Browsing by Author "Payne-Foster, Pamela"
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Item Assessment of Youth-Friendly Health Services and Quality from Users' Perspectives(University of Alabama Libraries, 2023) Oyerinde, Ifeoluwa; Payne-Foster, Pamela; Morales-Aleman, MercedesBackground:Youth-Friendly Health Services (YFHS) are one of those services recommended by the World Health Organization (WHO) to address adolescent and young people's sexual health needs. YFHS are sexual and reproductive health services that are accessible, acceptable, appropriate, effective, and equitable for young people. Therefore, this study aims to assess the utilization and perceived quality of Youth-Friendly Health Services among the users.Method:The study design was descriptive cross-sectional. A total of 122 respondents from the University of Alabama, Tuscaloosa, were recruited and sampled using a validated semi-structured self-administered questionnaire to collect data. Results: Of the 122 participants recruited, 5 were excluded due to age, and 117 respondents aged 18 - 24 were included for further analysis of this study. The 117 respondents were 59.8% males and 40.2% females; 87.2% were heterosexual, 53.8% were from urban areas, and 65.8% were living with both parents. The majority (72.6%) were from middle-income families, 17.1% from low-income, and 9.4% from high-income families. This study revealed low awareness (17.9%) and low utilization (11.1%) of YFHS among young people. About 15.4% of those who ever visited the school health center (SHC) for YFHS rated the service as good, 53.8% were comfortable going to SHC for YFHS, 30.8% were comfortable discussing their sexuality with the healthcare provider, 38.5% were extremely satisfied with the services received. The quality of service from the users' perspective was low. Factors associated with the utilization of YHFS include gender, family income, accessibility, and appropriateness of the YFHS at a statistically significant value of p<0.001, 0.018, 0.046, and 0.048, respectively.Conclusions:Awareness and utilization of YFHS in this study were relatively low. The quality of YFHS provided at the student health center did not meet all the five components of YFHS. More than half of the users perceived the YFHS at the school health center as inaccessible and unacceptable. Awareness of YFHS should be aired in the university through health promotion, health education programs, and sharing of media materials. Also, campus-wide health interventions, campaigns, and outreach should be organized to increase the health-seeking behavior of young people. Policymakers and health advocate should formulate and strategically implement policies to improve the quality of YFHS provided at the health center. Keywords: Youth-Friendly Health Services, YFHS, Sexual and Reproductive Health, SRH, Utilization,Young peopleItem Community Perspectives and Environmental Justice Issues in an Unincorporated Black Township(MDPI, 2022) Moore, Teriana; Payne-Foster, Pamela; Oliver, JoAnn S.; Spears, Ellen Griffith; Spencer, Christopher H.; Maye, Jacqueline; Allen, Rebecca S.; University of Alabama TuscaloosaThrough each era, the southeastern United States was and continues to be an epicenter for industrial companies to establish factories and plants. Though this development attracts economic gain for the companies and surrounding areas, low-income and predominantly Black communities bear the brunt of the environmental consequences while frequently remaining stagnant economically. This qualitative, community-based participatory research study grew out of a larger study designed to recruit lay community advisors from communities labeled as hard to reach in research. We focus on Holt, Alabama, an unincorporated community in the southeastern United States region. The primary goal of this research inquiry is to thematically analyze community interviews stemming from a topic of research, practice, and policy interest to community members: the effects of industrial pollution on Holt citizens' daily lives. Content analysis of focus-group transcripts revealed four emergent themes, including: (1) how the pollution affects their water, soil, and air quality; (2) illness related to pollution; (3) community engagement and empowerment; and (4) suggestions regarding what government officials could do to address this area of need. Building upon the prior research regarding environmental justice, human flourishing, and the definition of nurturing environments, suggestions are made regarding the creation, implementation, and maintenance of project advisory councils focused on issues of environmental justice. Community advocacy and empowerment as well as community and scientific partnerships are imperative to alleviate problems associated with environmental justice.Item The context of dementia: visualizing the features of daily life for rural-dwelling, informal, veteran dementia dyads(University of Alabama Libraries, 2021) Loup, Julia; Snow, A. Lynn; Hilgeman, Michelle M.; University of Alabama TuscaloosaRural-dwelling, informal, veteran dementia caregiving dyads (a veteran diagnosed with dementia (PWD) and their caregiver) make up a population with unique needs compared to their non-caregiving or urban caregiver counterparts. However, according to commonly used measures of and approaches to studying rurality (e.g., Rural-Urban Commuting Area Codes, RUCA), individual differences are underrepresented in the design, implementation, and delivery of dementia-focused care for rural older PWDs and their caregivers. The present study qualitatively categorized daily life needs in the context of informal, rural-dwelling, dementia caregiving, and developed visualizations to present the findings across several stakeholder groups. In turn, the objective of this study was to gain more contextualized awareness this population’s daily-life needs by means of this novel qualitative-visual analysis approach. Rapid, thematic, and content analyses were performed on 30 semi-structured interviews with dementia dyads associated with the Tuscaloosa VA Medical Center. A categorical understanding of the sample’s daily life needs (including activities and resources) emerged and was translated visually using two data visualization modalities: Network Analysis and Life-Space Mapping. Results suggest this two-stage method of qualitative and visual analysis successfully delivers insight into the daily life needs of rural-dwelling, veteran, dementia dyads for care providers and policy makers. Taking a visual approach to qualitative needs assessment and rural care may assist in the development of tailored dementia caregiving interventions from integrated medical systems, such as the Veterans Health Administration.Item Cultural Adaptation of the "Media Aware Parent Program": an In-Depth Analysis of Intervention Strategies(University of Alabama Libraries, 2023) Adams, Josephine; Morales-Alemán, Mercedes MLatinos/as adolescents in the U.S. South experience multiple sexual health disparities. One way to address these sexual health disparities is by equipping Latinos/as parents with the tool needed to discuss sexual health related topics with their children. The rising use of technology presents a promising solution to provide technology-based interventions for Latinos/as families in the U.S. South. The purpose of this qualitative study was to explore the lived experiences of Latinos/as health experts and parents in West Alabama regarding their perception of the intervention model, Media Aware Parents program, using a phenomenological approach. Data collection was by semi-structured qualitative interviews and with 7 Latino/as health experts and 8 Latina parents who lived in West Alabama. Using a purposeful convenience sampling, we recruited a community-based sample (i.e., mothers and fathers, parents of boys and girls, parents of adolescents and older adolescents etc.). Content analysis of qualitative data revealed: 1) feedback on user/interactive experience with platform, 2) media literacy challenges among the Latinx community, 3) usefulness of media plan for Latinx parents, 4) need for teaching parents about social media, 5) need for bright colors in the slides, 6) need to tailor the intervention to better represent the Latinx community, and 7) need for support groups or facilitated intervention implementation. Our study identifies the need to develop a culturally appropriate technology-based intervention and evaluate the feasibility of the MAP intervention in promoting sexual health and media usage among Latinos/as. These results may inform the cultural adaptation process of the Media Aware Parents program and promote effective parent-child communication.Item Developing FAITHH: Methods to Develop a Faith-Based HIV Stigma-Reduction Intervention in the Rural South(Sage, 2018) Bradley, Erin L. P.; Sutton, Madeline Y.; Cooks, Eric; Washington-Ball, Brittney; Gaul, Zaneta; Gaskins, Susan; Payne-Foster, Pamela; Centers for Disease Control & Prevention - USA; University of Alabama TuscaloosaHuman immunodeficiency virus (HIV) disproportionately affects Blacks/African Americans, particularly those residing in the southern United States. HIV-related stigma adversely affects strategies to successfully engage people in HIV education, prevention, and care. Interventions targeting stigma reduction are vital as additional tools to move toward improved outcomes with HIV prevention and care, consistent with national goals. Faith institutions in the South have been understudied as partners in HIV stigma-reduction efforts, and some at-risk, Black/African American communities are involved with southern faith institutions. We describe the collaborative effort with rural, southern faith leaders from various denominations to develop and pilot test Project Faith-based Anti-stigma Initiative Towards Healing HIV/AIDS (FAITHH), an HIV stigma-reduction intervention that built on strategies previously used with other nonrural, Black/African American faith communities. The eight-module intervention included educational materials, myth-busting exercises to increase accurate HIV knowledge, role-playing, activities to confront stigma, and opportunities to develop and practice delivering a sermon about HIV that included scripture-based content and guidance. Engaging faith leaders facilitated the successful tailoring of the intervention, and congregation members were willing participants in the research process in support of increased HIV awareness, prevention, and care.Item Examining the determinants of condom use among African American college students attending predominantly white institutions(University of Alabama Libraries, 2016) Aduloju-Ajijola, Natasha Aduloju-Ajijola; Paschal, Angelia M.; University of Alabama TuscaloosaAfrican American college students at predominantly White institutions (PWIs) are disproportionally at risk for experiencing negative sexual health outcomes. African Americans between the ages of 18 and 24 are disproportionally affected by unplanned pregnancy and sexually transmitted infections, which are associated with risky sexual behaviors, including sex without a condom. The risks and stress associated with living at the intersection of both African American risk factors and college risk factors may play a role in the sexual behavior of African American college students. The purpose of this study was to examine the determinants of condom use among African American undergraduates at predominantly White Institutions (PWIs). This study used the constructs of the Theory of Planned Behavior (TPB) to examine the factors that contribute to condom use. An added factor the study examined was the relationship between different types of stress and condom use. The relationship between stress, intention to use condoms, and actual condom use was also investigated. The study employed a cross-sectional design and used surveys to collect data on African American college students between the ages of 18 and 24 years old at PWIs. The survey was disseminated through Qualtrics online survey software. The sample of 202 students engaged in a range of sexual behaviors (vaginal, oral, and anal sex) and had inconsistent condom use during these activities. The study found that constructs of the Theory of Planned Behavior, namely intentions and attitudes, were independently significant at predicting condom use. However, the interaction between intentions and overall stress was more significant in predicting condom use among African American college students attending PWIs over the past 30 days. The study findings have promising implications for health education practitioners, university stakeholders, and researchers who are interested in reducing sexual health disparities. Coordinated efforts are needed to reduce the risk factors that contribute to unsafe sexual behaviors among college students, especially among those at greater risk such as African American college students at PWIs.Item Exploring the life experiences of Afro-Caribbean immigrant women living with HIV: a phenomenological investigation(University of Alabama Libraries, 2014) Cooper, Krista; Csikai, Ellen L.; University of Alabama TuscaloosaOver 35 million individuals across the globe are living with HIV, nearly one-half of whom are women (UNAIDS, 2013). In the most affected areas, Sub-Saharan Africa and the Caribbean, women comprise up to 60% of those living with HIV (UNAIDS, 2012, UNAIDS, 2013). Little research has focused the life experiences of Afro-Caribbean immigrant women living with HIV. Prior studies primarily emphasized epidemiological data (Hoffman, Ransome, Adams-Skinner, Shiun, & Terzian, 2012) and high risk behaviors and attitudes (Braithwaite & Thomas, 2001; Gillespie-Johnson, 2005; Hoffman, et al., 2008; Shedlin, et al., 2006). This phenomenological study explored the life experiences of eight Afro-Caribbean adult immigrant women from the English-speaking Caribbean living in New York City who were HIV positive. Participants were identified with the assistance of key informants in the Afro-Caribbean community. A semi-structured interview guide facilitated discussion around topics such as immigration status, coping, self-perception, formal and informal support networks. Participants were given a $25 Metro Card or grocery gift card as a "thank you" for their time. Data were analyzed according to Creswell's (2007) Simplification of the Stevick-Colaizzi-Keen Method of Phenomenological Analysis created by Moustakas (1994). This entailed bracketing, identification of meaning units and themes, construction of individual textural and structural descriptions. A composite description encapsulated the "essence" of the phenomenon. These Afro-Caribbean women portrayed specific cultural nuances related to disclosure and the accompanying stigma and discrimination. Maintaining secrecy.to ensure the safety of families who remained in home countries was of utmost importance. The women relied heavily on community support networks facilitated by caseworkers, social workers and medical professionals. Additionally, they focused on self-care and spirituality. These elements, combined, defined their overall experiences. Social workers can assist in enhancing the quality of life of this population by identifying specific challenges and creating culturally-appropriate and gender-specific interventions, including prevention/education programs. Advocacy should focus on immigration issues and programming specific to immigrant populations. The unique experiences shared by these Afro-Caribbean women living with HIV supports further investigation with other sub-populations within the group such as with women, non-English speaking Caribbean populations, and more recently diagnosed women.Item The health of rural Black communities during COVID: Some affirmations, some surprises(Frontiers, 2023) Newman, Sharlene D.; Moss, Kimberly; Pichon, Melonie; Scott, Deborah; Rogers, Kileema; Orr, Angela; Bui, Chuong; Payne-Foster, Pamela; University of Alabama TuscaloosaBackground and objectiveThere are overwhelming health disparities in the Deep South. It is important to include the voice of communities affected by these disparities when developing interventions. The goal of the current study was to develop an academic community engaged partnership to strengthen the ability to address priority health concerns of rural African American communities with a focus on health literacy and health advocacy. MethodsA community-based participatory research approach was used to administer a 15-item community health survey in five rural communities led by African American mayors in Alabama (N = 752). The survey assessed the health concerns and the potential behaviors that may be associated with those health concerns. ResultsThe five communities demonstrated similarities as well as differences in both the health concerns endorsed and the potential health behaviors that may contribute to those concerns. All five communities identified cardiovascular disease as a health concern with three endorsing mental health issues and 2 dental health. With respect to behaviors, all five communities identified either unhealthy eating/exercise and substance use as concerns with one community identifying racism as a risky behavior affecting health. ConclusionThe results presented replicate CBPR studies demonstrating that communities are important sources of information about local health priorities and concerns.Item Increased dietary fiber is associated with weight loss among Full Plate Living program participants(Frontiers, 2023) Kelly, Rebecca K.; Calhoun, Janet; Hanus, Amy; Payne-Foster, Pamela; Stout, Ron; Sherman, Bruce W.; University of Alabama Tuscaloosa; University of North Carolina; University of North Carolina GreensboroIntroductionPrior studies have demonstrated that an intake of foods rich in dietary fiber is associated with a favorable impact on health status and body weight. However, the association between fiber intake and weight loss has not been well-studied in employer settings. This research aimed to assess the relationship between dietary fiber and weight loss among individuals participating in the Full Plate Living (FPL) program. MethodsThe 16-week plant-predominant fiber-rich eating program was delivered to 72 employers, primarily in the Southwest U.S., over 3 years (2017-2019). Participants received weekly video lessons, FPL materials, and additional online resources. A retrospective analysis of repeated measures was conducted using participant data obtained from 4,477 participants, of which 2,792 (62.5%) reduced body weight. Analysis of variance with post hoc analysis was used to assess the statistical significance of the changes between baseline and follow-up measures of dietary fiber intake in each of the food categories, specifically the relationship between changes in individual and combined (composite) daily servings of fruits, vegetables, whole grains, beans, and nuts on body weight measures among three groups at follow-up: those who lost, maintained, or gained weight. Multilevel modeling was used to test the hypothesis that increased intake of fiber was associated with greater weight loss. ResultsThe mean weight loss for the weight loss group was 3.28 kg. As compared to the two other groups, the intake of whole fiber-rich foods at follow-up was significantly higher among the weight loss group with fruits (2.45 servings), vegetables (2.99 servings), beans (1.03 servings), and total fiber composites (9.07 servings; P < 0.001). A significant increase in servings of grains was also noted (P < 0.05). Multilevel modeling demonstrated that a higher total fiber composite (Model 1), as well as higher intakes of either vegetables or fruits (Model 2), resulted in greater weight loss. DiscussionOur findings indicate that the FPL program can be a part of a lifestyle medicine approach to healthy eating and weight loss. Delivering the program in clinical, community, and workplace settings can increase its reach as an effective and low-cost offering.Item Left behind in the US ' Deep South: Addressing critical gaps in HIV and intimate partner violence prevention efforts targeting Black women(Frontiers, 2022) Johnson, Karen A.; Binion, Stefanie; Waller, Bernadine; Sutton, Amber; Wilkes, Sherron; Payne-Foster, Pamela; Carlson, Catherine; University of Alabama Tuscaloosa; Columbia University; Auburn UniversityItem The Lived Experiences of Black Women with PCOS from Diagnosis to Treatment: a Narrative Approach(University of Alabama Libraries, 2023) Opoku, Annabella Achiaamah; Bradley, Lilanta JPolycystic ovary syndrome or polycystic ovarian syndrome (PCOS) is a hormonal and reproductive health condition that affects women of reproductive age. PCOS is quite common among women of all races/ethnicities between the ages of 15-44, with 5-10% of them having the condition. Although PCOS affects all women of childbearing age, regardless of race/ethnicity, the literature has found that Black women have a higher risk of suffering from complications like MetSyn. There is limited data on this phenomenon, but it poses the question of what factors play a role and how that can impact diagnosis and treatment plans for Black women. The goal of this study is to better understand Black women's experiences when seeking diagnosis and treatment for PCOS from the moment they suspect having the condition to receiving treatment recommendations. The participants recruited for this study included seven adult females in the age range 18-34. Eligible participants are women who self-identify as Black or African-American (non-Hispanic/Latino) and live in the U.S. Inductive thematic analysis to analyze the data by patterns and themes that arise from the data. The interviews were held virtually through Zoom to comply with COVID-19 guidelines and allow participants who otherwise could not participate because of distance to be included in the study. A phone screening process was conducted to pre-screen participants to determine whether they were eligible. Once eligible, participants had the opportunity to consent to participate and be audio-recorded for the study verbally. Participants were instructed to complete a brief survey on Qualtrics that collected demographic information. Within the interviews, subthemes were identified in various aspects of participants' experience with PCOS. The interviewees expressed their thoughts regarding steps that led to diagnosis, their interactions with their providers, receiving support, and the impact PCOS has had on them. Having Black woman share their stories surrounding PCOS is important in understanding what health disparities impact their health outcome and how PCOS exacerbates that and also spreading awareness on the condition for both them and their providers.Item Long-term survival among individuals diagnosed with end stage renal disease: an exploratory study(University of Alabama Libraries, 2013) Williams, Jacqueline Trask; Csikai, Ellen L.; University of Alabama Tuscaloosayour wordsItem Patient and Provider Perspectives on HIV Stigma in Healthcare Settings in Underserved Areas of the US South: A Mixed Methods Study(Springer, 2022) Crockett, Kaylee B.; Turan, Bulent; Whitfield, Samantha; Kay, Emma Sophia; Budhwani, Henna; Fifolt, Matthew; Hauenstein, Kris; Ladner, Murray D.; Sewell, Joshua; Payne-Foster, Pamela; Nyblade, Laura; Batey, D. Scott; Turan, Janet M.; University of Alabama Birmingham; Koc University; University of Alabama Tuscaloosa; Research Triangle InstituteStigma experienced in healthcare settings is a barrier to ending the HIV epidemic. Using a convergent parallel mixed methods approach, we collected qualitative data from 14 focus groups with People with HIV (PWH) and Healthcare workers (HCW) and quantitative survey data (N = 762 PWH and N = 192 HCW) from seven HIV healthcare clinics outside of major urban areas in the southeastern US. Four key themes emerged: (1) HIV-related stigma and discrimination in healthcare settings; (2) experiences of intersectional stigma; (3) disclosure concerns in healthcare settings; and (4) impact of stigma on HIV-related health behavior. Implications for future stigma interventions in healthcare settings include the importance of engaging PWH in the development of interventions, the need for interventions in settings that do not specialize in HIV care, and the importance of engaging all staff when addressing HIV-related stigma.Item A pilot study of prostate cancer knowledge among African American men and their health care advocates: implications for screening decisions(Springer, 2018) Oliver, Joann S.; Allen, Rebecca S.; Eichorst, Morgan K.; Mieskowski, Lisa; Ewell, Patrick J.; Payne-Foster, Pamela; Ragin, Camille; University of Alabama Tuscaloosa; US Department of Veterans Affairs; Veterans Health Administration (VHA); Salem Veterans Affairs Medical Center; Kenyon CollegeProstate cancer (PCa) is the second leading cause of cancer death in U.S. men [American Cancer Society (ACS)], most often affecting men age 50 and older. The study provides information about factors that influence rural AA men in their decision to undergo screening for PCa with a specific focus on PCa knowledge among AA men and their health care advocates. A longitudinal quantitative study included AA males and their health care advocates. Participants were from three Alabama rural counties. Measures included demographics, PCa knowledge, decisional conflict, and health literacy scales. Thirty-three men with a mean age of 54.61 and 35 health care advocates were included in the study. PROCASE Knowledge Index measure results indicate a lack of PCa knowledge among both male primary participants and their advocates. The knowledge of AA men in the study was somewhat low, with individuals correctly answering approximately six questions out of ten at multiple time points (baseline total M = 6.42, SD = 1.52). Decisional conflict responses at 12 months (38.64) were lower than at baseline (M = 62.88) and at 6 months (M = 58.33), p < .005. Health care advocates of the 33 male participants were usually women, spouses, or significant others, supporting the vital role women play in men's health specifically in rural underserved communities. Low overall PCa knowledge, including their risk for PCa, among these participants indicates a need for PCa and screening educational interventions and dialogue that include males and their significant others.Item Preparation and Planning for Future Care in the Deep South: Adapting a Validated Tool for Cultural Sensitivity(Oxford University Press, 2019) Allen, Rebecca S.; Oliver, JoAnn S.; Eichorst, Morgan K.; Mieskowski, Lisa; Payne-Foster, Pamela; Sorensen, Silvia; University of Alabama Tuscaloosa; US Department of Veterans Affairs; Veterans Health Administration (VHA); Salem Veterans Affairs Medical Center; University of RochesterBackground and Objectives: This study describes the adaptation and validation of Sorensen et al. (2017)'s preparation for future care (PFC) scale with diverse samples including rural dwelling African Americans and certified nursing assistants (CNAs), and subsequent psychometric development. Research Design and Methods: Responses to the five-subscale PFC survey from 33 rural African American men across 12 months and cognitive interviews with a subset of 12 of these men are described. Psychometric refinement included descriptive qualitative analyses of consultations with experienced lay research advisors (N = 4 and N = 7) regarding potential changes to the PFC and a confirmatory factor analysis of the resultant scale (N = 138). Results: Cognitive interviews with rural African American men revealed difficulty understanding Eurocentric questions. Emergent themes included emotional avoidance of planning, considerations of nursing homes and possible care providers, and coping strategies. In two consultation meetings, trained lay research advisors recommended language modifications to the original questions and response options. Factor analyzing the resultant scale revealed support for the original subscale constructs (acceptable fit: chi(2) = 205.03, df = 124, p < .001; root mean square error of approximation = .069 [.052-.085]; comparative fit index = .93; Tucker-Lewis index = .91). Discussion and Implications: PFC and engagement in advance care planning is uncommon among African Americans, possibly due to distrust of and lack of cultural competency among health care professionals. The resulting tool and response options may be used as an interview guide/survey with African Americans to gain understanding about their preparation for future health care needs.Item The Senior Sex Education Experience (SEXEE) Study: Considerations for the Development of an Adult Sex Education Pilot Intervention(University of Alabama Libraries, 2020) Pierpaoli Parker, Christina; King, Martha R.; Scogin, Forrest R.; University of Alabama TuscaloosaOverview: Remaining sexually active into later life has health benefits and risks, but middle-aged and older adults (MOAs) receive virtually no sex education. Unprecedented spikes in the prevalence of later-life sexual dysfunction and disease notwithstanding, no study to date has conceptualized a framework for an evidence- and needs-based sex education program for adults. Using the biopsychosocial and sexual health models as guiding theories, this research conceptualized one such program. Methods: A key component of analysis assessed physicians’ and adults’ lived experiences, needs, and recommendations directly, integrating findings into a usable framework. The purposive sample included 17 adults, ages 53 to 77 (M = 65; SD = 7.63; 64.70% female) and six physicians, including two family medicine providers, two geriatricians, and two urogynecologists (M = 56.16; SD = 13.34; 50% female). All participants provided basic demographic information and completed a measure of late-life sexual knowledge. MOAs participated in three separate focus groups to determine their needs, interest in, and suggestions for an educational intervention, while providing additional insights into their lived experiences with aging and sexuality. Physicians completed semi-structured interviews to describe their experiences discussing sexual health, identify the perceived facilitators and barriers to those discussions, and elicit their program recommendations. Constructivist grounded theory oriented qualitative coding techniques. Results: Late life sexual knowledge appeared suboptimal among MOAs and physicians alike. Both groups agreed on the value of an adult sex education program. Of the 21 separate educational modules proposed, physicians and MOAs shared six, including (a) sexual changes with aging, (b) the spectrum of sex, (c) STDs, (d) health and sexuality, (e) sex and dementia, and (f) dating. Adults reported receiving and internalizing ageist messages about their sexuality. Though MOAs and physicians considered sexuality important to successful aging, both identified individual, dynamic, and environmental barriers to clinical sexual health discussions, including (a) time and other logistical barriers; (b) ageist assumptions, attitudes, and beliefs about sexuality; (c) physicians’ perceived lack of knowledge or experience; and (d) avoidance and discomfort. However, they agreed on five facilitators, including (a) bedside manner, (b) rapport, (c) privacy, (d) standardized sexual health assessment, and (e) a comfortable clinical setting.Item Sociocultural HIV risk knowledge and behavior among female African-American adolescents and emerging adults in the southeast(University of Alabama Libraries, 2016) Thomas, Martina; DeCaro, Jason A.; University of Alabama TuscaloosaThe aim of this study is to determine sociocultural influences of HIV risk knowledge and behavior among African-American adolescent and emerging adult women in Tuscaloosa, Alabama. Bridging multiple worlds, cultural consensus, and cultural consonance theories were combined to discover sociocultural influences of HIV risk. Sociocultural descriptions of HIV risk converge and diverge with the public health model of HIV prevention. This following was hypothesized: (1) girls aged 14-18 will share a cultural model of HIV risk; (2) greater social integration and support will correlate with lower retrospective culturally-defined HIV risk scores among women age 18-24; (3) greater social support and lower culturally-defined HIV risk scores will be mediated by greater number of important individuals and social worlds, and will be moderated by (a) location and (b) SES; (4) location will reveal variance in culturally-defined HIV risk scores among participants 18-24 based on location; and (5) lower culturally-defined HIV risk scores in high school will be correlated with current decreased perceived stress, with this relationship being mediated by (a) greater worlds, (b) greater number of important people, (c) greater past social support, and (d) greater present social support. In-depth interviews, focus groups, participant observation, and informal discussions ethnographically describe African-American adolescent life in Alabama. Cultural consensus analysis is used to determine if the cultural model is shared, while techniques informed by cultural consonance analysis determined how individuals enact the model. Statistical testing include correlation, ANOVA, mediation, and moderation analysis. Results show a shared cultural model of HIV risk consisting of characteristics, behaviors, iii social worlds, and important people describing low and high risk. Relationships between social support and culturally-defined HIV risk scores are moderated by SES. In addition, location of recruitment and interview showed differing mean culturally-defined HIV risk scores, with highest mean scores found in lowest and highest SES settings, and lowest mean scores in the middle SES setting. Lastly, risk scores mediated the relationship between total past social support and current perceived social stress, and total important people in high school and current perceived stress.Item Vital Voices: HIV Prevention and Care Interventions Developed for Disproportionately Affected Communities by Historically Underrepresented, Early-Career Scientists(Springer, 2021) Sutton, Madeline Y.; Martinez, Omar; Brawner, Bridgette M.; Prado, Guillermo; Camacho-Gonzalez, Andres; Estrada, Yannine; Payne-Foster, Pamela; Rodriguez-Diaz, Carlos E.; Hussen, Sophia A.; Lanier, Yzette; van den Berg, Jacob J.; Malave-Rivera, Souhail M.; Hickson, DeMarc A.; Fields, Errol L.; Morehouse School of Medicine; Temple University; University of Pennsylvania; University of Miami; Emory University; University of Alabama Tuscaloosa; George Washington University; University of Puerto Rico; University of Puerto Rico Medical Sciences Campus; Rollins School Public Health; New York University; Brown University; Johns Hopkins UniversityBackground HIV prevention interventions which support engagement in care and increased awareness of biomedical options, including pre-exposure prophylaxis (PrEP), are highly desired for disproportionately affected Black/African American, Hispanic/Latinx and gay, bisexual, and other men who have sex with men (GBMSM) populations in the United States (US). However, in almost 40 years of HIV research, few interventions have been developed directly by and for these priority populations in domestic counties most at risk. We submit that interventions developed by early-career scientists who identify with and work directly with affected subgroups, and which include social and structural determinants of health, are vital as culturally tailored HIV prevention and care tools. Methods We reviewed and summarized interventions developed from 2007 to 2020 by historically underrepresented early-career HIV prevention scientists in a federally funded research mentoring program. We mapped these interventions to determine which were in jurisdictions deemed as high priority (based on HIV burden) by national prevention strategies. Results We summarized 11 HIV interventions; 10 (91%) of the 11 interventions are in geographic areas where HIV disparities are most concentrated and where new HIV prevention and care activities are focused. Each intervention addresses critical social and structural determinants of health disparities, and successfully reaches priority populations. Conclusion Focused funding that supports historically underrepresented scientists and their HIV prevention and care intervention research can help facilitate reaching national goals to reduce HIV-related disparities and end the HIV epidemic. Maintaining these funding streams should remain a priority as one of the tools for national HIV prevention.