A framework for using real-time evaluative interview feedback for health promotion program and evaluation improvement: The Check It case study.

Formative evaluation is a crucial strategy for health promotion program improvement. Early and ongoing formative evaluation can make a major impact on program outcomes; however, there are few frameworks that provide actual guidance on how programmatic or research teams can systematically perform this kind of important work. In this article we describe the use of an iterative real-time interview feedback framework we developed for Check It, a community-wide chlamydia screening and treatment program for young African American men in New Orleans, Louisiana. The framework considers the diverse and needed perspectives of multiple stakeholders, including participants, interviewers, transcribers, program staff, and lead researchers and/or administrators. Interviews were conducted with N = 15 Check It participants utilizing this approach. Employing the framework led to critical insights that resulted in several vital programmatic and evaluation improvements. Lessons learned, including strengths and challenges of utilizing the framework, are also shared so that this model can be replicated or adapted by program planning and evaluation professionals for other kinds of programs.

Sex education and STI fatalism, testing and infection among young African American men who have sex with women.

The purpose of this study was to examine the association between institution-delivered sex education given under real-world conditions and sexually transmitted infection (STI) rates, STI fatalism, and prior STI testing among African American men aged 15-24 who have sex with women. Participants were tested at community venues for Chlamydia and gonorrhoea and undertook a survey to elicit history of sex education and sexual health information. Among 1196 participants, 73.0% reported having received institution-delivered sex education topics including STI information (90.5%), condoms (89.2%), pregnancy/birth (72.1%) and birth control (67.1%). Among a subset of participants asked about the quality of sex education, 85.7% reported it was 'very good' or 'OK'. Prevalence rate for Chlamydia and/or gonorrhoea was 10.5%. Those who received sex education were more likely to have lower STI fatalism (51.0% vs. 42.4%, p=0.01) and more likely to report previous Chlamydia screening (44.1% vs. 31.6%, p<0.01), but did not have a significantly lower rate of Chlamydia and/or gonorrhoea (9.9% vs. 12.4%, p=0.20) compared to those who did not receive sex education. These findings suggest that institution-delivered sex education given under real-world conditions has beneficial effects on STI risk factors among young African American men.

Facilitators and Barriers to Patient-Delivered Partner Therapy Acceptance for Chlamydia trachomatis Among Young African American Men Who Have Sex With Women in a Southern Urban Epicenter.

BACKGROUND: Chlamydia trachomatis (Ct) disproportionately affects African American young people living in the Southern United States and can have negative consequences if left untreated. Patient-delivered partner therapy (PDPT) is an evidence-based practice in which individuals diagnosed with Ct can provide treatment directly to their sex partners. However, PDPT acceptance rates need improvement. Although reasons for PDPT acceptance have been explored previously, the facilitators and barriers to expedited partner therapy acceptance among young southern African American men who have sex with women have not yet been examined. METHODS: Twenty semistructured interviews were conducted as part of a community-based Ct screening and treatment intervention among African American men aged 15 to 25 years who had female sex partners. Participants were asked about why they did or did not accept PDPT for their sex partners. Data were transcribed and analyzed in NVivo qualitative software using an inductive thematic approach. RESULTS: Participants' decision making was multifaceted. Facilitators for PDPT acceptance included being able to cure their partner, convenient access to treatment, believing it was the right thing to do, having a close relationship with a partner, concern for the partner's well-being, and the perceived severity of Ct. Barriers to PDPT acceptance were the belief that a partner did not need treatment, not having a close relationship with the partner, being unable to contact the partner, and fear of conflict. CONCLUSIONS: Findings had similarities to other studies, indicating some universal messaging may be warranted alongside culturally tailored interventions for specific patient populations to increase PDPT acceptance. Implications for patient-provider communication are provided.

Adapting Index/Partner Services for the Treatment of Chlamydia Among Young African American Men in a Community Screening Program.

BACKGROUND: Screening for asymptomatic Chlamydia trachomatis (Ct) among men has not been recommended because feasibility and efficacy are unknown. Check It is a seek-test-treat community-based Ct screening program for African American men who have sex with women and who are 15 to 24 years of age. This is an evaluation of adaptations made to the program aimed at improving index/partner notification and treatment rates. METHODS: The original Check It intervention included free testing and treatment, contact tracing performed by a third party, expedited index therapy, and expedited partner therapy via pharmacy pickup. The intervention was adapted after a series of in-depth interviews eliciting information to refine the program. Changes included continuity of testing, notification, and treatment by the same staff; expanded hours; and patient-delivered partner therapy with a medication mail-delivery option. Rates of index male and partner treatment were compared using log-binomial models and generalized estimating equations. RESULTS: Men in the adapted intervention (n = 85) were more likely than men in the original intervention (n = 99) to be contacted (relative risk [RR], 1.14; 95% confidence interval [CI], 1.02-1.27), make a treatment plan (RR, 1.14; 95% CI, 1.01-1.27), and complete treatment (RR, 1.45; 95% CI, 1.20-1.75). Female sexual partners were significantly more likely to complete treatment in postadaptation (n = 153) compared with preadaptation (n = 161; RR, 3.02; 95% CI, 1.81-5.05). CONCLUSIONS: Compared with third-party notification and expedited index therapy/expedited partner therapy available by pharmacy pickup only, patient-delivered partner therapy with mail-delivery option, staff available at nontraditional hours, and staff continuity across testing, notification, and treatment significantly improved index and partner treatment completion.

Quantum critical behavior in Ce(Fe0.76Ru0.24)2Ge2.

Systems with embedded magnetic ions that exhibit a competition between magnetic order and disorder down to absolute zero can display unusual low-temperature behaviors of the resistivity, susceptibility, and specific heat. Moreover, the dynamic response of such a system can display hyperscaling behavior in which the relaxation back to equilibrium when an amount of energy E is given to the system at temperature T only depends on the ratio E/T. Ce(Fe0.755Ru0.245)2Ge2 is a system that displays these behaviors. We show that these complex behaviors are rooted in a fragmentation of the magnetic lattice upon cooling caused by a distribution of local Kondo screening temperatures, and that the hyperscaling behavior can be attributed to the flipping of the total magnetic moment of magnetic clusters that spontaneously form and order upon cooling. We present our arguments based on the review of two-decades worth of neutron scattering and transport data on this system, augmented with new polarized and unpolarized neutron scattering experiments.

Daily diary and ambulatory activity monitoring of sleep in patients with insomnia associated with chronic musculoskeletal pain.

Insomnia is a significant problem for many people with chronic pain. In this study, we used a combination of daily sleep diaries and ambulatory activity monitoring (actigraphy) to: (i) examine the nature and severity of the sleep disturbance in this patient group; (ii) determine the concordance between sleep diary and actigraph measures of different sleep parameters; (iii) assess the reliability of sleep parameters across nights; and (iv) identify the clinical correlates of insomnia severity. Forty subjects with insomnia associated with chronic musculoskeletal pain completed questionnaires addressing clinical issues of pain severity, medication use, sleep quality, and affective distress. For 2 consecutive nights, each subject then completed a sleep diary and wore an actigraph unit on the non-dominant wrist. The results showed that the sleep diaries and the actigraphs provided similar estimates of total sleep time, time awake after sleep onset, and sleep efficiency, but differed in the measurement of sleep onset latency and nocturnal awakenings. Both methods of assessment exhibited low to moderate reliability across nights. Measures of the same sleep parameters across the two methods of assessment showed low concordance. Of the clinical variables, pain severity had the strongest association with disturbed sleep, but only using the diary method of assessment. Subjects who reported high pain severity also reported greater sleep impairment than subjects with low pain severity, but this was not confirmed by actigraphy. In general, both methods of assessment point to the significance of insomnia associated with chronic musculoskeletal pain as a distinct clinical problem, but the activity monitoring and self-report procedures provide different information. These findings suggest that multi-method assessment is an important consideration for studies of insomnia in patients with chronic pain.