Health education lessons learned: the H.A.P.I. Kids Program

Challenges exist for effective health communication and health education within diverse populations of the United States. This article addresses the development process for educational materials and lessons learned from the Healthy Asian and Pacific Islander (H.A.P.I.) Kids Program, a vaccination demonstration project funded by the Centers for Disease Control and Prevention to promote catch-up hepatitis B vaccination for older American Asian and Pacific Islander children. Simplicity and a common message were incorporated in multiple strategies to disseminate information to a diverse population. Community representatives from the Cambodian, Hmong, Filipino, Lao, and Vietnamese communities were instrumental in the material development process, which included needs assessment, design, and translation. By making the target community part of the development process, important health messages can be disseminated effectively, carrying great impact to an otherwise hard-to-reach community.     

Rural school nurses' attitudes about AIDS and homosexuality

The AIDS epidemic has spread to rural areas of the United States. Conservative rural communities are facing the challenge of having children with HIV entering school. School nurses, as the only health care providers in the schools, are in a strong position to facilitate the education of children with HIV and to provide AIDS education to students, faculty, and parents. School nurses' knowledge and attitudes about AIDS and people with AIDS influence their effectiveness in prevention activities and care of HIV-infected children. This study examined the relationship between specific demographic, practice, and cultural variables and rural school nurses' attitudes about AIDS and homosexuality. Sixty-nine school nurses responded to a mailed questionnaire as part of a larger study of rural nurses. Results indicate attitudes about homosexuality were related to nurses' homosexual knowledge and religious beliefs while attitudes about AIDS were related to nurses' willingness to care for people with AIDS and feeling prepared to do so.     

Sex isn't that simple: Culture and context in HIV prevention interventions for gay and bisexual male adolescents.

Gay and bisexual male adolescents and young adults in the United States have been disproportionately impacted by the HIV pandemic. Despite the steadily increasing rise in their HIV infection rates, there has not been a commensurate increase in HIV prevention programs targeted to the unique social and sexual lives of these youths. Programs that address cultural and contextual factors that influence sexual risk and protective behaviors need to be developed, implemented, and rigorously evaluated. These interventions should address the potential influences of sexual and gay culture on the HIV risk/protective behaviors of gay and bisexual adolescents, as well as the influence of more traditional cultural factors related to ethnicity. The influence of contextual developmental factors should also be addressed. This may include an incorporation into prevention programs of the societal-level influences of heterosexism and masculinity ideology and the individual-level influences of sexual identity and ethnic identity development. Researchers and interventionists need to be creative and innovative in their HIV prevention approaches and ensure that programs are grounded in the lives and realities of gay and bisexual adolescents and young adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reframing HIV prevention for gay men in the United States.

The HIV epidemic in the United States has affected at least two generations of gay men. Despite numerous efforts to intervene on this public health crisis, HIV infections continue to escalate, especially among young men. This condition is compounded by an ever-growing number of gay men who are aging and living with HIV. We must enact an innovative and proactive vision and framework for HIV prevention that moves us beyond the undertakings rooted in social–cognitive paradigms that have informed this work for the past 25 years. A new framework for HIV prevention must give voice to gay men; must consider the totality of their lives; must delineate the underlying logic, which directs their relation to sex and HIV; and must concurrently respect their diverse life experiences. This approach should be rooted in a biopsychosocial paradigm, should be informed by both theory and practice, and should be directed by three theoretical lenses—a theory of syndemics, developmental theories, and contextual understandings of HIV disease. Taken together, these elements are a call to action for research and practice psychologists who are working to improve the lives of gay men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship characteristics and sexual risk-taking in young men who have sex with men.

Objective: Young men who have sex with men (MSM), particularly young men of color, are experiencing the largest increase in HIV incidence of any risk group in the United States Epidemiological research suggests that the majority of transmissions among MSM are occurring in the context of primary partnerships, but little research has been done on the processes within these dyads that increase HIV risk behaviors. The aim of this study was to use longitudinal partnership-level data to explore the effects of partner and relationship characteristics on the frequency of unprotected sex within young MSM relationships. Method: One hundred twenty-two young MSM (age 16–20 at baseline) were assessed at three time-points six months apart, with 91% retention at the 12-month follow-up wave. Over 80% were racial/ethnic minorities. At each wave, participants reported on characteristics of the relationships and partners for up to three sexual partners. Hierarchical linear modeling was used for analyses. Results: The largest effect was for considering the relationship to be serious, which was associated with nearly an eightfold increase in the rate of unprotected sex. Other factors that increased risk behaviors included older partners, drug use prior to sex, physical violence, forced sex, and partnership lasting more than six months. Partners met online were not associated with significantly more sexual risk. Conclusions: These data provide insight into the relationship processes that should be addressed in prevention programs targeted at young MSM. Relationships may serve as a promising unit for HIV prevention interventions, although more formative research will be required to address potential logistical obstacles to implementing such interventions. The partner-by-partner analytic approach (i.e., evaluating situational variables associated with several partners for a given participant) holds promise for future HIV behavioral research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Identification of vocal communication of emotions across cultures.

Constructed an audiotape containing 48 messages of 4 different lengths expressing happiness, fear, sadness, anger, indifference, and flirtation. Items were in English and ratings by 100 United States Ss had produced 60-80% agreement on ratings. The tape was presented twice to 52 United States, 55 Polish, and 54 Japanese students. The accuracy of the United States Ss did not increase with the increasing length of the messages, but that of the other 2 groups did until their accuracy was comparable with the United States group for the longest items. The most difficult items for the Japanese and Polish Ss were those expressing happiness and flirtation. Results indicate that the nonverbal vocal channel can be used to transmit intracultural information but not without some "noise." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implementation of a program to improve the continuity of mental health care through Clergy Outreach and Professional Engagement (C.O.P.E.).

There are over 260,000 religious congregations in the United States. They and their clergy are de facto providers of mental health care. Recent models promoting collaboration between clergy and psychologists advocate that shared religious values underlie effective working relationships. This view may impede collaboration with the majority of psychologists, who are not religious, excluding congregants from needed expertise. The Clergy Outreach and Professional Engagement (C.O.P.E.) model was developed and implemented to facilitate continuity of care across a diversity of caregivers. Handouts based on National Institute of Mental Health prevention science categories and case examples illustrate when and how clergy and clinicians would collaborate. The authors introduce and define the term burden reduction to describe a C.O.P.E. outcome. They consider this clinical work religion inclusive rather than faith based. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV infection in women and children. Special concerns in prevention and care

Unfortunately, HIV infection continues to spread rapidly among women in the United States, and infected women still have a poorer outcome than do infected men. Prevention, early diagnosis, and facilitation of care in women are critical to both their own and their children's health. Fortunately, significant advances continue to be made in prevention of HIV transmission to children. Not only HIV experts but also primary care physicians play an important role in identification and care of HIV-infected women and children. In addition, prevention of HIV infection requires the efforts of professionals throughout the healthcare spectrum.     

Love, sex, and power: Considering women's realities in HIV prevention.

The rates of HIV infection and AIDS cases among women in the United States have increased significantly in the last decade. Thanks in large part to the work of advocacy groups and to action by the U.S. Congress, there has been some progress in making HIV/AIDS research and services more responsive to women's needs (e.g., including women in clinical drug trials and revising the Centers for Disease Control definition of AIDS to include infections typical in women). However, little progress has been made in addressing the need for prevention of HIV infection among women. This article examines how researchers using behavioral approaches to HIV prevention have largely ignored how gender, women's social status, and women's roles affect sexual risk behaviors and the ability to take steps to reduce risk of infection. Additional factors to be considered in theories that guide future HIV/AIDS prevention programs are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Editorial.

I am honored and delighted to bring you the first official issue of the newly launched Asian American Journal of Psychology (AAJP). Much in the same way that the Chinese celebrate the new year for over a week rather than a single evening, as in New Year’s Eve, the launching of this journal for the Asian American Psychological Association (AAPA) has really spread out over a year. From the signing of the contract in early 2009 to the celebration of the journal’s launch at the AAPA and American Psychological Association (APA) conventions in Toronto in August 2009, we have now come to another benchmark of the journal, which is the publication of the first official issue. Whereas we were able to produce a sample issue (Leong, 2009) from previously published articles on Asian Americans in APA journals in August 2009, the articles in this current issue mark the official beginning of new studies, new perspectives, and new contributions to the field. The journal will publish empirical, theoretical, methodological, and practice-oriented articles covering topics relevant to Asian American individuals and communities, including prevention, intervention, training, and social justice. Particular consideration is given to empirical articles using quantitative, qualitative, and mixed methodology. For the journal, Asian Americans are broadly defined as people of Asian and Pacific Islander ancestry in the United States and Canada. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Planning and evaluating strategies for AIDS health education interventions in the Muslim community in Uganda

In 1992 the Islamic Medical Association of Uganda designed an AIDS prevention project. A baseline survey was conducted to assess prevailing knowledge, attitudes, and practices among the Muslim communities in two districts. A low rate of incorrect beliefs about HIV transmission was found, although gaps in knowledge remain, particularly regarding vertical transmission and asymptomatic HIV infection. Less than 10% knew that condoms can protect against HIV transmission. Lack of knowledge was documented regarding the risk of HIV transmission associated with practices common in the Islamic community, such as polygamous marriages, circumcision, and ablution of the dead. The AIDS prevention project has incorporated specific messages and interventions as a result of these findings.     

AIDS, hemophilia, and prevention efforts within a comprehensive care program.

Approximately 92% of persons with severe hemophilia A in the United States have been exposed to the human immunodeficiency virus (HIV), the cause of acquired immune deficiency syndrome (AIDS), from contaminated blood products. This article describes HIV prevention efforts initiated by the federally funded comprehensive hemophilia program. Comprehensive care centers are useful for the delivery and evaluation of educational and preventative efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing drug use in adolescents through media interventions.

The communications media, and the broadcast media in particular, have been disseminating an increasing volume of antidrug messages over the past several years. Many American business leaders believe that the media can help to reduce drug use, and they have supported a nationwide effort to highlight the dangers of illicit drug use on the airwaves and in newspapers and magazines. This article considers the efficacy of media-based efforts to prevent adolescent drug use. Selected theories and research are reviewed, and suggestions are made for integrating social and behavioral theory and research into media prevention strategies. The authors conclude that scientists and interventionists could do much to improve on current research and development in this prevention arena, within the limits of what is possible to achieve through mass communications as presently constituted in the United States. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contextual community prevention theory: Building interventions with community agency collaboration.

Translation from research to practice faces numerous problems that include replicating effectiveness, fidelity to the protocol and processes, and adaptations to different types of target populations. Working collaboratively with existing service providers can speed up the time for development and can ease the implementation of empirical randomized trials. Contextual community prevention theory is an innovative approach that focuses on changing behaviors of community members by creating a visible institutional presence that draws and pulls the targeted population into the organization’s activities and interventions. The result is an institution or organization within the community that provides a new active and dynamic context, engaging its community members into its activities, interventions, and functions. An HIV prevention program developed collaboratively from the ground up for Latino gay/bisexual men is presented. Results from the program evaluation efforts across the years suggest promise for testing its efficacy through a randomized trial. HIV prevention efforts need to develop dynamic support systems within communities where these men have ownership, have control, and feel safe; otherwise HIV infection rates in this population will increase. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV/AIDS communication among adolescents in psychiatric care and their parents.

The authors examined HIV/AIDS communication among 207 parent-adolescent dyads in psychiatric care to better understand the relationship between family communication and sexual risk behavior in an at-risk population. Dyads reported content and rated quality of family HIV/AIDS discussions, and adolescent sexual risk was assessed. Families discussed transmission, prevention, consequences, myths, and compassion. Parent-reported discussion of consequences was associated with greater sexual risk behavior, but only for girls. Higher quality communication reported by adolescents was associated with less sexual risk. Parents may send different messages about HIV/AIDS to sons versus daughters, and messages related to consequences may not effectively reduce risk among daughters. However, for boys and girls in psychiatric care, teaching parents how to discuss HIV/AIDS may promote safer sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hematologic disorders in children from southeast Asia

The overall laboratory features of the common RBC disorders occurring in Southeast Asians is summarized in Table 4. These erythrocyte disorders will continue to be important public health issues, and it has been predicted that most new cases of thalassemia in the United States will occur in this population group. The fertility rate in Southeast Asian families is very high, with an average of more than five children delivered by each married woman. This number of children is consistent with perceptions of ideal family size, and, to date, no evidence suggests any change in the size of Southeast Asian families who now reside in the United States. Moreover, attitudes about health care, reasons why one seeks medical attention, and a variety of other cultural issues may impair the effectiveness of genetic counseling and other preventive measures designed to reduce the incidence of serious blood diseases. Genetic screening and prenatal diagnosis clearly have led to a markedly decreased incidence of homozygous thalassemia disorders in high-risk Mediterranean populations throughout the world. With further assimilation into Western culture, a similar disease may occur in the Southeast Asian population also.     

Increasing levels of leukocyte-derived inflammatory mediators in plasma and cAMP in platelets during follow-up after acute cerebral ischemia

PURPOSE: The author reviews the risks of occupational exposure to HIV and provides a rationale for new postexposure guidelines for healthcare workers. OVERVIEW: Approximately 50,000 percutaneous exposures occur yearly among healthcare workers in the United States. Of these, approximately 5000 involve exposures to blood that is known to be infected with HIV. The risk of transmission after percutaneous exposure to HIV-tainted blood has been estimated to be 0.3%, but the risk may be considerably higher to the healthcare worker if any of the following is present: a deep injury; visible blood on the sharp device; a procedure that involves a needle placed in the patient's artery or vein; and a patient with advanced AIDS. The increasing resistance of HIV strains to antiretroviral therapy continues to make treatment more difficult. CLINICAL IMPLICATIONS: Postexposure prophylaxis with zidovudine may reduce the risk of occupational infection by 80%. Advances in the ability to ameliorate HIV transmission rates and to treat individuals with resistant disease through innovations in drug therapy, engineering of controls for injury prevention, and more focused postexposure evaluation offer the hope of reducing this infrequent, but dangerous, occupational threat.     

Issues in the prevention of AIDS among Black and Hispanic men.

Ethnic minority men, particularly Blacks and Hispanics, make up a significant proportion of all AIDS cases in the United States, with these cases linked primarily to homosexual or bisexual behavior and intravenous (IV) drug use. Difficulties in developing successful prevention strategies include (a) limited data on the prevalence of AIDS risk behaviors among minorities, (b) limited information on successful community interventions for minority populations, and (c) problems in using social networks for AIDS prevention. Suggestions are made to include culturally appropriate information in developing communication messages and to consider culture-specific values, norms, attitudes, and expectations in designing community interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring behavioral regulation in four societies.

The present study examined the psychometric properties of scores from a direct measure of behavioral regulation, the Head–Toes–Knees–Shoulders task (HTKS) with 3- to 6-year-old children in the United States, Taiwan, South Korea, and China. Specifically, we investigated (a) the nature and variability of HTKS scores, including relations to teacher-rated classroom behavioral regulation; and (b) relations between the HTKS and early mathematics, vocabulary, and literacy skills. Higher HTKS scores were significantly related to higher teacher ratings of classroom behavioral regulation in the United States and South Korea but not in Taiwan and China. Also, higher HTKS scores were significantly related to higher early mathematics, vocabulary, and literacy skills beyond the influence of demographic variables and teacher-rated classroom behavioral regulation. These initial findings suggest that HTKS scores may be interpreted as reflecting early behavioral regulation in these 4 societies and that behavioral regulation is important for early academic success in the United States and in Asian countries. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Primary HIV infection--a public health opportunity

Primary human immunodeficiency virus (HIV) infection should be considered a key target for HIV prevention activities. Mathematical models suggest that the primary HIV infection interval makes a disproportionate contribution to the HIV epidemic, perhaps accounting for as many as half of the existing infections at any point in time. If this is true, primary infection presents a special window of opportunity within which to exert a maximum impact on the spread of HIV. A combination of biological, behavioral, and social factors may account for the influence of primary infection on the HIV epidemic. HIV prevention measures can be focused on each of these factors. Biologically, detecting individuals early in the course of infection and offering treatment can reduce viral load and possibly an individual's infectiousness. Behaviorally, counseling newly infected persons about the importance of adopting safer practices may instill prevention behaviors at a critical time. Socially, using a network approach to notify persons exposed to those with primary infections can dampen the amplification effect of rapid HIV spread through high-risk environments. By focusing prevention efforts on the primary HIV infection interval, public health officials could increase their leverage in slowing the HIV epidemic.