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Research that 'grows apart' from its original design and proposal is not uncommon, especially when involving participatory and creative methods. However, the disconnect between research intentions and research realization is seldom probed for the insights offered; this paper addresses this gap. Taking up the conceptual lens of research imaginaries, this paper dives into the tensions and discoveries experienced in between the design and the practice of a multi-site participatory research project. The study involved two groups of young people, in two cities in two countries, with a focus on digital lives. In a commitment to collaboration with artists, senior researchers, research assistants, and young people in community spaces, a complex project emerged. This paper describes the tensions and possibilities of an emergent methodology and in doing so argues for increased attention to the movement of research designs; rather than the adherence to them. [ABSTRACT FROM AUTHOR]

Sexual violence is a major problem on college campuses, and innovative solutions are needed. Our university created a semester-long, credit-bearing, academic course as a curricular intervention intended to reduce sexual violence on campus. In this article, we describe the multiple methods used to evaluate the course, including a pre–post online survey with a quasi-experimental design, a qualitative content analysis of student reflection papers, and semistructured interviews with previously enrolled students conducted by a peer interviewer 3 months after course completion. The synthesis of evaluation findings indicated that an academic course has the potential to positively affect campus climate around sexual violence. Furthermore, using multiple methods enabled us to create a theory of change that illustrates how key course components shaped students' knowledge, attitudes, and behaviors about sexual violence, thereby ideally generating campus change. Results have been used by various stakeholders for both practice-based and scholarly purposes. We provide lessons learned and implications for practice that are transferable to other multimethod curricular intervention evaluations regardless of topical focus, including the many ways in which using multiple methods added value to the study; the considerable investment of time and resources needed when using multiple methods; the challenges that can arise when integrating findings across methods; the major benefits of having a multidisciplinary research team consisting of faculty and students; and the need to engage in critical reflexivity. [ABSTRACT FROM AUTHOR]

The assistive equipment provision process is routinely carried out with patients to mitigate fall risk factors via the fitment of assistive equipment within the home. However, currently, over 50% of assistive equipment is abandoned by the patients due to poor fit between the patient and the assistive equipment. This paper explores clinician perceptions of an early stage three-dimensional measurement aid prototype, which provides enhanced assistive equipment provision process guidance to clinicians. Ten occupational therapists trialled the three-dimensional measurement aid prototype application; think-aloud and semi-structured interview data was collected. Usability was measured with the System Usability Scale. Participants scored three-dimensional measurement aid prototype as 'excellent' and agreed strongly with items relating to the usability and learnability of the application. The qualitative analysis identified opportunities for improving existing practice, including, improved interpretation/recording measurements; enhanced collaborative practice within the assistive equipment provision process. Future research is needed to determine the clinical utility of this application compared with two-dimensional counterpart paper-based guidance leaflets. [ABSTRACT FROM AUTHOR]

Summary: Social workers are expected to challenge the exclusion and oppression of marginalised populations which requires the critical interrogation of prejudicial views, discriminatory attitudes, and oppressive practices. In this regard, social work practitioners need to be vigilant of their own attitudes toward the people they serve. This is relevant to social work practice with sexual minorities. This paper presents the results of a mixed-methods study informed by a critical theoretical frame that explored Vietnamese social work practitioners' attitudes toward sexual minorities. The findings presented in this article were drawn from a survey of 292 social work practitioners based in Hanoi, Vietnam and 12 semi-structured interviews with volunteers recruited from the pool of survey participants. Findings: The findings suggest that practitioners who participated in this study held relatively positive attitudes toward people who identify as lesbian or gay. However, those who had what could be considered moderate to positive attitudes were not necessarily free from prejudicial and discriminatory views, particularly when it came to certain matters such as those relating to their own families and work with young children. Applications: The discussion of the findings illustrate the relevance of the broader social context to Vietnamese social work practitioners' attitudes toward sexual minorities. It highlights the potent influence of dominant ideologies in shaping prejudicial views and attitudes and points to the need for practice at a broader level targeting Vietnamese society and culture as a whole. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a study that examined Vietnamese social work practitioners' conceptions of practice with people who identified as lesbian or gay. The findings presented in this article, drawn from semi-structured interviews with 12 social work practitioners in Hanoi, Vietnam, form part of the findings of a bigger study that looked into the attitudes of Vietnamese social work practitioners toward sexual minorities and how they conceptualise practice in relation to this segment of the population. A notable proportion of the interview participants, all of whom presented as having moderate to positive attitudes toward sexual minorities, were found to hold a heterosexist assumption with regards to the sexual identity of their clients. And while there was consensus in the need for a social work response, there were differences in the practitioners' conceptions of what form this should take. The participants were open to direct practice with individuals and a limited degree of community engagement but were apprehensive with the prospect of undertaking policy advocacy. It is argued that these conceptions of practice are informed by limitations imposed by their political environment as well as dominant ideological and philosophical influences. [ABSTRACT FROM AUTHOR]

Introduction: Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes. Methods: A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was conducted to explore biosafety issues. Results: The agreement analysis was conducted on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI:1.3%−98.7%) positive agreement and 96% (95% CI: 92.5%−98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857−0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%−99.6%) positive agreement and 100% (95% CI: 63.1%−100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549−1). The dry run highlighted four main sources of contamination that led to the modification of the standard operating procedures. Simulation post-modification showed no further evidence of contamination. Conclusion: Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption. [ABSTRACT FROM AUTHOR]

Summary Only recently has social work begun to grapple with its place in relation to environmental issues. While considerable progress has been made in bringing environmental considerations into the centre of our profession's scholarship and practice, this project is far from complete. Drawing on environmental literature and based on findings of a qualitative case study of water activism in one Canadian city, this paper argues that the concept of “community resilience” provides both a practical and a conceptual framework for advancing social work's engagement with issues of the natural environment and environmental justice through community praxis. Findings In Guelph, Ontario, Canada, water issues are the focal point of considerable community activism. The case study research reveals, however, that while water is the focus, much of this activism is driven by three broad social priorities that reflect ideas of community resilience and which suggest entry points for social work participation in community-based environmental initiatives: self-reliance and sustainability, localization and direct citizen participation, and community. Applications “Community resilience” is increasingly popular in environmental and community development fields as a conceptual framework for assessing and building the capacity of communities to support wellbeing in the face of environmental change, adversity and risk. While the concept of “resilience” is well established in social work, “community resilience” remains under-examined in social work literature. In this paper, the author draws attention to this arena of resilience thinking, highlighting its potential for the integration of considerations of the natural environment into social work scholarship, education, and practice. [ABSTRACT FROM AUTHOR]

Background: Minimal research has been done to determine how well European nursing students understand the core principles of academic integrity and how often they deviate from good academic practice. Aim: The aim of this study was to find out what educational needs nursing students have in terms of academic integrity. Research design: A quantitative cross-sectional study in the form of a survey of nursing students was conducted via questionnaire in the fall of 2020. Participants: The sample was composed of 79 students in the BScN and MScN programs at Zürich University of Applied Sciences. Ethical considerations: An application for a non-competence clearance was approved by the Ethics Committee in Zurich (BASEC No. Req-2020-00868). The survey was anonymous, and informed consent was obtained prior to participation. Results: The participants had a high level of confidence in their own knowledge but were in many cases unable to correctly identify clear-cut examples of misconduct and to differentiate them from questionable practices. About 13% of the participants admitted that during their university education they had copied shorter passages from other sources into their own text without marking them as quotes. Conclusions: The study documents extensive knowledge gaps among nursing students regarding both academic misconduct and questionable practices and indicates a need for improved academic integrity training. [ABSTRACT FROM AUTHOR]

Community-based healthcare delivery systems frequently lack cancer-specific survivorship support services. This leads to a burden of unmet needs that is magnified in rural areas. Using sequential mixed methods we assessed unmet needs among rural cancer survivors diagnosed between 2015 and 2021. The Supportive Care Needs Survey (SCNS) assessed 5 domains; Physical and Daily Living, Psychological, Support and Supportive Services, Sexual, and Health Information. Needs were analyzed across domains by cancer type. Survey respondents were recruited for qualitative interviews to identify care gaps. Three hundred and sixty two surveys were analyzed. Participants were 85% White (n = 349) 65% (n = 234) female and averaged 2.03 years beyond cancer diagnosis. Nearly half (49.5%) of respondents reported unmet needs, predominantly in physical, psychological, and health information domains. Needs differed by stage of disease. Eleven interviews identified care gap themes regarding; Finding Support and Supportive Services and Health Information regarding Care Delivery and Continuity of Care. Patients experience persistent unmet needs after a cancer diagnosis across multiple functional domains. Access to community-based support services and health information is lacking. Community based resources are needed to improve access to care for long-term cancer survivors. [ABSTRACT FROM AUTHOR]

The Support and Aid to Families Electronically (SAFE) pilot program was developed through a community–university partnership to support parents of elementary students in Ontario, while providing stable practicums for social work students in the midst of COVID-19 restrictions. Purpose: The aim of the current study was to examine the feasibility of the SAFE pilot program as a mental health support to families by examining three feasibility objectives: demand, acceptably, and implementation. Method: Qualitative data from interviews, focus groups, and qualitative surveys involving service users, social work students, referring school board and university professionals (n = 37) were examined. Results: Demand for SAFE extended beyond the pandemic. A high-level of acceptance of SAFE was identified. Areas of success and considerations for implementation are outlined. Discussion: This study provides practice guidance on implementing this unique program, with potential to address gaps in service provision and the ongoing crisis in field education. [ABSTRACT FROM AUTHOR]

Background: People experiencing homelessness have limited access to palliative care support despite high levels of ill health and premature mortality. Most research exploring these challenges in the United Kingdom has focused on people living in hostels or temporary accommodation. People with uncertain or restricted immigration status are often unable to access this accommodation due to lack of entitlement to benefits. There is little research about the experiences of those in the United Kingdom who cannot access hostels or temporary accommodation due to restricted or uncertain immigration status with regards to palliative and end-of-life care access. Aim: To explore the barriers to palliative and end-of-life care access for people with uncertain or restricted immigration status, who are experiencing homelessness and have advanced ill health, and the experiences of UK hospices of supporting people in this situation. Design: A multi-method cross-sectional study. Setting/participants: An online survey for hospice staff followed by online focus groups with staff from inclusion health, homelessness and palliative care services, charities and interviews with people experiencing homelessness. Results: Fifty hospice staff responded to the online survey and 17 people participated in focus groups and interviews (focus groups: n = 10; interviews: n = 7). The survey demonstrated how hospices are not currently supporting many people with restricted or uncertain immigration status who are homeless and that hospice staff have received limited training around eligibility for entitlements or National Health Service (NHS) care. Interview and focus group data demonstrated high levels of unmet need. Reasons for this included a lack of consistency around eligibility for support from local authorities, issues relating to NHS charging, and mistrust and limited knowledge of the UK health and social care system. These barriers leave many people unable to access care toward the end of their lives. Conclusion: To advocate for and provide compassionate palliative and end-of-life care for people with uncertain immigration status, there is need for more legal literacy, with training around people's entitlement to care and support, as well as easier access to specialist legal advice. Plain language summary: Palliative care, homelessness and restricted or uncertain immigration status Most research from the UK about access to support at the end of life for people who are homeless has looked at the experiences of people who are staying in hostels or temporary accommodation. People that are not UK nationals are not entitled to the benefit which pays for hostel or temporary accommodation. There is a group of people in the UK who are very unwell, who are homeless and are not able to access hostel accommodation due to their immigration status. This project explored the experiences of this group around access to palliative care. We spoke to professionals from health and social care services, charities and local councils and people who are in this situation themselves. Hospice staff were also surveyed to see if they had experience of supporting people in this situation. The survey showed that hospices are not currently supporting many people with restricted or uncertain immigration status who are homeless, and that they have limited training around supporting people in this situation. In the interviews and focus groups, opinions were heard about challenges to palliative care support for people with uncertain or restricted immigration status who were experiencing homelessness. Professionals described how it can be hard to obtain support from local authorities, and also understanding rules about who has to pay to receive NHS care. People with uncertain or restricted immigration status who were also homeless did not always know how to access the UK health and social care system and had negative experiences of doing so in the past. As a result, many people are unable to access care towards the end of their lives. To provide compassionate palliative and end-of-life care for people with uncertain immigration status, there is need for more legal literacy, with training around people's entitlement to care and support, as well as easier access to specialist legal advice. [ABSTRACT FROM AUTHOR]

This large mixed methods study adopted a citizenship lens to examine the impact of intimate partner violence (IPV) on women's social participation. The study found that social participation in all categories contracted dramatically during IPV and, in most cases, never regained pre-violence levels. The study also found that following initial social withdrawal, many women went on to reengage in new ways, including through political activism on gendered violence, revealing how failures on the part of the state and community to adequately respond to IPV can lead to new forms of participatory citizenship. [ABSTRACT FROM AUTHOR]

This project sought to describe the involvement of doctors in leadership roles in the NHS and the organisational structures and management processes in use in NHS trusts. A mixed methods approach was adopted combining a questionnaire survey of English NHS trusts and in-depth case studies of nine organisations who responded to the survey. Respondents identified a number of challenges in the development of medical leadership, and there was often perceived to be an engagement gap between medical leaders and doctors in clinical roles. While some progress has been made in the development of medical leadership in the NHS in England, much remains to be done to complete the journey that started with the Griffiths Report in 1983. We conclude that a greater degree of professionalism needs to be brought to bear in the development of medical leadership. This includes developing career structures to make it easier for doctors to take on leadership roles; providing training, development and support in management and leadership at different stages of doctors’ careers; and ensuring that pay and other rewards are commensurate with the responsibilities of medical leaders. The time commitment of medical leaders and the proportion of doctors in leadership roles both need to increase. The paper concludes considering the implications of these findings for other health systems. [ABSTRACT FROM PUBLISHER]

Limited research has examined predictors of anti-gay victimization among men who have sex with men (MSM), despite anti-gay violence continuing to be a global problem. We conducted a secondary analysis of data from structured interviews with 600 MSM adults to examine anti-gay victimization and earlier sexual debut among MSM in Kazakhstan. Multiple linear regression was used to test for associations between earlier sexual debut—categorized as age of sexual onset between 13 and 15 years of age and prior to 13 years old, with ages 16 and older as the reference group—and recent and lifetime anti-gay victimization. Adjusted logistic regression models were used to assess earlier sexual debut and specific types of victimization. The majority of MSM reported lifetime (89%) or recent (68%) experiences of anti-gay victimization. Earlier sexual debut prior to 13 years of age was significantly associated with greater number of types of lifetime and recent reports of anti-gay victimization. Among specific types of anti-gay victimization, earlier sexual debut was associated with higher odds of experiencing verbal, physical, and sexual violence. Anti-gay violence in Kazakhstan is a significant and prevalent public health issue. Future research and clinical interventions addressing anti-gay victimization among MSM populations should consider the lifetime and current implications of consensual and non-consensual childhood and adolescent sexual experiences. [ABSTRACT FROM AUTHOR]

Purpose: Financial knowledge often does not translate into financial well-being. This study looks at how knowledge might be converted to well-being for people living in low-income environments, based on a theory called Financial PSS. Methods: The study tests the validity of the two scales that make up Financial PSS: Perceived Financial Barriers and Financial Hope. Then it examines how these measures along with an intervention measure called TIP are associated with financial capability. Results: Results validated the Perceived Financial Barrier Scale and Financial Hope Scale. Next, the study found that the Perceived Financial Barriers Scale and the Financial Hope Scale are associated with financial capability, as is the TIP score. Conclusions: The study concludes that Financial PSS as a newly applied practice-based theory should be further tested. Workforce providers could integrate financial education and empowerment-based F-PSS process models and see a positive impact on their placement and retention outcomes. [ABSTRACT FROM AUTHOR]

This pilot study integrated quantitative and qualitative data to examine the feasibility of implementing a modified version of a multiple family group behavioral parent training intervention (The 4Rs and 2Ss for Strengthening Families Program [4Rs and 2Ss]) in child welfare (CW) placement prevention services from the perspectives of participating caregivers (n = 12) and CW staff (n = 12; i.e., 6 caseworkers, 4 supervisors, and 2 administrators). Quantitative surveys were administered to caregivers and CW staff followed by semi-structured interviews to examine the feasibility of implementing the modified 4Rs and 2Ss program as well as factors impacting feasibility. Results indicated that quantitative benchmarks for high feasibility were met in all assessed areas (e.g., family recruitment, caseworker fidelity ratings, CW staff feasibility ratings) except for family attendance, which was markedly lower than desired. Factors facilitating feasibility included agency and research support, intervention ease-of-use, perceived benefits to existing CW practice, and logistical support (e.g., food, transportation, child care) promoting attendance. Factors hindering feasibility included conflicts between research-based eligibility criteria and existing client population demographics, research-related processes resulting in delays, CW staff role conflicts, added workload burden, complex family issues, and power differentials inherent to CW services which complicated families' voluntary participation. [ABSTRACT FROM AUTHOR]

Introduction: Medication assisted treatment (MAT) for opioid use disorder (OUD) saves lives and enhances quality of life for people in recovery. However, only a small percentage of people eligible for MAT in the United States receive treatment, and among those who do seek treatment, retention is a challenge. This study aims to understand factors that help individuals enter and stay in MAT from the perspective of those in recovery. The patient perspective is vital in efforts to improve care delivery and best support individuals in treatment. Methods: Survey development was driven by a review of current peer-reviewed literature plus information gained through 3 semi-structured interviews and follow-up discussions with 5 individuals who have lived experience in MAT, termed Participant Advisors. Survey questions focused in part on MAT participants' opinions relating to program policies such as drug testing, relapse protocols, duration of treatment, participant use of anti-anxiety medications and marijuana, and requirements for attendance in peer recovery groups such as Narcotics Anonymous and Alcoholics Anonymous. Responses were collected from West Virginia-based MAT programs from February through August 2021, with 1700 surveys distributed to 21 MAT programs. Results: At the close of data collection, 225 survey responses, including over 500 free-text comments, were received (13.2% response rate). Most (n = 207, 95%) were currently in a MAT program and most (n = 187, 88.6%) reported using buprenorphine/naloxone for MAT, though participants reported having used other medications for treatment of OUD as well. Questions about how long a person should have MAT prescribed, how long they should be able to stay in treatment, whether they can use marijuana or anti-anxiety drugs while in treatment, and whether they should use a 12-step program generated mixed opinions. Findings strongly support consideration of individual situations and shared decision-making with providers. [ABSTRACT FROM AUTHOR]

Women often delay moving to VAW shelters if their companion animals' safety is not ensured. Yet, few shelters accommodate them together. The purpose of this study is to explore what may help to promote services for women with companion animals facing violence, through learning from professionals who already provide support. Our email survey with VAW shelters in Ontario, Canada identified services and potential interviewees. Nine semi-structured telephone interviews with professionals were conducted to explore their experiences and views on human–animal relationships. All agencies that provided onsite programs, plus one about to start, participated. We utilized Critical Animal Studies as a theory to understand human–animal relationships through concepts such as intersectionality, anthropocentrism, speciesism, and feminist ethics of responsibility. The study found: (1) seven approaches shelters used to help women with companion animals; (2) programs that accept companion animals helped women move to shelters quickly but also affirmed women's mutually respectful relationships with companion animals; (3) shelters also benefited, including expanding support from local communities and opportunities to educate them. The study suggests that by shifting ontological and theoretical approaches and including a critical examination of human–animal relationships at interpersonal and social structural levels, professional education promotes mobilizing resources for women with companion animals. [ABSTRACT FROM AUTHOR]

The objective of the CONTINUE (conversations in routine OB care) pilot study was to gather preliminary data on the benefits of integrating a well-designed pregnancy support tool ("CONTINUE Tool") in low-income prenatal care. A total of 184 tools were distributed by 21 OB providers during the study implementation period. Follow-up data were collected from 71 (38.5%) prenatal patients across three community-based midwestern OB clinics serving a diverse prenatal patient population. Early-gestation prenatal patients received the strategically designed CONTINUE Tool during routine prenatal care and later completed a semi-structured interview or electronic survey to report pre-determined individual benefit items experienced due to tool usage. Factor analysis used individual benefit items to identify factors representing common underlying benefits ("factor benefits"). Logistic regression analyses were performed to describe the relative odds of participants with low income (public insurance) experiencing individual and factor benefits of tool use compared to participants of higher income (private insurance). Chi square tests (or Fisher's exact tests) were performed to generate P values reflecting statistically significant differences by income group. More low-income prenatal participants reported experiencing individual benefits as compared to higher-income participants. Among factor benefits, low-income participants were statistically more likely to report experiencing a time-related logistics benefit (OR = 4.00; 95% CI 1.02-15.73; P =.045). Low-income participants reported experiencing an overall logistics factor benefit (OR = 4.29; 95% CI 0.47-38.75), including a cost-related logistics benefit (OR = 3.08; CI 0.59-16.00), as well as an understanding benefit (OR = 1.90; 95% CI 0.72-5.04) and a self-efficacy benefit (OR = 1.30; 95% CI 0.44-3.87). While this study is limited by sample size due to being a pilot study, the findings suggest there may be tangible benefits to introducing the CONTINUE Tool among low-income prenatal patients. Given the staggering inequity in OB care and subsequent health outcomes, any preliminary findings on ways to help combat this are necessary and should lay the groundwork for subsequent randomized trials. Our preliminary findings show that supplementing routine OB care with the CONTINUE Tool can confer benefits to both providers and patients, but particularly for low-income prenatal patients who tend to have more structural barriers to adequate care in the first place. [ABSTRACT FROM AUTHOR]

Introduction: Dementia Friends is a dementia awareness program that trains lay leaders (called "dementia champions") to give presentations about dementia to combat stigma in their community. Objective: In this mixed methods study, we aimed to evaluate the impact and implementation of a pilot Dementia Friends program in Washington State to assess whether it improved attitudes towards people living with dementia. Method: Fifteen champions were recruited, who organized 22 Dementia Friends sessions, reaching 214 Dementia Friends participants. We collected data through interviews with champions and surveys administered to Dementia Friends participants before, immediately after, and 1-month after attending a Dementia Friends session. The survey collected demographic information and measured respondent attitudes towards people living with dementia using the Dementia Attitudes Scale. Results: Quantitative analysis showed that Dementia Attitude scores improved after a Dementia Friends session; this improvement was maintained through the 1-month follow-up. In qualitative analysis of champion interviews, we identified several suggestions regarding implementation of the Dementia Friends program, which could strengthen the program and better support champions in their role, such as increasing logistical assistance during participant recruitment. Conclusion: Dementia Friends sessions were effective in improving participant attitudes towards people living with dementia and inspiring ongoing action towards building Dementia-Friendly communities. Champions found deep meaning in their role, but would benefit from increased support to make the volunteer role more sustainable. Our findings can inform efforts to successfully deliver Dementia Friends in other locations. [ABSTRACT FROM AUTHOR]

Background: Preventing Loss of Independence through Exercise (PLI'E) is an in-person group mind-body movement program for people across the spectrum of cognitive decline and care partners (CPs). Objective: This study developed and refined an online version called Moving Together and tested feasibility and satisfaction with an online delivery. Methods: In Phase 1, we used qualitative methods to determine which elements of the in-person program were essential to retain for the online version and adaptations that would be needed to support the user experience. In Phase 2, we created a prototype of the online program and iteratively refined it based on user feedback. In Phase 3, we assessed feasibility of online delivery based on class attendance and program completion; we assessed satisfaction and participant-reported outcomes using a post-program evaluation survey with quantitative and qualitative components. Results: Phase 1 findings from 27 participants (14 PLWD, 13 CPs) revealed three key considerations related to online delivery of PLI'E: technology use, social connection as a primary motivator, and physical safety concerns. Phase 2 iterative testing among 25 participants (14 PLWD, 11 CPs) resulted in key refinements to program delivery and instructional elements; Phase 3 pilot testing included 39 participants (12 PLWD, 15 CPs, 12 MCI) who attended 75 ± 29% of 24 classes; 77% completed the 12-week program, of whom 96% rated it as excellent or good. Participant-reported outcomes included improvements in social connection, emotional well-being, physical function, cognitive function and present-centered body awareness. PLWD or MCI also reported improvements in self-concept, and CPs reported improvements in caregiving self-efficacy. The primary challenges were related to participant navigation of technology. Conclusion: The Moving Together online program is feasible for PLWD or MCI and CPs with participants reporting high satisfaction and positive outcomes across multiple domains. Providing individual technology support is critical for the success of livestreamed, online interventions for dementia. [ABSTRACT FROM AUTHOR]

This study investigates the effects of adolescent bariatric surgery among young adults approximately 10 years post-surgery. Participants were recruited from a hospital-based bariatric registry. We used an exploratory, qualitatively-driven mixed methods design. Findings were integrated with medical chart data and the SF-36, Body QoL, and the Transition Readiness Assessment Questionnaire. Of the 22 participants who completed surveys (14 females and 8 males), 20 participants also completed a phone interview. Median participant age was 25 years (range = 19–30). Median weight-loss was 23% (6.0%‒58%). Four themes emerged: taking control, weight loss challenges, body image adjustment, and growing up. Participants reported physical benefits of surgery yet were challenged by eating habits, body image, and interpersonal relationships. Participants were indifferent to preventative healthcare, despite the potential for vitamin deficiencies and the return of weight-related comorbidities. Clinicians can facilitate the transition to young adulthood by providing continued mental support, education, and medical monitoring. [ABSTRACT FROM AUTHOR]

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – 'the positives, perils and pitfalls of Facebook for nurses'. It explores the specific issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and 'snowballed' through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 (66.9%) completed surveys and 54 partially (33.1%) completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme 'blurred boundaries' was generated, which comprised three sub-themes: 'follow the science, 'abuse of power and erosion of trust' and 'the moral and ethical responsibility to safeguard public health'. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of 'every act has a consequence'; however, in this article, the theme 'blurred boundaries' offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. [ABSTRACT FROM AUTHOR]

This article explores the impact of neoliberalism and biomedicalism on social work mental health care practice through presenting the results of a Canadian provincial study which illustrates the experiences of social work service users, providers, and supervisors. While Canada has a universal health care program, the intensification of the free-market approach is evident in the shifts from public sector support to growing rationalization and marked cutbacks to the provision of social welfare services. The specific impact of neoliberal economic restraint on social justice in mental health services has pressured practitioners to adopt medicalized, short-term strategies, under efficiency-based models. The participants in this study reported significant co-occurring concerns with the state of mental health service delivery, and results suggest social work is increasingly co-opted by the conservative individualizing, pathologizing, and contextualizing dominant biomedical framework in the provision of mental health social services and lack of professional practice autonomy. [ABSTRACT FROM AUTHOR]

This study examines whether victims of violent street crimes who are known to the police as past offenders, when compared with victims with no arrest history, have different outcomes related to receipt of victim and health-related services, while taking into consideration whether or not police responded to the victimization incident. The sample is comprised of 103 men and women between the age of 18 and 40 living in one Mid-Atlantic city who were victims of street violence within the year before study recruitment. Logistic regression was used to assess the impact of police response to the victimization incident on receipt of victim services, and receipt of victim services on engagement with counseling and mental health services. The results show that prior arrests were not associated with receipt of services. However, having police officers respond to the victimization was associated with higher odds of receiving victim services, and in turn, victim services were associated with receiving mental health treatment. Police response appears to set victims on a path to accessing services. Although the number of arrests was not associated with service receipt, a small percentage of victims who did not receive services stated they were reluctant to cooperate with the police, thus limiting their opportunity for victim services. Because most victims who did not access victim services did not know that they existed, policies that promote more knowledge of and initial engagement with victim services could improve access to needed health and mental health services. [ABSTRACT FROM AUTHOR]

This paper examines the future sustainability of the Fijian Ministry of Health's (MoH) information and communication technology (ITC) system for patient management (PATIS). PATIS was developed with AusAID funding and, as the owner of the system, AusAID has no commercial competence or interest in further development of the system. Thus, the question that arises is: should Fiji adopt a commercially available patient administration system or retain the existing PATIS? In-depth consultations with senior executives and line managers of units that were major users of PATIS were undertaken. Semi-structured interviews and focus group discussion approaches were utilised. The consensus or majority views of the users were that the existing PATIS performed more than adequately. The future sustainability of the system is threatened by the lack of investment in resources (e.g. hardware maintenance and human resources) required to keep the system operating at its optimum. It was found that PATIS provides Fiji with a satisfactory patient administration system. The identified problems with the system are not related to the application per se but rather to an under-investment in resources for its utilisation. [ABSTRACT FROM AUTHOR]

Despite disproportionate health outcome disparities experienced by Black women, reproductive coercion (RC), a range of behaviors to promote unwanted pregnancy and childbearing motivations among poor young Black men are underexamined in current empirical literature. We aimed to describe perceptions of RC behaviors and childbearing motivations among poor young Black men in Baltimore City. We recruited a convenience sample of young Black men aged 18 to 25 (N = 25). Data were collected using semi-structured interviews and demographic surveys. Thematic analysis was guided by Miller's Traits-Desires-Intentions-Behaviors (TDIB) framework. According to survey data (N = 23), mean age was 22 (2.1). Majority of participants reported sexual relationships with one person (74%; n = 17), almost half (48%; n = 12) were biological fathers, and six (26%) participants reported using RC toward an intimate partner; three (13%) reported experiencing RC behaviors from a female partner. According to qualitative interviews (N = 25), participants described perceived women-partner motivations for RC as entrapment. Childbearing motivations were influenced by (a) legacies and bonding and (b) escaping/correcting the past. Childbearing desires included (a) love feelings and intimacy and (b) good father. Childbearing intentions included (a) resistance to medical interventions and (b) preparation. Perceptions of RC and childbearing motivations reflected desires from participants to fulfill cultural expectations for conventional masculinity and enhance personal dreams for fatherhood. Although some perceptions and behavior patterns aligned with previous studies, RC was relatively rare in this sample. Findings demonstrated nuanced antithesis to stereotypical notions of young Black men and fatherhood. Provision of reproductive care for young men and their sexual partners should include discussions about RC, pregnancy motivations, and healthy sexual communication strategies. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has impacted persons with serious illness, including those with chronic, neurodegenerative conditions. While there are several reports on COVID-19's impact on inpatient palliative care, literature is limited about the impact on outpatient care which may be more relevant for these patients. Aim: To generate a person-centered description of the impact of COVID-19 from the perspectives of patients living with neurodegenerative disease and caregivers to improve outpatient palliative care delivery. Design: This qualitative study used rapid analysis via matrix design to identify emergent themes related to participant perspectives on the challenges of COVID-19. Data sources included semi-structured interviews, open-ended survey responses, medical record documentation and participant-researcher communications. Setting/Participants: Data was collected from 108 patients with Parkinson's disease, Alzheimer's disease or related disorders and 90 caregivers enrolled in a multicenter, clinical trial of community-based, outpatient palliative care between March 20, 2020 and August 8, 2020 (NCT03076671). Results: Four main themes emerged: (1) disruptions to delivery of healthcare and other supportive services; (2) increased symptomatic and psychosocial needs; (3) increased caregiver burden; (4) limitations of telecommunications when compared to in-person contact. We observed that these themes interacted and intersected. Conclusions: Patients and caregivers have unmet care needs because of the pandemic, exacerbated by social isolation. While telemedicine has helped improve access to healthcare, patients and caregivers perceive clear limitations compared to in-person services. Changes in society and healthcare delivery in response to COVID-19 highlight ongoing and novel gaps that must be addressed to optimize future outpatient palliative care for neurologic illness. [ABSTRACT FROM AUTHOR]

In this article, we explore the context and determinants of pod-mod electronic cigarette (ECIG) use among college students aged 18 to 24 in the United States. We conducted semi-structured interviews with 55 students (M age = 20 years, 56% female, 65% White) on three campuses in the Northwest, Midwest, and Southeast. We performed a thematic analysis. Students described ECIG use by peers, increased ECIG exposure and prevalence in college, and school-related stress as reasons for vaping. Pod-mod features such as convenience, design, easy concealment, and flavors made vaping more appealing. Negative aspects of vaping included addiction, cost, and possible health consequences. Most viewed vaping as a college behavior and intended to quit after graduation. Our results show that the college environment plays a major role in young adult ECIG use. These findings can inform the development of targeted interventions to prevent and control uptake of ECIGs by young adults. [ABSTRACT FROM AUTHOR]

Introduction: Caregivers of patients undergoing hematopoietic stem cell transplantation need encouragement to maintain their own wellbeing. This feasibility study explored a six-session wellness intervention for caregivers entitled Ready to CARE (Connect, Actively Relax, and Exercise). Method: This study used a single-arm pre–post design to explore the feasibility and acceptability of the intervention and study procedures. The individual, participant-directed intervention was initiated at hospitalization for stem cell reinfusion. Caregivers completed telephone surveys on four occasions and engaged in one semi-structured interview to share their perceptions of the intervention. Results: Twenty participants enrolled and completed the baseline survey, with 50%, 90%, and 80% completing the subsequent three surveys, respectively. Seventy-four percent completed all six sessions of the intervention. Caregivers most often used the sessions to set goals related to physical activity (36%), stress management (14%), sleep (13%), and caregiving tasks (11%). Caregivers reported appreciation of the intervention's focus on supporting caregivers, taking action with goal-setting, and allowing caregivers to determine the focus of the goals. Scheduling the sessions was the most problematic aspect of the intervention. Conclusion: While caregivers were open to a wellness intervention, a high degree of flexibility and tailoring is needed to engage and support busy caregivers. Clinical Trial Registration: NCT03210727 [ABSTRACT FROM AUTHOR]

Despite ample evidence of the protective role of social support for mental and physical health, key gaps remain in our understanding of the pathways and mediating processes explaining these relationships in specific vulnerable populations. The author applies a theoretical framework developed by House et al. to qualitative data, collected with 24 caregivers of children living in HIV-endemic South African communities, to explore potential effects and processes linking social support to health. The data used for this analysis were part of a sequential mixed-methods research study with caregivers of children; previous survey findings (n = 2,477) showed significant associations between more social support and better mental health and self-reported physical health. Results point to multiple pathways and biopsychosocial mediating processes possibly explaining the support–health relationship. The author develops an exploratory model to illustrate these findings, based on the House et al. framework, and discusses implications for research, interventions, and theory. [ABSTRACT FROM AUTHOR]

Little research has focused on African American women's sexual assault victimization and mental health seeking. A mixed methods study was conducted to explore African American women's sexual assault in relationship to mental health seeking and experiences with mental health providers in a large community sample. Quantitative survey and qualitative interview data indicated unique correlates of immediate and longer term seeking of help from various mental health sources. Barriers and facilitators of African American women's mental health seeking were identified and qualitative themes were uncovered relevant to this group of survivors. Implications for research and clinical practice with this population are provided. [ABSTRACT FROM AUTHOR]

Low-income U.S. patients with co-occurring behavioral and physical health conditions often struggle to obtain high-quality health care. The health and sociocultural resources of such "complex" patients are misaligned with expectations in most medical settings, which ask patients to mobilize forms of these assets common among healthier and wealthier populations. Thus, complex patients encounter barriers to engagement with their health behaviors and health care providers, resulting in poor outcomes. But this outcome is not inevitable. This study uses in-depth interviews with two interprofessional primary care teams and surveys of all six teams in a complex patient program to examine strategies for improving patient engagement. Five primary care team strategies are identified. While team member burnout was a common byproduct, professional support offered by the team structure reduced this effect. Team perspectives offer insight into mechanisms of improvement and the professional burdens and benefits of efforts to counter health care marginalization among complex patients. [ABSTRACT FROM AUTHOR]

Students with mathematics difficulties and disabilities require evidence-based instructional strategies and interventions to improve their mathematical performance. Dissemination of these practices to teachers in rural settings presents specific challenges, including lack of Internet access, few discretionary resources, and geographic isolation. This mixed-method study explored rural Texas teachers' perceptions of their algebra content knowledge; their comfort with strategies, interventions, and resources; and professional development experiences related to students with mathematics difficulties and disabilities. Findings suggest that teachers are unfamiliar with or do not regularly implement evidence-based strategies and report regular use of strategies such as learning styles that have a limited evidence base. A discussion of findings includes suggestions for professional development tailored to the needs of rural Texas algebra teachers. [ABSTRACT FROM AUTHOR]

Introduction Meaningful activities of daily living promote the quality of life of residents of long-term care facilities. This project aimed to develop an approach to enable meaningful activities of daily living and to guide long-term care facilities in a creative and innovative attitude towards residents' meaningful activities of daily living. Method The approach was developed in six steps: (1) in-depth-interviews with 14 residents; (2) a survey with 171 residents; (3) a systematic map and synthesis review on interventions enriching meaningful activities of daily living; (4) qualitative analysis of 24 'good examples' and, to support future implementation, (5) focus groups with staff (n = 69). Results determined the components of the new approach which was (6) pilot-tested in one long-term care facility. Quantitative and qualitative data were gathered concerning benefits for the residents and feasibility for the staff. Results A client- and activity-oriented approach was developed, characterised by an active participatory attitude of residents and staff and a systematic iterative process. Significant positive effects were found for the number of activities, the satisfaction with the leisure offered, the social network, medication use, but not for quality of life. The approach appeared to be feasible. Conclusion This approach stimulates residents' meaningful activities of daily living and social life. Further investigation is needed to evaluate its outcome and implementation potentials. [ABSTRACT FROM AUTHOR]

Breast cancer survivors are at lifetime risk for the development of breast cancer–related lymphedema, a chronic, potentially debilitating condition that requires life-long symptom management. Suboptimal self-management rates suggest that health care providers may not be offering educative-support options that are customized to patient-perceived needs. An Institutional Review Board–approved focus group (N = 9) and mailed surveys (N = 15) were used to identify (a) barriers to lymphedema self-management, (b) how breast cancer survivors with lymphedema defined education and support, (c) what type of education and support they had received, and (d) what kind of education and support they wanted. Physiological, psychological, and psychosocial factors were identified as barriers to successful lymphedema self-management. One of the main barriers identified was lack of education about lymphedema treatment and risk reduction. In addition, more than half defined support as “prescriptions” and “referrals”; therefore, it is unclear whether patients were exposed to support other than medical treatment. [ABSTRACT FROM AUTHOR]

Objectives The objective of the study was to assess the patient safety situation in Ghana. Specifically, the study aimed at assessing the WHO's 12 action areas of patient safety. Design This was a descriptive cross-sectional survey. Data collection methods included interviews and observation using WHO adapted questionnaire. Setting The setting was mainly 16 selected hospitals, including two teaching hospitals selected from the northern and southern parts of the Ghana. Participants Respondents were purposively selected based on their position in the health facilities and the type of information required. Main Outcome Measure(s): The main outcome measures were the WHO's 12 action areas of patient safety. Results The median bed capacity of the hospitals assessed was 93 (min = 60, max = 1812). The country's highest score (94%) was in the action area of knowledge and learning in patient safety where all (16, 100%) sampled facilities had systems in place for recording adverse events, specific protocols for patient care, etc. Five (5) of the 12 action areas (i.e. national patient policy, hospital acquired infections, surgical safety, patient safety partnerships and patient safety funding) had scores lower than the mean score (66%). Conclusion The key strength identified in the patient safety situational analysis of Ghana was knowledge and learning in patient safety while patient safety surveillance was the weakest action area identified. There were also weaknesses in areas such as national patient policy, healthcare associated infections, surgical safety, patient safety partnerships and patient safety funding, respectively. [ABSTRACT FROM AUTHOR]

New technology has made pornography increasingly accessible to young people, and a growing evidence base has identified a relationship between viewing pornography and violent or abusive behavior in young men. This article reports findings from a large survey of 4,564 young people aged 14 to 17 in five European countries which illuminate the relationship between regular viewing of online pornography, sexual coercion and abuse and the sending and receiving of sexual images and messages, known as “sexting.” In addition to the survey, which was completed in schools, 91 interviews were undertaken with young people who had direct experience of interpersonal violence and abuse in their own relationships. Rates for regularly viewing online pornography were very much higher among boys and most had chosen to watch pornography. Boys’ perpetration of sexual coercion and abuse was significantly associated with regular viewing of online pornography. Viewing online pornography was also associated with a significantly increased probability of having sent sexual images/messages for boys in nearly all countries. In addition, boys who regularly watched online pornography were significantly more likely to hold negative gender attitudes. The qualitative interviews illustrated that, although sexting is normalized and perceived positively by most young people, it has the potential to reproduce sexist features of pornography such as control and humiliation. Sex and relationships education should aim to promote a critical understanding of pornography among young people that recognizes its abusive and gendered values. [ABSTRACT FROM AUTHOR]

This research note presents findings from a qualitative study exploring female, system-involved intimate partner violence (IPV) survivors’ perspectives on substance use disclosure in the context of research studies. The study sample includes 22 women who completed a court- and/or child protective services (CPS)–mandated IPV parenting program. Analyses revealed three key areas of participants’ perspectives on substance use assessment and disclosure: (a) administration setting/format and measurement clarity, (b) administrator characteristics, and (c) repercussions due to breach of confidentiality. Findings from the current study offer insights into barriers for survivors reporting their substance use and suggestions for researchers seeking to assess substance use among this population. [ABSTRACT FROM AUTHOR]

Purpose: This study explored the experiences of Black nurse faculty employed in predominantly White schools of nursing. High attrition rates of this group were noted in previous literature. Understanding their experiences is important to increase nurse diversity. Design: Hermeneutic phenomenology was used to explore the experiences of 15 Black nurse faculty using interviews. Findings: Four themes were extracted as the following: cultural norms of the workplace, coping with improper assets, life as a “Lone Ranger,” and surviving the workplace environment. Discussion: The study provided insight to understand the meaning that Black faculty members give to their experiences working in predominantly White schools of nursing. Findings exemplify the need to improve culturally competent work environments and mentoring programs. Implications for Practice: Results suggest that better communication and proper respect from students, colleagues, and administrators are necessary. The limited research on this topic illustrates that Black nurse faculty remain under investigated; research is necessary to determine effective change strategies. [ABSTRACT FROM AUTHOR]

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients (N = 46). Analysis of transcript data yielded empirical support for four distinct models of health decision making. The implications of these findings for developing interventions to improve the quality of treatment decision making and overall well-being are discussed. [ABSTRACT FROM AUTHOR]

A growing number of studies have examined the “immigrant paradox” with respect to health behaviors in the United States. However, little research attention has been afforded to the study of adverse childhood experiences (ACE; neglect, physical and sexual abuse, and witnessing violence) among immigrants in the United States. The present study, using Waves I and II data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), aims to address these gaps by comparing forms of ACE of first- and second-generation immigrants with native-born American adults in the United States. We also examined the latent structure of ACE among immigrants and conducted analyses to assess the psychiatric correlates of identified latent classes. With the exception of neglect, the prevalence of ACE was markedly higher among native-born Americans and second-generation immigrants compared with first-generation immigrants. Four latent classes were identified—limited adverse experience (n = 3,497), emotional and physical abuse (n = 1,262), family violence (n = 358), and global adversity (n = 246). The latter three classes evinced greater likelihood of being diagnosed with a mood, anxiety, personality, and substance use disorder, and to report violent and non-violent antisocial behavior. Consistent with prior research examining the associations between the immigrant paradox and health outcomes, results suggest that first-generation immigrants to the United States are less likely to have experienced physical and sexual abuse and witness domestic violence. However, likely due to cultural circumstances, first-generation immigrants were more likely to report experiences that are deemed neglectful by Western standards. [ABSTRACT FROM AUTHOR]

Law enforcement officials and prosecutors have been called “gatekeepers” of the criminal justice system, as their discretionary decisions determine case outcomes. Using the focal concerns perspective as our theoretical foundation, we explore the factors that influence arrest and charging decisions in intimate partner sexual assaults (IPSA) reported to Los Angeles law enforcement in 2008. Quantitative findings are supplemented with qualitative examples from Los Angeles Police Department (LAPD) detectives interviewed in 2010 and charge evaluation sheets from complaints referred to Los Angeles prosecution in 2008. Attempting to expand its theoretical relevance, we develop an alternative conceptualization and operationalization of the focal concerns perspective that is more appropriate to IPSA cases. Findings suggest that arrest decisions are motivated by suspect blameworthiness, community protection, and practical constraints and organizational consequences. In addition, charging decisions are influenced by community protection and practical constraints. Extralegal factors did not influence decision making. Directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Introduction This English study is the first to focus on the contribution of occupational therapists to the work of community mental health teams for older people. Method A mixed methods study comprising: a national survey of community mental health team managers; caseload audit; qualitative interviews; and a practitioner survey provided information on team membership and functions, user characteristics, accounts of occupational therapists’ roles and experiences, and work characteristics. Findings Occupational therapists worked mainly with people with dementia and were involved in both generic and specialist tasks, with the latter focusing largely on maintaining functionality. They had found ways to balance their roles for the benefit of the team without loss of professional identity. Some differences of opinion between clinical leads and occupational therapists were reported. Stress levels among occupational therapists were similar to those of professional colleagues. Conclusion Some findings contrast with earlier studies of community mental health teams for working-age adults, offering new insights into the nature of the occupational therapists’ experiences. To ensure that occupational therapists in these settings are able to contribute effectively, a shared understanding of their role is required between them and their clinical leads. [ABSTRACT FROM AUTHOR]

Background: There is a developing emphasis on intuition and affect in the illness risk perception process, yet there have been no available strategies to measure these constructs in non-English speakers. This study examined the comprehensibility and acceptability of translations of cancer risk beliefs in Haitian-Creole and Spanish. Method: An established, iterative, team-based translation process was employed. Cognitive interviews (n = 20 in Haitian-Creole speakers; n = 23 in Spanish speakers) were conducted in an inner-city primary care clinic by trained interviewers who were native speakers of each language. Use of an established coding scheme for problematic terms and ambiguous concepts resulted in rewording and dropping items. Results: Most items (90% in the Haitian-Creole version; 87% in the Spanish version) were highly comprehensible. Discussion: This work will allow for further research examining health outcomes associated with risk perceptions across diverse, non-English language subgroups, paving the way for targeted risk communication with these populations. [ABSTRACT FROM AUTHOR]

This study tested depression as a mediator between childhood sexual abuse and adherence to antiretroviral therapy, an effect moderated by resilience. In total, 149 HIV+ Latino men who have sex with men were recruited for this study. Using a regression-based bootstrap approach, depression mediated the relationship between childhood sexual abuse and antiretroviral therapy adherence, with worse adherence for participants at lowest percentiles of the resilience index. The prevalence of childhood sexual abuse and depression in HIV+ men who have sex with men is high and must be addressed to better prevent disease progression and reduce transmission, especially in expanding Latino populations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the current level of involvement of nurse practitioners (NPs) in activities related to preventing and managing fractures in long-term care (LTC). This study used a sequential explanatory mixed methods design that included two phases—a cross-sectional survey followed by qualitative interviews. A final sample of 12 NPs completed the online survey for a response rate of 67%. Eleven of the 12 NPs who completed the survey agreed to participate in a follow-up interview. NPs reported that they were quite engaged in managing fractures in LTC; specifically, they were most active in caring for residents post-fracture. NPs described their role as being holistic in nature in their assessment and treatments related to managing fractures. The findings from this mixed method study add to the growing body of knowledge related to how NPs manage fractures in LTC. [ABSTRACT FROM AUTHOR]

Background and Objective. This study is a qualitative analysis examining caregivers’ expectations for pediatricians with regard to behavioral health care. Methods. Fifty-five parents/caregivers of children seen in an urban primary care clinic participated in semistructured interviews. Participants were parents or guardians of children between the ages of 2 and 17 years, referred from the pediatric clinic to the mental health center. Interviews were analyzed using grounded theory methods. Results. Pertinent themes were the following: expected range of care, components of an effective primary care provider (PCP) relationship, action of the PCP, and parent reaction to PCP intervention. Forty-seven percent of caregivers saw the PCP role as strictly for physical health care; 53% expected the PCP to have a role in both physical and behavioral health. Responses were overwhelmingly positive from caregivers when the PCP asked about or conducted a behavioral health intervention. Conclusion. Caregivers did not consistently expect but responded positively to PCPs engaging around behavioral health concerns. [ABSTRACT FROM AUTHOR]

Girls are vulnerable to HIV in part because the social systems in which they live have failed to support and protect them. The goal of this research was to develop a viable supportive community index and test its association with intermediate variables associated with HIV risk across 16 communities in Botswana, Malawi, and Mozambique. This cross-sectional survey with separate samples randomly drawn in each country (2010) yielded a total sample of 1,418 adolescent girls (aged 11–18). Multilevel, multivariate logistic regression, while controlling for vulnerability, age, religion, and residence, found that an increase in supportive community index is positively associated with the odds of indicating improved community support for girls and with the confidence to refuse unwanted sex with a boyfriend across the three countries, as well as with self-efficacy to insist on condom use in Botswana and Mozambique. Program implementers and decision makers alike can use the supportive community index to identify and measure structural factors associated with girls’ vulnerability to HIV/AIDS; this will potentially contribute to judicious decision making regarding resource allocation to enhance community-level, protective factors for adolescent girls. [ABSTRACT FROM AUTHOR]