels were low among women, those with higher acculturation were found to be more physically active.ConclusionsFuture studies should examine strategies to increase partner support and address acculturation within intervention programs to enhance overall PA among MAW

Male Veterans Coping with the Pendulum Swing of Rheumatoid Arthritis Pain: A Qualitative Study

This study describes the physical, psychological and social context of rheumatoid arthritis (RA) pain from the male veterans. A qualitative, descriptive design was employed using a purposive sampling to ensure representation of male veterans. Interviews were conducted with 12 male veterans of the VA Greater Los Angeles Healthcare System. Socio-demographic characteristics, clinical profiles and descriptors of rheumatoid pain experienced by male veterans’ since their diagnoses were gathered. Interviews were audio recorded and transcribed verbatim. Grounded Theory analysis techniques were used to identify concepts related to living with RA Pain. Six concepts related to RA pain adaptation emerged. Three concepts were associated with movement (keep moving, consequences of not moving, staying physically active) and three were related to emotion (thinking positive thoughts, doing jobs, focusing on male identity). The “keep moving” concept explained coping with chronic RA pain through three activity types: physical, cognitive and socio-economic activities. These activities fluctuated in intensity depending upon the disease stage and RA symptoms. The forward and backward pendulum swing described the unpredictable course and pain coping strategy of the veterans. Further studies are recommended to determine the transferability of our findings to other populations and to confirm the impact of continuous motion as an effective pain management strategy for RA

Knowledge and Attitudes about HIV/AIDS among Homoeopathic Practitioners and Educators in India

This study is designed to assess AIDS knowledge among Homeopathy educators and physicians in India, which has not been evaluated previously. India now has the largest number of HIV infected persons worldwide, with an estimated cumulative 5.1 million infections. Homeopathy is the dominant system among the nationally-recognized alternative or complementary systems of medicine, which collectively provide health care to around 600 million people in India. Homeopathy, with its holistic and patient-centered approach, has a wide reach to people at risk of contracting human immunodeficiency virus (HIV). Participants were 68 homeopathy physicians (34 educators and 34 practitioners) who completed a CDC questionnaire measuring HIV/AIDS Knowledge regarding AIDS. This study reports the current level of knowledge of, and attitudes about, HIV/AIDS among homeopathy educators and practitioners. These findings will assist in the development of an education module to equip homeopathic health care personnel to impart accurate AIDS information and prevention counseling to their patients in an efficient manner

Digital Health-Enabled Community-Centered Care: Scalable Model to Empower Future Community Health Workers Using Human-in-the-Loop Artificial Intelligence

Digital health–enabled community-centered care (D-CCC) represents a pioneering vision for the future of community-centered care. D-CCC aims to support and amplify the digital footprint of community health workers through a novel artificial intelligence–enabled closed-loop digital health platform designed for, and with, community health workers. By focusing digitalization at the level of the community health worker, D-CCC enables more timely, supported, and individualized community health worker–delivered interventions. D-CCC has the potential to move community-centered care into an expanded, digitally interconnected, and collaborative community-centered health and social care ecosystem of the future, grounded within a robust and digitally empowered community health workforce.</p

Psychosocial predictors of current drug use, drug problems, and physical drug dependence in homeless women

We examined risk and protective factors associated with three qualitatively different drug use constructs describing a continuum of drug use among a sample of 1,179 homeless women. Relationships among positive and negative sources of social support, positive and negative coping strategies, depression, and the drug constructs of current drug use, drug problems, and physical drug dependence were assessed using structural equation models with latent variables. Current drug use was predicted by more negative social support (from drug-using family/friends), depression, and less positive coping. Drug Problems were predicted by more negative coping, depression, and less positive coping. Physical Drug Dependence was predicted by more negative social support and depression, and less positive social support. Results highlighted the importance of investigating both the positive and negative dimensions of psychosocial functioning, while suggesting that empowering homeless women and offering tangible resources for coping with the stress of being homeless may be beneficial to them