We aimed to determine in a randomized trial if young adult black, Hispanic, and white men-who-have-sex-with-men (YMSM) are more likely to complete home-based oral fluid rapid HIV self-testing than either mail-in blood sample collection or medical facility/community organization-based HIV testing. Stratified by race/ethnicity, participants were randomly assigned to use a free oral fluid rapid HIV self-test (n = 142), a free mail-in blood sample collection HIV test (n = 142), or be tested at a medical facility/community organization of their choice (n = 141). Of the 425 participants, completion of assigned test (66% oral fluid vs. 40% mail-in blood sample vs. 56% medical facility/community), willingness to refer (36% oral fluid vs. 20% mail-in blood sample vs. 26% medical facility/community), and legitimate referrals (58% oral fluid vs. 43% mail-in blood sample vs. 43% medical facility/community) were greater in the oral fluid rapid HIV self-test than the mail-in blood sample collection HIV test arm, but not the medical facility/community testing arm. There were no differences in assigned test completion by race/ethnicity. Although free home-based oral fluid rapid HIV self-testing showed moderate promise in facilitating HIV testing among black, Hispanic, and white YMSM, it did not lead to greater testing than directing these YMSM to medical facility/community HIV testing venues. ClinicalTrials.gov Identifier: NCT02369627.

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Objective: To describe the modification and validation of an existing instrument, the Environment and Policy Assessment and Observation (EPAO), to better capture provider feeding practices. Design: Modifications to the EPAO were made, validity assessed through expert review, pilot tested and then used to collect follow-up data during a two-day home visit from an ongoing cluster-randomized trial. Exploratory factor analysis investigated the underlying factor structure of the feeding practices. To test predictive validity of the factors, multi-level mixed models examined associations between factors and child’s diet quality as captured by the Healthy Eating Index (HEI) score (measured via the Dietary Observation in Childcare Protocol). Setting: Family child care homes (FCCH) in Rhode Island and North Carolina. Subjects: The modified EPAO was pilot tested with 53 FCCH and then used to collect data in 133 FCCH. Results: “The final 3-factor solution captured 43% of total variance: coercive control and indulgent feeding practices, autonomy supportive practices, and negative role modeling. In multi-level mixed models adjusted for covariates, autonomy supportive practices was positively associated with children’s diet quality. A 1-unit increase in the use of autonomy supportive practices was associated with a 9.4 unit increase in child HEI score (p=0.001). Conclusions: Similar to the parenting literature, constructs which describe coercive controlling practices and those which describe autonomy supportive practices emerged. Given that diets of preschoolers in the US remain suboptimal, teaching childcare providers about supportive feeding practices may help improve children’s diet quality.

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