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Purpose: the purpose of this NIH-funded protocol is to adapt (Aim 1) and pilot test (Aim 2) an mHealth intervention to improve maternal and child health in Cameroon. We will adapt the 24/7 University of Alabama at Birmingham Medical Information Service via Telephone (MIST) provider support system to mMIST (mobile MIST) for peripheral providers who provide healthcare to pregnant and postpartum women and newborns in Cameroon. Methods: in Aim 1, we apply qualitative and participatory methods (in-depth interviews and focus groups with key stakeholders) to inform the adaptation of mMIST for use in Cameroon. We use the sequential phases of the ADAPT-ITT framework to iteratively adapt mMIST incorporating qualitative findings and tailoring for local contexts. In Aim 2, we test the adapted intervention for feasibility and acceptability in Ndop, Cameroon. Results: this study is ongoing at the time that this protocol is published. Conclusion: the adaptation, refinement, and pilot testing of mMIST will be used to inform a larger-scale stepped wedged cluster randomized controlled effectiveness trial. If successful, this mHealth intervention could be a powerful tool enabling providers in low-resource settings to deliver improved pregnancy care, thereby reducing maternal and fetal deaths., Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); National Institutes of Health (NIH); Fogarty International Center (FIC); National Institute of Mental Health (NIMH)

As our knowledge of HIV evolved over the decades, so have the approaches taken to prevent its transmission. Public health scholars and practitioners have engaged in four key strategies for HIV prevention: behavioral-, technological-, biomedical-, and structural/community-level interventions. We reviewed recent literature in these areas to provide an overview of current advances in HIV prevention science in the United States. Building on classical approaches, current HIV prevention models leverage intimate partners, families, social media, emerging technologies, medication therapy, and policy modifications to effect change. Although much progress has been made, additional work is needed to achieve the national goal of ending the HIV epidemic by 2030. Nurses are in a prime position to advance HIV prevention science in partnership with transdisciplinary experts from other fields (e.g., psychology, informatics, and social work). Future considerations for nursing science include leveraging transdisciplinary collaborations and consider social and structural challenges for individual-level interventions.

The purpose of this systematic review was to assess the state of adherence to HIV care such as HIV medication and appointment adherence among Black women in the United States. After a systematic search of CINAHL, PubMed, EMBASE, and clinicialtrials.gov, 26 studies and two ongoing trials met inclusion criteria. Psychosocial factors such as intersectional stigmas and depression were among the salient factors associated with adherence-to-care behaviors in women living with HIV (WLWH). In addition, interpersonal factors such as social support and the patient-provider relationship were frequently associated with adherence-to-care behaviors. No culturally relevant interventions for Black WLWH were found in the literature, but one ongoing trial that was developed specifically for Black WLWH seemed promising. Considering the dearth of tailored interventions, more gender-specific and culturally relevant interventions are urgently needed to improve adherence-to-care behaviors and optimize health outcomes for Black WLWH.

As people age with HIV, cognitive problems may become more prevalent and severe, but lifestyle behaviors (i.e., physical activity) have been shown to protect brain health and cognition. We examined the perceptions that older adults living with HIV have about protecting and improving brain health and cognition through lifestyle behaviors. Qualitative data were analyzed from four focus groups (N = 30) of African Americans and Caucasians living with HIV and at least 50 years of age. An open-coding scheme using conventional content analysis was employed. Two results were found. First, many older adults with HIV in our study expressed a variety of cognitive complaints that interfered with daily function. Second, these participants reported few specific ideas about how such health behaviors were important to their own brain health and cognition. Education interventions may help older adults with HIV learn to improve and protect brain health and cognition as they age.

Purpose The purpose of this paper was to examine the psychometric properties of Champion's Health Belief Model Scales for cervical cancer and screening among women living with HIV. Methods A secondary data analysis was conducted using data from an exploratory cross-sectional study with a convenience sample of 300 women living with HIV receiving care at two HIV ambulatory care clinics in Florida. A 39-item adaptation of the Champion's Health Belief Model Scales was administered via paper and pencil. Results The authors used internal consistency measures, confirmatory factor analysis, and ordinal item response theory (IRT) techniques to examine the psychometric properties of the instrument. The 39-item instrument had adequate internal consistency and factor structure. However, the IRT analyses suggested that the instrument could be reduced to 24-items (61.5%), without loss of relevant information. Conclusion A shortened 24-item instrument demonstrated good internal consistency among women living with HIV. Future work should include validating the properties of the reduced instrument in diverse samples of patients and conditions.

Objective: In the United States, 26,534 young women (≤45 years) were diagnosed with breast cancer in 2017. Young African American (AA) women have higher incidence and mortality rates than Whites an...

Employment requires one to learn new skills, establish a routine, and engage socially, all of which can also provide purpose or meaning to one’s life and provide income. All of these can directly or indirectly bolster cognitive reserve, which may protect cognitive health, especially as one ages. Unfortunately, if one is incapacitated due to illness, such as depression, HIV, or other diseases and chronic conditions, it may necessitate reduction/withdrawal from employment, which could limit employment-induced cognitive health benefits. This article examines these issues within the framework of neuroplasticity and cognitive reserve, thus providing implications for practice and research for nurses and health care professionals. HIV, breast cancer, depression, neuroplasticity, occupation, morbidities, health behaviors

African American (AA) women ages 20-44 develop breast cancer at higher rates compared with Caucasian women. These young survivors (45 years) also have disparate quality of life (QOL). Little is known about survivorship information needs of young AA survivors. The purpose of this study was to explore young AA survivors' perceptions of an existing QOL intervention for breast cancer survivors, identifying information needs to address using a targeted intervention.Two semistructured interviews were conducted with each of 15 young AA survivors who had completed breast cancer treatment. This article focuses on the second interview in which young AA survivors reviewed intervention materials and described their perceptions of the intervention. Content analysis was used to identify themes, which were validated by participants.Participants (n: 15; mean age at study entry: 35 years) reported that the existing evidence-based intervention discussed relevant but general survivorship information. They suggested adapting the information for young AA survivors: addition of content geared toward finances, how to better communicate to manage dating and relationships, how to engage in healthful activities, and how to find local resources for any stage of survivorship. Furthermore, they suggested multiple modes of information delivery and inclusion of diverse imagery.Engaging young AA survivors yielded pearls of wisdom, highlighting the general nature of an existing intervention and suggesting adaptations to meet young AA survivors' information needs. Applying such pearls can be a powerful method to target survivorship interventions for this disparate group of cancer survivors.

African Americans in the rural Southern United States continue to experience disproportionate increases in new HIV/AIDS infections. Electronic gaming interventions hold promise but the use of HIV prevention games is limited. The purpose of this study was to assess the acceptability and relevance of a web-based HIV prevention game for African American rural adolescents. Findings from focus groups conducted with 42 participants suggested that the game was educational and somewhat entertaining but lacking in real-life scenarios and player-control. Findings are congruent with self-efficacy literature and constructivist approaches to learning. Findings have implications for gaming intervention development and further research.

Nearly 50% of adult persons living with HIV (PLWH) experience HIV-associated neurocognitive disorder (HAND), which is associated with deteriorating brain health and cognitive functioning. Multimodal interventions that simultaneously improve physical activity, nutrition, and sleep hygiene may be of value for adult PLWH, especially as they age and become vulnerable to HAND. We used four focus groups of PLWH (N = 30; ages ≥ 50 years) to solicit feedback about Cognitive Prescriptions, a multimodal cognitive intervention. Lifestyle and health behaviors pertaining to Cognitive Prescriptions were assessed, including: (a) physical activity, (b) mental activity, (c) nutrition, (d) social engagement, (e) emotional health, (f) sleep hygiene, and (g) substance use. When presented a template of the intervention, participants expressed favorable opinions and remarked they would want to work with a clinician, paraprofessional, or peer to implement such a program into their own daily routines. From this, implications for practice and research are provided.

The HIV/AIDS epidemic is becoming increasingly concentrated among African Americans who live in the rural South. HIV denial, stigma, and misconceptions have been identified as helping spread the virus among adults. However, little is known about these psychosocial factors among African American rural adolescents. This article presents findings from a study aimed at exploring the role HIV denial, stigma, and misconceptions play in the disproportionate impact of HIV/AIDS on African American adolescents in the rural South. A mixed-method study, which included questionnaires and focus group discussions, was used. Results indicated that the majority of participants had average HIV knowledge levels and that HIV denial, stigma, and misconceptions played a role in the current HIV/AIDS epidemic among rural African American adolescents. Nurses and health care professionals can play a key role in understanding and addressing HIV stigma, denial, and misconceptions among African American adolescents in the rural South to reduce HIV/AIDS health disparities among this population. [ Journal of Psychosocial Nursing and Mental Health Services, 52 (6), 50–56.]

Digital games have shown promise in studies focusing on disease prevention and disease self-management in children and young adolescents. The purpose of this study was to gather formative data for the design of an HIV prevention game for adolescents. Qualitative research methods that included focus group sessions with four groups of adolescents were used (N = 38). Content analysis strategies were used to analyze verbatim transcripts and observational notes. Themes emerging from the data included: players’ control, virtual reward systems, immersive action, and the need for tailoring. Findings are being used in the design of a digital game that is responsive to recommendations to “make it like the real world.” HIV prevention strategies could benefit from incorporating emerging technologies that are inherently attractive to many adolescents. Adolescent participants support the use of digital games in HIV prevention and wanted such games to reflect their lives.

Purpose: Determining and incorporating the perspective of the target population is important to the developments of effective and sustainable HIV prevention efforts. Cameroonian preadolescent females remain at high risk for contract-ing HIV and have not benefitted from targeted HIV prevention efforts. In this report, findings are presented from data collected from 60 Cameroonian preadolescent females; ages 10-12 years; following their completion of an HIV preven-tion intervention. Methods: The theory-based intervention utilized the World Health Organization’s Responsible Be-havior: Delaying Sex curriculum which had been tailored for the target population with the assistance of Cameroonian experts. The data reported here were collected as part of a questionnaire participants completed post-intervention. Re-sults: With only a few exceptions, participants perceived the intervention to be appropriate and relevant. No significant differences were found in participants’ assessment of the intervention across different ages and ethnic groups. Discus-sion: Evaluating the appropriateness of interventions to the developmental level, gender, and culture of participants is an essential step in developing effective and sustainable interventions. Findings in this study are encouraging and indi-cate that interventions adapted with the assistance of local experts can be perceived relevant and appropriate by par-ticipants.

Background/Purpose Recent data indicate that 11% of the 230,000 women diagnosed with breast cancer each year are young (18-44). Though the five-year survival rates of these young women are improving, there are large health disparities in breast cancer survivorship among young African American women in the United States (e.g. higher breast cancer incidence and mortality when compared with young Caucasians). Further, young African American breast cancer survivors (YAABCS) report poorer quality of life than young Caucasians. Despite recommendations to provide evidence-based and tailored survivorship care for cancer survivors, there are about 23,000 YAABCS between the ages of 20-49 living in a southern tri-state area (Alabama- AL, Louisiana- LA, and Mississippi- MS) for whom a comprehensive breast cancer survivorship education/support intervention does not exist. As few studies have examined YAABCS's survivorship experiences and/or tested intervention efficacy among this group, further study of their survivorship is warranted to inform the adaptation of an age- and culturally-specific survivorship psychoeducational intervention for YAABCS. As part of an ongoing dissertation study, a Research Tested Intervention Program called the Breast Cancer Education Intervention (BCEi) is being adapted into Y-AMBIENT (the BCEi for YAABCS). The purpose of this abstract is to describe early results of the lived experience of young African American breast cancer survivorship, which will be used to inform the adaptation of Y-AMBIENT. Methods A transcendental phenomenological study design guided by the conceptual framework of the BCEi (Quality of Life Model Applied to Breast Cancer [QOL-BC]) was used. A purposive and snowball sample of YAABCS was recruited from AL, LA, and MS. The study recruitment flyer was disseminated online and via email through breast cancer-affiliated organizations and support groups. Word-of mouth dissemination was also encouraged. Data collected included two semi-structured interviews, a sociodemographic survey, volunteered personal effects from YAABCS, and field/reflective notes. Data were analyzed using NVivo11 Software (qualitative data) and IBM SPSS Software v. 23 (quantitative data), then validated among participating YAABCS. Early Results Early results of the ongoing dissertation study were informed by 7 of 15 YAABCS (mean age= 32 years; mean survivorship= 4 years). These YAABCS perceived survivorship as a labile, new normal. Feeling as though survivorship was a burden, YAABCS described the need to be “strong” for themselves and others. These women actively structured their lives to manage changes to their physical, psychological, social, and spiritual selves. While YAABCS reported successful survivorship management to co-survivors and others, they acknowledged that survivorship was an ongoing “struggle” in which spirituality and survivorship education were key. Discussion/Conclusion Early results indicated a fluid and complex experience of survivorship among YAABCS. While most reported an intensive need for spiritual connection, all reported a need for more comprehensive survivorship education. Thus, a tailored survivorship education intervention may be needed for YAABCS. Future Directions The ongoing dissertation study to adapt Y-AMBIENT will be informed by the lived experience of young African American breast cancer survivorship. Future research examining YAABCS's perceptions of the BCEi and the inter-relation of QOL-BC constructs may inform this and future interventions that aim to decrease quality of life health disparities among YAABCS. Acknowledgements This research is funded by an American Cancer Society Doctoral Degree Scholarship in Cancer Nursing (DSCN-15-073-01), Susan G. Komen Graduate Traineeship in Disparities Research, Jonas Nurse Leaders Scholarship, and Gladys Farmer Colvin Doctoral Fellowship. Citation Format: Timiya S. Nolan, Tiffany L. Carson, Susan Davies, Comfort Enah, Nataliya Ivankova, Karen Meneses. Exploring the lived experience of young African American breast cancer survivorship: Early results toward informing a psychoeducational intervention. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B18.

Carrie Ann Gakumo,1 Comfort C Enah,1 David E Vance,1,2 Efe Sahinoglu,3 Jim L Raper1,3,4 1School of Nursing, 2Center for Nursing Research, 3School of Medicine, 41917 HIV/AIDS Outpatient Clinic, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: Health literacy is lower in minorities and older adults, and has been associated with nonadherence to medications, treatment, and care in people living with human immunodeficiency virus (HIV). Likewise, African Americans with HIV are more likely to be nonadherent to their HIV medications, less likely to keep their clinic appointments related to HIV treatment and care, and more likely to die during hospitalizations than their ethnic counterparts. The present study explored the preferences of older African Americans with HIV for a health literacy intervention to promote HIV management.Patients and methods: In this qualitative study, 20 older adult African Americans living with HIV were recruited from an HIV/acquired immunodeficiency syndrome outpatient clinic in the southeastern region of the US. Using patient-centered participatory design methods, semi-structured individual interviews were conducted to determine patient preferences for intervention development and design. Health literacy was also measured using the Rapid Estimate of Adult Literacy in Medicine – Revised (REALM-R).Results: Four major themes emerged related to intervention development and design: keep health information simple; use a team-based approach for health education; tailor teaching strategies to patients’ individual needs; and account for patients’ low experience, but high interest, in technology. Forty-five percent of the study population had low health literacy based on the revised Rapid Estimate of Adult Literacy in Medicine.Conclusion: Future interventions that target minorities and older adults living with HIV should consider patients’ learning needs, sex-specific and mental health needs, and delivery approaches, in order to increase uptake and improve disease management and health outcomes. Keywords: health disparities, health literacy, HIV/AIDS, medication adherence, older adults, racial disparities

By 2015, approximately half of adults with HIV in the United States will be 50 and older. The demographic changes in this population due to successful treatment represent a unique challenge, not only in assisting these individuals to cope with their illness, but also in helping them to age successfully with this disease. Religious involvement and spirituality have been observed to promote successful aging in the general population and help those with HIV cope with their disease, yet little is known about how these resources may affect aging with HIV. Also, inherent barriers such as HIV stigma and ageism may prevent people from benefitting from religious and spiritual sources of solace as they age with HIV. In this paper, we present a model of barriers to successful aging with HIV, along with a discussion of how spirituality and religiousness may help people overcome these barriers. From this synthesis, implications for practice and research to improve the quality of life of this aging population are provided.