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BackgroundAdherence to HIV care is complex, as barriers to care are multidimensional, particularly for ethnic minority women. Mobile health (mHealth) solutions are supportive in improving HIV health care outcomes. In the United States, however, mHealth interventions are not widely implemented in public HIV clinics and have not been customized for women. There is an unmet need for culturally and linguistically appropriate mHealth interventions that address the health care needs of minority women living with HIV. ObjectiveThis study aims to describe a protocol investigating the feasibility of an mHealth intervention for treatment adherence among women living with HIV. This is a two-phase, mixed methods, pilot randomized controlled trial that begins with qualitative patient interviews to inform the system design. Participants will be block randomized by language (English, Spanish, and Haitian Creole) to 1 of 2 study arms. MethodsWomen (age ≥18 years) who were followed up at the women’s HIV clinic of an academic medical center, with a recent history of nonadherence to HIV care (missed appointments, unsuppressed viral load, or not taking medications as prescribed), will be enrolled. The experimental arm will receive the intervention, which includes health reminders and psychoeducational messaging, plus clinical standard of care reminders. The psychoeducational messaging will target patient-level barriers of HIV stigma and medical mistrust and resilience as a patient-level strength. The control arm will receive standard of care reminders only (ie, mailed appointments and automated telephone calls). All aspects of the study and intervention will be offered in the participants’ preferred language. The primary outcome is the feasibility and acceptability of the study. The secondary outcomes are changes in self-reported medication adherence, depression symptoms, HIV stigma, medical mistrust, resilience, and clinic attendance and viral suppression extracted from the participants’ medical records. Data will be assessed at baseline (T0) and 2 subsequent clinic visits—approximately 3 to 4 months from the baseline (time 1; T1) and 6 to 9 months from the baseline (time 2; T2). Qualitative data will be transcribed and analyzed iteratively. Bivariate analyses will compare data by the study group (chi-square, odds ratios, and t tests). Exploratory analyses will be conducted for each outcome variable—T1 and T2 values will be compared with values at T0 by the study group. ResultsAs of March 2020, baseline quantitative data were collected on 54 participants (28 English speakers, 14 Spanish speakers, and 12 Haitian Creole speakers). The first 3 focus groups (1 in each of the 3 languages) were completed, with a total of 20 participants. The findings are currently being integrated into the beta version of the mHealth texting system. ConclusionsThe findings of this novel HIV adherence intervention may shed light on the barriers and facilitators of HIV health care and the mechanisms of an mHealth intervention that is customized for ethnic minority women living with HIV. Trial RegistrationClinicalTrials.gov NCT03738410; https://clinicaltrials.gov/ct2/show/NCT03738410 International Registered Report Identifier (IRRID)DERR1-10.2196/17656

Background Little is understood about child welfare involvement (CWI) in cases where the birth mother has experienced human trafficking. Objectives The aim of this study was to explore provider perceptions of the impact of CWI for the trafficked mother. Methods Participants were selected among providers caring for trafficked birth mothers. Semi-structured interviews were conducted with providers and qualitative content analysis was conducted. Results Interviewees reported reasons for CWI, positive and negative impacts of CWI and provided recommendations for systems improvement. Conclusion for Practice Recommendations from this exploratory study include mechanisms to support trafficked mothers, train hospital social workers, and systems change. During the prenatal period, strategies to support the trafficked mother may include addressing gaps in social determinants of health, ensuring appropriate medical and mental health care, early screening and referral to substance use treatment services, enhancing community support, and working to develop safety plans for survivors and their families. Enhanced engagement of social workers and all providers to improve understanding of the unique complexity of trafficked mothers is needed. Education should include an understanding that judgement of a caretaker's ability to parent should be current and holistic and not reflexive based on history in the electronic medical record. An exploration of the child welfare system itself should also be undertaken to identify and modify discriminatory laws and policies. Finally, efforts to address social determinants of health in the community and enhance the trauma-informed nature of child welfare referrals could improve the lives of trafficked mothers., Author(s): Hanni Stoklosa [sup.1] [sup.2] , Lujain Alhajji [sup.3] , Lindsey Finch [sup.4] , Sacha Williams [sup.5] , Jaya Prakash [sup.6] , Anna K. Sfakianaki [sup.7] , Lunthita M. Duthely [...]

Objectives: The objective of this study was to evaluate global longitudinal publication trends in oncology in the Cochrane Database of Systematic Reviews (CDSR) from 2001-2020. Design: Retrospective bibliometric analysis. Primary and secondary outcome measures: The primary outcome measures were the numbers and percentages of women as first, last, and corresponding author across all CDSR oncology publications. Additional outcomes included authorship differences between countries and percentages of women authors over time compared using the Cochran-Armitage trend test. Results: In total, 548 articles were analyzed. Women were first authors in 52.26% (n=277) and corresponding authors in 50.75% (n=272), respectively. Women represented only 39.4% (n=210) of last authors, significantly less frequent than male counterparts (p < 0.001). The percentage of women last and corresponding authors has increased significantly in the past 20 years (p < 0.05). Countries such as the Netherlands and Australia consistently showed equitable representation in first, corresponding, and last authorship, while other countries such as Italy and China had uniformly low rates of female authorship. Coclusions: Our results highlight patterns of gender inequity in oncology publication authorship in the CDSR from 2001-2020 at a global level. Notably, women were less likely to serve in the last author position which, independent of assigned corresponding authorship, is generally assumed in academic oncology to designate the leader of a published study. Substantive efforts to correct this disparity are needed to achieve gender parity in publicly perceived leadership in oncology publications. [ABSTRACT FROM AUTHOR]