Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
Branch vital, angela condom use among african-american women-nfmij-6-1-09William Kritsonis
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
The FDA plans to prioritize improvements in the quality of demographic subgroup data collection, reporting and analysis, encourages greater participation of diverse patients, and supports the transparency of subgroup data. To this end, ways to recruit, engage, educate, and study those of diverse backgrounds to alopecia areata trials will be discussed.
Clinico-demographic trend of Benign Vocal Cord Lesions among Urban Population...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Perceptions of tertiary students on the prevention of sexually transmitted di...iosrjce
The purpose of the study was to evaluate tertiary student’s sexual behaviour and their knowledge and attitudes
towards STDs, among students of University for Development Studies (UDS).
The research design: data was collected by using a quantitative survey using self-answered questionnaire, from
a sample of one hundred and thirty-four (n=134) out of a total student population of 3,881, using the simple
random sampling technique in the data gathering process.
Results/findings: out of the sample size of 134 students aged 15-44, 46.3% were males and 53.7% were females.
About 24.6%, (n=33) have ever had sex without a condom. The study revealed that 99.3% ever heard of STDs,
85.1% had either below or average knowledge about the causes of STDs, 55.2% had knowledge above average
on the prevention of STDs and more than 90% of the student sampled indicated that STDs are very common.
Interestingly, 6.7% of the sampled population said STDs are mainly female infections.
Recommendations: There is need for wider education at various levels of the educational system on STDs by
health care providers, and effective collaboration among health care providers, social activists, NGOs and
tertiary students to promote peer education on STDs prevention among students.
Branch vital, angela condom use among african-american women-nfmij-6-1-09William Kritsonis
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
The FDA plans to prioritize improvements in the quality of demographic subgroup data collection, reporting and analysis, encourages greater participation of diverse patients, and supports the transparency of subgroup data. To this end, ways to recruit, engage, educate, and study those of diverse backgrounds to alopecia areata trials will be discussed.
Clinico-demographic trend of Benign Vocal Cord Lesions among Urban Population...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Perceptions of tertiary students on the prevention of sexually transmitted di...iosrjce
The purpose of the study was to evaluate tertiary student’s sexual behaviour and their knowledge and attitudes
towards STDs, among students of University for Development Studies (UDS).
The research design: data was collected by using a quantitative survey using self-answered questionnaire, from
a sample of one hundred and thirty-four (n=134) out of a total student population of 3,881, using the simple
random sampling technique in the data gathering process.
Results/findings: out of the sample size of 134 students aged 15-44, 46.3% were males and 53.7% were females.
About 24.6%, (n=33) have ever had sex without a condom. The study revealed that 99.3% ever heard of STDs,
85.1% had either below or average knowledge about the causes of STDs, 55.2% had knowledge above average
on the prevention of STDs and more than 90% of the student sampled indicated that STDs are very common.
Interestingly, 6.7% of the sampled population said STDs are mainly female infections.
Recommendations: There is need for wider education at various levels of the educational system on STDs by
health care providers, and effective collaboration among health care providers, social activists, NGOs and
tertiary students to promote peer education on STDs prevention among students.
Patient Related Barriers Associated with Under Enrollment in Hospice: A ReviewQUESTJOURNAL
Background: Hospice care provides better quality of life compared with usual care, and focuses on caring, rather than curing. Many factors facing cancer patients at the last days of life prevent them from enrollment in hospice. Purpose:to identify the barriers associated with hospice under enrollment for terminally ill cancer patients. Methodology: an integrative literature review design was utilized, CINAHL, and PubMed were accessed by using key words (hospice, barriers, and cancer patients), and after applying inclusion criteria 8 articles were considered to meet the purpose of this review. Findings: through reviewing literatures,15% of hospice patients dis enrolled from hospice due to long-stay hospitalization, hospital death, & higher medicare expenditure with in sufficient insurance coverage (financial burden), and some other factors may contribute in under enrollment in hospice such as knowledge deficiency with misconception of hospice terminology and scope,mistrust of health care professionals, death timing, and some policies may create a barrier and restrict access to care for hospice. Conclusion:factors that may be associated with under enrollment of terminally ill cancer patients in hospice were lack of knowledge and misperception of hospice scope, emotional, physical and financial burden toward patient and family, death timing and bad quality of care
Profile of Sexually transmitted infections (STIs) among students of tertiary ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Racism as Experienced by Physicians
of Color in the Health Care Setting
Kelly Serafini, PhD; Caitlin Coyer, MS; Joedrecka Brown Speights, MD; Dennis Donovan, PhD;
Jessica Guh, MD; Judy Washington, MD; Carla Ainsworth, MD, MPH
Hepatitis C Risk Assessment, Testing and Referral for Treatment in primary Ca...Real Wellness, LLC
Dr. Robert Winn worked with a team to determine rates of hepatitis C (HCV) risk factor ascertainment, testing, and referral in urban primary care practices, with particular attention to the effect of race and ethnicity.
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapa...DrHeena tiwari
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapadu Village of Guntur District, Andhra Pradesh, India: An Original Research
Cohort, case control & survival studies-2014Ramnath Takiar
The presentation discusses about Cohort, Case-control and Survival studies. The concept of Cohort and Case-control studies is explained with the help of diagrams as perceived by me. Some discussion is also there about survival and relative survival. Appropriate data is also provided to explain about survival and relative survival.
The prevalence, patterns of usage and people's attitude towards complementary...home
The prevalence of CAM in Chatsworth is similar to findings in other parts of the
world. Although CAM was used to treat many different ailments, this practice could not be
attributed to any particular demographic profile. The majority of CAM users were satisfied with
the effects of CAM. Findings support a need for greater integration of allopathic medicine and
CAM, as well as improved communication between patients and caregivers regarding CAM usage.
HEALTH POLICY AND ETHICSFacilitating HIV DisclosureFac.docxpooleavelina
HEALTH POLICY AND ETHICS
Facilitating HIV Disclosure
Facilitating HIV Disclosure Across Diverse Settings: A Review
Carla Makhlouf Obermeyer, DSc, Parijat Baijal, MA, and Elisabetta Pegurri, MSc
HIV status disclosure is cen-
tral to debates about HIV be-
cause of its potential for HIV
prevention and its links to pri-
vacy and confidentiality as hu-
man-rights issues.
Our review of the HIV-dis-
closure literature found that
few people keep their status
completely secret; disclosure
tends to be iterative and to be
higher in high-income coun-
tries; gender shapes disclosure
motivations and reactions; in-
voluntary disclosure and low
levels of partner disclosure
highlight the difficulties faced
by health workers; the mean-
ing and process of disclosure
differ across settings; stigmati-
zation increases fears of disclo-
sure; and the ethical dilemmas
resulting from competing
values concerning confidenti-
ality influence the extent to
which disclosure can be facil-
itated.
Our results suggest that
structural changes, including
making more services avail-
able, could facilitate HIV dis-
closure as much as individual
approaches and counseling
do. (Am J Public Health. 2011;
101:1011–1023. doi:10.2105/
AJPH.2010.300102)
THE TOPIC OF HIV STATUS
disclosure is central to debates
about HIV, because of its links to
confidentiality and privacy as hu-
man-rights issues and its potential
role in prevention.1 Disclosure is
also considered a way to ‘‘open up’’
the HIV epidemic2 and hence is
a crucial step toward ending stigma
and discrimination against people
living with HIV and AIDS
(PLWHA). Recognizing its impor-
tance, a number of researchers
have reviewed the literature on
disclosure by women,3 by men,4 or
by parents to children.5 Others
have reviewed what is known
about the factors associated with
disclosure, including the connec-
tions among stigma, disclosure, and
social support for PLWHA6; the
links among disclosure, personal
identity, and relationships7; and
client and provider experiences
with HIV partner counseling and
referral.8 We sought to comple-
ment existing reviews by including
available information on low- and
middle-income countries, which are
poorly represented in all but 1 of
the extant literature reviews, and by
focusing on the role of health ser-
vices and health care providers in
HIV disclosure.
Recently, increased attention to
transmission within serodiscordant
couples has highlighted the po-
tential role of disclosure as a way
to encourage prevention.9 More-
over, as countries scale up HIV
testing, counseling, and treatment,
better evidence is needed to inform
laws and policies, particularly re-
garding how best to facilitate dis-
closure while protecting medical
confidentiality. Ongoing debates
about mandatory disclosure to
partners, health workers’ role in
disclosing without patients’ consent,
and the criminalization of HIV
transmission raise important ques-
tions about the place of disclosur ...
Patient Related Barriers Associated with Under Enrollment in Hospice: A ReviewQUESTJOURNAL
Background: Hospice care provides better quality of life compared with usual care, and focuses on caring, rather than curing. Many factors facing cancer patients at the last days of life prevent them from enrollment in hospice. Purpose:to identify the barriers associated with hospice under enrollment for terminally ill cancer patients. Methodology: an integrative literature review design was utilized, CINAHL, and PubMed were accessed by using key words (hospice, barriers, and cancer patients), and after applying inclusion criteria 8 articles were considered to meet the purpose of this review. Findings: through reviewing literatures,15% of hospice patients dis enrolled from hospice due to long-stay hospitalization, hospital death, & higher medicare expenditure with in sufficient insurance coverage (financial burden), and some other factors may contribute in under enrollment in hospice such as knowledge deficiency with misconception of hospice terminology and scope,mistrust of health care professionals, death timing, and some policies may create a barrier and restrict access to care for hospice. Conclusion:factors that may be associated with under enrollment of terminally ill cancer patients in hospice were lack of knowledge and misperception of hospice scope, emotional, physical and financial burden toward patient and family, death timing and bad quality of care
Profile of Sexually transmitted infections (STIs) among students of tertiary ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Racism as Experienced by Physicians
of Color in the Health Care Setting
Kelly Serafini, PhD; Caitlin Coyer, MS; Joedrecka Brown Speights, MD; Dennis Donovan, PhD;
Jessica Guh, MD; Judy Washington, MD; Carla Ainsworth, MD, MPH
Hepatitis C Risk Assessment, Testing and Referral for Treatment in primary Ca...Real Wellness, LLC
Dr. Robert Winn worked with a team to determine rates of hepatitis C (HCV) risk factor ascertainment, testing, and referral in urban primary care practices, with particular attention to the effect of race and ethnicity.
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapa...DrHeena tiwari
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapadu Village of Guntur District, Andhra Pradesh, India: An Original Research
Cohort, case control & survival studies-2014Ramnath Takiar
The presentation discusses about Cohort, Case-control and Survival studies. The concept of Cohort and Case-control studies is explained with the help of diagrams as perceived by me. Some discussion is also there about survival and relative survival. Appropriate data is also provided to explain about survival and relative survival.
The prevalence, patterns of usage and people's attitude towards complementary...home
The prevalence of CAM in Chatsworth is similar to findings in other parts of the
world. Although CAM was used to treat many different ailments, this practice could not be
attributed to any particular demographic profile. The majority of CAM users were satisfied with
the effects of CAM. Findings support a need for greater integration of allopathic medicine and
CAM, as well as improved communication between patients and caregivers regarding CAM usage.
HEALTH POLICY AND ETHICSFacilitating HIV DisclosureFac.docxpooleavelina
HEALTH POLICY AND ETHICS
Facilitating HIV Disclosure
Facilitating HIV Disclosure Across Diverse Settings: A Review
Carla Makhlouf Obermeyer, DSc, Parijat Baijal, MA, and Elisabetta Pegurri, MSc
HIV status disclosure is cen-
tral to debates about HIV be-
cause of its potential for HIV
prevention and its links to pri-
vacy and confidentiality as hu-
man-rights issues.
Our review of the HIV-dis-
closure literature found that
few people keep their status
completely secret; disclosure
tends to be iterative and to be
higher in high-income coun-
tries; gender shapes disclosure
motivations and reactions; in-
voluntary disclosure and low
levels of partner disclosure
highlight the difficulties faced
by health workers; the mean-
ing and process of disclosure
differ across settings; stigmati-
zation increases fears of disclo-
sure; and the ethical dilemmas
resulting from competing
values concerning confidenti-
ality influence the extent to
which disclosure can be facil-
itated.
Our results suggest that
structural changes, including
making more services avail-
able, could facilitate HIV dis-
closure as much as individual
approaches and counseling
do. (Am J Public Health. 2011;
101:1011–1023. doi:10.2105/
AJPH.2010.300102)
THE TOPIC OF HIV STATUS
disclosure is central to debates
about HIV, because of its links to
confidentiality and privacy as hu-
man-rights issues and its potential
role in prevention.1 Disclosure is
also considered a way to ‘‘open up’’
the HIV epidemic2 and hence is
a crucial step toward ending stigma
and discrimination against people
living with HIV and AIDS
(PLWHA). Recognizing its impor-
tance, a number of researchers
have reviewed the literature on
disclosure by women,3 by men,4 or
by parents to children.5 Others
have reviewed what is known
about the factors associated with
disclosure, including the connec-
tions among stigma, disclosure, and
social support for PLWHA6; the
links among disclosure, personal
identity, and relationships7; and
client and provider experiences
with HIV partner counseling and
referral.8 We sought to comple-
ment existing reviews by including
available information on low- and
middle-income countries, which are
poorly represented in all but 1 of
the extant literature reviews, and by
focusing on the role of health ser-
vices and health care providers in
HIV disclosure.
Recently, increased attention to
transmission within serodiscordant
couples has highlighted the po-
tential role of disclosure as a way
to encourage prevention.9 More-
over, as countries scale up HIV
testing, counseling, and treatment,
better evidence is needed to inform
laws and policies, particularly re-
garding how best to facilitate dis-
closure while protecting medical
confidentiality. Ongoing debates
about mandatory disclosure to
partners, health workers’ role in
disclosing without patients’ consent,
and the criminalization of HIV
transmission raise important ques-
tions about the place of disclosur ...
Estimating HIV prevalence and risk behaviors of transgender persons in the Un...Santé des trans
Cet article, paru en 2008 dans la revue AIDS and Behavior, présente une synthèse des données disponibles dans la littérature scientifique concernant la prévalence du VIH parmi les trans aux Etats-Unis et leurs facteurs de risque comportementaux par rapport à la transmission du virus.
CLINICAL SCHOLARSHIPHealth Education Needs of Incarcerated.docxbartholomeocoombs
CLINICAL SCHOLARSHIP
Health Education Needs of Incarcerated Women
Shirley Dinkel, PhD, APRN, BC1 & Katie Schmidt, BSN, RN2
1 Associate Professor, School of Nursing, Washburn University, Topeka, KS, USA
2 Director of Nursing, Topeka Corrections Facility, Topeka, KS, USA
Key words
Incarcerated women, health education, prison
nursing, naturalistic design, qualitative nursing
Correspondence
Dr. Shirley Dinkel, School of Nursing, Washburn
University, 1700 SW College Ave., Topeka, KS
66611. E-mail: [email protected]
Accepted: February 3, 2014
doi: 10.1111/jnu.12079
Abstract
Purpose: This study identifies the healthcare education needs of incarcerated
women in a state corrections facility.
Methods: This was a naturalistic qualitative study. Focus groups included two
groups of adult women incarcerated in a state corrections facility. One group
consisted of women housed in maximum security, and one group consisted
of women housed in medium security. Data were analyzed using a constant
comparison approach.
Findings: Three guiding questions provided the foundation for the identified
themes. Themes included six healthcare education topics important to incar-
cerated women and three related to health education strategies best suited for
incarcerated women.
Conclusions: Trust, respect and empowerment are key concepts in educating
incarcerated women about their personal health and health of their families.
Clinical Relevance: With over 200,000 women incarcerated in the United
States today, creating policies and practices that focus on the healthcare edu-
cation needs of women that are woman focused may enhance knowledge and
skills and may ultimately lead to reduced recidivism.
Over 200,000 women are currently imprisoned in the
United States, a number that has grown more than 800%
over the past three decades (Institute on Women & Crim-
inal Justice, 2009). Because the majority of prisoners are
male, prison programs often focus on issues faced by male
prisoners and overlook those faced by female prisoners
(Bissonnette, n.d; Stolnik, 2011). As the population of in-
carcerated females continues to increase at a rate nearly
twice that of males (Stolnik, 2011), health-related pro-
grams, educational opportunities, and initiatives focus-
ing on the specific needs of female inmates are becoming
more and more essential.
Incarcerated women often have a history of sub-
stance abuse; physical, sexual, and emotional trauma
(Bissonnette, n.d.); and limited access to healthcare ser-
vices (Palmer, 2007). The World Health Organization
has identified this trend globally, as research conducted
in the United Kingdom (Palmer, 2007) revealed simi-
lar conclusions. Because of intense, pre-incarceration liv-
ing situations, women often neglect their health while at
liberty. When they enter prison, they make great de-
mands on corrections health services (Yeager, 2012).
The limited research conducted on incarcerated females
throughout the United States consistently id.
Transgender Health : Findings From Two Needs Assessment Studies In PhiladelphiaSanté des trans
Transgender Health: Findings from Two Needs Assessment Studies in Philadelphia.
Il s'agit d'un article de Gretchen P. Kenagy, paru dans la revue Health and Social Work (volume: 30. Issue: 1) en 2005.
Il présente les résultats de deux enquêtes de recueil des besoins des trans en matière de santé à Philadelphie.
Il s'agit d'une présentation powerpoint de la Directrice du Center Of Excellence For Transgender HIV Prevention,UCSF (2009)
Il y est question d'épidémiologie, bien évidemment, dans un contexte où n'existe aux Etats-Unis (comme en France) aucune donnée nationale sur le nombre de personnes trans, et donc encore moins sur le nombre de trans vivant avec le VIH. La présentation donne des pistes de recommandation concernant la production de données épidémiologiques spécifiques.
La présentation est également l'occasion de passer en revue les enjeux et déterminants de santé liés à l'épidémie de VIH chez les trans, et plus largement à leur état de santé.
Objectifs de l'épidémiologie du VIH chez les personnes trans :
- comprendre les tendances épidémiologiques en cours dans les populations transgenres ;
- comprendre les facteurs favorisant le risque de dissémination du VIH parmi les femmes transgenres
(déterminants négatifs) ;
- comprend les facteurs protecteurs contre les "facteurs négatifs du point de vue de la santé" (negative health outcomes) parmi les transgenres (déterminants positifs).
HIV Prevention And Health Service Needs Of The Transgender Community In San F...Santé des trans
HIV Prevention and Health Service Needs of the Transgender Community in San Francisco by Kristen Clements, MPH, Willy Wilkinson, Kerrily Kitano, Rani Marx.
Il s'agit de l'un des articles parus dans le numéro spécial de l'International Journal of Transgenderism consacré en 1999 à "Transgenders and HIV : risks, prevention and care" (référence : IJT Volume 3, Number 1+2, January - June 1999).
EXPLORING U.S. MINORITY ATTITUDES TOWARDS CLINICAL TRIALSCOUCH Health
Patient diversity is still a huge issue in clinical trials. And like us, you might be wondering why this is still an ongoing challenge, and how can it be improved?
This report summarises research from ethnic minority groups in the US to find the answers to those very questions.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
Normal Labour/ Stages of Labour/ Mechanism of Labour
Branch vital-multicultural journal-done
1. NATIONAL FORUM OF MULTICULTURAL ISSUES JOURNAL
VOLUME 6, NUMBER 1, 2009
Condom Use Knowledge and Condom Use among African-
American Women: Evidence from a Cross-Sectional Study in
Harris County, Texas
Angela Branch-Vital, PhD
Assistant Professor
Department of Health
Whitlowe R. Green College of education
Prairie View A&M University
Prairie View, TX
Maria Fernandez, PhD
Micheal Ross, PhD, MPH, DrMedSc
Wenyaw Chan, PhD
Professors
School of Public Health
University of Texas Health Science Center
Harris County, TX
Willie Smith, MED
Instructor
University of Louisville
Louisville, KY
_______________________________________________________________________
ABSTRACT
The aim of this study was to determine the association between self-reported
condom use knowledge and condom use at last intercourse among African-
American women (≥ 18 years of age) in Harris County, Texas. The Condom Use
Assessment Questionnaire was administered to 297 African-American women in
Harris County, Texas, from August-November 2007. Chi-square and T-test statistics
were conducted to assess the difference between condom users and non condom
users. It was determined that there was no significant difference between condom
use knowledge and condom use (p=0.27). Based on the findings of this study, it is
important to further understand other risk factors (i.e. substance abuse, lack of
awareness of HIV serostatus, sexually transmitted diseases, socioeconomic issues
2. and homophobia and concealment of homosexual behavior) that influence condom
use in the African-American community in order to design effective interventions to
promote safer sex, and thereby, reduce the rate of HIV in this group.
_______________________________________________________________________
_
Introduction
Human Immunodeficiency Virus (HIV) infection continues to disproportionately
affect African-American communities. An estimated 1.7 million people in the United
States have been diagnosed with HIV, with approximately 40,000 new infections
occurring each year (CDC, 2007). While African-Americans represented only 13% of the
population in the United States in 2005, they represented 54% of the United States HIV
cases (CDC, 2008). In 2005, 23,472 adults lived with HIV in Texas (Texas Department
of State Health Services (TDHS, 2007). In Texas, African-Americans shared a greater
burden of HIV than members of any other racial/ethnic groups. While African-Americans
comprised only 11.7% of the population in Texas in 2008, they represented 41% of Texas
HIV cases. African-American females accounted for 60% of HIV cases in Texas (TDHS,
2007).
In 2008, Harris County, one of the largest counties in Texas, had a population of
approximately 3,984, 349 with Houston as its urban center (U.S. Census Bureau, 2007).
Between January 1999 and September 2006, there were approximately 13,382
persons living with HIV in Harris County (Houston Department of Health and Human
Services [HDHHS], 2008). The majority of these HIV cases were among African-
Americans (54%), followed by Caucasians (25%), Hispanics (20%) and others (1%).
Among the female cases, the majority were African-Americans (74% of the female HIV
cases in Harris County) in the 20-29 age groups (36%). The primary mode of
transmission among African-American females was unprotected heterosexual contact
(HDHHS, 2008).
Several studies have examined whether condom use knowledge and condom use
is an important predictor of condom use. For example, Lazarus, Himedan, Ostergaard &
Liljiatand (2006) explored knowledge with regards to HIV/AIDS and condom use among
192 Somali and Sudanese men and women immigrants in Denmark, aged 18-49, who
lived in Denmark for one or more years. The participants completed a 78-item
questionnaire. It was reported that less than 50% of both men and women scored more
than 70% on the knowledge portion of the questionnaire. It was concluded that in the
two Danish immigrant groups, condom use knowledge level and condom use were low.
Women with poor educational level were reported to have low knowledge of condom use
and low use of condoms compared to those women with a higher educational level
(Lazarus, Himedan, Ostergaard & Liljiatand, 2006). Another study conducted by
Holmes, Ogungbade, Ward, Ross, Ekong & Essien (2008) that focused on baseline data
from the Situationally Focused Individual HIV/AIDS intervention to promote HIV
protective behavior among 2,213 Nigerian Military Personnel were analyzed. Using
composite score of the six steps for the knowledge of condom use and modeling as the
outcome variable, they examined educational status as a predictor variable, modeling
3. with unconditional univariable and multivariable logistic regression. This study reported
low knowledge of condom use and modeling among the Nigerian military personnel; as
well as a direct correlation between education attainment and knowledge of condom use
and modeling (Holmes, Ogungbade, Ward, Ross, Ekong & Essien, 2008).
In this study, results are presented from a self-administered questionnaire that
targets a large sample of African-American women and assesses self-reported condom
use. Our objective in this study was to determine if there was an association between
condom use knowledge and self-reported condom use based on age, educational level,
marital status and religious affiliation among African-American women (≥ 18 years of
age) in Harris County, Texas. Promoting condom use has been a major goal of programs
designed to prevent HIV infection (CDC, 2008). Recent studies have provided a great
deal of information regarding condom use, but nearly all of these studies have been
limited. They were restricted to a narrow age range or they had relatively small samples.
Methods
Participants
A convenience sample of 342 eligible women were asked to participate in the
study; 45 eligible women declined to participant in the study due to time constraints.
Two hundred and ninety-seven African-American women (≥ 18 years of age) in Harris
County, Texas participated in the study. Participants were recruited from a community
center and a local health fair in Harris County, Texas from August-November 2007.
These sites were selected based on the availability of the population; the time frame in
which the study was conducted; and the large numbers of African-American women
participating and or involved in the public congregations (churches, civic clubs, social
clubs, community centers, health fairs and job fairs) in Harris County, Texas.
Eligibility was based on whether the women were: 1) African-American; 2) 18
years of age or older; 3) residents of Harris County; and 4) able to understand and
complete the questionnaire in English.
Recruitment Procedures
All procedures and the questionnaire were reviewed and approved by the
Committee for the Protection of Human Subjects (CPHS), the Institutional Review Board
(IRB) for the University of Texas Health Science Center at Houston (UTHSC-H).
Recruitment commenced in August 2007 and concluded in November 2007. Letters
summarizing the purpose of the study were mailed to the directors of the James Prince
Community Center and Sharpstown Health Fair for dissemination to members and guests.
The letters sought permission for the study to be conducted at those locations. Once
permission was granted, the directors of the community center and health fair scheduled
appointments for the researchers to be introduced to the target population. The directors
of the community center and health fair described the study to the target population and
introduced the researchers. The researchers explained the purpose, the risks and benefits
of the study. Participants were advised that they could refuse to answer any questions
and participation would be both voluntary and anonymous. All participants signed a
consent form and were given the questionnaire. The participants were instructed to
4. deposit the completed questionnaire in a sealed box located by the exit doors of the
community center and the health fair. Completion of the questionnaire took
approximately thirty-five minutes.
Measurements
Condom Use. Condom use was measured with one variable, condom use at last
intercourse with any sexual partner (Norris Phillips, Statton, Pearson, 2005; Williams,
Bowen, Timpson, McCoy, Perkins et al, 2001). The question was as follow: “Was a
condom used the last time you had sexual intercourse?” (Yes/No). This measure was
chosen because it requires relatively one question and is easier to answer accurately as
compared to other measures that include questions that require respondents to estimate
their frequency of condom use during some specified time interval (Prata, Morris,
Mazive, Vahidnia & Stehr, 2006). Another study conducted by Meekers & Rossem
(2005) also used a similar condom use question.
Condom Use Knowledge. Knowledge of how to use condoms with the Condom
Use Knowledge Scale was measured with 17 items with a Cronbach α = 0.73 (Lindberg,
1993). The original Condom Use Knowledge Scale consisted of 19 multiple-choice items
with internal consistency (Cronbach α = 0.66). In this study, we revised the scale by
removing two questions based on feedback from the focus group and two behavioral HIV
experts. Each question had four possible answers. The correct answer was worth one
point and an incorrect answer received no points. Test scores could range from zero
(lowest) to 17 (highest). The number of correct answers was summed (range: 0–17), with
17 being the maximum (highest) knowledge of condom use score.
Demographics. We used seven variables to categorize participants’ age, gender,
racial/ethnic background, educational level, marital status, location and religious
affiliation.
Analysis
Frequency analyses were conducted on the outcome variable (condom use) and on
all categorical demographic variables. Means, standard deviations, and ranges for all
continuous demographic variables and condom-use knowledge scores were calculated.
Two-sample t-test and chi square statistics were used to assess the difference in the mean
scores in condom use knowledge among participants who used condoms and participants
who do not use condoms. All tests were considered to be statistically significant if
p<0.05. All analyses were performed by STATA statistical software package (version 9).
Results
Descriptive Analyses
Table 1 provides an overview of the demographic characteristics of the
participants in this study. The participants in the study were diverse in age, educational
level, religious affiliation and marital status. Majority of the participants in the study
were between the ages of 18-29 years and had a post-high school education. Also, the
majority of the participants self-reported as being single (65%) and declared themselves
to be affiliated with the Protestant (Baptist) faith (55%).
5. Table 1. Demographic characteristics of participants
Variables N=297
Educational Level
Did not complete high school 55(19%)
Completed high school/G.E.D. 63(21%)
Attended college but not completed / completed associate college degree 115(39%)
Completed college / attended or completed graduate school
64(21%)
Age Group
18-29 130(44%)
30-39 63(22%)
40+ 104(34%)
Marital status
Single 194(65%)
Married 71(24%)
Divorced/Widowed 31(11%)
Religious affiliation
Baptist 163(55%)
Methodist 20(7%)
Catholic 63(21%)
Other 43(14%)
None 8(3%)
Abbreviation:
%= percentage
Table 2 depicts the demographics of self-reported condom use at last intercourse.
Forty-three percent (43%) of women reported condom use at last intercourse.
Participants who self-reported condom use during their last sexual intercourse were more
likely to be single, have a Baptist affiliation, and have had some college-level education.
All demographic characteristics were statistically associated with condom use knowledge
(p<0.001).
Table 2. Demographics of self-reported condom use across condom use knowledge score
(N=276)
6. Condom use TP
n=119 (43%)
Non-condom use TP
n=157(57%)
P-value
Educational level
< high school 33(28%) 16(10%) <.0001
Completed H.S./G.E.D. 24 (20%) 35(22%)
Some college / completed
associate college degree
38(32% ) 71(45%)
Completed college or higher 24(20%) 35(22% )
Age Group
18-29 69(58% ) 53(34%) <.0001
30-39 18(15%) 41(26%)
40+ 32(27% ) 63(40%)
Marital status
Single 87(73%) 91(58%) <.0001
Married 15(13%) 56(36% )
Divorced/Widowed 16(13%) 10(6%)
Religious affiliation
Baptist 69(58%) 84(54%) <.0001
Methodist 3(3%) 17(11%)
Catholic 20(17%) 41(26%)
Other 24(20%) 11(7%)
None 3(3%) 4(3%)
Abbreviations:
TP= Total Population
%=Percentage
H.S= high school
Condom Use Knowledge and Condom Use. From the results of the two-sample t-
test, the mean Condom Use Knowledge score for participants who used condoms was
10.5 (SD=2.97) and participants who did not use condoms were 10.1 (SD=3.84), there
was no significant differences in condom use knowledge between participants who used
condoms and participants who did not use condoms (p=0.27).
The majority of the women in the sample knew that K-Y jelly or other water-
soluble lubricant was safe to use to lubricate a condom. In addition, non-condom users
answered more questions correct as compared to condom users. Regardless of condom
use, few women demonstrated an understanding of methods and techniques used to
7. enhance sexual pleasure for their partner while using a condom or the proper actions to
take if the condom breaks during sexual intercourse.
Chi-square statistic was performed on each item of the Condom Use Knowledge
Scale to distinguish condom users and non-condom users. It was determined that nearly
half of the items (items # 1, 3, 4, 8, 10, 14, 15 and 17) were able to distinguish condom
users and non-condom users when assessed independently. A detailed overview is
provided in Table 3.
Table 3.Percentage of participants correct responses -Condom Use Knowledge (N=275)
Condom Use
n=118
Non-
condom use
n=157
Questions Count Count X2
P
1 .When is the correct time to put a condom on your
partner?
94 (47%) 108 (53%) 4.08
p=0.04
2. What is the correct way to apply a condom? 76 (41%) 111 (59%) 1.22
p= 0.27
3. What is safe to use to lubricate (wet) a condom? 102 (46%) 119 (54%) 4.84
p= 0.03
4. Which should you do to decrease the chance of a condom
breaking?
92 (47%) 104 (53%) 4.52
p= 0.03
5. What is the best type of condom to use for protection
from HIV/AIDS and other Sexually Transmitted
Diseases/Venereal Diseases (STDS/VDS)?
84(42%) 117 (58%) 0.61
p= 0.44
6. Which of the following is important to do when putting
on a condom?
72(47%) 82 (53%) 1.86
p=0.17
7. When using condoms, what is important to do after
giving a man oral sex but before having vaginal sex?
77(40%) 114 (60%) 2.42
p= 0.12
8. What is important to do if a man loses his erection (get
soft) during intercourse?
87(48%) 94 (52%) 5.32
p= 0.02
9. What will enhance sexual pleasure for the man while
using a condom?
34(49%) 36 (51%) 1.12
p= 0.29
10. What should you do to make sure the condom is
protecting you before the man ejaculates (comes/cum)?
76 (48%) 81 (52%) 4.54
p=0.03
11. What is important to do after the man comes/cum
(ejaculates)?
74 (42%) 101 (58%) 0.16
p=0.69
8. 12. When are condoms most likely to come off the penis
during sex?
55 (39%) 87 (61%) 3.34
p=0.19
13. What is not true about buying, using and storing
condoms?
75 (42%) 102 (58%) 0.13
0.72
14. What is a reason for using a lubricant with a condom? 92 (48%) 100 (52%) 6.04
p=0.01
15. To protect you against HIV/AIDS, what is the best thing
to do if the condom breaks?
28 (34%) 55 (66%) 4.34
p=0.04
16. How do you dispose of condoms? 45 (40%) 68 (60%) 0.16
p=0.69
17. What should you do if you attempt to put a condom on
backwards or inside out?
96 (48%) 103 (52%) 7.84
p= 0.05
Discussion
The aim of this study was to evaluate the association between condom use
knowledge and condom use behavior. Our study contrasts with the studies of several
researchers (Holmes, Ogungbade, Ward, Ross, Ekong & Essien, 2008; Lazarus,
Himedan, Ostergaard & Liljiatand, 2006; Weller & Davis, 2002), who reported a
significant association, but corroborates with other studies of researchers (Rock, Resnickl
& McNeely, 2005; Zellner, 2003), who have reported no significant association between
condom use knowledge and condom use.
Level of condom use in this study was consistent with previous studies with
African-Americans, which reflected low rates of condom use (Holmes, Ogungbade,
Ward, Ross, Ekong & Essien, 2008; Prata, Morris, Mazine, Valideria, & Stehr, 2006).
Specifically, this study documented 43% of the women who reported condom use at last
intercourse. The researchers in this study reported lower use of condoms among
divorced /widowed and married women. Given the disproportionate cases of HIV
among African-American women in Houston, Harris County, it is important to promote
consistent and correct condom use for both steady and casual sexual partners.
However, asking your sexual partner(s) to use a condom during sexual intercourse may
signal mistrust to the partner (Prata, Morris, Mazine, Valideria, & Stehr, 2006).
Addressing this issue requires condom use knowledge education, counseling, and skill-
based interventions to encourage condom use for those engaging in risky sexual
behaviors.
In addition, this study has used an array of questions to measure knowledge of
condoms, from participants general knowledge about condoms to their general
understanding of condoms use (e.g., when is the correct time to put a condom on your
9. partner, what is the correct way to apply a condom, what is safe to use to lubricate (wet) a
condom, what is important to do if a man loses his erection (get soft) during intercourse )
Our study, which modified Lindberg’s (1993) condom use knowledge survey is
generalizable to African-American women in Houston, Harris County aged 18 and older.
This study contributes to the literature on condom use and prevention of HIV by
examining the participants’ condom use knowledge level and their condom use.
The Condom Use Knowledge Scale was not able to distinguish condom users and
non-condom users, however when each item on The Condom Knowledge Scale was
assessed individually, nearly half of the items (8) were able to distinguish condom users
and non-condom users. It is possible that a scale could be created with the 8 items that
distinguished condom users and non-condom users. Developing the 8 items on the
Condom Use Knowledge Scale enables researchers to increase condom use by teaching
specifically about the 8 items with distinguished condom users and non-condom users.
Research demonstrates that by merely telling people to use condoms to prevent
the spread of HIV is not enough to change their behavior (CDC, 2007). Condom use is a
dyadic behavior: it involves two people and an agreement to use a condom. Thus,
looking at just one of the two partners and their characteristics is only half of the condom
use equation. Since the condom is worn by the male, it is likely that it is characteristic of
the male, rather than the female, are crucial ones to study in regard to condom use
There were a few limitations to the study. First, a temporal sequence of cause and
effect relationship between the independent and outcome variables could not be
established due to the use of a cross-sectional study design. The study collected data from
two geographic locations, which may limit the ability to generalize the study results.
However, this study selected sites that increased the likelihood of potential participants
being representative of various locations within Houston, Harris County, Texas by
selecting a community center and a health fair on days where outreach activities involved
inputs from all communities. In addition, we obtained the data for this study based on
participants self-reported condom use and condom use knowledge. Second, the use of a
non-probability (convenience) sample might have introduced the potential for selection
bias, limiting our ability to generalize to other settings, times and populations. A third
limitation was that the data for this study was obtained through a self-reported
questionnaire, which could lead to potential information bias. However, it was
established that self-reported condom use was the only way to determine condom use
(Geary, 2003). Fourth, having participants recall their last sexual intercourse and condom
use could lead to recall bias. However, assessing condom use at last intercourse requires
relatively few questions that are easier to answer accurately compared to other measures
that requires respondents to estimate their frequency of condom use during a specified
interval (Anderson, Rietmeijer & Wilson, 1998). Finally, another form of information
bias that could occur was prevarication (lying) bias, which occurs when participants have
ulterior motives for answering a question. If the collected information did not reflect the
participants’ true behavior, the study results would be inaccurate and invalid. To prevent
this type of bias, the questionnaire was self-administered and the researchers assured
participants that their responses would remain confidential.
Concluding Remarks
10. It is especially important to understand the factors that influence condom use in
the African-American community in order to design effective interventions to promote
safer sex and, as a result, reduce the rate of HIV within this group. Our findings
suggested that the participants’ condom use could depend on the participants’
demographic characteristics. Several studies (Lazarus, Himedan, Ostergaard &
Liljiatand, 2006; Prata, Morris, Mazine, Valideria, Stehr, 2006) have reported similar
results indicating that condom use could be related to participants’ educational level.
Although we have assessed demographic characteristics in this study, we did not examine
other factors, including substance abuse, lack of awareness of HIV serostatus, sexually
transmitted diseases, socioeconomic issues and homophobia and concealment of
homosexual behavior. These factors have been identified by CDC (2008) as risk
behaviors but previous studies have focused separately on these factors among African-
Americans and their condom use. There has not been a comprehensive study
addressing risk behaviors in the African-American community. Continued measurements
of condom use behaviors are needed in the African-American communities to increase
condom use in this community. Secondly, more research is needed to educate both men
and women regarding the risks and consequences of contracting HIV and other STDs
with non condom use. Finally, greater efforts must be made to target programs toward
African-Americans, both males and females.
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