scholarly journals U.S. transgender women’s preferences for microeconomic interventions to address structural determinants of HIV vulnerability: a qualitative assessment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tonia Poteat ◽  
Larissa Jennings Mayo-Wilson ◽  
Nastacia Pereira ◽  
Brittanni N. Wright ◽  
Shelby A. Smout ◽  
...  
Keyword(s):  
Financial Literacy ◽  
Career Planning ◽  
Strong Support ◽  
The United States ◽  
Transgender Women ◽  
Qualitative Assessment ◽  
Full Time ◽  
Structural Determinants ◽  
Women’S Preferences ◽  
Hiv Vulnerability

Abstract Background Transgender women in the United States (U.S.) experience a disproportionate burden of HIV infection and challenges to engagement in HIV prevention and care. This excess burden is driven by structural and economic inequities. Microeconomic interventions may be effective strategies for reducing HIV inequities for this population. However, few studies have explored transgender women’s preferences for microeconomic interventions to address structural determinants of HIV vulnerability. Methods We conducted individual interviews with 19 adult transgender women in 2 U.S. cities (Richmond, VA and St. Louis, MO) who reported one or more sexual risk behaviors and recent economic hardship related to employment/income, housing, or food security. Interviews were recorded, transcribed, and analyzed using thematic content analysis. Results The majority (74%) of transgender women were racial/ethnic minorities with mean age of 26.3 years. 89% were currently economically vulnerable; and 23% were employed full-time. 37% reported living with HIV. Participants expressed strong support for unrestricted vouchers, with many expressing the need for funds to support gender-affirming interventions. Assistance with how to budget and save and support for job acquisition, career planning, and employment sustainment were also preferred, including access to non-stigmatizing employment. Visible transgender leadership, group empowerment, and small (rather than large) numbers of participants were considered important aspects of intervention design for transgender women, including outreach through existing transgender networks to facilitate inclusion. Incorporating HIV counseling and testing to reduce vulnerability to HIV was acceptable. However, transgender women enrolled in the study preferred that HIV not be the focus of an intervention. Conclusions Flexible microeconomic interventions that support gender affirming interventions, improve financial literacy, and provide living-wage non-stigmatizing employment are desired by economically vulnerable transgender women. While not focused on HIV, such interventions have the potential to reduce the structural drivers of HIV vulnerability among transgender women.

Structural Determinants of Homelessness in the United States

1991 ◽  
Vol 38 (1) ◽  
pp. 113-131 ◽  
Author(s):  
Marta Elliott ◽  
Lauren J. Krivo
Keyword(s):  
United States ◽  
The United States ◽  
Structural Determinants

Telemedicine for Patients with Inflammatory Bowel Disease (TELE-IBD) Clinical Trial: Qualitative Assessment of Participants’ Perceptions of the TELE-IBD Intervention (Preprint)

2019 ◽  
Author(s):  
Charlene C Quinn ◽  
Sarah Chard ◽  
Erin G Roth ◽  
J. Kevin Eckert ◽  
Katharine M Russman ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Disease Activity ◽  
Remote Monitoring ◽  
Standard Care ◽  
Disease Process ◽  
The United States ◽  
Qualitative Assessment ◽  
Structured Interviews ◽  
Treatment Groups ◽  
Inflammatory Bowel

BACKGROUND Inflammatory bowel diseases (IBD), comprising Crohn’s disease and ulcerative colitis, affects 1 to 3 million people in the United States. Telemedicine has shown promise in IBD. The objective of the parent study, TELE-IBD, was to compare disease activity and quality of life (QoL) in a one-year randomized clinical trial of IBD patients receiving telemedicine versus standard care. Treatment groups experienced improvements in disease activity and QoL but there was not significant differences between groups. Study adherence to the text-based intervention was less than the 80% of the targeted goal. OBJECTIVE To understand adherence to remote monitoring, the goal of this qualitative assessment was to obtain TELE-IBD trial participants’ perceptions of the TELE-IBD system, including their recommendations for future TELE-IBD monitoring. METHODS In the parent study, patients attending three tertiary referral centers with worsening IBD symptoms in the previous two years were eligible for randomization to remote monitoring via texts every other week (EOW), weekly (W) or standard care. Participants (n=348) were evenly enrolled in the treatment groups and 259 (74.4%) completed the study. For this study, a purposive sample of adherent (N=15) and non-adherent (N=14) patients was drawn from the TELE-IBD trial population. Adherence was defined as the completion of 80% or more of the W or EOW self-assessments. Semi-structured interviews conducted by phone surveyed 1) the strengths and benefits of TELE-IBD; 2) challenges associated with using TELE-IBD; and 3) how to improve the TELE-IBD intervention. Interviews were recorded, professionally transcribed, and coded based on a priori concepts and emergent themes with the aid of ATLAS.ti qualitative data analysis software. RESULTS Participants' discussions centered on three elements of the intervention: 1) self-assessment questions, 2) action plans, and 3) educational messages. Participants also commented on: text-based platform, depression and adherence, TELE-IBD system in place of office visit, and their recommendations for future TELE-IBD systems. Adherent and non-adherent participants prefer a flexible system that is personalized, including targeted education messages, and they perceive TELE-IBD as effective in facilitating IBD self-management. CONCLUSIONS Participants identified clear benefits to the TELE-IBD system, including obtaining a better understanding of the disease process, monitoring their symptoms, and feeling connected to their health care provider. Participants' perceptions obtained in this qualitative study will assist in improving the TELE-IBD system to be more responsive to patients with IBD. CLINICALTRIAL NCT01692743

The Politics of Part-Time Work: Gender, Employment Status, and Preferences for Redistribution

2020 ◽  
pp. 1-38
Author(s):  
David S. Pedulla ◽  
Michael J. Donnelly
Keyword(s):  
Employment Status ◽  
General Social Survey ◽  
The United States ◽  
Limited Attention ◽  
Full Time ◽  
Cross Sectional ◽  
Preferences For Redistribution ◽  
Time Work ◽  
Part Time ◽  
Part Time Work

Abstract The social and economic forces that shape attitudes toward the welfare state are of central concern to social scientists. Scholarship in this area has paid limited attention to how working part-time, the employment status of nearly 20% of the U.S. workforce, affects redistribution preferences. In this article, we theoretically develop and empirically test an argument about the ways that part-time work, and its relationship to gender, shape redistribution preferences. We articulate two gender-differentiated pathways—one material and one about threats to social status—through which part-time work and gender may jointly shape individuals’ preferences for redistribution. We test our argument using cross-sectional and panel data from the General Social Survey in the United States. We find that the positive relationship between part-time employment, compared to full-time employment, and redistribution preferences is stronger for men than for women. Indeed, we do not detect a relationship between part-time work and redistribution preferences among women. Our results provide support for a gendered relationship between part-time employment and redistribution preferences and demonstrate that both material and status-based mechanisms shape this association.

scholarly journals Cyber Terrorism and Public Support for Retaliation – A Multi-Country Survey Experiment

2021 ◽  
pp. 1-19
Author(s):  
Ryan Shandler ◽  
Michael L. Gross ◽  
Sophia Backhaus ◽  
Daphna Canetti
Keyword(s):  
Television News ◽  
Public Support ◽  
Strong Support ◽  
The United States ◽  
Randomized Experiments ◽  
Cyber Terrorism ◽  
News Reports ◽  
Terror Attacks ◽  
Psychological Mechanisms ◽  
Psychological Mechanism

Abstract Does exposure to cyber terrorism prompt calls for retaliatory military strikes? By what psychological mechanism does it do so? Through a series of controlled, randomized experiments, this study exposed respondents (n = 2,028) to television news reports depicting cyber and conventional terror attacks against critical infrastructures in the United States, United Kingdom and Israel. The findings indicate that only lethal cyber terrorism triggers strong support for retaliation. Findings also confirm that anger bridges exposure to cyber terrorism and retaliation, rather than psychological mechanisms such as threat perception or anxiety as other studies propose. These findings extend to the cyber realm a recent trend that views anger as a primary mechanism linking exposure to terrorism with militant preferences. With cyber terrorism a mounting international concern, this study demonstrates how exposure to this threat can generate strong public support for retaliatory policies, depending on the lethality of the attack.

A Nationwide Survey of COVID-19 Testing in LGBTQ+ Populations in the United States

2021 ◽  
pp. 003335492110181
Author(s):  
Richard J. Martino ◽  
Kristen D. Krause ◽  
Marybec Griffin ◽  
Caleb LoSchiavo ◽  
Camilla Comer-Carruthers ◽  
...  
Keyword(s):  
United States ◽  
Gay Men ◽  
Antibody Test ◽  
Nationwide Survey ◽  
The United States ◽  
Sociodemographic Characteristics ◽  
Full Time ◽  
Test Results ◽  
Antibody Testing ◽  
And Gender

Objectives Lesbian, gay, bisexual, transgender, or queer and questioning (LGBTQ+) people and populations face myriad health disparities that are likely to be evident during the COVID-19 pandemic. The objectives of our study were to describe patterns of COVID-19 testing among LGBTQ+ people and to differentiate rates of COVID-19 testing and test results by sociodemographic characteristics. Methods Participants residing in the United States and US territories (N = 1090) aged ≥18 completed an internet-based survey from May through July 2020 that assessed COVID-19 testing and test results and sociodemographic characteristics, including sexual orientation and gender identity (SOGI). We analyzed data on receipt and results of polymerase chain reaction (PCR) and antibody testing for SARS-CoV-2 and symptoms of COVID-19 in relation to sociodemographic characteristics. Results Of the 1090 participants, 182 (16.7%) received a PCR test; of these, 16 (8.8%) had a positive test result. Of the 124 (11.4%) who received an antibody test, 45 (36.3%) had antibodies. Rates of PCR testing were higher among participants who were non–US-born (25.4%) versus US-born (16.3%) and employed full-time or part-time (18.5%) versus unemployed (10.8%). Antibody testing rates were higher among gay cisgender men (17.2%) versus other SOGI groups, non–US-born (25.4%) versus US-born participants, employed (12.6%) versus unemployed participants, and participants residing in the Northeast (20.0%) versus other regions. Among SOGI groups with sufficient cell sizes (n > 10), positive PCR results were highest among cisgender gay men (16.1%). Conclusions The differential patterns of testing and positivity, particularly among gay men in our sample, confirm the need to create COVID-19 public health messaging and programming that attend to the LGBTQ+ population.

scholarly journals Methodological and Measurement Advances in Social Determinants of HIV: View from NIH

2021 ◽  
Author(s):  
Gregory Greenwood ◽  
Paul Gaist ◽  
Ann Namkung ◽  
Dianne Rausch
Keyword(s):  
Social Determinants ◽  
Social Dynamics ◽  
The United States ◽  
Lessons Learned ◽  
Structural Determinants ◽  
Effective Interventions ◽  
Suboptimal Care ◽  
The Social ◽  
Hiv Acquisition ◽  
Ecological Momentary

AbstractSocial determinants are increasingly understood as key contributors to patterns of heightened risk for HIV acquisition and suboptimal care and treatment outcomes. Yet, the ability to rigorously model, map and measure these nuanced social dynamics has been a challenge, resulting in limited examples of effective interventions and resource allocation. In 2016, the United States National Institute of Mental Health (NIMH) and the National Institute of Allergy and Infectious Diseases (NIAID) issued a Request for Applications calling for methodological innovations around the social determinants of HIV. In May of 2019, NIMH, in collaboration with American University’s Center on Health, Risk and Society and the DC Center for AIDS Research, sponsored a symposium to bring together the funded teams to share accomplishments, distill lessons learned and reflect on the state of the science with other key stakeholders. Presentations focused on causal inference, multi-level analysis and mathematical modeling (Models); geospatial analytics and ecological momentary assessments (Maps); and measurement of social and structural determinants including inequalities and stigmas (Measures). Cross-cutting and higher-level themes were discussed and largely focused on the importance of critical and careful integration of social theory, community engagement and mixed methodologies into research on the social determinants of HIV.

Medication Administration Practices in United States’ Schools: A Systematic Review and Meta-synthesis

2021 ◽  
pp. 105984052110263
Author(s):  
Ashley A. Lowe ◽  
Joe K. Gerald ◽  
Conrad Clemens ◽  
Cherie Gaither ◽  
Lynn B. Gerald
Keyword(s):  
United States ◽  
Systematic Review ◽  
Public Schools ◽  
Medication Management ◽  
The United States ◽  
Medication Administration ◽  
Full Time ◽  
Level Of Training ◽  
K 12 ◽  
Keyword Searches

Schools often provide medication management to children at school, yet, most U.S. schools lack a full-time, licensed nurse. Schools rely heavily on unlicensed assistive personnel (UAP) to perform such tasks. This systematic review examined medication management among K-12 school nurses. Keyword searches in three databases were performed. We included studies that examined: (a) K-12 charter, private/parochial, or public schools, (b) UAPs and licensed nurses, (c) policies and practices for medication management, or (d) nurse delegation laws. Three concepts were synthesized: (a) level of training, (b) nurse delegation, and (c) emergency medications. One-hundred twelve articles were screened. Of these, 37.5% (42/112) were comprehensively reviewed. Eighty-one percent discussed level of training, 69% nurse delegation, and 57% emergency medications. Succinct and consistent policies within and across the United States aimed at increasing access to emergency medications in schools remain necessary.

Psychology Staffing at Cancer Centers: Data From National Comprehensive Cancer Network Member Institutions

2020 ◽  
Vol 16 (11) ◽  
pp. e1343-e1354
Author(s):  
Laura Melton ◽  
Diana Krause ◽  
Jessica Sugalski
Keyword(s):  
National Comprehensive Cancer Network ◽  
Patient Care ◽  
Clinical Care ◽  
The United States ◽  
Direct Patient Care ◽  
Cancer Center ◽  
Network Member ◽  
Full Time ◽  
Cancer Centers ◽  
Cancer Network

PURPOSE: The field of psycho-oncology is relatively undeveloped, with little information existing regarding the use of psychologists at cancer centers. Comprising 30 leading cancer centers across the United States, the National Comprehensive Cancer Network (NCCN) set out to understand the trends in its Member Institutions. METHODS: The NCCN Best Practices Committee surveyed NCCN Member Institutions regarding their use of psychologists. The survey was administered electronically in the spring/summer of 2017. RESULTS: The survey was completed by 18 cancer centers. Across institutions, 94% have psychologists appointed to provide direct care to their cancer center patients. The number of licensed psychologist full-time equivalents (FTEs) on staff who provide direct patient care ranged from < 1.0 FTE (17%) to 17.0-17.9 FTEs (6%). Regarding psychologist appointments, 41% have both faculty and staff appointments, 41% have all faculty appointments, and 18% have all staff appointments. Forty-three percent of institutions indicated that some licensed psychologists at their centers (ranging from 1%-65%) do not provide any direct clinical care, and 57% indicated that all licensed psychologist on staff devote some amount of time to direct clinical care. The percent of clinical care time that is spent on direct clinical care ranged from 15%-90%. CONCLUSION: There is great variability in psychology staffing, academic appointments, and the amount of direct patient care provided by on-staff psychologists at cancer centers.

Low Self-Control, Substance-Using Peers and Intimate Partners, Pro-Drug Use Definitions, and Inhalant Use Among Convicted Offenders in South Korea

2020 ◽  
Vol 51 (1) ◽  
pp. 128-142 ◽  
Author(s):  
Jaeyong Choi ◽  
Nathan E. Kruis
Keyword(s):  
Social Learning ◽  
South Korea ◽  
Strong Support ◽  
The United States ◽  
Self Control ◽  
Learning Mechanisms ◽  
Mediation Effects ◽  
Mediation Hypothesis ◽  
Low Self Control ◽  
The Relationship

Hirschi has repeatedly argued that the relationship between social learning variables and crime is a product of “self-selection” driven by low self-control (LSC). Akers’ has suggested that social learning mechanisms, such as affiliations with deviant individuals and acceptance of criminal definitions, can mediate the effects of LSC on crime. Interestingly, there has been little comparative work done to explore this mediation hypothesis in the realm of substance use for offender populations outside of the United States. This study helps fill these gaps in the literature by exploring the potential mediation effects of social learning variables on the relationship between LSC and inhalant use among a sample of 739 male offenders in South Korea. Our results provide strong support for the mediation hypothesis that LSC indirectly influences self-reported inhalant use through social learning mechanisms.

Will Routine Annual Influenza Prevention and Control Systems Serve the United States Well in a Pandemic?

2009 ◽  
Vol 3 (S2) ◽  
pp. S160-S165 ◽  
Author(s):  
Jeanne S. Ringel ◽  
Melinda Moore ◽  
John Zambrano ◽  
Nicole Lurie
Keyword(s):  
Public Health ◽  
United States ◽  
Prevention And Control ◽  
The United States ◽  
Qualitative Assessment ◽  
Full Potential ◽  
Pandemic Preparedness ◽  
The Public ◽  
Influenza Prevention ◽  
And Control

ABSTRACTObjective: To assess the extent to which the systems in place for prevention and control of routine annual influenza could provide the information and experience needed to manage a pandemic.Methods: The authors conducted a qualitative assessment based on key informant interviews and the review of relevant documents.Results: Although there are a number of systems in place that would likely serve the United States well in a pandemic, much of the information and experience needed to manage a pandemic optimally is not available.Conclusions: Systems in place for routine annual influenza prevention and control are necessary but not sufficient for managing a pandemic, nor are they used to their full potential for pandemic preparedness. Pandemic preparedness can be strengthened by building more explicitly upon routine influenza activities and the public health system’s response to the unique challenges that arise each influenza season (eg, vaccine supply issues, higher than normal rates of influenza-related deaths). (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S160–S165)

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