Evidence for use of a healthy relationships assessment tool in the CHARISMA pilot study

Introduction The CHARISMA intervention, nested within the MTN-025/HOPE vaginal ring trial in Johannesburg, South Africa, seeks to facilitate women’s use of HIV prevention products by promoting partner dialogue and mitigating intimate partner violence (IPV). We developed “HEART”, a lay counselor-administered relationship assessment tool, for the CHARISMA pilot. The five-scale tool assesses participants’ endorsement of Traditional Values (TV), her HIV Prevention Readiness (HPR) and levels of partner support (PS), abuse and control (PAC), and resistance to HIV prevention (PR), guiding decisions about which of three counselling modules to offer (partner communication/A; ring disclosure/B; and IPV prevention/C). Methods We correlated baseline scores on HEART subscales with a) independent measures of relationship stability, disclosure and IPV to assess construct validity, and b) with specific modules offered to determine how HEART was used in the pilot. We examined changes in HEART scores at three and six months. Finally, we ran separate growth models for each subscale to examine changes in scores, accounting for partnership changes and counseling module(s) received. Results Baseline HEART scores correlated as predicted among subscales and with other measures. Reliabilities for four subscales were 0.75 or higher. Women who disclosed study participation and ring use scored higher on PS and lower on PR. Women experiencing IPV scored lower on PS, and higher on PAC and PR. During the pilot, 82% of women received one and 17% received two or more modules; over half received the IPV module. Women with higher PAC and PR scores were more likely to receive the IPV than the communication or disclosure modules. Over time, the TV, PAC and PR scores decreased, and PS score increased. Receiving the IPV module was associated with a decreased PAC score. Conclusions These data offer preliminary evidence for HEART construct and predictive validity and support its further evaluation to guide implementation and monitor the impact of the CHARISMA intervention in a randomized controlled evaluation.

A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania

Background HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV-enhanced and Centering-based group ANC model-Group ANC+ that uses interactive learning to practice partner communication is associated with improvements in partner HIV testing during pregnancy. Methods A randomized pilot study conducted in Malawi and Tanzania found multiple positive outcomes for pregnant women (n = 218) assigned to Group ANC+ versus individual ANC. This analysis adds previously unpublished results for two late pregnancy outcomes: communication with partner about three reproductive health topics (safer sex, HIV testing, and family planning) and partner HIV testing since the first antenatal care visit. Multivariate logistic regression models were used to assess the effect of type of ANC on partner communication and partner testing. We also conducted a mediation analysis to assess whether partner communication mediated the effect of type of care on partner HIV testing. Results Nearly 70% of women in Group ANC+ reported communicating about reproductive health with their partner, compared to 45% of women in individual ANC. After controlling for significant covariates, women in group ANC were twice as likely as those in individual ANC to report that their partner got an HIV test (OR 1.99; 95% CI: 1.08, 3.66). The positive effect of the Group ANC + model on partner HIV testing was fully mediated by increased partner communication. Conclusions HIV prevention was included in group ANC health promotion without compromising services and coverage of standard ANC topics, demonstrating that local high-priority health promotion needs can be integrated into ANC using a Group ANC+. These findings provide evidence that greater partner communication can promote healthy reproductive behaviors, including HIV prevention. Additional research is needed to understand the processes by which group ANC allowed women to discuss sensitive topics with partners and how these communications led to partner HIV testing.

The role of identity uncertainty in predicting relational turbulence and perceived partner communication for women coping with infertility

Infertility can change the way people see themselves and their relational roles. This study examined how changes to identity following reproductive hardship are associated with identity uncertainty and relationship outcomes. Drawing on relational turbulence theory, we position identity uncertainty as an antecedent condition for relational uncertainty and interdependence processes in the context of infertility and examine these relationship mechanisms as predictors of relational turbulence and perceptions of partner communication during this relationship transition. We surveyed 152 women who have been unsuccessful at conceiving for at least 12 months about their identity and perceptions of their relationship. Data were analyzed using structural equation modeling. Consistent with hypotheses, identity change was positively associated with identity uncertainty, which, in turn, predicted increased relational uncertainty. Relational turbulence was positively predicted by relational uncertainty, but not partner interference or facilitation. Perceptions of a partner’s communication were predicted by relational turbulence and partner facilitation. The theoretical and practical implications of the findings are discussed.

Romantic Partner Interference and Psychological Reactance in the Context of Caregiving for an Aging Family Member

Negotiating romantic relational dynamics is inherent to family caregiving situations, which continue to be on the rise in the United States. However, despite evidence that family caregiving duties are linked to a variety of negative relational outcomes, limited research examines communication processes that contribute to or alleviate the burden of caregiver duties on romantic relationships. Guided by psychological reactance theory (PRT), this study examined the link between romantic partner interference with family caregiving duties and the reactance process, as well as directness of communication about irritation as a type of freedom restoration behavior associated with reactance. Adults caring for aging family members recruited from MTurk ( N = 187) completed an online survey as part of a larger study of romantic partner communication surrounding family caregiving. Results using PROCESS serial mediation indicated that greater partner interference was related to heightened perceptions of freedom threat, which was positively associated with the experience of reactance, which in turn was associated with communication about irritation. However, the association between reactance and directness of communication about irritation was negative, the opposite direction of what was hypothesized. Implications for PRT and interventions with caregivers and their romantic partners are discussed.

Potret Tuturan Direktif Kata Pengantar: Portofolio Mata Kuliah Membaca Menulis Bahasa Jawa

Directive speech is understood as a speech event (behavior) that aims to create or appear a certain action desired by the speaker to the speech partner. Communication carried out by two parties requires an understanding of the language knowledge of the parties concerned. The purpose of the research is to describe the form, function, and strategy of directive speech contained in the introduction to a portfolio of Javanese reading and writing courses. The method used is descriptive method because it is adjusted to the objectives to be achieved. The literature study technique used by the researcher is done by collecting materials from various written sources, with the library study technique the role of the researcher is very influential with the results presented. The data analysis technique used by the researcher begins with carefully reading all the collected data, then data reduction is carried out, and the data is ready to be presented. The results of the study are indicated by the situation of speech forms which are marked by certain words, speech functions are characterized by the dominance of sentences in the collected data, and speech strategies are indicated by the dominance of understanding the context that is raised by the speaker to his interlocutor. Keywords: foreword, Javanese language portfolio, directive speech Abstrak: Tuturan direktif dipahami sebagai peristiwa (perilaku) bertutur yang bertujuan untuk penciptaan atau pemunculan adanya suatu tindakan tertentu yang dikehendaki oleh penutur kepada mitra tutur. Komunikasi yang dilakukan oleh dua pihak diharuskan ada pemahaman pengetahuan bahasa atas pihak terkait. Tujuan dari penelitian yakni dipaparkannya bentuk, fungsi, dan strategi dari tuturan direktif yang terdapat dalam kata pengantar portofolio mata kuliah membaca menulis bahasa Jawa. Metode yang digunakan adalah metode deskriptif, karena disesuaikan dengan tujuan yang akan dicapai. Teknik studi kepustakaan yang digunakan peneliti dilakukan dengan cara dikumpulkannya bahan dari berbagai sumber tertulis, dengan teknik studi kepustakaan peran yang dimiliki peneliti sangat berpengaruh dengan hasil yang disajikan. Teknik analisis data yang digunakan peneliti diawali dengan dibaca cermat seluruh data terkumpul, kemudian dilakukan reduksi data, dan data siap untuk disajikan. Hasil dari penelitian ditunjukkan dengan situasi bentuk tuturan yang ditandai kata tertentu, fungsi tuturan ditandai dengan dominasi kalimat pada data terkumpul, dan strategi tuturan ditunjukkan dengan dominasi pemahaman konteks yang dimunculkan oleh penutur kepada mitra tuturnya. Kata kunci: kata pengantar, portofolio bahasa Jawa, tuturan direktif

Understanding family planning outcomes in northwestern Nigeria: analysis and modeling of social and behavior change factors

Background Northwestern Nigeria faces a situation of high fertility and low contraceptive use, driven in large part by high-fertility norms, pro-natal cultural and religious beliefs, misconceptions about contraceptive methods, and gender inequalities. Social and behavior change (SBC) programs often try to shift drivers of high fertility through multiple channels including mass and social media, as well as community-level group, and interpersonal activities. This study seeks to assist SBC programs to better tailor their efforts by assessing the effects of intermediate determinants of contraceptive use/uptake and by demonstrating their potential impacts on contraceptive use, interpersonal communication with partners, and contraceptive approval. Methods Data for this study come from a cross-sectional household survey, conducted in the states of Kebbi, Sokoto and Zamfara in northwestern Nigeria in September 2019, involving 3000 women aged 15 to 49 years with a child under 2 years. Using an ideational framework of behavior that highlights psychosocial influences, mixed effects logistic regression analyses assess associations between ideational factors and family planning outcomes, and post-estimation simulations with regression coefficients model the magnitude of effects for these intermediate determinants. Results Knowledge, approval of family planning, and social influences, particularly from husbands, were all associated with improved family planning outcomes. Approval of family planning was critical – women who personally approve of family planning were nearly three times more likely to be currently using modern contraception and nearly six times more likely to intend to start use in the next 6 m. Husband’s influence was also critical. Women who had ever talked about family planning with their husbands were three times more likely both to be currently using modern contraception and to intend to start in the next 6 m. Conclusion SBC programs interested in improving family planning outcomes could potentially achieve large gains in contraceptive use—even without large-scale changes in socio-economic and health services factors—by designing and implementing effective SBC interventions that improve knowledge, encourage spousal/partner communication, and work towards increasing personal approval of family planning. Uncertainty about the time-order of influencers and outcomes however precludes inferences about the existence of causal relationships and the potential for impact from interventions.

Identifying Conservation Technology Needs, Barriers, and Opportunities

Amid accelerating threats to species and ecosystems, technology advancements to monitor, protect and conserve biodiversity have taken on increased importance. While most innovations stem from adaptation of off-the-shelf devices, these tools can fail to meet the specialized needs of conservation and research or lack the support to scale beyond a single site. Despite calls from the conservation community of its importance, a shift to bottom-up innovation driven by conservation professionals remains limited. We surveyed practitioners, academic researchers, and technologists to identify limitations of currently-available technologies, barriers to the development of new tools, and emerging technology needs. High cost was the main barrier to technology use across occupations, while development of new technologies faced barriers of cost and partner communication. Automated processing of data streams was the largest emerging need, and respondents focused mainly on applications for individual-level monitoring and automated image processing. Cross-discipline collaborations and expanded funding networks that encourage cyclical development and continued technical support are needed to address current limitations and meet the growing need for conservation technologies.

Queer Safer Sex Communication

Although communication scholars have been exploring the role of partner communication in sexual health promotion since the 1960s, the term safer sex, and its corollary safer sex communication, emerged in the late 1980s in the wake of the HIV/AIDS epidemic, which was and still is disproportionately affecting queer individuals. Numerous studies, along with some meta-analyses, point to the protective potential of safer sex discussions, defined here as the communicative management of health concerns with sex partners. Despite scholarly agreement regarding its importance, the term safer sex communication has received little explication, and much of what is known about it comes from studies with predominantly heterosexual samples. A review of the literature on queer safer sex communication points to some key issues related to age, race, trauma history, place, and pre-exposure prophylaxis (PrEP), and suggests important considerations for future research efforts.