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Tobacco denormalization is a widely accepted tobacco control strategy, shaping policies and programs throughout the United States as well as globally. In spite of widespread beliefs about the effectiveness of tobacco denormalization approaches, concerns about their emphasis on stigmatization have emerged. Social science research on smoking stigma raises questions about the potential iatrogenic consequences of tobacco denormalization approaches. Few studies have considered how smoking stigma may be internalized differently by different people, particularly those who experience stigmatization because of other socially ascribed makers of inequity (e.g. race, ethnicity, gender, sexuality). The intersection of multiple stigmas may work to intensify the ‘social isolation and marginalization’ that some people already experience. This paper presents results from a pattern-level analysis of focus group and interview data from a study investigating smoking-related stigma and perceptions of tobacco denormalization approaches among 15 low income Black women who smoke in the San Francisco Bay Area. Our analysis revealed a cycle where Black women’s experiences with structural oppression resulted in stress and the use of cigarettes to cope with that stress. Though the connection between smoking and stress is well documented in previous research, our analysis further revealed the additional contribution of the stigmatization of smoking and how it intensifies inequity for Black women who smoke. Implications of these findings for tobacco control and prevention are discussed. [ABSTRACT FROM PUBLISHER]

Although sex education is often provided to young people, there is a lack of spaces where adults can go to learn more about sex from experts in a free and welcoming environment. One place that provides an opportunity for adult sex education is adult sexual retail stores. While these stores aim to be commercially successful, they also fulfil a role of educating adults about sex and sexuality. This study explains how Good Vibrations (GV), a sex-positive adult sexual retail store company in the USA, disseminates sexuality education for adults. Using qualitative methods including observations, interviews and textual analysis, I show how GV serves as a coach to its patrons. The coaching framework described here promotes shared responsibility through inclusive and accessible education, highlighting communication and focusing on pleasure and positivity. This paper provides one of the first evidence-based accounts of how an adult sexual retailer educates its customers and provides a model for sexuality educators for all ages. [ABSTRACT FROM AUTHOR]

In recent years, there has been increasing concern about youthful 'binge' drinking and intoxication. Yet the meaning of intoxication remains under-theorized. This paper examines intoxication in a young adult nightlife scene, using data from a 2005-2008 National Institute on Drug Abuse-funded project on Asian American youth and nightlife. Analyzing in-depth qualitative interview data with 250 Asian American young adults in the San Francisco area, we examine their narratives about alcohol intoxication with respect to sociability, stress, and fun, and their navigation of the fine line between being 'buzzed' and being 'wasted.' Finally, limitations of the study and directions for future research are noted. [ABSTRACT FROM AUTHOR]

While the vast majority of farmworkers in California are Latinx, a small proportion of the farmworkers are Asian Indian who primarily speak Punjabi. To date, there are few COVID-19 resources developed that specifically target Punjabi-speaking farmworkers. This study examines the COVID-19 educational needs of Punjabi-speaking farmworkers in California and aims to inform future development of educational materials for Punjabi-speaking farmworkers. During early 2021, a two-phase qualitative study was conducted. In Phase 1, five key informant interviews were conducted using a semi-structured interview guide to assess the content, visual, and cultural relevance of current COVID-19 educational resources. Based on informant feedback, new agriculture-specific COVID-19 educational resources were developed in Punjabi. In Phase 2, three focus groups were conducted (in Fresno and Yuba Counties) with five participants in each group to evaluate the newly developed COVID-19 resources. Informant interviews showed that Punjabi-speaking farmworkers preferred printed handouts, videos, and radio messages to receive COVID-19 related information. Participants preferred 8–1/2"x11" sized printed handouts that were colorful and had culturally relevant photographs. Participant video preferences included live action videos that were short (1–3 mins) with characters representing the Punjabi community. A substantial majority of focus group participants approved the newly developed COVID-19 educational and safety resources. Current COVID-19 resources are not meeting the educational needs of Punjabi-speaking farmworkers. This community needs COVID-19 educational and safety materials that are culturally relevant and linguistically appropriate to be available in different formats: handouts, videos, and radio messages. [ABSTRACT FROM AUTHOR]

American Indian and Alaska Native (AIAN) communities have higher rates of substance use than other racial and ethnic groups. Substance use disorder (SUD) is tied to the increased risk of experiencing homelessness. National policies have also led to the disproportionate rates of homelessness among AIAN communities. However, specific experiences related to the occurrence of SUD and homelessness among AIAN in California, as well as seeking and accessing SUD treatment, are not well understood. This study explored potential SUD risk and resilience factors for AIANs experiencing homelessness and their experiences when seeking services for SUD. Nineteen interviews were conducted in northern, central, and southern California. Thematic analysis was used for these data. The five primary codes were: (1) risk factors for SUD, (2) resilience related to SUD service seeking, (3) services available, (4) barriers accessing services, and (5) services needed. Based on the results, themes for risk were trauma, mental health, and community conditions. Themes for resilience were identified at individual and community levels and included personal motivation and community support and inclusiveness. Themes for services available were limited knowledge about service types and services' location. The themes for barriers accessing services were identified at internal and external levels, and included lack of readiness and transportation challenges, respectively. Themes for services needed included continuum of care, integrated care, and culturally sensitive services. Findings highlight the importance of addressing the potential risk factors and service needs of AIANs experiencing homelessness to provide comprehensive and culturally sensitive services to reduce substance use. [ABSTRACT FROM AUTHOR]

Black Transgender women (BTW) are subjected to race and gender-based societal oppression, which makes them vulnerable to experience violence. The purpose of this study was to examine experiences of violence among BTW by centering their narratives. Ten participants from Los Angeles County were interviewed, and data were analyzed using Consensual Qualitative Research, which yielded four domains; however, the current article focused only on the first domain, Types of Violence, and its six themes: (a) Transgender-specific microaggressions, (b) verbal harassment, (c) intimate partner violence, (d) physical violence, (e) sexual violence, and (f) incarceration. Recommendations for Transgender specific trauma-informed interventions and future directions to promote BTW healing are provided. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the social factors that contribute to the mental health challenges that Somali young adults endure. In a two-phase qualitative approach carried-out in the San Diego area, in phase-I, we conducted exploratory interviews with key-informants including clinicians and local Somali leaders (n = 7) who are familiar with the challenges of young Somalis. This information was then augmented through a focus group discussion with Somali young adults (n = 4) to gain further contextual knowledge and for access to the larger community of young people for phase-II. In this second phase, we carried-out individual interviews with 21 Somali young adults. Interviews covered topics including the social factors influencing their mental health, typical strategies for coping with psychological distress, barriers to seeking professional mental health services, and suggestions for combating mental health problems affecting young Somalis. Participant narratives indicate that psychological distress (depression and posttraumatic stress disorder) are highly pervasive, and that shame, acculturative stress and ethnic discrimination as well as parents' dismissive reactions to their children's emotional problems perpetuate mental health problems. Coping strategies included support from friends, religious activities, and playing soccer. Suggestions for addressing their challenges centered on engagement from their own community to advocate for mental health. Implications of this study are discussed in the context of bridging intergenerational and acculturation divides to deliver culturally competent interventions that improve the mental health and well-being of Somali young adults and aid them in their adjustment to the U.S. [ABSTRACT FROM AUTHOR]

In response to the opioid crisis, states and health systems are encouraging clinicians to use risk mitigation strategies aimed at assessing a patient's risk for opioid misuse or abuse: opioid agreements, prescription drug monitoring programs (PDMPs), and urine drug tests (UDT). Objective: The objective of this qualitative study was to understand how clinicians perceived and used risk mitigation strategies for opioid abuse/misuse and identify barriers to implementation. Methods: We interviewed clinicians who prescribe opioid medications in the outpatient setting from 2016-2018 and analyzed the data using Constructivist Grounded Theory methodology. Results: We interviewed 21 primary care clinicians and 12 specialists. Nearly all clinicians reported using the PDMP. Some clinicians (adopters) found the opioid agreement and UDTs to be valuable, but most (non-adopters) did not. Adopters found the agreements and UDTs helpful in treating patients equitably, setting limits, and having objective evidence of misuse; protocols and workflows facilitated the use of the strategies. Non-adopters perceived the strategies as awkward, disruptive to the clinician-patient relationship, and introducing a power differential; they also cited lack of time and resources as barriers to use. Conclusions: Our study demonstrates that clinicians in certain settings have found effective ways to implement and use the PDMP, opioid agreements, and UDT but that other clinicians are less comfortable with their use. Administrators and policymakers should ensure that the strategies are designed in a way that strengthens the clinician-patient relationship while maximizing safety for patients and that clinicians are adequately trained and supported when introducing the strategies. [ABSTRACT FROM AUTHOR]

Latino immigrant families in the child welfare system are more likely than their U.S. born peers to experience barriers to the supportive services their families need. These clients must engage with their social workers to overcome obstacles including communicative challenges, cultural differences, limited Spanish language referral services, ineligibility for public programs, and fear of government authorities. This study used interviews with Spanish speaking clients and social workers in one child welfare agency to examine clients' and workers' perceptions of their relationships and the barriers and facilitators of their work together. Our findings suggest that child welfare agencies might better support Spanish speaking clients and workers by adopting strategies to strengthen workers' cultural competency, to reduce barriers to referral services, and to provide appropriate supervision to Spanish speaking workers. These institutional supports are needed to support client-worker engagement and enhance service delivery for Latino immigrant families. [ABSTRACT FROM AUTHOR]

While a range of sources exist for marijuana users to acquire marijuana for medical or personal use, prior research on marijuana sources primarily focused on single sources. In this analysis, we longitudinally examined characteristics of multiple sources selected by marijuana users, motivations to use sources, and how a blend of marijuana sources accommodated users' needs. Young adult marijuana users (n = 60) in Los Angeles, CA, where marijuana has been legal for medical use since 1996, completed two annual qualitative interviews on marijuana use practices and sources between 2014 and 2016. Approximately two-thirds were medical marijuana patients and one-third was non-patient users. Participants reported acquiring marijuana from the following primary sources across two interviews: dispensaries and delivery services, private sellers in the illicit market, friends and family, and marijuana events/conferences. While patients with legal medical access to marijuana typically purchased marijuana from dispensaries or delivery services, they often supplemented from other illicit sources. Non-patients often accessed marijuana through dispensary diversion but also other sources. As patients became non-patients and vice versa during the study period, source type changed too. Broad access to marijuana via legal and illicit sources in this sample is indicative of societal trends towards normalization of marijuana use. [ABSTRACT FROM AUTHOR]

This exploratory study examines how three types of fit (technical, cultural, and political) between an evidence-based practice and adopting organization explain fidelity in terms of quantity and quality of core components implemented. Using data from 20 supportive housing programs, fidelity was calculated using a quantitative scale and fit was coded using qualitative program director interviews. Relationships between fidelity and fit were tested with Fisher's exact tests. Cultural fit predicted both high quality and quantity fidelity, and technical fit predicted high-quality fidelity. Interviews provided qualitative examples of how fit influenced implementation. Study results provide preliminary support for the relationship between practice-organization fit and fidelity. [ABSTRACT FROM AUTHOR]

Studies indicate prescription stimulant use for cognitive performance enhancement is normalized, contributing to increases in non-medical prescription stimulant use (NPSU) through peer recommendations and drug diversion. NPSU may follow users beyond their academic years to the workforce with some initiating use later in adulthood. Aims: Examine findings from a San Francisco Bay Area National Institute on Drug Abuse funded research project. Explore motivations to initiate and continue NPSU focusing on San Francisco Bay Area adults in the workforce. Analyze motivations for use and use practices within the American sociocultural context. We also examine consequences of use, including falling into the 'Adderall trap' – a cycle of using to perform, sleeplessness, then using again to wake up and perform. Methods: 67 in-depth interviews analyzed using Grounded Theory methods. Findings: Increased availability combined with pressure to perform and compete at work, facilitated decisions to initiate and continue use. Some also used recreationally to mitigate the effects of alcohol and prolong a night out. Conclusions: Cultural factors such as the pressure to perform in a society as the US valuing hard work, competition, and success motivate NPSU. In these cases, NPSU is not necessarily considered to be deviant, but rather following conventional values. [ABSTRACT FROM AUTHOR]

Research on faith-based urban workers is limited despite the chronic and traumatic exposure inherent in their work. This study details the perception of positive interpersonal relationships during a time of trauma or crisis as described in semistructured 2- to 3-hour interviews with 13 faith-based urban workers in Los Angeles, California. Using strategies consistent with Consensual Qualitative Research, categories and subcategories defining positive interpersonal relationships were identified. Resulting categories suggested that there are specific characteristics, products, and types of relationships that urban workers experience as important during the time of trauma or crisis. Positive experiences were often religious in nature and included feeling supported, feeling connected, relationship growth, sharing and listening, authenticity, and feeling as through relationships facilitated personal growth or coping. The findings highlight participants’ need for both practical support and relational support which reflects and enhances their spiritual commitment. [ABSTRACT FROM PUBLISHER]

Intimate partner sexual violence (IPSV) has been relatively understudied particularly from the perspective of women of color. This study documents the experiences with partner sexual violence of ten Mexican-American women. Qualitative interviews were conducted using snowball sampling with women that had been in abusive marital relationships. A phenomenological approach was used and through a thematic analysis, participant narrative responses were synthesized into themes. All participants reported sexual coercion and violence in their marriages, yet most did not label those experiences as “rape” despite the threatening context in which these incidents occurred. Tacit, but not always explicit acceptance of machismo, patriarchy, and male dominance were common themes possibly increasing IPV risk. Results highlight the complex interaction between upholding cultural values on the one hand, and preserving individual well-being and safety, on the other, underscoring the need for more extensive culturally sensitive research, prevention and intervention efforts for abused Mexican-American women [ABSTRACT FROM AUTHOR]

Recent media accounts have highlighted issues of use and abuse of police force and policing practices targeted at ethnic minorities within inner city areas. To date, little research has focussed specifically on the experiences and perceptions of youth gang members in dealing with police. Using data from 253 in-depth interviews with ethnic minority San Francisco-based youth gang members, we examine perceptions of respectful and disrespectful police behaviour. Premised on a procedural justice model, we explore how frequently disrespectful police behaviour is reported and how these negative experiences shape gang members' attitudes towards the police more generally. We refine our investigation by comparing adverse encounters to examples in which gang members are treated respectfully. Using a data-driven inductive and qualitative theory testing deductive approach, our data revealed that male and female gang members regularly experience disrespectful police behaviour in terms of physical and verbal abuse. Our findings indicate that these exchanges contribute to negative attitudes, fear and distrust of police, while respectful interactions are meaningful and can contribute to positive attitudes towards officers. [ABSTRACT FROM AUTHOR]

We used a mixed-methods convergent parallel design to explore the effect of yoga on quality of life, trauma, and anxiety in low-income adults with mental illness. Participants included a convenience sample (N= 18) of parents at a community mental health agency who participated in a six-week yoga intervention. Participants completed standardized measures of quality of life, anxiety, and post-traumatic stress disorder (PTSD) pre- and post-intervention. Focus groups were conducted to further explore barriers to and the effects of participation in the yoga intervention. Wilcoxon Signed Ranks Tests indicated a statistically significant decrease in anxiety and PTSD after the yoga intervention, but no significant changes in quality of life or trait anxiety. Qualitative results reveal five themes related to participation in yoga classes, including barriers to participation and ways to improve the class. Qualitative results corroborate quantitative findings, suggesting improved relaxation and anger management for participants who strongly endorsed the benefits they experienced. [ABSTRACT FROM AUTHOR]

This article presents the qualitative results of semi-structured interviews with five established couples where one individual was diagnosed with early stage Alzheimer’s disease (AD). The interviews were designed to explore the effects of the initial diagnosis, the felt experience of the disease by both members of the couple, and the resulting impact on the couple’s dynamics. The aim of the study was to discover the issues unique to this situation, what successful management strategies these couples may have found, and thus to inform the future provision of couples therapies where AD is present. The primary findings support results found in other recent studies of couples encountering AD with some additional insights: (a) The actual diagnosis was very difficult to hear. An unexpected finding in this study was that the way the diagnosis was delivered was often more traumatic than the diagnosis itself. (b) All couples reported challenging issues of increasing dependency and marked changes in the balance of independent action for each partner versus shared responsibilities. In addition, couples shared their individual experiences of anger as a response to unfulfilled performance expectations, both by the AD patient and the well spouse. (c) This small study group saw travel, a common activity for older people, as maintaining “couplehood” in addition to its other benefits. [ABSTRACT FROM PUBLISHER]

The Salud con Hyland's Project: Comienzo Saludable, Familia Sana [Health With Hyland's Project: Healthy Start, Healthy Family],was developed to provide education and support to Latina mothers regarding healthy infant feeding practices and maternal health. The promotora-delivered intervention was comprised of two charlas (educational sessions) and a supplemental, culturally and linguistically relevant infant feeding and care rolling calendar. Results indicate that the intervention increased intention to breastfeed exclusively, as well as to delay infant initiation of solids by 5 to 6 months. Qualitative feedback identified barriers to maternal and child health education as well as highlighted several benefits of the intervention. [ABSTRACT FROM AUTHOR]

We present findings from two exploratory studies of San Francisco Bay Area women involved in illicit drug sales who saw both advantages and disadvantages to being women in traditionally male-dominated drug economies. We interviewed 160 sellers of street drugs and 50 sellers of prescription drugs during 2006-2009. Women perceived gender as a cover and managed their vulnerabilities by performing gendered actions and at times going against traditional gender expectations to protect themselves in harsh drug markets. The intersecting factors of race and type of drug sold played a crucial role, revealing the complex nature of women's social location in their drug-selling worlds. Study limitations are noted. [ABSTRACT FROM AUTHOR]

While anger is a common problem for veterans returning from wars in Afghanistan and Iraq, veterans' understanding of the causes, course, and consequences of anger has not been explored. We conducted this qualitative study to learn veterans' perspectives about their anger problems. We identify and describe three distinct patterns of anger problems that emerged as a consequence of (a) loss of structure during reintegration to civilian life, (b) moral injury sustained through a wartime experience, and (c) posttraumatic stress disorder (PTSD). While anger problems tended to be short lived for those experiencing loss of structure, problems persisted for years for those with moral injury or PTSD. Anger following all three patterns negatively impacted veterans' experiences with reintegration. We discuss the implications of these findings. [ABSTRACT FROM PUBLISHER]

This pilot study demonstrates the roles of popular culture, media and the arts in the health and self-esteem of homeless youth. Reflecting focus group findings from a representative sample of street and sheltered youth, this article provides a qualitative assessment of what they advocated as an effective intervention that would promote the receipt of health services within their vulnerable community. Unlike alienating disease models where adverse health behaviors and outcomes determine intervention success or failure, a culturally-sensitive approach which provided skills mentoring and engaged the youth as health advocates seemed likely to produce important recovery incentives and enhanced health outcomes. [ABSTRACT FROM AUTHOR]

This article disseminates findings from a pilot study undertaken to learn more about treatment providers’ perceptions of treatment access barriers faced by Latino migrants with substance use disorders (SUDs) in Northern California. Semi-structured interviews were conducted with treatment providers (N = 11) at 7 residential treatment programs with Spanish-language services. Interviewees identified and described three primary types of treatment barriers: language, legal, and gender based. In response to these barriers, Latino migrants with SUDs have opened their own residential recovery houses calledanexos(annexes). Collaborative efforts by community clinics and public health agencies are needed to facilitate Latino migrants’ access to SUD treatment. [ABSTRACT FROM PUBLISHER]

While many child mental health issues manifest themselves in primary care, few pediatricians have received mental health training, and their communication with social workers may be limited due to unfamiliarity with mental health professions. The purpose of this study was to use ethnographic interviews to investigate factors affecting communication satisfaction between social workers and pediatricians. The study found that scope of practice issues were a communication barrier. This barrier is significant because health reform may lead social workers and pediatricians to collaborate more frequently in the future. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify dimensions of elder mistreatment in Chinese and Korean immigrant communities and to increase sociocultural understanding of such mistreatment by elucidating the complexities of abuse embedded in unique social and cultural contexts. In-depth interviews were conducted with 20 local professionals working primarily in Asian elderly advocacy, and six focus group discussions were conducted involving 60 community members in the San Francisco Bay area. Five dimensions of elder mistreatment were identified: psychological abuse, neglect by a trusted person, financial exploitation, physical abuse, and sexual abuse. In general, fewer Korean community member participants reported having observed physical or financial abuse than Chinese groups, but they reported greater knowledge of situations involving psychological abuse, neglect by a trusted person, and sexual abuse. The contexts of cultural influences and immigration and acculturation were salient themes that shaped participants’ subjective perceptions and beliefs about elder abuse and hence help-seeking behaviors. [ABSTRACT FROM AUTHOR]

This case study explores the first decade (2002–2012) of the California Senior Leaders Program (CSLP), including participants' creation of a formal advocacy group, the California Senior Leaders Alliance. Grounded in concerns with ageism and invisibility, the CSLP provides recognition and support for diverse California elders engaged in community building and social justice work. This study employs qualitative analysis of data from participant interviews, event evaluations, program documents, video footage, and participant observation. Findings show emotional, learning, and networking benefits for participants, intergenerational influences, collective capacity and coalition building, and contributions to policy. Program challenges are described, and future directions discussed. [ABSTRACT FROM PUBLISHER]

The authors report the results of qualitative (n = 19) and quantitative (n = 545) interviews with young injection drug users (IDUs) in San Diego, California about their experiences using drugs in Tijuana, Mexico, and associated risks for HIV infection. Young IDUs who have ever traveled to Mexico (n = 365) used a variety of injection (54%) and noninjection (30%) drugs there and appear to be heavier users than those who have never traveled to Mexico. Sociocultural themes influencing drug use in Mexico included interactions among the purpose of travel, drug preference, and route of administration; familiarity with the border region; evolving relationships with the United States and Mexican drug markets; and the experience of crossing the U.S.–Mexico border. Interventions for IDUs in border regions need to be sensitive to the ethnicity, familiarity with the border region, and life history of participants, as well as differences in national policies that could influence drug use and risk for HIV on both sides of the border. [ABSTRACT FROM PUBLISHER]

The article describes the development and implementation and lessons learnt from parent nutrition education workshops conducted for a low-income, primarily Spanish-speaking population in an urban school district setting. The participating parents showed positive changes in their knowledge attitudes, self-efficacy and behaviors related to healthy eating indicating that this would lead to healthier eating habits among students.

Parental beliefs and rules regarding their teen's use of alcohol influence teen decisions regarding alcohol use. However, measurement of parental rules regarding adolescent alcohol use has not been thoroughly studied. This study used qualitative interviews with 174 parents of older teens from 100 families. From open-ended questions, themes emerged that describe explicit rules tied to circumscribed use, no tolerance, and “call me.” There was some inconsistency in explicit rules with and between parents. Responses also generated themes relating to implicit rules such as expectations and preferences. Parents described their methods of communicating their position via conversational methods, role modeling their own behavior, teaching socially appropriate use of alcohol by offering their teen alcohol, and monitoring their teens' social activities. Findings indicate that alcohol rules are not adequately captured by current assessment measures. [ABSTRACT FROM AUTHOR]

The drug 'Ecstasy' has been most commonly associated with raves, or electronic music dance events, and attributed with sexual disinhibition. In an ethnographic investigation of drug use among second-generation Southeast Asian youth in Northern California conducted in 2003, respondents described little use of or interest in using Ecstasy; yet in a second study, Ecstasy was the fourth most commonly used substance. This article investigates the social contexts for this change in use patterns. Respondents were second-generation Southeast Asian youths and young adults between the ages of 15 and 26 who were currently or recently drug-involved. We compared qualitative data from the two studies and found emerging patterns of meaning and context related to the observed change in use patterns. Ecstasy use among co-resident African American youth within the context of the local 'hyphy' hip-hop music subculture had influenced Southeast Asian youths' uptake of the drug, known as 'thizz.' Respondents referred to the effects of the drug as 'thizzin',' described as energizing, disinhibiting, numbing, and emotion enhancing. Reported consequences of 'thizzin'' included violence and aggression as well as fun, while sexual disinhibition was rarely mentioned. The meanings assigned to drugs, including the effects ascribed to them, may be relative to the social contexts within which users are exposed to and consume drugs. The findings indicate the susceptibility of youths to local trends in drug use, particularly associated with popular cultural movements and music. Second-generation youths may be particularly susceptible relative to the conditions of their immigration and processes of identity formation unique to them. [ABSTRACT FROM AUTHOR]

Although Synanon has been extensively studied, attention has seldom been paid to the question of how the many ex-members who left Synanon before or at its dissolution 'survived' their community and indoctrination, and how they now evaluate their involvement. This article explores how ex-members react to their previous affiliation to Synanon, the cradle of the therapeutic community (TC) for addiction. A series of critical incidents, following Synanon's public proclamation restyling itself as a religion, which led to the dismantlement of Synanon, are highlighted and contrasted with the achievements of the movement. For this research study, we used a social constructivist methodology. Following qualitative snowball targeted sampling, open interviews and text analysis, 14 statements, representing the main reactions, were retained. These served as the basis for a web-based survey. It was found that ex-Synanon members still believe in the positive realizations of their experience. On the other hand, they are not blind to the negative aspects of this time but tend to deny, or perhaps do not know, that the proclamation to become a religion was in fact initiated by the inner circle and that this was the start of the dismantling of the organization's value system and the introduction of strange and inappropriate behaviour. The article emphazises the potential powerful and long-lasting effects of 'community as method' as a means of indoctrination of values. It endorses the opinion that the drug-free concept-based TC operates within the framework of an effective belief system that encourages and reinforces behavioural change. It is therefore critically important to ensure that present-day TCs remain open to the views and expectations of society. [ABSTRACT FROM AUTHOR]

This article examines family influences on risk and protective factors associated with unsafe sex among gay Asian Pacific Islander men. Twenty-five gay Asian Pacific Islanders completed individual interviews regarding factors that may lead them to engage in unsafe sex as well as factors that may lead them to engage in protective sex. Analysis of qualitative data revealed three ways by which family members influence sexual behaviour. We found that the way that (1) the way these men perceived family obligation and the need to avoid shame, (2) the level of active family participation, and (3) internalisation of what these men perceived to be 'Asian' values influenced whether their families acted as a protective factor or not in terms of HIV risk behaviours. [ABSTRACT FROM AUTHOR]

The article presents a study which explores the efficacy of integrating the Socio-Ecological Model (SEM) and Developmental Assets (DA) in the Youth Health Action Board (YHAB) program. The study employs individual interviews to evaluate the impressions of youths on how their experience affected themselves and the community. The study shows that YHAB participants have felt personal growth through experiences of building external support in the community.

Treatment advocacy (TA) programs have been implemented by AIDS service organizations (ASOs) and primary care clinics across the USA to help engage clients with HIV into care and support their adherence to antiretroviral therapy (ART). TA aims to empower people with HIV through education and client-centered counseling regarding HIV, ART, and other health issues; advocate on behalf of patients with providers; and make referrals to healthcare services and clinical trials. However, relatively little is known about the impact TA has on clients' healthcare experiences. The present study's objectives included exploring how TA services help clients engage in HIV care, initiate ART, and adhere to HIV medications. We conducted 25 semi-structured qualitative open-ended interviews with clients living with HIV/AIDS recruited from AIDS Project Los Angeles (APLA); four HIV medical providers; and two TA staff at APLA. Of the 25 clients interviewed, 92% were male and 8% were female. The average age was 43 years (SD=9). About 60% were African-American, 20% were White, 12% were other or multiracial, 4% were Latino, and 4% were Asian/Pacific Islander. Five interconnected themes consistently emerged across clients, TAs, and providers. TAs helped clients understand treatments and supported adherence within a holistic context. Further, TAs acted as a bridge to providers and helped clients build self-advocacy skills. Our data show that TA services go beyond traditional areas of education and treatment adherence. TA services within an ASO also provide a safe place to discuss initial HIV diagnoses and other health issues in a more comprehensive manner. TA services complemented medical and other social services by preparing clients with HIV to be better consumers of healthcare services. Future quantitative research examining the effectiveness of TA on improving clients' engagement in care and adherence is a critical next step. [ABSTRACT FROM AUTHOR]