Feasibility and Outcomes of an HIV Testing Intervention in African American Churches.

The updated National HIV/AIDS Strategy recommends widespread HIV education and testing and calls the faith community to assist in these efforts. Yet, limited information exist on church-based HIV testing interventions. This study examined feasibility and assessed HIV testing outcomes of Taking It to the Pews (TIPS), a multilevel HIV education and testing intervention. Four African American churches were matched and randomized to TIPS or a standard-information control arm. Intervention churches delivered the religiously-tailored TIPS Tool Kit, which included educational materials to individuals and ministry groups; pastoral activities (e.g., sermons preached, receipt of HIV testing role-modeled), responsive readings, and church bulletin inserts in church services; and HIV testing during church services and church outreach events. All churches delivered 2-3 tools/month and coordinated 3 HIV testing events. At 12 months, significant increases in receipt of HIV testing (59% vs. 42%, p = 0.008), and particularly church-based testing (54% vs. 15%, p < 0.001), relative to controls were found. TIPS has great potential to increase reach, feasibility, and impact of HIV testing in African American churches.

Community-based participatory research (CBPR): Towards equitable involvement of community in psychology research.

Community-based participatory research (CBPR) answers the call for more patient-centered, community-driven research approaches to address growing health disparities. CBPR is a collaborative research approach that equitably involves community members, researchers, and other stakeholders in the research process and recognizes the unique strengths that each bring. The aim of CBPR is to combine knowledge and action to create positive and lasting social change. With its origins in psychology, sociology, and critical pedagogy, CBPR has become a common research approach in the fields of public health, medicine, and nursing. Although it is well aligned with psychology's ethical principles and research aims, it has not been widely implemented in psychology research. The present article introduces CBPR to a general psychology audience while considering the unique aims of and challenges in conducting psychology research. In this article, we define CBPR principles, differentiate it from a more traditional psychology research approach, retrace its historical roots, provide concrete steps for its implementation, discuss its potential benefits, and explore practical and ethical challenges for its integration into psychology research. Finally, we provide a case study of CBPR in psychology to illustrate its key constructs and implementation. In sum, CBPR is a relevant, important, and promising research framework that may guide the implementation of more effective, culturally appropriate, socially just, and sustainable community-based psychology research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

In their own words: Content analysis of pathways to recovery among individuals with the lived experience of homelessness and alcohol use disorders.

BACKGROUND: Alcohol use disorders (AUDs) are more prevalent among homeless individuals than in the general population, and homeless individuals are disproportionately affected by alcohol-related morbidity and mortality. Unfortunately, abstinence-based approaches are neither desirable to nor highly effective for most members of this population. Recent research has indicated that homeless people aspire to clinically significant recovery goals beyond alcohol abstinence, including alcohol harm reduction and quality-of-life improvement. However, no research has documented this population's preferred pathways toward self-defined recovery. Considering principles of patient-centred care, a richer understanding of this population's desired pathways to recovery may help providers better engage and support them. METHODS: Participants (N=50) had lived experience of homelessness and AUDs and participated in semi-structured interviews regarding histories of homelessness, alcohol use, and abstinence-based treatment as well as suggestions for improving alcohol treatment. Conventional content analysis was used to ascertain participants' perceptions of abstinence-based treatment and mutual-help modalities, while it additionally revealed alternative pathways to recovery. RESULTS: Most participants reported involvement in abstinence-based modalities for reasons other than the goal of achieving long-term abstinence from alcohol (e.g., having shelter in winter months, "taking a break" from alcohol use, being among "like-minded people"). In contrast, most participants preferred alternative pathways to recovery, including fulfilling basic needs (e.g., obtaining housing), using harm reduction approaches (e.g., switching from higher to lower alcohol content beverages), engaging in meaningful activities (e.g., art, outings, spiritual/cultural activities), and making positive social connections. CONCLUSIONS: Most people with the lived experience of homelessness and AUDs we interviewed were uninterested in abstinence-based modalities as a means of attaining long-term alcohol abstinence. These individuals do, however, have creative ideas about alternative pathways to recovery that treatment providers may support to reduce alcohol-related harm and enhance quality of life.

Beliefs About Sex and Parent-Child-Church Sex Communication Among Church-Based African American Youth.

Parent-child sex communication has been shown to be protective against sexual risk among African American youth. The current study sought to use the theory of planned behavior as a framework for focus group discussions (N = 54 youth participants aged 12-19 years) to explore church youths' (a) sex beliefs and values (attitudes), (b) sources and evaluation of sex communication and education (subjective norms), (c) facilitator/barriers to adolescent sexual risk reduction and communication behaviors (perceived behavioral control), and (d) intentions to engage in these behaviors. Additionally, participants identified strategies for consideration in developing tailored parent-child-church sex communication education programs for use in African American churches. Themes suggested both positive and negative attitudes toward premarital sex and parents and churches as key sources of sex education and communication. Strategies to enhance parent-child-church sex communication are discussed in the context of these findings.

Religiosity and risky sexual behaviors among an African American church-based population.

African Americans are disproportionately burdened by STDs and HIV in the US. This study examined the relationships between demographics, religiosity, and sexual risk behaviors among 255 adult African American church-based participants. Although participants were highly religious, they reported an average of seven lifetime sex partners and most inconsistently used condoms. Several demographic variables and religiosity significantly predicted lifetime HIV-related risk factors. Taken together, findings indicated that this population is at risk for HIV. Future research should continue to identify correlates of risky sexual behavior among African American parishioners to facilitate the development of HIV risk reduction interventions in their church settings.

Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention.

INTRODUCTION: The African American church is a highly influential institution with the potential to greatly increase the reach of HIV prevention interventions and address HIV-related stigma in US African American communities. However, there are few studies on HIV-related stigma and African American church populations. This study explored HIV-related stigma among church and community members participating in an HIV education and testing intervention pilot study in African American churches, named Taking It to the Pews. METHODS: Four African American churches located in Kansas City, MO and KS, were randomized to either intervention or comparison groups. Churches assigned to the intervention group received religiously tailored HIV education, testing and compassion messages/activities (e.g. sermons, brochures/church bulletins, testimonials) via the Taking It to the Pews HIV Tool Kit. Comparison churches received non-religiously tailored HIV information. HIV-related stigma was assessed with 543 church members and with community members served through church outreach services (e.g. food/clothing pantries, social services) in the four churches. Participants completed surveys at baseline, 6 months and 12 months to assess their HIV-related stigma beliefs, exposure to intervention components and satisfaction with the study. RESULTS: At baseline, HIV-related stigma beliefs were similar across experimental groups and were quite low. Mean HIV-related stigma scores were not significantly different between experimental groups at 6 months (p=0.92) or at 12 months (p=0.70). However, mean HIV-related stigma scores within both groups showed decreasing trends at six months, which approached significance. Analysis of previously studied HIV-related stigma factors (e.g. age, gender, income, HIV knowledge, religiosity) did not yield changes in the null findings. Intervention group participants were highly exposed to several intervention components (sermons, HIV resource tables, posters, brochures/church bulletins). Overall, participants were highly satisfied with the intervention pilot study. CONCLUSIONS: African American churches may be well positioned to increase the reach of HIV prevention interventions to church and community members and could serve an important role in addressing HIV-related stigma in their church communities. Future research is needed on measuring HIV-related stigma beliefs and on testing intensive, scalable, religiously tailored HIV interventions to impact HIV-related stigma in African American churches.

Assessment of daily and weekly fatigue among African American cancer survivors.

This investigation evaluates two common measures of cancer-related fatigue, one multidimensional/retrospective and one unidimensional/same day. Fifty-two African American survivors of diverse cancers completed fatigue visual analogue scales once daily, and the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) once weekly, for four weeks. Zero-order correlations showed retrospective fatigue was significantly related to average, peak, and most recent same-day fatigue. Multilevel random coefficient modeling showed unidimensional fatigue shared the most variance with the MFSI-SF's General subscale for three weeks, and with the Vigor subscale for one week. Researchers and clinicians may wish to prioritize multidimensional measures when assessing cancer-related fatigue, if appropriate.

Examining church capacity to develop and disseminate a religiously appropriate HIV tool kit with African American churches.

Increasingly, African American churches have been called upon to assist in efforts to address HIV/AIDS in underserved communities. African Americans churches may be well-positioned to provide HIV education, screening, and support services, particularly if they are equipped with church-appropriate, easy-to-deliver HIV tools that can be implemented through the naturalistic church environment. To inform the development of a church-based HIV tool kit, we examined church capacity with African American church leaders (N = 124 participants; n = 58 churches represented by senior pastors). Nearly all participants (96%) wanted to learn more about HIV and how to discuss it with their parishioners. Regarding church capacity, most of their representative churches held three regular services each week, facilitated various inreach and community outreach ministries, and had paid staff and computers. Also, many of their churches facilitated HIV/AIDS education/prevention and adolescent sex education activities. Guided by church capacity findings, an ecological framework, and a CBPR approach, we describe the resulting church-based HIV Tool Kit that "fits" naturalistically within a multilevel church infrastructure, builds upon churches' HIV-related experience, and equips faith leaders to efficiently promote HIV services with the communities they serve.

Religiosity, alcohol use, and sex behaviors among college student-athletes.

College student-athletes tend to consume more alcohol, engage in sex, and report more sex partners than nonathlete students. The current study examined the relationship between religiosity (e.g., influence of religious beliefs and church attendance) and alcohol use and sex behavior among college student-athletes. Most of the student-athletes (n=83) were religious. Influence of religious beliefs was a significant predictor of less alcohol use and less sexual activity (i.e., oral and vaginal sex, number of sex partners). However, increased church attendance was not found to be a protective factor. Findings suggest that religious beliefs may contribute to reduction of alcohol use and sexual risk among college student-athletes. Consideration should be given to incorporating religiosity aspects in sexual and alcohol risk-reduction interventions for student-athletes.

Factors Related to HIV testing among an African American church-affiliated population.

HIV continues to disproportionately impact communities of color, and more calls are being extended to African American churches to assist in HIV education and screening efforts. However, no studies have reported on the HIV testing practices of African American church-affiliated persons. This study examines demographic, social, and behavioral factors associated with ever receiving an HIV test and last 12-month HIV testing. Findings indicated not having insurance and condom use were predictors of ever receiving an HIV test. Predictors of HIV testing in the last 12 months included marital status (i.e., single, divorced, separated, or widowed) and intentions to get tested for HIV in the near future. These predictors should be considered when designing HIV education and screening interventions for African American church settings.

Taking It to the Pews: a CBPR-guided HIV awareness and screening project with black churches.

Utilizing a community-based participatory research (CBPR) approach is a potentially effective strategy for exploring the development, implementation, and evaluation of HIV interventions in African American churches. This CBPR-guided study describes a church-based HIV awareness and screening intervention (Taking It to the Pews [TIPS]) that fully involved African American church leaders in all phases of the research project. Findings from the implementation and evaluation phases indicated that church leaders delivered TIPS Tool Kit activities on an ongoing basis (about twice a month) over a 9-month period. TIPS church members were highly exposed to TIPS activities (e.g., 91% reported receiving HIV educational brochures, 84% heard a sermon about HIV). Most (87%) believed that the church should talk about HIV, and 77% believed that the church should offer HIV screening. These findings suggest that implementing an HIV intervention in Black church settings is achievable, particularly when a CBPR approach is used.

A motivational interviewing course for pharmacy students.

OBJECTIVE: To create, implement, and evaluate a pharmacy course on motivational interviewing. DESIGN: A 3-hour elective course was created to train doctor of pharmacy (PharmD) students in brief patient-centered motivational interviewing counseling strategies that have proven effective with the types of health issues most commonly addressed in pharmacy settings. Students were assisted in developing their skills through required readings, interactive lectures, in-class demonstrations and practice sessions, out of class skills practice, one-on-one supervision provided by doctoral level clinical health psychology students, and written reflections on each class session. ASSESSMENT: Students demonstrated significant improvement in motivational interviewing skills and a high level of motivation for and confidence in using these skills in their future practice. Students overall assessment of the course and supervision process was highly positive. CONCLUSION: This patient-centered counseling skills course was feasible and produced improvements in PharmD students' counseling skills and increased their motivation and confidence to use motivational interviewing skills in their future communications with patients.

Identifying problems faced by spouses and partners of patients with prostate cancer.

PURPOSE/OBJECTIVES: To describe problems chosen as targets of problem-solving therapy by spouses and partners of patients with prostate cancer. DESIGN: Descriptive, cross-sectional. SETTING: Spouses' and partners' homes. SAMPLE: Spouses and partners (N = 66) aged 32-79 years (mean = 60 years). The sample was predominantly Caucasian (82%) and African American (8%). METHODS: As part of a randomized clinical trial, women received problem-solving therapy to help manage issues related to their husbands' or partners' prostate cancer. The issues they chose to address during therapy and the categorization of the issues fell into four groups: treatment and side-effect issues, patient issues, family issues, and spouse issues. Scores on the Social Problem-Solving Inventory-Revised, which measures everyday problem-solving skills, and the Profile of Mood States, which measures mood disturbance, were contrasted with the problems women chose to address. MAIN RESEARCH VARIABLES: Problems faced by spouses and partners of patients with prostate cancer. FINDINGS: The most frequently reported categories were spouse issues (e.g., women's emotional wellness, balancing their medical concerns with their husbands' condition) and patient issues (e.g., men's lack of communication, fear, or depression). CONCLUSIONS: Findings of this study alert nurses to a variety of key problem areas for spouses and partners of patients with prostate cancer. IMPLICATIONS FOR NURSING: Spouses and partners play a critical role when their loved ones have cancer. Understanding the problems spouses and partners face can help nurses design optimal supportive care interventions.