Sexually transmitted infections among college students are a major public health concern and disproportionately impact minority students. The purpose of this study is to examine perceptions, expectations, and preferences for university-based interventions to increase condom negotiating skills among African American college women. One hundred women attending an urban minority institution participated in a qualitative study. A content data analysis allowed for emerging themes across the aggregated data collected from thirteen focus groups. Findings revealed several suggestions to reduce the stigma that cluster around three themes including condom distribution, sexual health education, and women-centered culturally competent health care. The burden of sexual and reproductive health challenges among young adults involves the need for effective prevention and interventions.

Aims: Racial/ethnic and cultural identity influences alcohol use consumption and help-seeking behaviors. The purpose of this systematic review was to assess alcohol prevention programs and interventions targeting African Americans/Blacks among the African Diaspora across the lifespan.Methods: According to PRISMA guidelines, literature searches were conducted via electronic databases, grey literature, and hand searches of relevant journal articles evaluating primary outcome data to reduce alcohol use. To be included in this systematic review, intervention and prevention studies required a population of more than 50% African descent and provided information about statistical significance ( p < .05) indicating changes in alcohol as a primary outcome.Results: Search strategy identified 5691 citations and the full-text of 148 studies were screened. A total of 23 articles met the inclusion criteria. Studies were geographically located in the United States and African countries. Interventions were implemented in community, patient-care, school, and workplace settings. Adult studies evaluated pharmacological and/or behavioral interventions while utilizing validated instruments and procedures to assess alcohol outcomes. Strategies to change alcohol behavior included psychotherapy, brief motivational interviewing (BMI), and counseling. Adolescent studies utilized family-based, computer-assisted technology, and career development interventions to reduce alcohol use.Conclusions: The systematic review identified a range of intervention articles addressing the reduction of alcohol use for African Americans/Blacks that may be used in various settings and by different age groups. Best practices and strategies designed to address socio-cultural factors by promoting protective and risk-reducing factors of alcohol use and successful alcohol interventions are needed.

Women and racial/ethnic minority groups in the U.S. report poor sleep health. While stress and alcohol use may contribute to sleep problems, few studies have examined the roles of stress and alcohol use on sleep among Black college women. Gender-racial ideology of Black womanhood may also play a role in sleep. This exploratory study sought to examine the relationships between stress, alcohol, ethnic-gender identity, and sleep. Guided by the biopsychosocial model and intersectionality theory, a cross-sectional study design recruited undergraduate women (18–24 years) attending a Historically Black College and University (HBCU) who self-identified as Black (N = 110). Participants completed the Insomnia Severity Index, Pittsburgh Sleep Quality Index, Perceived Stress Scale, Alcohol Use Disorders Test, and Giscombe Superwoman Schema Questionnaire. Univariate and multiple linear regressions were conducted to examine independent and multiple effects of stress, alcohol, and ethnic-gender identity on insomnia and sleep quality. Participants (mean age 19.4 years) represented diverse ethnic groups, 53% American, 25% African, and 20% Caribbean. Nearly 23% reported moderate to severe levels of insomnia. Scores from the Perceived Stress Scale, the Alcohol Use Disorders Test, and the Giscombe Superwoman Schema Questionnaire were independently associated with insomnia and sleep quality. In multivariate analyses, only perceived stress exhibited a significant association with insomnia and sleep quality. This exploratory study demonstrated that stress, excessive alcohol use, and ethnic-gender identity have relational impact on sleep health. Yet, stress may have greater importance and further research is needed to explore factors that mediated the relationship between stress and sleep.

BACKGROUND:Young African American women are disproportionately affected with sexually transmitted infections (STIs) and unintentional pregnancies. Despite adequate knowledge, assertiveness, and negotiation skills, consistent condom use remains low.AIMS:We sought to assess the role of pregnancy and STI risk perception in condom decision making among African American women.METHOD:We conducted a phenomenological qualitative study. Utilizing a purposive sampling strategy, 100 African American women (18-24 years) were recruited from a historically Black college and university for an open discussion of condom use. Thirteen focus groups were conducted via a semistructured interview guide and analyzed with an inductive thematic approach.RESULTS:Uniformly women perceived pregnancy as a greater threat than STIs which appears to be maintained by (a) their sense of fertility, (b) self-care concept, and (c) experiences with condom failure. Thus, women were skeptical about using condoms as a form of contraception. Women perceived casual sex as having the greatest HIV/STI risk and emphasized the importance of assertiveness and self-respect to negotiate condom use. However, condom use in monogamous relationships is less likely due to (a) testing/knowing partner's status, (b) relationship trust, and (c) the use of hormonal contraception for pregnancy prevention. Perceived threat of infidelity increases condom use.CONCLUSION:The implications of these findings suggest sexual health promotion programs may focus on improving women's estimate of the effectiveness of condoms to prevent pregnancy and addressing women's reliance on testing for STI prevention.

Family interactions play a central role in creating relationships. The dynamic roles of intersectionality and biopsychosocial factors including culture, race, gender and environments stimulate the synergistic effects of relationships. Sociocultural contexts provide meaning to individual lives. The mechanisms within a family dynamic impact the formation of life decisions and overall health, spiritual and mental well-being. The purpose of this chapter is to explain and expand on how many African American women and LGBTQ couples create and interpret family dynamics and romantic relationships; specifically investigating the influential impact of kinship support, the role of the sandwich generation and the occupation of the Black woman as a primary caregiver.

This study utilized quantitative and qualitative methods to (1) investigate the relationship between frequency of condom use and negotiation strategies and (2) evaluate experiences with condom negotiations among sexually active, heterosexual, African American college women. One hundred female students from a Historically Black Colleges and Universities (HBCU) completed a questionnaire that included the Condom Influence Strategies Scale (CIS) and participated in a focus group. An ANOVA was conducted to compare differences between never, inconsistent, and consistent condom users. Consistent condom users scored higher than never users on the "withholding sex" subscale of the CIS (4.88 vs. 3.55; p < 0.001) as well as endorsed items more strongly on the "direct request" subscale of the CIS (4.63 vs. 3.82, p < 0.05) than never users. A thematic analysis of open discussions identified overarching themes. Similarly, refusing sex and/or having direct communications with partner emerged as primary strategies. Threats to negotiation included deciding the "right timing" of discussion and having a previous history of sexual intercourse without a condom with their partner. Other key concepts that contribute to condom negotiation are the views that condoms are a male's responsibility and stigma of women who carry condoms.

BACKGROUND:Substance-related disorders are a growing problem in the United States. The patient-provider setting can serve as a crucial environment to detect and prevent at-risk substance use. Screening, brief intervention, and referral to treatment (SBIRT) is an integrated approach to deliver early intervention and treatment services for persons who have or are at risk for substance-related disorders. SBIRT training components can include online modules, in-person instruction, practical experience, and clinical skills assessment. This paper will evaluate the impact of multiple modes of training on acquisition of SBIRT skills as observed in a clinical skills assessment.METHODS:Residents were part of an SBIRT training program, from 2009 through 2013, consisting of lecture, role-play, online modules, patient encounters, and clinical skills assessment (CSA). Differences were assessed across satisfactory and unsatisfactory CSA performance.RESULTS:Seventy percent of the residents satisfactorily completed CSA. Demographics, type of components completed, and number of components completed were similar among residents who demonstrated satisfactory clinical skills compared with those who did not. All components of the training program were accepted equally across specialties and resident matriculation cohorts.CONCLUSION:The authors conclude that the components employed in SBIRT training do not have to be numerous or of a particular mode of training in order to see observable demonstration of SBIRT skills among medical residents. Thus, residency educators who have limited time or resources may utilize as few as 1 mode of training to effectually disseminate SBIRT skills among health care providers. As SBIRT continues to evolve as a promising tool to address at-risk substance-related disorders, it is critical to train medical residents and other health professionals.

OBJECTIVES:The purpose of this study was to elucidate changes in attitudes, experiences, readiness, and confidence levels of medical residents to perform screening, brief intervention, and referral to treatment (SBIRT) and factors that moderate these changes.METHODS:A cohort of 121 medical residents received an educational intervention. Self-reported experience, readiness, attitude, and confidence toward SBIRT-related skills were measured at baseline and at follow-up. Analyses were conducted to evaluate the effects of medical specialization.RESULTS:The intervention significantly increased experience (P<.001), attitude (P<.05), readiness (P<.001), and confidence (P<.001). Residents were more likely to report that their involvement influenced patients' substance use. However, experience applying SBIRT skills varied by country of birth, specialty, and baseline scores.CONCLUSIONS:This study suggested that SBIRT training was an effective educational tool that increased residents' sense of responsibility. However, application of skills might differ by specialization and other variables. Future studies are needed to explore and evaluate SBIRT knowledge obtained, within the context of cultural awareness and clinical skills.

The success of implementing a screening, brief intervention and referral to treatment (SBIRT) program within a medical residency program for sustainability is contingent upon a well-crafted training curriculum that incorporates substance abuse education and clinical practice skills. The goal of the Howard University (HU) SBIRT program is to train residents in providing culturally competent evidence-based screening, brief intervention and referral to treatment for patients who have a substance use disorder or who are at risk for developing the disorder. Utilizing the Office of Graduate Medical Education (GME) allows all residents to be trained in SBIRT techniques and receive continuing education in SBIRT and SBIRT-related topics through new resident orientation and the core lecture series. The utilization of Graduate Medical Education office has allowed a robust SBIRT training program to be implemented into medical residency education, contributing to the sustainability of SBIRT as a component of patient care.

Objectives. The purpose of this study was to elucidate changes in attitudes, experiences, readiness, and confidence levels of medical residents to perform screening, brief intervention, and referral to treatment (SBIRT) and factors that moderate these changes. Methods. A cohort of 121 medical residents received an educational intervention. Self-reported experience, readiness, attitude, and confidence toward SBIRT-related skills were measured at baseline and at follow-up. Analyses were conducted to evaluate the effects of medical specialization. Results. The intervention significantly increased experience (P< .001), attitude (P < .05), readiness (P< .001), and confidence (P < .001). Residents were more likely to report that their involvement influenced patients’ substance use. However, experience applying SBIRT skills varied by country of birth, specialty, and baseline scores. Conclusions. This study suggested that SBIRT training was an effective educational tool that increased residents’ sense of responsibility. However, application of skills might differ by specialization and other variables. Future studies are needed to explore and evaluate SBIRT knowledge obtained, within the context of cultural awareness and clinical skills. (Am J Public Health. 2012; 102:e30‐e36. doi:10.2105/AJPH.2012.300802)

summary The aim of this study was to assess the hypothesis that blood donation rates vary with Hispanic ethnicity (family origin in Spanish‐speaking countries) in addition to race in the United States. Lower blood donation rates have been reported among African Americans (AAs) compared with non‐Hispanic European Americans (EAs). Adequate published reports on donation rates are not available for Hispanic Americans (HAs). Using data from a 2002 national survey, which included 4923 men and 7600 women aged 15–44 years with complete data, we tested the hypothesis using weighted bivariate and multivariate statistics. Among men aged 25–44 years, the percentage [95% confidence limits (95% CL)] with a history of blood donation since 1985 was similar at ages 25–34 years (46%, 42–49) and 35–44 years (41%, 37–45). It was highest in non‐Hispanic EA (49%, 45–52%), intermediate in AA (35%, 30–40%) and lowest in HA (30%, 25–36%) (P < 0·001). Other variables significantly (P < 0·01) associated with history of blood donation in bivariate analyses were nativity (United States/other), education (<12/≥12 years), poverty (<200%/≥200% poverty limit) and married (yes/no). Variables that are not significantly associated were age, metropolitan residence (yes/no), receipt of public assistance (yes/no), current labour‐force participation (yes/no) and religion raised. Compared with non‐Hispanic EA, the adjusted odds ratios were essentially the same for Hispanics 0·66 (95% CL 0·47–0·92) and AAs 0·64 (95% CL 0·49–0·84). Only 34% of women had donated blood, but the association with race/ethnicity was similar. Similar patterns were also seen at ages 15–24 years. HAs and AAs have similar low blood donation rates compared with non‐Hispanic EAs. The difference is not explained by sociodemographic variables.