RESUMEN
INTRODUCTION: The Boston HAPPENS (HIV Adolescent Provider and Peer Education Network for Services) program is a collaborative network of care made up of 8 organizations that serve youth and provide coordinated care for human immunodeficiency virus (HIV)-positive, homeless, and at-risk youth aged 12 to 24 years. Learning youth perceptions about the program is essential to determine if the program is meeting their needs. METHODS: In this qualitative evaluation, 18 youth served by the network met in 4 focus groups to provide their view of the program. Services within 5 categories were assessed: (a) medical care, (b) mental health and substance abuse care, (c) HIV prevention and care, (d) case management, and (e) allocation of finances. RESULTS: Boston HAPPENS has achieved name recognition and provides many needed services for youth from a wide variety of backgrounds. The youth were comfortable receiving care and were appreciative of the comprehensive services available. They provided suggestions for how mental health services could be offered as one-on-one counseling as part of "wellness care." Young participants also requested more recreational and support opportunities for young people living with HIV. DISCUSSION: Qualitative evaluations such as this give a voice to youth to advocate for services they need. By including youth ideas and perspectives during program development and implementation, services can be more attractive to groups of at-risk youth who historically have been less likely to seek care.
Asunto(s)
Servicios de Salud del Adolescente/organización & administración , Atención Integral de Salud/organización & administración , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Jóvenes sin Hogar/psicología , Educación del Paciente como Asunto/organización & administración , Satisfacción del Paciente , Psicología del Adolescente , Servicios Urbanos de Salud/organización & administración , Adolescente , Adulto , Boston , Niño , Femenino , Grupos Focales , Humanos , Relaciones Interinstitucionales , Masculino , Evaluación de Necesidades , Grupo Paritario , Evaluación de Programas y Proyectos de Salud , Calidad de la Atención de SaludRESUMEN
With the advent of new therapies for HIV, case identification through HIV counseling and testing (CTS) has become critically important. Young women, youth of color, and disenfranchised youth are at significant risk of acquiring HIV. This study describes clients who access CTS at a program of comprehensive care for high-risk youth (aged 12 to 24 years), and assessed, using logistic regression analyses, whether youth at highest risk utilized CTS. Most of the 531 youth were female (72 percent) and nonwhite (60 percent). Sixty-eight percent received CTS. Logistic regression modeling revealed that white race and receiving care at the teaching hospital were the only independent predictors of testing. Data indicate that, despite targeted, youth-specific, developmentally appropriate and culturally sensitive outreach and intervention efforts, youth of color and high-risk youth are poorly accessing CTS. A greater understanding of the barriers to and cultural norms regarding CTS is needed.
Asunto(s)
Serodiagnóstico del SIDA/estadística & datos numéricos , Servicios de Salud del Adolescente/estadística & datos numéricos , Infecciones por VIH/prevención & control , Conductas Relacionadas con la Salud , Áreas de Pobreza , Adolescente , Adulto , Niño , Femenino , Infecciones por VIH/diagnóstico , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Riesgo , Estados UnidosRESUMEN
The Boston HAPPENS [Human immunodeficiency virus (HIV) Adolescent Provider and Peer Education Network for Services] Program is a project supported by Special Projects of National Significance (SPNS) Program, HIV/AIDS Bureau, Health Resources and Services Administration, which provides a network of care for homeless, at-risk, and HIV-positive youth (ages 12-24 years), involving eight agencies. The program has provided services to 1301 youth, including 46 who are HIV-positive. Boston HAPPENS provides a citywide network of culturally and developmentally appropriate adolescent-specific care, including: (a) outreach and risk-reduction counseling through professional and adult-supervised peer staff, (b) access to appropriate HIV counseling and testing support services, (c) life management counseling (mental health intake and visits as part of health care and at times of crisis), (d) health status screening and services needs assessment, (e) client-focused, comprehensive, multidisciplinary care and support, (f) follow-up and outreach to ensure continuing care, and (g) integrated care and communication among providers in the metropolitan Boston area. This innovative network of youth-specific care offers a continuum from street outreach to referral and HIV specialty care that crosses institutional barriers.
Asunto(s)
Servicios de Salud del Adolescente/organización & administración , Redes Comunitarias/organización & administración , Infecciones por VIH/terapia , Modelos Organizacionales , Programas Nacionales de Salud/organización & administración , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Síndrome de Inmunodeficiencia Adquirida/terapia , Adolescente , Adulto , Boston/epidemiología , Relaciones Comunidad-Institución , Consejo/métodos , Prestación Integrada de Atención de Salud/organización & administración , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Seropositividad para VIH/diagnóstico , Seropositividad para VIH/epidemiología , Educación en Salud/métodos , Jóvenes sin Hogar/estadística & datos numéricos , Humanos , Incidencia , Masculino , Tamizaje Masivo , Evaluación de Programas y Proyectos de Salud , Factores de RiesgoRESUMEN
There are few qualitative studies that assess the experiences and preferences of urban youth with regard to use of primary care. The purpose of this pilot survey was to identify positive and negative influences and underlying issues for adolescents leading to seeking and returning for primary health care. Four focus groups totaling 20 diverse adolescents ranging in age from 13 to 21 years were conducted between April 1994 and June 1994. Participants were recruited through existing peer leadership groups that meet regularly at community health centers or afterschool programs. Urban adolescents are most concerned with being respected and treated well by primary care providers. They want to be listened to, to have their problems taken seriously, and to be treated with dignity and respect. Participants expressed strong preferences regarding sex, sexual orientation, and language of providers, but not for race or ethnicity. Qualitative methods such as focus groups give a voice to youth to advocate for access to adolescent-specific health services. Further research is needed to corroborate the results of this study, to expand our understanding of existing problems, and to investigate the predictors of health care use by vulnerable youth.
Asunto(s)
Servicios de Salud del Adolescente/normas , Satisfacción del Paciente , Atención Primaria de Salud/normas , Psicología del Adolescente , Servicios Urbanos de Salud/normas , Adolescente , Adulto , Grupos Focales , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Proyectos PilotoRESUMEN
As the competition for funding increases, the need to make researchers aware of all available funding is becoming more acute. The solution presented here is a Selective Dissemination of Information (SDI) service which electronically mails funding information that matches a researcher's keywords. The keywords are part of extensive faculty profiles that make up a Faculty Expertise database. The funding information comes from the Sponsored Programs Information Network (SPIN) database. The software enables researchers to learn about appropriate funding opportunities without spending time actively searching for them.