Background Multilevel interventions are necessary to address the complex social contributors to health that limit pre-exposure prophylaxis use among Black women, including medical distrust, pre-exposure prophylaxis stigma, and access to equitable health care. Strategies to improve knowledge, awareness, and uptake of pre-exposure prophylaxis among Black women will be more successful if information-sharing and implementation take place within trusted environments. Providing women with information through trusted cultural and social channels can effectively support informed decision-making about pre-exposure prophylaxis for themselves and members of their social networks who are eligible for pre-exposure prophylaxis. Objective The goal of this project is to improve knowledge, awareness, uptake, and trust of pre-exposure prophylaxis, as well as reduce pre-exposure prophylaxis stigma, among Black women living in the US South. Methods This multilevel, mixed methods study uses a community-engagement approach to develop and pilot test a salon-based intervention. There are three components of this intervention: (1) stylist training, (2) women-focused entertainment videos and modules, and (3) engagement of a pre-exposure prophylaxis navigator. First, stylist training will be provided through two 2-hour training sessions delivered over 2 consecutive weeks. We will use a pre- and posttest design to examine knowledge and awareness improvement of pre-exposure prophylaxis among the stylists. Upon full completion of training, the stylists will receive a certificate of completion and “Ask Me about PrEP” signage for their beauty salons. Second, together with the community, we have codeveloped a 4-part entertainment series (The Wright Place) that uses culturally and socially relevant stories to highlight key messages about (1) HIV, (2) pre-exposure prophylaxis, and (3) Black women’s social contributors to health. Quantitative and qualitative measures will be used in a pre- and posttest design to examine pre-exposure prophylaxis knowledge, awareness, risk, stigma, trust, intentions, and women’s perceptions of the usability and acceptability of the overall intervention and its implementation strategies. A video blog will be provided after each video. Third, participants will have access through an email or text message link to a pre-exposure prophylaxis navigator, who will respond to them privately to answer questions or make referrals for pre-exposure prophylaxis as requested. Results This project was funded in October 2020 by Gilead Sciences and was approved by the Duke University School of Nursing institutional review board in April 2021 (Pro00106307). Intervention components were developed in partnership with community partners in the first year. Data collection for phase 1 began in April 2022. Data collection for phase 2 began in May 2022. The study will be complete by October 2022. Conclusions Multilevel interventions that consider the assets of the community have promise for promoting health among Black women who have influence within their social networks. The findings of this study have the potential to be generalizable to other populations. International Registered Report Identifier (IRRID) PRR1-10.2196/34556
BACKGROUND Multi-level interventions are necessary to address the complex social contributors to health that limit Black women’s uptake of PrEP, including medical distrust, PrEP stigma, and access to equitable health care. Strategies to improve knowledge, awareness, and uptake of PrEP among Black women will be more successful if they are informed by Black women and their communities and implemented within trusted environments. Providing women with information through trusted cultural and social channels can effectively support informed decision making about PrEP for themselves and members of their social networks who are eligible for PrEP. OBJECTIVE This multilevel, mixed-methods study uses a community-engagement approach to develop and pilot test a salon-based intervention with the goal of improving knowledge and awareness of PrEP as well as PrEP stigma and uptake. METHODS There are three components of this intervention: (1) stylist training, (2) women-focused entertainment videos and modules, and (3) engagement of PrEP Navigator. First, stylist training will be provided virtually through two 2-hour training sessions delivered over two consecutive weeks. We will use a pre-post test design to examine knowledge and awareness improvement of PrEP among stylists. Upon full completion of training, stylists will receive a certificate of completion and “Ask Me about PrEP” signage for their beauty salons. Second, together with the community, we have co-developed a 4-part entertainment series (The Wright Place) that uses culturally and socially relevant stories to highlight key messages about (a) HIV, (b) PrEP, and (c) Black women’s social contributors to health. Quantitative measures will be used in a pre-post test design to examine PrEP knowledge, awareness, risk, stigma, trust, and intentions. Qualitative data will be collected to examine women’s perceptions of the usability and acceptability of the overall intervention and its implementation strategies. A video blog and educational modules providing resources and links about PrEP will be provided after each video. Third, participants will have access through an email or text message link to a PrEP Navigator who will respond to them privately to answer any questions or make referrals for PrEP as requested. RESULTS This project was funded in October 2020 by Gilead Sciences, Inc. and approved by the institutional review board in April 2021. Data collection of Phase 1 will begin October 2021. Data collection for Phase 2 will begin November 2021, with study completion by October 2022. CONCLUSIONS Multilevel interventions that consider the assets of the community have promise for promoting health among Black women who have influence within their social networks but may have low perceptions of risk. The findings of this study have the potential to be generalizable to other populations.
Date Presented 04/22/2023 Individuals with hypermobile Ehlers-Danlos syndrome (hEDS) commonly experience sleep disturbances that can affect occupational performance and participation. The purpose of this study was to investigate common sleep disturbances in individuals with hEDS and OT interventions commonly utilized to facilitate sleep. Primary Author and Speaker: Susan S. McDonald Additional Authors and Speakers: David Levine Contributing Authors: Allison Johnson, Nicole Curtis, Elizabeth Smiddy, Anthony Foster
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