Applying the Social Ecological Model to Explore HIV-Related Stigma in the Southeastern United States: A Qualitative Study

2020 ◽  
Author(s):  
Veronica L Richards ◽  
Renessa Williams ◽  
Nichole E Stetten ◽  
Shantrel S Canidate ◽  
Angel Algarin ◽  
...  

Abstract Background: Although evidence suggests HIV-related stigma directly affects health and behaviors, we have a limited understanding of stigma’s influence beyond the individual-level. We aimed to describe HIV-related stigma and strategies to reduce it in the Southeastern U.S. within the context of the social ecological model (SEM). Methods: Qualitative surveys were distributed in-person at community events, conferences, and via email to persons affected by HIV periodically over 8 months. The final sample size included 87 participants (33 persons living with HIV, 54 without HIV). A directed content analysis was used to code responses into five levels of the SEM (individual, interpersonal, community, institutional, and structural). Results: Multiple themes emerged within each level: Individual – knowledge, fear, internalization; Interpersonal – social network; Community – judgements, discrimination, community organizations, norms; Institutional – competent providers, healthcare services; and Structural – systemic barriers, language, education. Conclusions: The findings exemplify the need for a multi-level approach to intervene and reduce HIV-related stigma. Based on the experiences and suggestions of people affected by HIV, future interventions should include substantial consideration from persons affected by HIV.

2018 ◽  
Vol 24 (1) ◽  
pp. 14 ◽  
Author(s):  
Jessica Taylor ◽  
Greer Lamaro Haintz

Refugees in Australia are not fully utilising the healthcare system for several reasons and this may be affecting their overall health outcomes. This qualitative systematic review examined the influence of the social determinants of health on refugees’ access to healthcare services in Australia. Electronic databases were searched using terms relating to refugees, social determinants, healthcare services, barriers, enablers and Australia. Only peer-reviewed studies published in English since 2006, which focused on refugees and specifically discussed social determinants influencing refugees’ access to healthcare services in Australia, were included. The studies were critically analysed using standard Critical Appraisal Skills Programme Tools. Eight studies were included in the review. Findings reveal multiple factors influence refugees’ access to healthcare in Australia, and these can be conceptualised within a social-ecological model of health; that is, they operate across individual, interpersonal, environmental, organisational and policy levels. The novel finding of this review was the re-occurrence of similar influences across multiple healthcare service settings in Australia. The prevalence and re-occurring nature of the social determinants of health suggests that refugees are experiencing multilayered barriers to accessing Australian healthcare. All levels of a social-ecological model must be addressed in any attempt to break down these barriers.


SAGE Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 215824402091952
Author(s):  
Jasvir Kaur ◽  
Manmeet Kaur ◽  
Venkatesan Chakrapani ◽  
Rajesh Kumar

Designing effective interventions for achieving desired dietary behavior changes requires an in-depth study of people’s behaviors situated in sociocultural and interpersonal contexts. Guided by the Social Ecological Model, we explored the individual, family, and social-structural-level influences on dietary behaviors related to consumption of fat, sugar, salt, fruits, and vegetables among urban adults in India. We conducted 10 focus groups with a sample of men and women in diverse socioeconomic groups. Data were explored using framework analysis. Social Ecological Model helped in identifying multilevel influences that facilitated or hindered healthy dietary behaviors: Individual-level influences—awareness of dietary recommendations, self-efficacy, risk perception, and perceived benefits and costs; Family-level influences—family members’ preferences, family norms, family support, and the home environment; and Social-structural influences—societal norms, culture, media, cost, availability and accessibility of fruits and vegetables, and government policies. Overall, the findings indicated the need for a range of multilevel interventions that are more likely to promote and sustain healthy dietary behaviors—for example, improving awareness about dietary recommendations (individual level), promoting positive family norms through involvement of family members (family level), and restricting the use of fat, sugar, and salt in packaged food, and supportive policies for promoting consumption of fruits and vegetables (structural level).


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ethan Cowan ◽  
Maria R. Khan ◽  
Siri Shastry ◽  
E. Jennifer Edelman

AbstractThe COVID-19 pandemic has resulted in unparalleled societal disruption with wide ranging effects on individual liberties, the economy, and physical and mental health. While no social strata or population has been spared, the pandemic has posed unique and poorly characterized challenges for individuals with opioid use disorder (OUD). Given the pandemic’s broad effects, it is helpful to organize the risks posed to specific populations using theoretical models. These models can guide scientific inquiry, interventions, and public policy. Models also provide a visual image of the interplay of individual-, network-, community-, structural-, and pandemic-level factors that can lead to increased risks of infection and associated morbidity and mortality for individuals and populations. Such models are not unidirectional, in that actions of individuals, networks, communities and structural changes can also affect overall disease incidence and prevalence. In this commentary, we describe how the social ecological model (SEM) may be applied to describe the theoretical effects of the COVID-19 pandemic on individuals with opioid use disorder (OUD). This model can provide a necessary framework to systematically guide time-sensitive research and implementation of individual-, community-, and policy-level interventions to mitigate the impact of the COVID-19 pandemic on individuals with OUD.


2021 ◽  
Vol 33 (6) ◽  
pp. 511-533
Author(s):  
Kenneth C. Hergenrather ◽  
Diona Emmanuel ◽  
Robert J. Zeglin ◽  
David J. Ruda ◽  
Scott D. Rhodes

In the United States, gay, bisexual men, and men who have sex with men (MSM) represent 86% of new HIV infections among males. Approximately 1 in 7 men with HIV are unaware of their HIV status (CDC, 2017, 2019a, 2020a). To explore influences on MSM HIV risk behavior, the authors performed a systematic review of quantitative studies conducted in the U.S. assessing what is purported as masculinity. From 30 identified studies, significant findings were framed within the Social Ecological Model (SEM) levels (e.g., Individual, Relationship, Community). SEM level themes were applied to create the Masculinity 10, a preliminary 10-item assessment to explore the influence of masculinity on MSM HIV risk behavior. To increase MSM engagement in HIV prevention and treatment, the influences of masculinity (e.g., attitude toward sexual minorities, appearance, emotion, temperament, substance use, sexual activity, social support, intimate relationships, health care) on HIV risk behavior should be further explored.


2018 ◽  
Vol 78 (1) ◽  
pp. 51-66 ◽  
Author(s):  
Odette Jack ◽  
Elaine Chase ◽  
Ian Warwick

Objective: This study aimed to investigate how well a single higher education institution (HEI) was perceived to be meeting the psychosocial support needs of refugee students and to identify possible ways in which the HEI might better promote refugee students’ psychosocial well-being. Design: Adopting an exploratory, focused case study design, the research employed a qualitative interpretive approach utilising three data collection methods: narrative inquiry, Photovoice and key informant interviews. The social ecological model and the health-promoting university approach guided the enquiry and analysis. Setting: A single HEI in London, UK. Results: Refugee student-participants reported stressful and traumatic experiences at different points in their migratory experience. Participants were motivated by being involved in education but identified barriers to seeking institutional support to improve their health and well-being. Student-participants and staff identified ways in which support for refugee student well-being could be improved. Conclusion: Refugee students were found to have specific health and well-being support needs which were not met due to a range of organisational constraints. The social ecological model and the health-promoting university offer frameworks for HEIs to respond better to the diverse health and well-being needs of students.


2021 ◽  
pp. 118-151
Author(s):  
Gordon Braxton

Chapter 6 considers the “heroes” of Black boys and identifies some of the current and historical messages from entertainment media, with a particular focus on hip-hop and R&B music. The film industry is also discussed as a potential site where positive messaging can occur. The need to defend these heroes is examined, and discussion of their faults is presented as a window for having difficult conversations with boys. Informed by the social-ecological model, the chapter closes by asking about the appropriate standards to which celebrities should be held and challenging the reader to fill the moral voids vacated by media figures.


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