This paper describes the results of an interview study investigating facilitators and barriers to adoption of patient portals among low-income, older adults in rural and urban populations in the southeastern United States. We describe attitudes of this population of older adults and their current level of technology use and patient portal use. From qualitative analysis of 36 patient interviews and 16 caregiver interviews within these communities, we derive themes related to benefits of portals, barriers to use, concerns and desired features. Based on our initial findings, we present a set of considerations for designing the patient portal user experience, aimed at helping healthcare clinics to meet U.S. federally-mandated 'meaningful use' requirements.

Interventions focusing on increasing mental health knowledge and improving beliefs can improve MHL among male college students. Further, interventions should be tailored for racial groups and major classifications.

Considered a public health issue, the prevalence and severity of poor mental well-being on college campuses has continued to rise. While many college campuses offer mental health counseling services, and utilization rates are increasing, their proportional usage is low especially among males, who often deal with poor mental well-being by adopting unhealthy coping strategies. The purpose of this study was to use the Information-Motivation-Behavioral Skills (IMB) model to assess the relationship between the determinants as factors that may impact help-seeking behaviors in a large sample (n = 1,242) of male college students. Employing a cross-sectional study design, a 71-item online survey assessed information via total mental health literacy (MHL), motivation via attitudes toward mental health and subjective norms regarding mental health, and behavioral skills via intentions regarding help-seeking behaviors, and stigma. Results revealed correlations between information and motivation (r = .363, p < .01), information and behavioral skills (r = .166, p < .01), and motivation and behavioral skills (r = .399, p < .01). Multiple regression was used to determine stigma is a mediator for all relationships. These findings represent an opportunity to take a public health approach to male mental health through developing multilayered interventions that address information, motivation, behavioral skills, and stigma.

Recently, national attention has been drawn to the increasing number of adolescents infected with HIV in the US, particularly in the South. According to the Center for Disease Control and Prevention (2007), at least 50% of new HIV infections occur in persons 15-25 years of age, and the majority of these persons are likely infected in their teens. Adolescents with HIV present new challenges to health and social-service providers. Infected teens are typically identified and initially followed by pediatricians and pediatric staff upon diagnosis. The transition to adult infectious disease care can be difficult due to the increased responsibility for self-care and monitoring placed on the young adult. Interviews were conducted with 19 professionals who provide care for children and adults with HIV in North Carolina in order to identify the best practices for transition to adult care. Approximately half of the providers self-identified as pediatric care providers. Nine of those interviewed were nurses and physicians and 10 were social workers. Interviews were transcribed and emergent themes were identified. Findings indicate that promoting medical independence among adolescents, close communication between pediatric and adult providers, and addressing system level concerns, including helping patients' families navigate health insurance and other social services, as well as having a separate clinic for adolescents with HIV, constitute best practices for transitioning youth with HIV from pediatric to adult care.

Rates of HIV infection among adolescents in the US continues to rise, resulting in more individuals who must eventually transition from pediatric to adult care. It is critical that this process go smoothly to ensure continuity of care and to maximize patient outcomes. While research has examined youths' experiences with the transition process, disease-specific indicators of successful transition from pediatric to adult care remain undefined. Identifying indicators will facilitate the evaluation of transition processes, and, ultimately, the empirical determination of best practices. Interviews were conducted with 19 professionals who provide care for children and adults with HIV in southeastern state in the US. Approximately half of the providers self-identified as pediatric care providers. Nine of those interviewed were nurses and physicians and 10 were social workers. Providers had been working in the field of HIV for an average of 11.2 years. Interviews were taped, transcribed, and coded for emergent themes. Providers who care for HIV-infected youth identified both behavior and seriologic indicators of succesful transitions. Behavioral indicators identified were keeping appointments, medication adherence, and demonstrating ownership of medical care. Providers also identified serological markers of a succesful transition, specifically,viral load and CD4 count. Findings provided valuable insight into the perspectives of infectious disease care providers on indicators of successful transition from pediatric to adult care for adolescents with HIV. This is an important first step in developing empirical evaluation measures for transition practices and models. Similar research should be conducted with other groups of providers to assess the generalizability of these findings. Additionally, future research should seek to operationalize the identified behavioral indicators and determine appropriate values to indicate success for all indicators.

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