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HIV information needs of parents of young men who have sex with men
Abstract
Objective:
Young men who have sex with men (YMSM) have unique health concerns, including high rates of HIV infection. To prevent HIV, YMSM need credible information from trusted sources, specifically parents. Little is known about what health information resources parents of YMSM need to communicate with their child about HIV prevention. The primary objective of this study was to examine the proxy health information seeking behaviours of parents of YMSM and to identify information resources that parents need to communicate with their YMSM identified child about HIV prevention.
Methods:
Qualitative findings were grouped into four categories: parents' current health information sources; barriers to seeking health information; parents' health information needs; and recommendations for delivery of health information for parents. Ten in-depth interviews were conducted with parents of YMSM.
Results:
Parents reported consulting physicians and the Internet for HIV/AIDS information. They reported finding limited information targeted towards parents of YMSM and provided suggestions for improving the delivery of health information including training, websites and the local news.
Conclusions:
Delivery of tailored HIV prevention information to parents may be effective in helping combat HIV among YMSM. Given that YMSM bear the greatest burden for HIV, this study highlights the need to include parents of YMSM in future interventions aimed at reducing YMSM's risk of HIV/AIDS.
... Research has shown that sexual minority male AYAs whose parents communicated with them about sexual health are more likely to use condoms, get HIV tested, and use HIV pre-exposure prophylaxis than sexual minority males who did not have parent-child sex communication Bouris et al., 2015;Flores et al., 2020aFlores et al., , 2020bThoma & Huebner, 2018a, 2018b. Many parents of SGM AYAs self-reported talking with their children about sexual health topics (Grant et al., 2023;LaSala, 2007LaSala, , 2015LaSala et al., 2016;Rose & Friedman, 2016;Rose et al., 2014). However, most also reported feeling uncomfortable and unknowledgeable about SGM-related sexual health (LaSala, 2007(LaSala, , 2015LaSala et al., 2016;Newcomb et al., 2018;Rose & Friedman, 2016;Rose et al., 2014). ...
... Many parents of SGM AYAs self-reported talking with their children about sexual health topics (Grant et al., 2023;LaSala, 2007LaSala, , 2015LaSala et al., 2016;Rose & Friedman, 2016;Rose et al., 2014). However, most also reported feeling uncomfortable and unknowledgeable about SGM-related sexual health (LaSala, 2007(LaSala, , 2015LaSala et al., 2016;Newcomb et al., 2018;Rose & Friedman, 2016;Rose et al., 2014). Many SGM AYAs feel the same, perceiving their parents as unknowledgeable and awkward when discussing sexuality at large and SGM sexuality (Charmaraman et al., 2021;Feinstein et al., 2018;Flores et al., 2019). ...
... It is important to note that in addition to the limited number of parent-based interventions that have been efficacy tested, there is a significant shortage of literature on the willingness of parents of SGM teens to participate in such interventions and their attitudes toward participation. While some qualitative studies suggested that parents of SGM teens find online parent-based sex communication interventions necessary, their attitudes toward participating in such interventions are unknown (LaSala et al., 2016;Newcomb et al., 2018;Rose & Friedman, 2016). Quantitative studies have demonstrated that most parents hold positive attitudes toward ASSIST and PATHS, finding them satisfactory, easy to use, and of high quality (Flores et al., 2021;Huebner et al., 2023). ...
Although parents of sexual and gender minority (SGM) adolescents play a critical role in communicating about sexual health to their children, most parents have reported that they are unknowledgeable and uncomfortable talking about sexual health to their SGM adolescent. Because of the limited availability of sex education programs for parents of SGM adolescents, the study aimed to (1) describe the attitudes toward using and willingness to use a hypothetical online sex communication intervention for parents of SGM adolescents and (2) examine factors associated with willingness to use such an intervention. Parents of SGM adolescents from across the United States (N = 385) completed an online survey from March 10–16, 2023. Most participants were open to participating in a hypothetical online sex communication program and had positive attitudes toward it. Logistic regression results showed that participants who overall agreed a hypothetical online parent-based sex education intervention would be helpful and of interest had higher odds of being overall willing to participate in such a hypothetical intervention. Additionally, participants with higher income levels were also more likely to be willing to participate in a hypothetical program. Results from this exploratory study suggest that most parents of SGM adolescents have positive attitudes toward a hypothetical online parent-based sex education program and are willing to participate in it, highlighting a need to develop sex education programs tailored to the needs and preferences of parents of SGM adolescents. Additionally, equitable access to such programs is necessary especially regarding income level.
... Studies have shown that interpersonal sources are most frequently used by proxy seekers. Healthcare providers (e. g., Cutrona et al., 2015;Rose & Friedman, 2016), including physicians, pharmacists, doctors, nurses, and other health professionals, were often cited as priority interpersonal sources of health information by surrogate seekers, followed by family members and friends (Thomas, 2020). Proxy seekers perceived healthcare providers as reliable, trustworthy, and accessible (Rose & Friedman, 2016). ...
... Healthcare providers (e. g., Cutrona et al., 2015;Rose & Friedman, 2016), including physicians, pharmacists, doctors, nurses, and other health professionals, were often cited as priority interpersonal sources of health information by surrogate seekers, followed by family members and friends (Thomas, 2020). Proxy seekers perceived healthcare providers as reliable, trustworthy, and accessible (Rose & Friedman, 2016). Moreover, people also used anecdotal health information based on personal experience (Cole, 2014). ...
... 2) Internet sources. Studies have shown that participants accessed health information on the Internet more frequently because of the convenience, cost-efficiency, and level of privacy it provides (Rose & Friedman, 2016). Studies identified various websites, including search engines (e.g., Xie et al., 2021), government websites (e.g., Thomas, 2020), social media (e.g., Song, Zhao, Li, & Zhu, 2022), online health forums (e.g., Song, Zhao, Li, & Zhu, 2022), commercial websites (e.g., Chang, Zhang and Gwizdka, 2021), and Q&A communities (e.g., Xie et al., 2021). ...
Seeking health-related information on behalf of or because of others is a common activity in everyday life and a topic of constant interest across multiple disciplines. The research aims to characterize recent research progress and provide a comprehensive framework of proxy health information-seeking behavior (PHISB). A total of 47 studies published after 2003 were selected, followed by structural encoding. The main contributions include 1) a summary of the key characteristics of individuals who often access health information through proxy seekers; 2) types of health information surrogates sought and sources employed; 3) a classification scheme of factors influencing PHISB; 4) a synthesis of how health information used and its subsequent outcomes; 5) a theoretical framework for proxy health information-seeking. Results point to an intellectual benchmark for future exploring related issues. The findings can shed light on public health intervention and management, especially through guiding search strategies to help people obtain relevant, helpful, and credible health information.
... Aujourd'hui, le VIH n'est plus considéré comme une maladie mortelle, mais bien comme une maladie chronique (45). Cependant, cette condition est associée à un manque d'information, de la stigmatisation et de la discrimination, principalement envers les jeunes adultes homosexuels masculins, ainsi que certaines personnes issues des minorités visibles ou ethniques (45)(46)(47)(48). Le manque de consensus concernant le devoir de divulgation du statut sérologique des patients infectés par le VIH est parfois associé au flou dans l'interprétation du degré de dangerosité associé à la transmission du virus. ...
Bien que l’étude du jugement moral ait gagné en popularité ces dernières années dans le domaine de la psychologie, peu de recherches se sont intéressées aux dilemmes de confidentialité en contexte de jugement moral. Or, les personnes cliniciennes font régulièrement face à de tels dilemmes qui surviennent souvent dans des contextes chargés émotionnellement. Cette étude évalue le rôle des émotions dans les réponses à ces dilemmes de confidentialité. En tout, 186 participants étudiant en psychologie dans différentes universités du Québec ont été assignés aléatoirement à l’un des trois groupes d’un devis expérimental (modalité audio dramatique, modalité audio neutre, modalité texte) et ont répondu à des dilemmes de confidentialité en choisissant entre la protection ou la levée de la confidentialité. Le positionnement des participants sur un continuum allant du déontologisme à l’utilitarisme, grâce à la réponse à des dilemmes sacrificiels, a également été pris en considération. Le modèle de régression linéaire multiple hiérarchique utilisé indique un apport significatif provenant des réponses aux dilemmes sacrificiels, de l’intensité émotionnelle perçue des dilemmes de confidentialité et de la formation obtenue dans le domaine de l’éthique et de la déontologie. L’analyse révèle en outre l’effet modérateur de l’exposition à la condition expérimentale sur la relation entre la tendance à l’utilitarisme et la propension à la levée de la confidentialité dans une relation psychothérapeutique. Ces résultats ont des implications pratiques concernant le cursus en psychologie, où des mises en situation avec une validité écologique pourraient bonifier la formation en éthique.
... Although many of these parents described a process through which they eventually became closer to their children by seeking education about LGBTQ issues, the period immediately after coming out may be a time during which LGBTQ youth are particularly vulnerable to negative health outcomes. With regard to sexual health, studies have found that many parents avoid discussing sexuality with their gay or bisexual male teens because they are uncomfortable talking about same-sex sexuality (LaSala, 2015) or because they lack knowledge about these issues (Rose & Friedman, 2016). However, general perceptions of parent-child closeness (as reported by both the parent and teen) are associated with less sexual risk behavior (LaSala, 2007(LaSala, , 2015, indicating that supportive relationships may buffer against negative sexual health outcomes. ...
Lesbian, gay, bisexual, transgender, and other sexual and gender minority (LGBTQ) adolescents experience higher rates of negative sexual health outcomes relative to their heterosexual and cisgender peers. Healthy parent-adolescent relationships and effective parenting are robust predictors of sexual health in heterosexual adolescents, but very little is known about barriers to and facilitators of effective parenting from the perspective of parents of LGBTQ adolescents. This study conducted online focus groups with 44 parents of LGBTQ adolescents in order to describe the factors influencing effective sexual health communication and parental monitoring in this population. Parents described generally positive relationships with teens, but many noted they went through a transition process in which they struggled with their child’s identity and were less supportive of their LGBTQ teen. Lack of understanding about LGBTQ-specific sexuality was a commonly endorsed barrier to effective communication, and this was most commonly endorsed by parents of cisgender girls. Parents of cisgender boys and transgender/gender-nonconforming teens described fears about long-term sexual health (i.e., sexual predators, consent) as a barrier to parental monitoring. Parents of LGBTQ adolescents need information and skills to optimize their teen’s sexual health. Parent-based programs for LGBTQ adolescents are long overdue for addressing these issues.
Purpose:
Parents' attitudes toward contraceptive delivery methods have been shown to impact their adolescents' use of contraceptive methods. However, little is known about the HIV pre-exposure prophylaxis (PrEP) delivery method attitudes of parents of sexual and gender minority (SGM) adolescents assigned male at birth (AMAB). This exploratory, mixed-method formative study examined the PrEP delivery method preferences among a convenience sample of 33 parents of SGM adolescents AMAB who live in Texas.
Methods:
Participants completed an online survey, where they selected their preferred PrEP method for their SGM adolescent AMAB to use: PrEP as a daily oral pill, a bimonthly injectable, or a yearly implant. Parents answered an open-ended question about their reasons for choosing their preferred method. We analyzed data through descriptive statistics and inductive content analysis.
Results:
Findings from this convenience sample suggest that there is not one PrEP delivery method that parents of SGM adolescents AMAB prefer: one third of parents (33.3%) selected PrEP as a daily oral pill, 45.5% selected PrEP as a bimonthly injectable, and 21.2% selected PrEP as an annual implant. Parents cited multiple reasons for selecting a delivery method over another, with the most prevalent reasons being adherence (57.6%), access or cost (21.2%), and generic convenience or ease (21.2%).
Discussion:
Findings from this formative exploratory study sets the stage for future research and intervention development in increasing parental knowledge, preferences, and preference motivations for PrEP delivery methods.
Prevention efforts for adolescent dating violence (ADV) have largely focused on adolescent-based interventions with little emphasis on parent- and family-based interventions, despite the integral role parents serve in adolescent relationship development. This literature review provides an overview of the existing parent- and family-based intervention efforts for ADV. This review highlights that some programs are geared toward a universal audience, whereas others are more targeted towards populations believed to be at greater risk for ADV. Some programs primarily target parents, whereas others integrate parent-based components into primarily adolescent-focused or comprehensive programs. Aspects to consider when selecting a program are discussed, as well as future directions. Suggested future directions involve broadening existing parent- and family-based programming for ADV to include a focus on secondary and tertiary prevention, gender differences, and gender and sexual minorities. This review also highlights the need for existing programs to expand their evaluation of behavioral outcomes and comparison of programs to one another.
Sexual and gender minority (SGM) youth are at disproportionate risk for HIV. Schools play an integral role in educating young people about sexual health in addition to providing sexual health services. This qualitative study examined SGM youths’ perception of school sexual health education and services. A total of 42 self-identified African American SGM males participated in focus groups or in an in-depth interview. Qualitative findings revealed that schools are missing the opportunity to educate SGM youth about sexual health. Youth participants noted several barriers to accessing sexual health education and services at schools including limited, targeted health information and school nurses not being knowledgeable of health issues that impact SGM youth. Participants noted that school sexual health services are not adequately marketed to students and sometimes do not include testing for HIV and other sexually transmitted diseases. Suggestions for future research and implications for school nurses and sexual health services are discussed.
Narrowing the gap between what we want to achieve as writings – publishing a report of our project – and what we achieve as readers – finding a study to inform our practice – can be challenging. One solution in enabling us to achieve this goal is to learn from close reading the writing of others, including writing in development. Close reading, appraisal in its broadest term, encourages us to articulate what we, putting us in touch with how an author has organised information, selected their words and structured their arguments.
Context:
HIV incidence is increasing among 13-24-year-old U.S. men who have sex with men, yet limited research is available to guide HIV prevention efforts for this population.
Methods:
National Survey of Family Growth data collected in 2002, in 2006-2010 and in 2011-2013 from 8,068 males aged 15-24 were analyzed to describe the population of U.S. young sexual minority males (i.e., males reporting same-sex attraction, identity or behavior). Correlates of sexual minority classification were assessed in logistic regression models.
Results:
An estimated 10% of young males, representing a population of 2.1 million, were sexual minorities. Males had an elevated likelihood of being sexual minorities if they were aged 18-19 or 20-24, rather than 15-17 (prevalence ratio, 1.7 for each); belonged to nonblack, non-Hispanic racial or ethnic minority groups (1.6); had no religious affiliation, rather than considering religion very important (1.9); or lived below the federal poverty level (1.3). They had a reduced likelihood of being sexual minorities if they lived in metropolitan areas outside of central cities (0.7). Among young sexual minority males, 44% were 15-19 years old, 29% were poor and 59% resided outside central cities. Forty-seven percent had engaged in same-sex behavior. Of those with data on all measured dimensions of sexuality, 24% reported same-sex attraction, identity and behavior; 22% considered themselves heterosexual, yet had had a male sex partner.
Conclusion:
Future investigations can further explore subpopulations of young sexual minority males and assess sexual trajectories, resilience and HIV risk.
This study examines 83 IS qualitative studies in leading IS journals for the following purposes: (a) identifying the extent to which IS qualitative studies employ best practices of justifying sample size; (b) identifying optimal ranges of interviews for various types of qualitative research; and (c) identifying the extent to which cultural factors (such as journal of publication, number of authors, world region) impact sample size of interviews. Little or no rigor for justifying sample size was shown for virtually all of the IS studies in this dataset. Furthermore, the number of interviews conducted for qualitative studies is correlated with cultural factors, implying the subjective nature of sample size in qualitative IS studies. Recommendations are provided for minimally acceptable practices of justifying sample size of interviews in qualitative IS studies.
Local television news remains a primary news source for Americans and is a key source of consumer health information. This study explores why local television health journalists cover particular topics and assesses why health journalism newsgathering practices often differ from the normative newsgathering practices of general assignment reporters. Fifteen in-depth telephone interviews were conducted with health journalists from varying geographical regions and media markets. Influence from local hospitals and personal interest in a health topic often determined the health content the journalists produced. Journalists said it was difficult to cover health issues in addition to other newsroom responsibilities.
The effectiveness of multiple innovative recruitment strategies for enrolling Black/African American participants to the Adventist Health Study-2 (AHS-2) is described. The study's focus is diet and breast, prostate and colon cancer.
Promotions centered on trust, relationship building and incentives for increasing enrollment and questionnaire return rate. Of the sub-studies described, one had a randomized control group, and the others, informal controls. The subjects are from all states of the U.S. and some provinces of Canada. The offer of a Black art piece, follow-up calls, a competitive tournament as well as other strategies accounted for nearly 3,000 additional returns even though they were often used in small subsets.
Flexibility and multiple strategies proved advantageous in gaining the cooperation of Blacks, who are usually reluctant to participate in research studies.
Lessons learned during initial enrollment should help us retain our final Black cohort of 26,000, and obtain new information when required.
Young black men who have sex with men (YBMSM) are experiencing high and rising rates of HIV infection, more than any other age-risk group category in the USA. Contributors to HIV risk in this group remain incompletely elucidated. We conducted exploratory qualitative interviews with 20 HIV-positive YBMSM aged 17-24 and found that father-son relationships were perceived to be important sociocontextual influences in participants' lives. Participants discussed the degree of their fathers' involvement in their lives, emotional qualities of the father-son relationship, communication about sex, and masculine socialization. Participants also described pathways linking father-son relationships to HIV risk, which were mediated by psychological and situational risk scenarios. Our thematic analysis suggests that father-son relationships are important to the psychosocial development of YBMSM, with the potential to either exacerbate or attenuate sexual risk for HIV. Interventions designed to strengthen father-son relationships may provide a promising direction for future health promotion efforts in this population.
The current study used a qualitative, phenomenological approach to investigate the health information–seeking practices of African American young men who have sex with men (AAYMSM). Forty-two self-identified AAYMSM, aged 18 to 21, residing in a Southeastern U.S. city participated in a qualitative focus group or face-to-face interview to examine their access to health information, current and preferred sources and types of health information, and recommendations for improving the delivery of health information to AAYMSM. Participants reported accessing health information from a complex network of sources, including peers, health care professionals, parents, and the Internet. Most consulted these sources to access information about the prevention of sexually transmitted infections (STIs) and HIV/AIDS. In addition, participants provided recommendations to improve delivery of health information and identified parents and the Internet as preferred sources of health information. This research highlights the importance of developing health information, specifically for AAYMSM.
Background
The quantum increases in home Internet access and available online health information with limited control over information quality highlight the necessity of exploring decision making processes in accessing and using online information, specifically in relation to children who do not make their health decisions. The aim of this study was to understand the processes explaining parents’ decisions to use online health information for child health care.
Methods
Parents (N = 391) completed an initial questionnaire assessing the theory of planned behaviour constructs of attitude, subjective norm, and perceived behavioural control, as well as perceived risk, group norm, and additional demographic factors. Two months later, 187 parents completed a follow-up questionnaire assessing their decisions to use online information for their child’s health care, specifically to 1) diagnose and/or treat their child’s suspected medical condition/illness and 2) increase understanding about a diagnosis or treatment recommended by a health professional.
Results
Hierarchical multiple regression showed that, for both behaviours, attitude, subjective norm, perceived behavioural control, (less) perceived risk, group norm, and (non) medical background were the significant predictors of intention. For parents’ use of online child health information, for both behaviours, intention was the sole significant predictor of behaviour. The findings explain 77% of the variance in parents’ intention to treat/diagnose a child health problem and 74% of the variance in their intentions to increase their understanding about child health concerns.
Conclusions
Understanding parents’ socio-cognitive processes that guide their use of online information for child health care is important given the increase in Internet usage and the sometimes-questionable quality of health information provided online. Findings highlight parents’ thirst for information; there is an urgent need for health professionals to provide parents with evidence-based child health websites in addition to general population education on how to evaluate the quality of online health information.
Despite the moderate efficacy of HIV prevention interventions for at risk gay, bisexual, and other men who have sex with men (MSM), MSM continue to represent the largest group of new HIV infections and the largest number of individuals living with HIV in the US. Environmental factors such as sexual minority stress increase the vulnerability of MSM for mental health problems. These mental health problems can be a barrier to consistently engaging in self-care health behaviors such as sexual risk reduction. We consider the following observations critical to identifying priorities for HIV prevention among MSM: (1) gay, bisexual and other MSM have higher rates of mental health problems than general population estimates; (2) these mental health problems co-occur with each other and interact synergistically to increase HIV risk; and (3) comorbid mental health problems may compromise the impact of prevention programs, and integrating treatment of mental health issues into prevention programs may improve program efficacy. Novel prevention interventions for at risk MSM that integrate programming with the treatment of co-occurring and interfering mental health issues are the most promising avenue to increase prevention intervention efficacy and effectiveness. By addressing significant mental health issues and supporting broad based prevention efforts at the individual and community level, there is also the potential to improve the overall quality of life and public mental health of gay, bisexual, and other MSM.
Printed health education materials frequently consist of mass-produced brochures, booklets, or pamphlets designed for a general population audience. Although this one-size-fits-all approach might be appropriate under certain circumstances and even produce small changes at relatively modest costs, it cannot address the unique needs, interests, and concerns of different individuals. With the advent and dissemination of new communication technologies, our ability to collect information from individuals and provide feedback tailored to the specific information collected is not only possible, but practical. The purpose of this article is to: (a) distinguish between tailored print communication and other common communication-based approaches to health education and behavior change; (b) present a theoretical and public health rationale for tailoring health information; and (c) describe the steps involved in creating and delivering tailored print communication programs. Studies suggest computer tailoring is a promising strategy for health education and behavior change. Practitioners and researchers should understand the approach and consider the possibilities it presents for enhancing their work in disease prevention.
The prevalence of HIV infection is disproportionately higher in both racial/ethnic minority men who have sex with men (MSM) and in men under the age of 25, where the leading exposure category is homosexual contact. Less is known, however, about patterns of HIV prevalence in young racial/ethnic minority MSM. We analyzed data from the Young Men's Survey (YMS), an anonymous, cross-sectional survey of 351 MSM in Baltimore and 529 MSM in New York City, aged 15-22, to determine whether race/ethnicity differences exist in the prevalence of HIV infection and associated risk factors. Potential participants were selected systematically at MSM-identified public venues. Venues and associated time periods for subject selection were selected randomly on a monthly basis. Eligible and willing subjects provided informed consent and underwent an interview, HIV pretest counseling, and a blood draw for HIV antibody testing. In multivariate analysis, adjusted for city of recruitment and age, HIV seroprevalence was highest for African Americans [adjusted odds ratio (AOR) = 12.5], intermediate for those of "other/mixed" race/ethnicity (AOR = 8.6), and moderately elevated for Hispanics (AOR = 4.6) as compared to whites. Stratified analysis showed different risk factors for HIV prevalence in each ethnic group: for African Americans, these were history of sexually transmitted diseases (STDs) and not being in school; for Hispanics, risk factors were being aged 20-22, greater number of male partners and use of recreational drugs; and for those of "other/mixed" race/ethnicity, risk factors included injection drug use and (marginally) STDs. These findings suggest the need for HIV prevention and testing programs which target young racial/ethnic minority MSM and highlight identified risk factors and behaviors.
The decades surrounding the turn of the millennium will be remembered as a time of extraordinary opportunity in cancer communication. In 1990, the number of age-adjusted deaths due to cancer in the U.S. population began a slow steady decline after a century of disparaging increase. Reasons for this decline have been attributed to long-awaited successes in primary prevention, especially related to tobacco, and early detection for cervical, breast, prostate, and colorectal cancers, as well as advances in treatment. This was also a time of unparalleled change in the cancer communication environment. Scientific health discoveries escalated with the completion of the Human Genome project in 2003, and penetration of the Internet made health information available directly to consumers. To seize the opportunity afforded by these changes, the National Cancer Institute (NCI) launched the Health Information National Trends Survey (HINTS). Fielded for the first time in 2003, the HINTS is a nationally representative, general population survey of noninstitutionalized adults in the United States 18 years and older. This supplement contains a compilation of original research conducted using the data generated by the first administration of the HINTS telephone interviews. Covering topics in cancer knowledge, cancer cognition, risk perception, and information seeking, the articles represent an interdisciplinary view of cancer communication at the turn of the millennium and offer insight into the road ahead.
Members of vulnerable populations are underrepresented in research studies.
To evaluate and synthesize the evidence regarding interventions to enhance enrollment of vulnerable populations into health research studies.
Studies were identified by searching MEDLINE, the Web of Science database, personal sources, hand searching of related journals, and article references. Studies that contained data on recruitment interventions for vulnerable populations (minority, underserved, poor, rural, urban, or inner city) and for which the parent study (study for which recruitment was taking place) was an intervention study were included. A total of 2,648 study titles were screened and 48 articles met inclusion criteria, representing 56 parent studies. Two investigators extracted data from each study.
African Americans were the most frequently targeted population (82% of the studies), while 46% targeted Hispanics/Latinos. Many studies assessed 2 or more interventions, including social marketing (82% of studies), community outreach (80%), health system recruitment (52%), and referrals (28%). The methodologic rigor varied substantially. Only 40 studies (71%) incorporated a control group and 21% used statistical analysis to compare interventions. Social marketing, health system, and referral recruitment were each found to be the most successful intervention about 35-45% of the studies in which they were attempted, while community outreach was the most successful intervention in only 2 of 16 studies (13%) in which it was employed. People contacted as a result of social marketing were no less likely to enroll than people contacted through other mechanisms.
Further work with greater methodologic rigor is needed to identify evidence-based strategies for increasing minority enrollment in research studies; community outreach, as an isolated strategy, may be less successful than other strategies.
Despite the recognized need for culturally tailored HIV prevention interventions for gay, bisexual, and questioning youth, few studies have examined if predictors of unprotected sex vary for youth from different ethnic groups. This study reports on a sample of 189 gay, bisexual, and questioning youth (age 15-22) from three racial/ethnic backgrounds (African American, Hispanic, and White) recruited in Chicago, IL and Miami-Dade and Broward Counties, Florida. For African American youth, being in a long-term relationship, having been kicked out of the home for having sex with men, and younger age at initiation of sexual behavior were associated with unprotected sex. For Hispanic youth, higher ethnic identification and older age at initiation of sexual behavior were associated with unprotected sex. For White youth, no predictors were associated with unprotected sex. Our findings point to the importance of understanding the varying predictors of unprotected sex and integrating them into tailored prevention interventions.
The present study evaluated the efficacy of Familias Unidas + Parent-Preadolescent Training for HIV Prevention (PATH), a Hispanic-specific, parent-centered intervention, in preventing adolescent substance use and unsafe sexual behavior. Two hundred sixty-six 8th-grade Hispanic adolescents and their primary caregivers were randomly assigned to 1 of 3 conditions: Familias Unidas + PATH, English for Speakers of Other Languages (ESOL) + PATH, and ESOL + HeartPower! for Hispanics (HEART). Participants were assessed at baseline and at 6, 12, 24, and 36 months postbaseline. Results showed that (a) Familias Unidas + PATH was efficacious in preventing and reducing cigarette use relative to both control conditions; (b) Familias Unidas + PATH was efficacious, relative to ESOL + HEART, in reducing illicit drug use; and (c) Familias Unidas + PATH was efficacious, relative to ESOL + PATH, in reducing unsafe sexual behavior. The effects of Familias Unidas + PATH on these distal outcomes were partially mediated by improvements in family functioning. These findings suggest that strengthening the family system, rather than targeting specific health behaviors, may be most efficacious in preventing and/or reducing cigarette smoking, illicit drug use, and unsafe sex in Hispanic adolescents.
Young men who have sex with men (MSM) account for the majority of HIV infections among young people in the United States and young women who have sex with women and men can also become infected with HIV. While family-based approaches have been established for other groups of youth, very few have been developed and tested with sexual minority youth. This chapter reviews evidence for the feasibility of developing family-based programs for these youth as well some of the factors that should be incorporated into such an approach. © 2012 Springer Science+Business Media, LLC. All rights reserved.
The family has long been considered a powerful influence on youth's high‐risk behaviors. However, little is known about preventive family influences for gay and bisexual youth, a group at high risk for HIV infection. For this study, qualitative interviews from a sample of 38 gay and bisexual youth and their parents/guardians underwent a thematic analysis. Youth described parent–child closeness, parental warnings, and urgings to use condoms as influences. Youth denying family influence came from families in which parent–child relationships were disrupted or HIV ‐related discussion was lacking. Most families reported discomfort discussing HIV risk. These findings, along with a case example, suggest how family therapists can enhance parental influence by helping these families strengthen their relationships and discuss this important topic.
Video Abstract
Positive perceptions of parent–child communication can influence behavioral outcomes such as sexual behavior and substance use among young people. Parent–child communication has been effective in modifying adverse health outcomes among heterosexual youth; however, limited research has examined the perceptions of parent–child communication among sexual minority youth, specifically African American young men who have sex with men (AAYMSM). Understanding AAYMSM's and parents’ health communication perceptions and practices is critical for improving delivery of health information for this population and communication about sensitive health issues. Using mixed-methods research, the authors conducted focus groups and interviews and administered a cross-sectional survey to 42 AAYMSM and 10 parents of AAYMSM. Descriptive statistics were used to examine survey responses. Thematic analysis revealed that sexual orientation and HIV/AIDS were the most reported topics discussed among both parent and youth participants. Barriers to parent–child communication included fear, embarrassment, lack of time, and the limited availability of AAYMSM-specific health information. Recommended strategies for improving parent–child communication are discussed. Findings will assist in the development of targeted interventions to improve parent–child communication about health among AAYMSM and parents.
African American men who have sex with men (AAMSM) are disproportionately burdened by new and existing HIV infections. In spite of this, few HIV prevention interventions have been developed that meet the specific needs of AAMSM and that are culturally appropriate and build on strengths and resources. In this paper, we examine constructed families, including those who belong to houses and those who do not, from a three city sample of 196 AAMSM. Results show that the majority of AAMSM who belong to constructed families do not participate in houses or balls. Both house and non-house affiliated constructed families are important sources of social support among AAMSM. Participants reported limited success in spreading HIV messages at ball events, but talk about HIV within their constructed families. Social network approaches to HIV prevention may capitalize on existing social ties within constructed families to promote safer sexual behaviors.
Background:
'Hard-to-reach' is a term used to describe those sub-groups of the population that may be difficult to reach or involve in research or public health programmes. Application of a single term to call these sub-sections of populations implies a homogeneity within distinct groups, which does not necessarily exist. Different sampling techniques were introduced so far to recruit hard-to-reach populations. In this article, we have reviewed a range of ap-proaches that have been used to widen participation in studies.
Methods:
We performed a Pubmed and Google search for relevant English language articles using the keywords and phrases: (hard-to-reach AND population* OR sampl*), (hidden AND population* OR sample*) and ("hard to reach" AND population* OR sample*) and a consul-tation of the retrieved articles' bibliographies to extract empirical evidence from publications that discussed or examined the use of sampling techniques to recruit hidden or hard-to-reach populations in health studies.
Results:
Reviewing the literature has identified a range of techniques to recruit hard-to-reach populations, including snowball sampling, respondent-driven sampling (RDS), indigenous field worker sampling (IFWS), facility-based sampling (FBS), targeted sampling (TS), time-location (space) sampling (TLS), conventional cluster sampling (CCS) and capture re-capture sampling (CR).
Conclusion:
The degree of compliance with a study by a certain 'hard-to-reach' group de-pends on the characteristics of that group, recruitment technique used and the subject of inter-est. Irrespective of potential advantages or limitations of the recruitment techniques reviewed, their successful use depends mainly upon our knowledge about specific characteristics of the target populations. Thus in line with attempts to expand the current boundaries of our know-ledge about recruitment techniques in health studies and their applications in varying situa-tions, we should also focus on possibly all contributing factors which may have an impact on participation rate within a defined population group.
Parental monitoring and parent-adolescent communication about sex protect against HIV-related sexual risk behaviors among heterosexual adolescents, but it is unknown if these findings generalize to young men who have sex with men (YMSM). Sexual orientation-specific stressors, including "coming out" to parents, complicate the family context of YMSM. We examined associations between parental monitoring, communication about sex, outness to cohabitating parents, and sexual behaviors. Ethnically diverse YMSM ages 14-19 provided cross-sectional data (n = 257). Monitoring and outness to parents interacted to predict recent same-sex unprotected anal intercourse (UAI). For YMSM who reported mixed or uncertain outness to parents, higher levels of perceived parental monitoring were associated with greater risk of UAI. Higher levels of communication about sex were associated with greater risk of UAI for YMSM out to parents. Parental monitoring and communication about sex might not protect YMSM against sexual risk in the same way they protect heterosexual youth. Future research should examine whether adapted forms of family factors could protect YMSM, and family-based HIV risk-reduction interventions for YMSM should be attuned to the unique ways family factors function within this group.
Journalists have a unique opportunity to educate the community about public health and health care. In order for health communication messages to be effective, characteristics of the intended audience must be considered. Limited attention has been given to health journalists' perceptions of their target communities and little is known about how journalists' perceptions may impact the delivery of health information in the news. Fifteen in-depth telephone interviews were conducted with health journalists from varying geographic regions and media market sizes. Interview questions examined health journalists' perceptions of their target communities, the content and delivery of their health-related stories, and the current state of health journalism. Interviews were audio-recorded for transcription and thematic analysis. Health journalists perceived their audiences to be primarily mothers and adults with limited education. Participants reported they often used personal stories and strong headlines to engage their communities. They also stated that their news stories were quite technical and may not have been written at an appropriate reading level for their audience. When asked about the current state of health journalism, participants reported that there were areas for improvement. Journalists stated that increased collaborations with public health practitioners would improve their own understanding of health and medical information and allow them to develop health news content that was more appropriate for their target communities.
Objective
To systematically review literature focused on the health information seeking practices of sexual minority youth (SMY), those youth who identify as lesbian, gay or bisexual. The aims of this systematic literature review were to determine the health information seeking practices of SMY by: (1) identifying their commonly cited sources of health information; (2) examining barriers associated with accessing health information; and (3) identifying study methodologies used in research with SMY.
Method
A systematic review of the health information seeking practices of SMY was conducted. Empirical studies published between 1990 and 2010 on the health information seeking and health communication practices of SMY were found using medical/health and sociology databases.
Results
A total of 398 citations were retrieved from four databases using specific search terms. Nineteen articles met the inclusion criteria of: written in English; peer reviewed; original empirical study; and referenced search terms in title, abstract or keywords.
Conclusion
Findings show inaccurate and limited health information targeted specifically toward SMY. Without culturally specific and accurate health information, it will be difficult for health educators and healthcare professionals to address the health concerns faced by this population.
Discussion of library users who seek information for others focuses on a study of public library adult reference desks that identifies the relationships between agents and imposers that motivate reference desk use and describes agent users in terms of their self-reported education levels and frequency of library and reference desk use. (Author/LRW)
This report summarizes three bodies of research on teenage pregnancy and programs to reduce the risk of teenage pregnancy. Studies included in this report were completed in 1980 or later, conducted in the United States or Canada, targeted adolescents, employed an experimental or quasi-experimental design, had a sample size of at least 100 in the combined treatment and control group, and measured the impact on sexual or contraceptive behavior, pregnancy, or childbearing. Six chapters focus on: (1) "Making the Case for Prevention Efforts: Adolescent Risk-Taking Behavior and Its Consequences"; (2) "Looking for Reasons Why: The Antecedents of Adolescent Sexual Behavior"; (3) "Assessing the Evidence: Factors Affecting the Strength of Research Results"; (4) "Emerging Answers: The Behavioral Impact of Programs To Reduce Adolescent Sexual Risk-Taking"; (5) "Looking Forward: Conclusions about the State of Research and the Effectiveness of Programs"; and (6) "Bringing It Home: Applying These Research Results in Communities." (Chapters contain references.) (SM)
This volume explores the philosophical underpinnings, history, and key elements of five qualitative inquiry approaches: narrative research, phenomenology, grounded theory, ethnography, and case study. Using an accessible and engaging writing style, author John W. Creswell compares theoretical frameworks, methodologies in employing standards of quality, strategies for writing introductions to studies, the collection and analysis of data, narrative writing, and result verification. New to the Second Edition: (a) Brings the philosophical and theoretical orientations to the beginning of the book: This change helps ground students in the foundational thinking behind these methods much earlier. (b) Gives broader coverage of narrative research: Creswell expands one of the original five approaches from "Biography" to "Narrative," thus exploring a wider range of narrative opportunities--biography still being one of them. (c) Offers a much deeper discussion of interpretive approaches: This edition places much more emphasis on interpretive and postmodern perspectives such as feminism, ethnicity, and critical theory. (d) Provides more specific steps for doing research within each approach: Creswell discusses the actual procedure for each approach and includes the types of qualitative research within each of the five approaches. (e) Illustrates phenomenology and ethnography: The Second Edition contains two new, recent sample journal articles: one covering a phenomenological study, the other covering ethnographic study. (f) Includes additional examples: The author provides examples from the field of human services to enhance the already robust examples from education, sociology, and psychology. Intended Audience: This is a useful text for advanced undergraduate and graduate courses in introductory qualitative research methods across the social, behavioral, and health sciences. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
We examined the potential for a family-based HIV prevention approach for gay and bisexually identified young men who have sex with men (MSM). The majority of our urban, ethnically diverse sample disclosed their sexual orientation to parents, who were generally supportive. Family connectedness significantly decreased the odds of an HIV positive status.
Recruitment for research and clinical trials continues to be challenging. Prostate cancer is the most commonly diagnosed cancer in men and disproportionately affects African American men; thus, effective recruitment strategies are essential for this population.
The aim of this study was to focus on innovative and effective recruitment strategies for research on prostate cancer with minorities.
A systematic description is provided of the recruitment efforts for a hermeneutic phenomenological qualitative study of African American men's experiences in decision making on whether to have a prostate cancer screening.
Seventeen African American men were enrolled from rural Central Virginia. Recruiting strategies were targeted on places where African American men usually are found but that are rarely used for recruitment: barbershops, community health centers, and churches. Word of mouth was also used, and most of the participants (n = 11) were reached through this method.
Recruitment efforts have been noted to be particularly challenging among minorities, for numerous reasons. Making minority recruitment a priority in any research or clinical trial is essential in gaining a representative sample. Word of mouth is a powerful tool that is often forgotten but should be looked at in further detail.
Gay youth and those questioning their sexual identity have been referred to as "hidden," "invisible," "stigmatized," and "marginalized." As a result, the unique safety and health needs of this subculture have been overlooked, or worse, ignored, placing these youth at risk. Because school nurses have been identifying at-risk populations of students and developing programs to promote youth and family health for years, they should be prepared to provide health care for the subculture of gay youth. However, nurses are saying they do not have the knowledge or skills needed to identify and address the needs of this group. Providing school nursing care for gay youth requires the school nurse to be culturally competent. School nurses need to be aware of, sensitive to, and knowledgeable about the subculture. They must also possess communication skills required to relate appropriately to this group. This article presents information and nursing strategies that will promote the safety and health of gay youth while enhancing the school nurse's cultural competence.
Disseminating health and medical information on the Internet can improve knowledge transfer from health professionals to the population, and help individuals to maintain and improve their health. There are currently several medical information websites that directly target the general population with the aim of providing information about health problems, self-care and prevention. However, this new technology also hides several shortcomings, such as: (i) uneven quality of medical information available on the Internet; (ii) difficulties in finding, understanding and using this information; (iii) lack of access for the unconnected population; and (iv) the potential for harm and risks of over-consumption. To be able to overcome these dangers, it is important that public health practitioners and health professionals be involved in the design, dissemination and evaluation of Web-based health and medical information.
Local television news is the number 1 source of information for most Americans, and media health reporting has increased significantly during the past 10 years.
To evaluate the health topics and reporting characteristics of health stories on local television news across the United States.
Content analysis of full-length broadcasts of local television news from a representative sample of the top 50 US media markets (122 stations).
Two trained coders evaluated all health stories for topics and reporting characteristics. Any discrepancies were resolved by a third independent coder.
Among 2795 broadcasts reviewed, 1799 health stories were aired. Seventy-six percent of all stories were about medical conditions. The median story airtime was 33 seconds. Breast cancer and West Nile virus were the 2 most common topics reported on. Among 1371 stories about disease, few gave recommendations, cited specific data sources, or discussed prevalence. Egregious errors were identified that could harm viewers who relied on the information.
Local television news devotes significant airtime to health stories, yet few newscasts provide useful information, and some stories with factually incorrect information and potentially dangerous advice were aired. Regularly reaching 165 million people, local television news has the power to provide health information to most Americans. It is crucial that television reporting of health news be improved and that reporting errors be eliminated.
To begin to understand the role that family relationships and interactions play in young gay men's decisions to avoid unsafe sexual practices, parents and sons (ages 16 to 25) in 30 families were qualitatively interviewed about issues and concerns related to HIV risk. Most of the youths reported feeling obliged to their parents to stay healthy, and these feelings of obligation were important factors in their decisions to avoid unsafe sex. Youths who reported no parental influence came from families in which parents had historically been preoccupied with personal or marital problems or in which there was a history of parental rejection. On the basis of these exploratory findings, AIDS prevention specialists are advised to recruit parents, assess family relationships, and facilitate parent-child communication in their efforts to encourage gay youths to consistently engage in safer sex practices.
To identify the information needs of parents of children with health care needs.
A series of three focus groups and one in-depth interview were held with parents (n = 10, 90% female) in Barnsley, South Yorkshire, UK.
Findings were grouped into four themes: delivery of information; levels of support; relationship between the family and professional; and management of events. Parents expressed a preference for information to be delivered on a verbal, 'one-to-one' basis by a professional, supplemented by accessible, written reference materials. The provision of a contact telephone number for a named professional, so further information could be obtained when required, was identified as a key source of support. Participants emphasized the importance of being consulted about the care of their child, the interaction between professional and child, and also of being treated as an individual by the professional.
Delivery of information to parents may be most effective on a verbal, 'one-to-one' basis with a professional, in conjunction with written accessible general and child-specific reference materials. The importance to parents of the provision of contact details for a named professional and specialist nurse support is also emphasized. The psychosocial experiences of parents, along with the impact of the relationship between family and professional, and requirement for good channels of communication, must be taken into account by professionals during the care of children with health care needs. These findings have important implications for professionals and service providers for the future delivery of information to parents of children with health care needs.
Studies have shown increasing Internet use for health information. We aimed to broadly examine parents' utilisation of information sources for their children's health, their trust in them and to define the role of the Internet for children's health information
Interview of a convenience sample of parents of patients presenting to a tertiary paediatric emergency department (ED) (Royal Children's Hospital, Melbourne, Australia) in 2006/2007.
A total of 360 parents completed the interview. Parents had used on average five sources of health information for their children in the previous 6 months. In the previous 6 months and immediately prior to the ED visit, general practitioners were consulted for health information by 87% and 39%, chemists by 44% and 2%, the Internet by 43% and 6% and telephone advice health lines by 30% and 10%, respectively. Of these sources, parents 'greatly trusted' Royal Children's Hospital ED doctors and nurses 82% (n = 112) their regular general practitioners in 73% (n = 303), chemists in 45% (n = 160), telephone advice health lines (Nurse-On-Call) in 42% (n = 90) and the Internet in general in 10% (n = 112). Overall, 52% had sought health information for their children on the Internet. Only 20% knew and 11% had ever used the regional children's hospital web site (http://www.rch.org.au/kidsinfo), but 97% of the Internet users reported they would trust this information.
While using numerous different sources, parents in this study mostly use and trust traditional sources of health information. Scores of respondents use the Internet to seek health information for their children and would value easier access to Internet sources that they trust.
Young black MSM acquiring HIV at three times the rate of White MSM
- Whitehorn L.
Social Psychology: Handbook of Basic Principles
- C. E. Rusbult
- P. A. M. Van Lange
Health Information Seeking
- D. J. Johnson
- D. O. Case
A Logic Model of Parent–Child Connectedness: Using the Behavior-Determinant-Intervention (BDI) Logic Model to Identify Parent Behaviors Necessary for Connectedness with Teen Children
- L. Rolleri
- S. Bean
- N. Ecker
Homosexuality and the Black church
- Harris A. C.
Promoting culturally competent care for gay youth
- L. J. Bakker
- A. Cavendar