The development, feasibility and acceptability of an Internet-based STI-HIV prevention intervention for young Chilean women.

BACKGROUND: Young Chilean women between 18 and 24 years of age are at high risk of contracting sexually transmitted infection (STI) and human immunodeficiency virus (HIV). The literature shows a shortage of STI-HIV prevention interventions focused on this specific high-risk population and a unique set of barriers to receiving prevention messages. Internet-based interventions are promising for delivering STI-HIV prevention interventions and avoiding barriers to services. AIMS: The study aimed to develop a culturally informed Internet-based STI-HIV prevention intervention for Chilean women between 18 and 24 years of age, to investigate its feasibility and acceptability, and to compile recommendations on what would make the intervention more acceptable and feasible for these women. METHODS: The development of the Internet intervention was facilitated by a process that featured consultation with content and technology experts. A pre-post test design was used to test the acceptability and feasibility of the intervention with 40 young Chilean women between 18 and 24 years of age. RESULTS: The intervention website consisted of four modules of content and activities that support learning. The intervention was feasible and acceptable for young Chilean women between 18 and 24 years of age. DISCUSSION AND CONCLUSION: This study demonstrated the value of engaging multiple expert panels to develop culturally informed and technology-based interventions. The results of this study support the feasibility and acceptability of conducting an Internet-based intervention with multiple sessions, yielding high participation rates in a population in which there are barriers to discussion of STI-HIV prevention and sex-related content. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The outcomes have implications for nursing education and clinical practice and they can be used for the legal and judicial systems to promote or reinforce policies that encourage STI-HIV prevention strategies among women.

Mental health training experiences among Haitian healthcare workers post-earthquake 2010.

BACKGROUND: After the 2010 earthquake in Haiti, the large number of persons with major limb damage, amputations, shock, trauma, anxiety and depression placed a severe strain on mental health (MH) services. PURPOSE: This qualitative study describes the impact and acceptability of a Mental Health Training Program (MHTP) implemented in the north of Haiti after the earthquake. METHODS: A total of 113 healthcare workers (HCWs) participated in a training program designed to build local MH care capacity. The training curriculum draws on literature related to MH and the impact of the Haiti earthquake. Two focus groups were conducted with 16 HCWs; discussions centred on the personal and professional impact and acceptability of the training program. DISCUSSION: Results demonstrated that the MHTP changed the HCWs' perceptions about MH issues and provided them with the knowledge and skills to respond to growing community MH needs. Acceptability of the MHTP was related to the content covered, to the delivery mode of the content and to the cultural appropriateness of the program. CONCLUSIONS: Disasters of different types will continue to occur and to impact MH in communities around the world. MH training will allow nurses to quickly and effectively respond to disasters. A coordinated emergency plan that is subject to frequent review, rehearsal and evaluation is also essential.

Impact of Mano a Mano-Mujer, an HIV prevention intervention, on depressive symptoms among Chilean women.

Worldwide, and in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low-income Chilean women. Depressed people are less willing to participate in behaviours that protect them against HIV. The aim of this study is to analyze the impact of Mano a Mano-Mujer (MM-M), and HIV prevention intervention, on depressive symptoms among Chilean women. A quasi-experimental design was used for this study. The research was conducted in Santiago, Chile; a total of 400 women participated in the study (intervention group, n=182; control group, n=218). The intervention was guided by the social-cognitive model and the primary health care model. The intervention consists of six 2-h sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face-to-face interviews were conducted at baseline and at 3-month follow-up. Chilean women who participated in MM-M significantly decreased, at 3 months follow up, their reported depressive symptoms. MM-M provided significant benefits for women's depression symptoms. In this study nurses participated as leaders for the screening of depressive symptoms and as facilitators of community interventions.

[HIV PREVENTION FOR HISPANIC WOMEN FIFTY YEARS AND OLDER.] / PREVENCION DE VIH PARA MUJERES HISPANAS DE 50 AÑOS Y MÁS.

INTRODUCTION: Hispanic women aged 50 and over (OHW) are a minority in the U.S. at high risk of acquiring HIV and the least studied group of population in relation to health, social characteristics and sexual behavior. OBJECTIVE: To investigate the factors that increase HIV risk among OHW with the purpose of developing or adapting an intervention appropriate for their "age and culture". METHODOLOGY: A cross-sectional descriptive study with a sample of 50 OHW, sexually active and who residing in Miami, Florida, U.S. A structured questionnaire was administered by trained bilingual interviewers (English/Spanish). Participants were recruited from different locations in South Florida. Data were analyzed using descriptive statistics, including central tendency and dispersion measures. RESULTS: OHW's mean age was 55.7 ± 6 years old (range 50-76 years old). All the OHW were in the menopause. HIV PREVENTION: OHW reported average levels of HIV knowledge and partner communication. In the sample OHW reported depression symptoms, intimate partner violence, negative attitudes towards people living with HIV and low perceived risk of acquiring HIV. OHW mentioned learning needs in topics related to HIV prevention and age changes. CONCLUSION: OHW are at risk of acquiring HIV and they have special needs in terms of HIV prevention.

Research agenda for Hispanics in the United States: a nursing perspective.

Heterogeneity is perhaps the most salient characteristic that defines Hispanic populations of the United States. Hispanic populations include native-born, migrant, and immigrant peoples with distinctive national origins and regional settlement patterns. This multigenerational migratory and social adjustment process has produced important cultural variations within and among the respective Hispanic ethnic groups. Moreover, the demographic structure of Hispanic populations is also varied and complex. These historical, demographic, and sociocultural features shape the health and disease experience of Hispanics. As expected, respective Hispanic ethnic groups vary in health status and have differing needs for health services. This article provides demographic background, a historical perspective, a synthesis of Hispanic issues identified in major and authoritative government documents, summary on the state-of-the-science for nursing research with Hispanics, and recommendations for future nursing research directions.

Use of herbal therapies among midlife Mexican women.

The cultural traditions of Mexican women living in the United States make it likely that some women promote their health and manage their symptoms using various herbal therapies, yet we know little about this phenomenon. The purpose of this study was to describe and compare midlife Mexican women living in the U.S. who were or were not using herbal therapies with regard to the extent of their acculturation, beliefs about herbs, and factors associated with their utilization of health services. A convenience sample of 30 Mexican women between the ages of 40 and 56 years completed face-to-face interviews in either English or Spanish. Nearly half reported using herbal therapies. With the exception of positive beliefs about herbs, we found few differences between herbal users and nonusers on acculturation or access to, and satisfaction with, health services. Although acculturation did not appear to influence whether the women used herbal therapies, it did relate to the types of herbs selected. Women most commonly reported using herbs popular in traditional Mexican culture, including manzanilla (chamomile), savila (aloe vera), ajo (garlic), uña de gato (cat's claw), and yerba buena (spearmint).

Acculturation and breast self-examination among immigrant Latina women in the USA.

This article is an extension of previous work, which identified acculturation as an important variable in predicting breast self-examination (BSE) in this sample of women. Here, acculturation is further examined as an intervening factor in predicting BSE. This paper presents the association between level of acculturation to mainstream culture in the USA and the practice of BSE among a population of low-income immigrant Mexican and Puerto Rican women (n = 111) in an urban area of the Midwest in the USA. The majority of women (84.7%) scored a low level of acculturation and 85% did not practice correct BSE. The crude odds ratio indicated that Latina women having a high level of acculturation (15.3%) were twice as likely to practice correct BSE than women with low acculturation. We would suggest that a clearer understanding of the variables that define the performance of BSE will assist in enabling nurses globally to incorporate assessments in their practice that will lead to more successful interventions.

Breast care among Latino immigrant women in the U.S.

Although the U.S. is recognized as a developed country, knowledge of how to perform a breast self-examination (BSE) and the availability and accessibility screening mammography are not evenly distributed across ethnic, racial, and socioeconomic groups. Some U.S. organizations have decreased their emphases on BSE and are strongly promoting technological advances such as mammography. Disparities in obtaining breast health care are found worldwide. In this article we present the findings of a study that was conducted in a large urban area in the Midwest of the United States, to identify factors associated with breast care in Latino immigrant women (n = 111). Limited knowledge about breast care, unemployment, and short period of residence in the U.S. were all found to be related to inadequate breast care in this group of women. These findings have global implications for health care practitioners in directing attention toward discovering factors that promote and inhibit early breast cancer detection.

Cervical cancer screening practices among Latino women in Chicago.

Previous studies have determined that Latino women, especially Mexican women, have the lowest rates of cancer-screening practices of any racial and ethnic group in the United States (L. S. Caplan, B. L. Wells, & S. Haynes, 1992; L. C. Harlan, A. B. Bernstein, & L. G. Kessler, 1991). The purpose of this descriptive study was to identify factors associated with irregular Papanicolaou (Pap) screening among Latino women. The convenience sample consisted of 111 Mexican and Puerto Rican women ages 40 and older, recruited through two inner-city clinics, located in two major Latino communities in Chicago. The women were interviewed face-to-face by trained bilingual interviewers, using a structured questionnaire. Mexican ethnicity and older age were found to be associated with irregular cervical cancer-screening practices. These results suggest that interventions need to be developed for educating Latino women about the purpose and importance of Pap test-screening practices. Further research is needed to examine other barriers that impede these women from using cervical cancer-screening services.

Practice variations in treating urban minority asthmatics in Chicago.

This study explores provider adherence to national guidelines in treating Latino and African-American asthmatics. We hypothesized that there would be more variations in asthma treatment existing for minorities as a result of variation in physician's adherent to the guidelines. A 96-item survey was administered to 138 Latino and African-American asthmatics attending a hospital emergency department. Data were obtained on demography, severity, access, patient satisfaction, and patient's assessment of physician asthma management. Results were analyzed by ethnicity, gender, practice site of regular provider, and severity. Variation in physician practice was found in these variables. Asthma treatment received by Latino and African-American respondents was deficient compared to guidelines. Regression analyses showed that Latinos fared more poorly on the number of prednisone bursts taken, use of written crisis plans and dispensation of peak flow meters controlling for gender, practice site and severity. African-Americans expressed less dissatisfaction in obtaining services, while both groups expressed high degrees of satisfaction with their providers.

Latino women and AIDS risk.

This study describes risk behaviors among Puerto Rican women and identifies variables related to high-risk behavior, including sociodemographic status, knowledge about HIV and AIDS, religiosity, acculturation, and attitudes toward contraceptive use and homosexuality. Puerto Rican women (N = 121) were recruited through a community-based organization in Philadelphia. Respondents were an average of 30 years old; 21% were married and not separated, 79% were either single (50.9%), separated (14.3%), divorced (11.6%), or widowed (1.8%); 69% had 1-3 children. Most women (74%) were at moderate to high risk for AIDS. Results from logistic regression with a single independent variable yielded no statistical significance for the following variables: income, number of children, religiosity, Rosenberg Self-Esteem Scale, AIDS knowledge, homophobia, Symptom Checklist-90-R, and Population Policy Questionnaire items. When the three acculturation variables consisting of a language score, an activity score, and a preference score were examined, however, the language score was highly statistically significant, with a p value of 0.0001. Its positive logistic regression coefficient indicates that AIDS risk increases as preference for English increases. Further research is needed of Latino women that studies other Latino subgroups, given that HIV prevalence varies across subgroups.