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1.
J Acquir Immune Defic Syndr ; 96(3): 259-269, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38905476

RESUMO

INTRODUCTION: There is evidence that a supportive male partner facilitates maternal HIV testing during pregnancy, increases maternal antiretroviral therapy initiation and adherence, and increases HIV-free infant survival. Most male partner engagement clinical strategies have focused on increasing uptake of couple-based HIV testing and counseling. We delivered a couple-based care and treatment intervention to improve antiretroviral therapy adherence in expectant couples living with HIV. METHODS: We implemented a cluster randomized controlled trial for seroconcordant couples living with HIV, comparing retention (using a patient's medication possession ratio) in HIV care for a couple-based care and treatment intervention vs. standard of care services in rural Mozambique. The intervention included couple-based treatment, couple-based education and skills building, and couple-peer educator support. RESULTS: We recruited 1080 couples to participate in the study. Using a linear mixed effect model with a random effect for clinic, the intervention had no impact on the medication possession ratio among women at 12 months. However, the intervention increased men's medication ratio by 8.77%. Our unadjusted logistic regression model found the odds of an infant seroconverting in the intervention group was 30% less than in the control group, but the results were not statistically significant. DISCUSSION: Our study found no difference in maternal outcomes by study arm, but our intervention resulted in an improved medication possession ratio among male partners. We provide a community/clinic-based treatment framework that can improve outcomes among male partners. Further work needs to be done to improve social support for pregnant women and to facilitate prevention of vertical transmission to infants among couples living with HIV.


Assuntos
Infecções por HIV , População Rural , Humanos , Moçambique , Feminino , Masculino , Infecções por HIV/tratamento farmacológico , Adulto , Gravidez , Fármacos Anti-HIV/uso terapêutico , Cuidado Pré-Natal , Parceiros Sexuais , Cuidado Pós-Natal , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Adulto Jovem , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adesão à Medicação
2.
Child Dev ; 95(1): 296-312, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37501628

RESUMO

Critical consciousness (CC) is associated with beneficial developmental outcomes among youth contending with oppression, yet we know little about how CC develops and how the three dimensions of CC (i.e., critical action, critical motivation, and critical reflection) interrelate over time. Therefore, this study employed second-order latent growth modeling to illuminate the longitudinal interplay between the three dimensions of CC among 518 youth activists (Mage = 16; girls = 53%; 11% Asian, 20% Black, 39% Latinx, 8% Multiracial, and 6% White). Youth demonstrated significant growth in critical reflection and action over time, but not in critical motivation. Participation in community-based activism was positively associated with CC development. Altogether, these findings illuminate channels for fostering youth CC and increase our understanding of CC's dynamic development.


Assuntos
Comportamento do Adolescente , Estado de Consciência , Feminino , Humanos , Adolescente , Desenvolvimento do Adolescente , Grupos Raciais
3.
Child Dev ; 95(1): 223-241, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37583353

RESUMO

This preregistered study aimed to identify antecedents and consequences of adolescents' critical consciousness (CC) profiles with person-centered approaches based on data from 663 ethnically diverse German adolescents collected from 2017 to 2019 (Mage = 12.91, 50% male, 50% female). Latent profile analyses of adolescents' critical reflection and interpersonal and structural critical action intentions yielded three profiles: "uncritical," "armchair activists," and "actionists." Discrimination experiences, but not CC classroom climate, predicted a higher likelihood of being in the armchair activist or actionist profiles. The actionist profile showed better, but the armchair activist profile worse socioemotional and academic adaptation cross-sectionally and over time (vs. the other profiles). The results highlight the potential of person-centered approaches and of fostering developmentally appropriate forms of critical action among adolescents in novel contexts.


Assuntos
Comportamento do Adolescente , Humanos , Masculino , Adolescente , Feminino , Criança , Comportamento do Adolescente/psicologia , Estado de Consciência , Desenvolvimento do Adolescente
4.
PLoS One ; 18(9): e0281790, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37768968

RESUMO

BACKGROUND: Despite decades of calls for increased diversity in the health research workforce, disparities exist for many populations, including Black, Indigenous, and People of Color individuals, those from low-income families, and first-generation college students. To increase representation of historically marginalized populations, there is a critical need to develop programs that strengthen their path toward health research careers. High school is a critically important time to catalyze interest and rebuild engagement among youth who may have previously felt excluded from science, technology, engineering, and mathematics (STEM) and health research careers. METHODS: The overall objective of the MYHealth program is to engage high school students in a community-based participatory research program focused on adolescent health. Investigators will work alongside community partners to recruit 9th through 12th graders who self-identify as a member of a group underrepresented in STEM or health research careers (e.g., based on race and ethnicity, socioeconomic status, first generation college student, disability, etc.). MYHealth students are trained to be co-researchers who work alongside academic researchers, which will help them to envision themselves as scientists capable of positively impacting their communities through research. Implemented in three phases, the MYHealth program aims to foster a continuing interest in health research careers by developing: 1) researcher identities, 2) scientific literacy, 3) scientific self-efficacy, and 4) teamwork and leadership self-efficacy. In each phase, students will build knowledge and skills in research, ethics, data collection, data analysis, and dissemination. Students will directly collaborate with and be mentored by a team that includes investigators, community advisors, scientific advisors, and youth peers. DISCUSSION: Each year, a new cohort of up to 70 high school students will be enrolled in MYHealth. We anticipate the MYHealth program will increase interest and persistence in STEM and health research among groups that have been historically excluded in health research careers.


Assuntos
Grupos Minoritários , Estudantes , Adolescente , Humanos , Grupos Minoritários/educação , Etnicidade , Instituições Acadêmicas , Mentores
5.
Glob Health Action ; 16(1): 2210882, 2023 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-37171405

RESUMO

Partner engagement in antenatal care can improve care for pregnant people living with HIV. However, concerns about engaging unsupportive non-pregnant partners warrant further study to avoid engaging partners who pressure their pregnant partner to refuse testing or treatment and/or perpetuate intimate partner violence. We adapted established relationship functioning and partner behaviour questionnaires among pregnant people living with HIV initiating antenatal care in rural South Africa. We identified 13 previously validated psychometric scales with 255 items that assess relationship functioning and partner behaviour, but, to our knowledge, had not been used in Southern Africa. After item translation and cognitive interviewing with 30 pregnant people, we recruited an additional 208 pregnant people living with HIV receiving antenatal care. We conducted an exploratory factor analysis with maximum-likelihood extraction and oblique promax rotation with the 58 items and 10 scales that remained after translation and cognitive interviewing. We used parallel analysis, scree plots, and the Kaiser criterion to guide factor retention and assessed internal factor consistency via Cronbach's alpha. Of the 208 participants recruited, 197 (95%) answered each question and were included in the analysis. Exploratory factor analysis revealed 7 factors that assessed partner social support, sexual relationship power, emotional intimacy, threatened or enacted violence, sexual intimacy, violence in relationships, and partner engagement in pregnancy care via 37 items. Factor absolute Spearman correlations ranged from 0.012 to 0.518 and Cronbach's alpha ranged from 0.84 to 0.92. This preliminary analysis will guide further scale development. Future developments will also include relevant clinical outcomes to assess the predictive validity of the resulting measures. These steps will further refine these questions into a succinct screening tool to assess relationship functioning and partner behaviour. This screening tool may eventually guide the selection of partner-based interventions during pregnancy to improve outcomes for pregnant people and their partners.


Assuntos
Infecções por HIV , Violência por Parceiro Íntimo , Feminino , Humanos , Gravidez , África do Sul , Comportamento Sexual , Parceiros Sexuais/psicologia , Cuidado Pré-Natal , Infecções por HIV/prevenção & controle
6.
AIDS Behav ; 26(12): 4135-4143, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35689708

RESUMO

Psychometric instruments can quantify how people living with HIV experience three key barriers to antiretroviral therapy (ART) and retention: partner support, trust in medical professionals, and internalized HIV-related stigma. However, two challenges arise when using these instruments to measure and interpret relational processes among Mozambican couples, especially those participating in a couples intervention. First, relational measures have almost exclusively been developed and normed with Western, middle-class, and/or White adults. Second, traditional measurement approaches neglect the relational processes between partners. Using dyadic modeling, this paper demonstrates metric and scalar invariance for instruments measuring partner support (CFI = 0.964, TLI = 0.965, RMSEA = 0.034, SRMR = 0.052), trust in medical professionals (CFI = 0.978, TLI = 0.980, RMSEA = 0.033, SRMR = 0.039), and internalized HIV-related stigma (CFI = 0.960, TLI = 0.961, RMSEA = 0.050, SRMR = 0.060) within the novel context of seroconcordant HIV+ couples in Zambézia province.


RESUMEN: Los instrumentos psicométricos pueden cuantificar cómo las personas que viven con VIH experimentan tres barreras claves para la terapia antirretroviral (TAR) y la retención: el apoyo de la pareja, la confianza en los profesionales médicos y el estigma internalizado del VIH. Sin embargo, surgen dos desafíos cuando se utilizan estos instrumentos para medir e interpretar los procesos relacionales entre las parejas mozambiqueñas, especialmente aquellas que participan en una intervención de pareja. Primero, las medidas relacionales se han desarrollado y normado casi exclusivamente con adultos occidentales, de clase media y/o blancos. En segundo lugar, los enfoques tradicionales de medición descuidan los procesos relacionales entre parejas. Con modelos diádicos, este artículo demuestra la invariancia métrica y escalar de los instrumentos que miden el apoyo de la pareja (CFI = 0.964, TLI = 0.965, RMSEA = 0.034, SRMR = 0.052), la confianza en los profesionales médicos (CFI = 0.978, TLI = 0.980, RMSEA = 0.033, SRMR = 0.039) y el estigma internalizado del VIH (CFI = 0.960, TLI = 0.961, RMSEA = 0.050, SRMR = 0.060) en el contexto novedoso de parejas seroconcordantes VIH positivas en la provincia de Zambézia.


Assuntos
Infecções por HIV , Médicos , Adulto , Humanos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Confiança , Moçambique , Estigma Social , Apoio Social
7.
Cultur Divers Ethnic Minor Psychol ; 27(3): 546-557, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33914581

RESUMO

Objectives: Critical action (sociopolitical action to combat social inequity) provides racially marginalized youth with a pathway to coping. Sociocultural factors (like experiences of racial discrimination and contact with racially marginalized peers) are integral for fostering critical action among racially marginalized youth, yet few empirical studies have explored these relationships longitudinally. This study examines: (a) longitudinal trajectories of critical action and racial discrimination among Black and Latinx college students, (b) whether racial discrimination or critical action predict the other's longitudinal trajectory, and (c) whether having Black and Latinx friends and ethnic-racial club participation strengthen these relationships. Method: These trajectories were assessed by estimating growth models with a longitudinal sample of 504 Black and Latinx college students. Results: Analyses revealed that racial discrimination significantly increased over the first 2 years of college, whereas critical action significantly declined. Additionally, racial discrimination predicted changes in critical action, but critical action did not predict changes in racial discrimination. Ethnic-racial club participation slowed the decline of critical action. Conclusions: Our findings suggest that the transition to college is associated with changes in racial discrimination and critical action and these trajectories are enhanced by ethnic-racial club participation. Implications of these findings are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Racismo , Adolescente , Negro ou Afro-Americano , Hispânico ou Latino , Humanos , Grupo Associado , Estudantes
8.
J Community Psychol ; 49(8): 3079-3100, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-31691984

RESUMO

The current study examined whether youth perceptions of school racial messages that acknowledged the reality of racism (critical consciousness [CC] messages) or denied racism (color-blind messages) predicted youth anti-racism action through interpersonal and communal/political means. We further tested whether youths' critical reflection of perceived inequality and anger toward social injustice-psychological aspects of CC development-mediated relations between school messages and youth actions. These questions were explored using structural equation modeling with 372 racially/ethnically diverse adolescents (Mage = 17.00; standard deviation = 1.29; female = 51.0%). Results indicated that youth perceptions of CC messages predicted their involvement in both interpersonal and communal/political anti-racism action. Youths' anger toward social injustice mediated links between school racial messages and anti-racism action, albeit in unique ways. These findings underscore the power of schools in prompting youth anti-racism action. Implications of the importance of partnerships between schools and youth community organizing groups to stimulate youth anti-racism action were discussed.


Assuntos
Racismo , Adolescente , Negro ou Afro-Americano , Estado de Consciência , Feminino , Humanos , Instituições Acadêmicas , Socialização
9.
J Appl Dev Psychol ; 70: 101192, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32921861

RESUMO

Deep-seated structural racism in the U.S. has been thrown into bold relief by the racially disproportionate impacts of COVID-19 and a series of highly visible police murders of Black Americans. Longstanding and intergenerational economic inequalities have been laid bare by the ensuing economic recession. This special issue's focus on how people critique, challenge, negotiate and change inequities is therefore particularly (and, unfortunately) relevant and timely. These three papers approach critical consciousness from three distinct angles. In this commentary, I will offer several points of praise for these three papers, along with a few suggestions on ways that the authors' lines of thinking could be extended or more nuanced. I will identify a few themes that cut across these three papers: (1) the importance of focusing on critical action, (2) how these papers advance our thinking on how, when, and for whom CC develops, with specific attention paid to the social identities, life phases, and events that impact CC, and (3) a deepening of our understanding of the antecedents and consequences of CC. In reviewing these three papers, I consider how each of them adds to the collective conversation about the ways that we might recognize, challenge, and work to change marginalizing systems and transform inequity to create a more just world.

10.
BMC Psychol ; 8(1): 90, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32859272

RESUMO

BACKGROUND: The ability to understand another's emotions and act appropriately, empathy, is an important mediator of relationship function and health intervention fidelity. We adapted the Interpersonal Reactivity Index (IRI) - an empathy scale - among seroconcordant expectant couples with HIV in the Homens para Saúde Mais (HoPS+) trial - a cluster randomized controlled trial assessing couple-based versus individual treatment on viral suppression - in Zambézia Province, Mozambique. METHODS: Using baseline data from 1332 HoPS+ trial participants (666 couples), an exploratory factor analysis assessed culturally relevant questions from the IRI. Because empathy is interdependent among couples, we validated the results of the exploratory factor analysis using a dyadic confirmatory factor analysis (CFA) with dyadic measurement invariance testing. Finally, we assessed the relationship between scores on our final scale and basic demographic characteristics (sex, age, education, and depression) using t-tests. RESULTS: We found two subscales: 1) a seven-item cognitive empathy subscale (Cronbach's alpha 0.78) and 2) a six-item affective empathy subscale (Cronbach's alpha 0.73). The dyadic CFA found acceptable model fit and metric invariance across partners (Comparative Fit Index (CFI) = 0.914, Tucker Lewis Index = 0.904, Root Mean Squared Error of Approximation = 0.056, ΔCFI = 0.011). We observed higher cognitive (p: 0.012) and affective (p: 0.049) empathy among males and higher cognitive (p: 0.031) and affective (p: 0.030) empathy among younger participants. More educated participants had higher affective empathy (p: 0.017) and depressed participants had higher cognitive empathy (p: < 0.001). This two-subscale, 13-item version of the IRI measures cognitive and affective empathy in HoPS+ trial participants and adults while accounting for the interdependent nature of empathy within partner dyads. CONCLUSIONS: This scale will allow us to assess the interplay between empathy and other psychometric constructs (stigma, social support, etc.) in the HoPS+ trial and how each relates to retention in HIV, adherence to treatment, and prevention of maternal to child HIV transmission. Furthermore, this scale can be adapted for other sub-Saharan African populations, which will allow researchers to better assess HIV-related intervention efficacy. TRIAL REGISTRATION: This study is within the context of the HoPS+ trial, registered at ClinicalTrials.gov as number NCT03149237 . Registered May 11, 2017.


Assuntos
Emoções , Infecções por HIV , Relações Interpessoais , Adulto , Feminino , Humanos , Masculino , Moçambique , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
11.
J Youth Adolesc ; 49(5): 1092-1093, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32103402

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

12.
Cultur Divers Ethnic Minor Psychol ; 26(2): 176-188, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30816755

RESUMO

OBJECTIVES: Latinx and Black young adults' experiences with the U.S. political system have been contentious. Despite this, they utilize psychological strengths, such as their critical consciousness (CC), to participate in the political process. This research explored relations between CC (e.g., critical reflection of social inequality and voting likelihood) and forms of civic/political engagement (e.g., sociopolitical action and social media engagement) among Latinx and Black young adults. METHOD: Measurement invariance (MI) tests and structural equation modeling (SEM) were used with Latinx (N = 354, Mage = 26.08, SD = 5.03) young adults who were slightly predominately male (55.1%) and Black American young adults (N = 160, Mage = 25.84, SD = 4.98) who were slightly predominately female (52.5%). RESULTS: MI results indicated measures were not invariant (i.e., they were measured differently) across groups. Therefore, the hypothesized model was examined separately for groups. SEM analyses suggested both groups' critical reflection positively predicted voting likelihood and sociopolitical action. For Latinx young adults, voting likelihood mediated the relation between critical reflection and social media engagement. Black young adults' voting likelihood was unrelated to sociopolitical action and social media engagement. Alternative models examined bidirectional relations between CC and civic/political engagement. CONCLUSIONS: Findings suggest civic/political engagement pathways differ for Latinx and Black young adults. However, fostering critical reflection has the potential to stimulate both groups' intent to vote and sociopolitical action. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Desenvolvimento do Adolescente , Negro ou Afro-Americano/psicologia , Hispânico ou Latino/psicologia , Política , Adolescente , Estado de Consciência , Feminino , Humanos , Masculino , Mudança Social , Responsabilidade Social , Estados Unidos , Adulto Jovem
13.
J Youth Adolesc ; 49(5): 1073-1091, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31707579

RESUMO

Wealth plays a pervasive role in sustaining inequality and is more inequitably distributed than household income. Research has identified that wealth contributes to children's educational outcomes. However, the specific mechanisms accounting for these outcomes are unknown. Using the Panel Study of Income Dynamics (PSID) and its supplements, SEM was used to test a hypothesized longitudinal chain of mediating processes. Framed by the parent investment model, this study tracks children and their parents over twenty-seven years, from pre-birth to early adulthood. The analytic sample was comprised of 1247 young people who were between 6-12 years of age (M= 5.66, SD= 2.12) in 1997, the first wave of the PSID's Child Development Supplement. This analytic sample was roughly equivalent by gender (N= 774; 53% identified as female and N= 693; 47% identified as male). The racial/ethnic background of participants was nearly an equal split between individuals who identified as White (N= 666; 45%) or Black (N= 634; 43%), with an additional 7% (N= 97) who identified as "Hispanic," 2% (N= 40) as "Other," 1% (N= 20) as Asian or Pacific Islander, and less than 1% (N= 6) who identified as American Indian or Alaskan Native. The results indicated that wealth (a) engenders parental and child processes-primarily expectations and achievement-that promote educational success, (b) plays a different role across the life course, and (c) that pre-birth wealth has a significant mediated relationship to educational attainment seventeen years later. These findings advance understanding of specific mediating mechanisms by which wealth may foster children's educational success across the life course, as well as how wealth may differentially shape educational outcomes in childhood, adolescence, and young adulthood.


Assuntos
Sucesso Acadêmico , Desenvolvimento Infantil , Renda/estatística & dados numéricos , Fatores Socioeconômicos , Logro , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Criança , Etnicidade/estatística & dados numéricos , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Indígenas Norte-Americanos/estatística & dados numéricos , Masculino , População Branca/estatística & dados numéricos , Adulto Jovem
14.
Dev Psychol ; 55(3): 538-549, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30802105

RESUMO

This study applies multiple indicator and multiple causes modeling to examine to what extent critical social analysis of inequality, a dimension of critical consciousness (CC), may be explained by political party identification (i.e., Republican vs. Democrat) or political ideology (i.e., conservative vs. liberal). These issues were examined among 237 public high school students from a large Midwestern city, who generally came from historically marginalized groups. Analyses suggest that political party identification was only marginally associated with critical social analysis of inequality and political ideology had a small positive association with critical social analysis of inequality. Further, political identification and political ideology only explained between 2% and 4% of the variance in critical social analysis of inequality. These results suggest complexity in how youth think about political institutions and inequality, while also providing evidence that a critical social analysis of inequality is largely independent of political identification and ideology. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Desenvolvimento do Adolescente , Estado de Consciência , Grupos Minoritários , Política , Marginalização Social , Fatores Socioeconômicos , Pensamento , Adolescente , Feminino , Humanos , Masculino , Meio-Oeste dos Estados Unidos
15.
Emerg Adulthood ; 7(6): 478-489, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33907632

RESUMO

This study explores changes in perceived leadership ability during emerging adulthood among a predominantly African American sample, with special consideration of the differences between the experiences of individuals who attended four-year universities and those who did not. We used data from a longitudinal study that followed participants from high school into adulthood. Participants in the sample were predominantly African American and all exhibited low academic performance at the beginning of the study. Findings demonstrated that perceived leadership ability declined between the ages of 18 and 22, with the largest declines occurring among emerging adults who did not attend four-year colleges. These findings suggest that perceived leadership ability is malleable and responds to contextual factors, such as limited access to leadership roles during emerging adulthood. We conclude with implications for practice to support leadership development among emerging adults.

16.
J Res Adolesc ; 29(2): 449-465, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-29570890

RESUMO

This study examines how student perceptions of teacher practices contribute to female high school students' math beliefs and achievement. Guided by the expectancy-value framework, we hypothesized that students' motivation beliefs and achievement outcomes in mathematics are fostered by teachers' emphasis on the relevance of mathematics and constrained by gender-based differential treatment. To examine these questions, structural equation modeling was applied to a longitudinal panel of 518 female students from the Maryland Adolescent Development in Context Study. While controlling for prior achievement and race, gendered differential treatment was negatively associated with math beliefs and achievement, whereas relevant math instruction was positively associated with these outcomes. These findings suggest inroads that may foster positive math motivational beliefs and achievement among young women.


Assuntos
Sucesso Acadêmico , Atitude , Cultura , Matemática , Mulheres/psicologia , Adolescente , Feminino , Humanos , Professores Escolares , Autorrelato
17.
Contemp. clin. trials ; 70: 63-69, Aug 2018. tab, fig
Artigo em Inglês | RDSM | ID: biblio-1538326

RESUMO

Background: In resource-limited rural settings, scale-up of services to eliminate mother-to-child transmission of HIV has not been as effective as in better resourced urban settings. In sub-Saharan Africa, women often require male partner approval to access and remain engaged in HIV care. Our study will evaluate a promising male engagement intervention ("Homens para Saúde Mais" (HoPS+) [Men for Health Plus]) targeting the elimination of mother-to-child transmission in rural Mozambique. Design: We will use a cluster randomized clinical trial design to engage 24 health facilities (12 intervention and 12 standard of care), with 45 HIV-infected seroconcordant couples per clinic. The planned intervention will engage male partners to address social-structural and cultural factors influencing eMTCT based on new couple-centered integrated HIV services. Conclusions: The HoPS+ study will evaluate the effectiveness of engaging male partners in antenatal care to improve outcomes among HIV-infected pregnant women, their HIV-infected male partners, and their newborn children. Our objectives are to: (1) Implement and evaluate the impact of male-engaged, couple-centered services on partners' retention in care, adherence to antiretroviral therapy, early infant diagnosis uptake, and mother-to-child transmission throughout pregnancy and breastfeeding; (2) Investigate the impact of HoPS+ intervention on hypothesized mechanisms of change; and (3) Use validated simulation models to evaluate the cost-effectiveness of the HoPS+ intervention with the use of routine clinical data from our trial. We expect the intervention to lead to strategies that can improve outcomes related to partners' retention in care, uptake of services for HIV-exposed infants, and reduced MTCT.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Adulto , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Infecções por HIV/terapia , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , População Rural , Aleitamento Materno/métodos , Recém-Nascido , Infecções por HIV/transmissão , Relações Interpessoais , Moçambique/epidemiologia
18.
Contemp Clin Trials ; 71: 63-69, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29879469

RESUMO

BACKGROUND: In resource-limited rural settings, scale-up of services to eliminate mother-to-child transmission of HIV has not been as effective as in better resourced urban settings. In sub-Saharan Africa, women often require male partner approval to access and remain engaged in HIV care. Our study will evaluate a promising male engagement intervention ("Homens para Saúde Mais" (HoPS+) [Men for Health Plus]) targeting the elimination of mother-to-child transmission in rural Mozambique. DESIGN: We will use a cluster randomized clinical trial design to engage 24 health facilities (12 intervention and 12 standard of care), with 45 HIV-infected seroconcordant couples per clinic. The planned intervention will engage male partners to address social-structural and cultural factors influencing eMTCT based on new couple-centered integrated HIV services. CONCLUSIONS: The HoPS+ study will evaluate the effectiveness of engaging male partners in antenatal care to improve outcomes among HIV-infected pregnant women, their HIV-infected male partners, and their newborn children. Our objectives are to: (1) Implement and evaluate the impact of male-engaged, couple-centered services on partners' retention in care, adherence to antiretroviral therapy, early infant diagnosis uptake, and mother-to-child transmission throughout pregnancy and breastfeeding; (2) Investigate the impact of HoPS+ intervention on hypothesized mechanisms of change; and (3) Use validated simulation models to evaluate the cost-effectiveness of the HoPS+ intervention with the use of routine clinical data from our trial. We expect the intervention to lead to strategies that can improve outcomes related to partners' retention in care, uptake of services for HIV-exposed infants, and reduced MTCT.


Assuntos
Infecções por HIV , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Assistência Perinatal , Adulto , Aleitamento Materno/métodos , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Infecções por HIV/terapia , Infecções por HIV/transmissão , Humanos , Recém-Nascido , Relações Interpessoais , Masculino , Moçambique , Assistência Perinatal/métodos , Assistência Perinatal/normas , Gravidez , Melhoria de Qualidade , Projetos de Pesquisa , População Rural
19.
Dev Psychol ; 54(1): 127-137, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28933884

RESUMO

Marginalized youth's development occurs in contexts rife with racialized, gendered, and socioeconomic social identity threats and barriers to social mobility. An emergent line of inquiry suggests critical action-a component of critical consciousness, defined as engaging in individual or collective social action to produce social change-may bolster career development for those experiencing marginalization. Yet, the specific mechanisms underlying critical action-career development associations are not well understood. Applying structural equation modeling (SEM) to 4 waves of longitudinal data from the Maryland Adolescent Development in Context Study (when participants were 17, 19, 21, and 29 years old), the authors explore the role of critical action for African American participants from lower-SES households (n = 261). The obtained model, which links critical action to career expectancies in adolescence and occupational attainment in adulthood, converges with earlier research linking critical consciousness to career development, social mobility pathways, and occupational attainment among marginalized youth. This study adds to previous literature by suggesting that critical action: (a) plays a significant role in fostering career expectancies in adolescence, particularly during high school, among marginalized youth; and (b) may promote the attainment of higher-status occupations in adulthood. Given the role of occupational attainment in social mobility and inclusion, these findings suggest an important mechanism by which social inequities may be narrowed. (PsycINFO Database Record


Assuntos
Negro ou Afro-Americano/psicologia , Ativismo Político , Pobreza/psicologia , Mobilidade Social , Logro , Adolescente , Adulto , Antecipação Psicológica , Mobilidade Ocupacional , Análise Fatorial , Humanos , Estudos Longitudinais , Maryland , Modelos Psicológicos , Autorrelato , Mudança Social , Adulto Jovem
20.
J Res Educ Eff ; 11(3): 317-338, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-38250254

RESUMO

Light-touch social psychological interventions have gained considerable attention for their potential to improve academic outcomes for underrepresented and/or disadvantaged students in postsecondary education. While findings from previous interventions have demonstrated positive effects for racial and ethnic minority and first-generation students in small samples, few interventions have been implemented at a larger scale with more heterogeneous student populations. To address this research gap, 7,686 students, representing more than 90% of incoming first-year students at a large Midwestern public university, were randomly assigned to an online growth mindset intervention, social belonging intervention, or a comparison group. Results suggest that after the fall semester, the growth mindset intervention significantly improved grade point averages for Latino/a students by about .40 points. This represents a 72% reduction in the GPA gap between White and Latino/a students. Further, this effect was replicated for both spring semester GPA and cumulative GPA. These findings indicate that light-touch interventions may be a minimally invasive approach to improving academic outcomes for underrepresented students. Our findings also highlight the complexity of implementing customized belonging interventions in heterogeneous contexts.

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