RESUMEN
OBJECTIVE: Yoga is recognized as an effective approach to improving overall physical and mental health; however, there may be perceived barriers to yoga participation, particularly among populations most at risk for mental health issues. We conducted qualitative formative research to help inform recruitment practices for a future study and to specifically understand the barriers and facilitators to engagement in yoga practice among racial/ethnic minority adolescents, as well as adolescents in outpatient mental health treatment. METHODS: Qualitative data were collected at a community health clinic that serves low income families in southeastern Florida. Using semi structured interviews with racial and ethnic minority adolescents between 12 and 17 years old, participants were asked about beliefs and perceptions about yoga, as well as recommendations on recruiting peers. A thematic analysis approach was used to identify and examine common themes. RESULTS: Twenty interviews were conducted and eight major themes emerged from the data. Themes were grouped as (1) Facilitators to recruitment and (2) Barriers to recruitment. INTERPRETATION: Advertising free yoga that emphasizes the social, physical, and mental benefits can help assuage negative perceptions of yoga and promote the advantages of yoga among teenagers. Having recruitment materials and modalities that highlight inclusivity of all genders and physical abilities in the yoga classes are also important in facilitating participation. Understanding perceptions of yoga, as well as perceived barriers and facilitators, among racially/ethnically diverse adolescents in outpatient mental health treatment, can assist recruitment efforts, increase yoga intervention participation, and ultimately, improve mental health outcomes for underserved populations.
Asunto(s)
Cultura , Selección de Paciente , Yoga/psicología , Adolescente , Niño , Femenino , Florida , Humanos , Masculino , Servicios de Salud Mental , Grupos Minoritarios/psicología , Pobreza/psicología , Investigación CualitativaRESUMEN
INTRODUCTION: Mounting evidence suggests that bariatric surgery, or weight loss surgery (WLS), patients might be vulnerable to developing post-operative alcohol use problems. While the majority of published research offers information concerning the prevalence of problematic alcohol use post-WLS, the literature lacks comprehensive, qualitative explorations examining why alcohol misuse might emerge after WLS. Such data-driven hypotheses are needed to effectively target this emerging concern. Additionally, young adults and racial/ethnic minorities are both increasingly undergoing WLS and are at heightened risk for problems related to alcohol use. To date, these groups have been under-represented in study samples. METHODS: To address these important gaps in the literature, racially/ethnically diverse, young adult WLS patients who indicated a post-WLS increase in alcohol use (n = 12) participated in an individual, semi-structured qualitative interview. Data were analyzed through two coding cycles; an external audit of the emerging themes was also conducted to further ensure the trustworthiness of the data. RESULTS: Interviews revealed four major themes prompting an increase in alcohol use after WLS: (1) increased sensitivity to alcohol intoxication, (2) utilizing alcohol as a replacement self-soothing mechanism for food, (3) increase in socialization, and (4) utilizing alcohol as a coping mechanism. CONCLUSIONS: By understanding the drivers of increases in alcohol use after WLS, precision-targeted pre- and post-surgical counseling interventions can be developed to address this emerging concern.
Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Alcoholismo/epidemiología , Cirugía Bariátrica/estadística & datos numéricos , Etnicidad/estadística & datos numéricos , Obesidad Mórbida/cirugía , Complicaciones Posoperatorias/epidemiología , Grupos Raciales/estadística & datos numéricos , Adaptación Psicológica/fisiología , Adulto , Consumo de Bebidas Alcohólicas/etnología , Consumo de Bebidas Alcohólicas/psicología , Alcoholismo/etnología , Cirugía Bariátrica/psicología , Cirugía Bariátrica/rehabilitación , Etnicidad/psicología , Femenino , Estudios de Seguimiento , Humanos , Entrevistas como Asunto , Masculino , Obesidad Mórbida/epidemiología , Obesidad Mórbida/psicología , Obesidad Mórbida/rehabilitación , Complicaciones Posoperatorias/etnología , Complicaciones Posoperatorias/psicología , Periodo Posoperatorio , Prevalencia , Grupos Raciales/psicología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVES: Latina women are disproportionately affected by HIV in the US, and account for 30% of all HIV infections in Miami-Dade County, Florida. The main risk for Latina women is heterosexual contact. Little is known about the relational and cultural factors that may impact women's HIV risk perception. This study aims to describe Latina women's perception of their HIV risk within a relational, cultural, and linguistic context. DESIGN: Eight focus groups of Latina women (n = 28), four English speaking groups and four Spanish speaking groups, were conducted between December 2013 and May 2014. Women were recruited from a diversion program for criminal justice clients and by word of mouth. Eligibility criteria included the following: self-identify as Hispanic/Latino, 18-49 years of age, and self-identify as heterosexual. A two-level open coding analytic approach was conducted to identify themes across groups. RESULTS: Most participants were foreign-born (61%) and represented the following countries: Cuba (47%), Honduras (17.5%), Mexico (12%), as well as Nicaragua, Puerto Rico, Colombia, and Venezuela (15%). Participant ages ranged between 18 and 49, with a mean age of 32 years. Relationship factors were important in perceiving HIV risk including male infidelity, women's trust in their male partners, relationship type, and getting caught up in the heat of the moment. For women in the English speaking groups, drug use and trading sex for drugs were also reasons cited for putting them at risk for HIV. English speaking women also reported that women should take more responsibility regarding condom use. CONCLUSION: Findings emphasize the importance of taking relational and cultural context into account when developing HIV prevention programs for Latina women. Interventions targeting English speaking Latina women should focus on women being more proactive in their sexual health; interventions focused on Spanish speaking women might target their prevention messages to either men or couples.
Asunto(s)
Características Culturales , Infecciones por VIH/prevención & control , Hispánicos o Latinos/psicología , Amor , Confianza , Adulto , Condones/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Florida , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Asunción de Riesgos , Parejas SexualesRESUMEN
Latinos are more likely to delay HIV testing, present to care with an AIDS defining illness, and die within one year of learning their HIV-positive status than non-Latino blacks and whites. For this paper, we explore the role of partner-relationship characteristics and health behaviors, in predicting HIV testing among Latina adult women who engaged in risky sexual behaviors (i.e., unprotected vaginal and/or anal sex). Data from a convenience sample of 168 Latina adult women who engaged in risky sexual behavior in the year prior to assessment were analyzed for this paper. Rates and predictors of HIV testing among this sample were assessed after a five-year follow-up. Descriptive and analytical estimates include incidence rates and adjusted odds ratios (AOR) from multilevel models. At five-year follow-up, 63.7% (n = 107) women reported having been tested for HIV, of whom 12.2% (n = 13) were women who never tested before. Main reasons for not having been tested at follow-up included: low risk perception (62.1%) and trusting their partner(s)/being in a monogamous relationship/knowing their partner's HIV status (17.2%). Predictors of HIV testing included: age (AOR: 0.96; 95% CI = 0.92-0.99), provider endorsement of HIV testing (AOR: 4.59; 95% CI = 1.77-11.95), poor quality of their romantic relationships (AOR: 1.12; 95% CI = 1.03-1.26), and knowing the HIV sero-status of sexual partner (AOR: 3.61; 95% CI = 1.46-8.95). This study characterizes a group of Latina women at high risk for HIV infection and their HIV testing behaviors. Our findings underscore the need of increasing access to quality health-care services and HIV behavioral interventions, and to strengthen the adherence to HIV/sexually transmitted disease testing recommendations and guidelines among local health-care providers serving the Latino community in South Florida.
Asunto(s)
Infecciones por VIH/diagnóstico , Hispánicos o Latinos , Asunción de Riesgos , Conducta Sexual , Adulto , Femenino , Florida , Estudios de Seguimiento , Infecciones por VIH/etnología , HumanosRESUMEN
BACKGROUND: Patterns of social and structural factors experienced by vulnerable populations may negatively affect willingness and ability to seek out health care services, and ultimately, their health. METHODS: The outcome variable was utilization of health care services in the previous 12 months. Using Andersen's Behavioral Model for Vulnerable Populations, we examined self-reported data on utilization of health care services among a sample of 546 Black, street-based, female sex workers in Miami, Florida. To evaluate the impact of each domain of the model on predicting health care utilization, domains were included in the logistic regression analysis by blocks using the traditional variables first and then adding the vulnerable domain variables. FINDINGS: The most consistent variables predicting health care utilization were having a regular source of care and self-rated health. The model that included only enabling variables was the most efficient model in predicting health care utilization. CONCLUSIONS: Any type of resource, link, or connection to or with an institution, or any consistent point of care, contributes significantly to health care utilization behaviors. A consistent and reliable source for health care may increase health care utilization and subsequently decrease health disparities among vulnerable and marginalized populations, as well as contribute to public health efforts that encourage preventive health.
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Población Negra/estadística & datos numéricos , Conductas Relacionadas con la Salud/etnología , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Servicios de Salud/estadística & datos numéricos , Trabajadores Sexuales , Poblaciones Vulnerables/etnología , Adolescente , Adulto , Estudios Transversales , Femenino , Florida , Servicios de Salud/economía , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Análisis de Regresión , Autoinforme , Trabajo Sexual/etnología , Trabajo Sexual/psicología , Factores Socioeconómicos , Encuestas y Cuestionarios , Poblaciones Vulnerables/psicología , Adulto JovenRESUMEN
Difficulties with recruitment of hidden populations, such as Hispanic men who have sex with men (MSM), have hampered HIV prevention research, leading researchers to explore alternative recruitment modalities such as the Internet. In this paper, we compare the efficiency and cost of recruiting HMSM from Internet chat rooms versus community venues and examine the differences between participants recruited from each type of venue. Internet recruitment was more efficient and somewhat less costly than community recruitment. Although the two groups were comparable in most demographic factors and HIV risk behaviors, Internet recruits were more likely to be bisexual, more likely to be HIV seropositive, had a higher level of education, and reported higher levels of psychological distress and lower levels of gay community attachment. Implications of our findings for using Internet chatrooms as recruitment venues are discussed.
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Infecciones por VIH/prevención & control , Hispánicos o Latinos/psicología , Internet/estadística & datos numéricos , Selección de Paciente , Adulto , Bisexualidad/etnología , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricos , Costos y Análisis de Costo , Escolaridad , Infecciones por VIH/etnología , Homosexualidad Masculina/etnología , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Asunción de Riesgos , Sexo Inseguro/etnología , Sexo Inseguro/prevención & controlRESUMEN
This study measured use of club drugs among 262 Hispanic men who have sex with men (MSM) recruited at community venues in Miami-Dade County, Florida in 2001. More than 50% of men used club drugs, and 36% used them in the last 3 months. Lifetime and 3-month rates were: ecstasy (36% and 20%), cocaine (34% and 12%), amyl nitrates (28% and 9%), and crystal methamphetamine (20% and 15%). Thirty-six percent had used two or more drugs (polydrug use) in their lifetime and 20% reported polydrug use in the last 3 months. Club drug users had significantly more sex partners in the last 12 months than nonclub drug users. High rates (35%) of unprotected anal sex in the last 3 months were reported by both groups. Men who reported polydrug use in the last 3 months were significantly more likely than men who used a single club drug to have had sex under the influence of club drugs (83% vs. 57%; X2=7.4, p=0.006). At the multivariate level, a significant association between preference for use of English and lifetime club drug use emerged. Effective interventions to reduce club drug use and risky sex for Hispanic MSM are needed.
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Trastornos Relacionados con Anfetaminas/epidemiología , Trastornos Relacionados con Cocaína/epidemiología , Hispánicos o Latinos/psicología , Homosexualidad , Asunción de Riesgos , Adolescente , Adulto , Florida/epidemiología , Encuestas Epidemiológicas , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Recreación , Población UrbanaRESUMEN
The Internet presents unique and growing opportunities for conducting HIV/ STD research. This article reports on the first 171 participants enrolled in an ongoing study examining use of the Internet to recruit Hispanic men who have sex with men (HMSM) living in an AIDS epicenter to participate in community-based studies. First, it describes initial success with chatroom recruitment. Second, it compares the demographic, psychosocial, and sexual risk practices among HMSM recruited through the Internet who had used club drugs in the last 6 months and those who had not. In 2 months, 211 hours were spent recruiting in chatrooms; 735 chatroom users were engaged. Researchers used a scripted dialogue to describe the study and to invite chatroom users to visit the study's community sites for screening and enrollment. One hundred and seventy-six men came to the community sites; 172 (98%) were eligible and completed an audio-computer assisted self-interview. In the last 6 months, 48.5% of the sample had used club drugs [defined as cocaine, crystal methamphetamines (crystal), amyl nitrites (poppers), Ecstasy, gamma-hydroxybutyrate (GHB), ketamine (Special K), and Viagra]. The proportion of men reporting use of each drug was: cocaine (15.8%), crystal (11.7%), poppers (31.6%), Ecstasy (14%), GHB (3.5%), Special K (3.5%), and Viagra (19.3%). In multivariate analyses, having higher number of sex partners, having higher social isolation scores, and having engaged in unprotected receptive anal intercourse were significantly associated with club-drug use. These initial findings suggest that high-risk HMSM can be successfully recruited through chatroom dialogues to participate in community-based HIV studies. The alarmingly high rates of club-drug use and risky sexual practices among HMSM underscore the need for effective HIV preventive interventions for this population.
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Hispánicos o Latinos , Homosexualidad Masculina/etnología , Drogas Ilícitas , Internet , Trastornos Relacionados con Sustancias/etnología , Adulto , Florida , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Asunción de Riesgos , Conducta Sexual , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
CONTEXT AND PURPOSE: This study examined the predictors of HIV testing and factors associated with intention to accept a free HIV test among 244 Hispanic migrant/seasonal farmworkers in South Florida. METHODS: Time and space sampling procedures were used to recruit participants in public venues. Bilingual staff interviewed eligible respondents in these settings. FINDINGS: Despite high rates of sexual risk, only 21% of respondents had been tested for HIV. The majority of those tested were females tested during prenatal care. In multivariable logistic regression analyses, being female (odds ratio [OR] = 3.73), having at least 12 years of education (OR = 4.46), earning more than $201 per week (OR = 2.76), and ever having used marijuana (OR = 3.31) were positively associated with having been tested for HIV, while not being documented (OR = 0.24) and having rated one's health as "very good" or "good" (OR = 0.42) were negatively associated with testing. The multivariable predictors of intention to accept a free HIV test were having visited a health care provider and/or an emergency room in the past 12 months (OR = 1.97), having been tested for HIV (OR = 2.36), preferring an HIV test that used a finger stick for specimen collection with results given in 30 minutes (OR = 4.47), and worrying "some" or "a lot" about getting HIV (OR = 3.64). Women (OR = 0.52) were less likely than men to intend to accept a free HIV test. CONCLUSIONS: Our findings highlight the importance of routinely offering HIV testing to sexually active individuals in high HIV prevalence areas. They also suggest the need to make testing more accessible to migrant and seasonal farmworkers.
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Agricultura/estadística & datos numéricos , Seropositividad para VIH/diagnóstico , Seropositividad para VIH/etnología , Conductas Relacionadas con la Salud/etnología , Hispánicos o Latinos/psicología , Aceptación de la Atención de Salud/etnología , Adulto , Distribución de Chi-Cuadrado , Intervalos de Confianza , Femenino , Florida/epidemiología , Humanos , Intención , Masculino , Oportunidad Relativa , Aceptación de la Atención de Salud/estadística & datos numéricos , Distribución por Sexo , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
This study examined factors associated with being at risk of sexually acquiring HIV among a community sample of 244 Hispanic migrant and seasonal farm workers. Bilingual staff interviewed respondents anonymously at worksites, camps, and other public venues in South Florida during the 2002 winter/spring growing season. The following variables were positively associated with being at risk of sexually acquiring HIV in multivariable analyses: being female; being married; having "some" or "a lot" of knowledge about HIV transmission, having ever used marijuana, having two or more sex partners in the last 12 months, and having had a sexually transmitted infection. The findings heighten the importance of recognizing women's elevated risk of HIV infection and conducting further studies to examine the factors associated with this increased risk. The study is an important first step toward developing tailored HIV prevention interventions for this at-risk, understudied population.