The results indicate that information technology has a promising role in alleviating distress and depression among groups of AD caregivers. The data also demonstrate that interventions have differential impacts according to ethnic group and the caregiver-patient relationship.
This study tests the efficacy of Structural Ecosystems Therapy (SET), a family-ecological intervention, in improving psychosocial functioning when compared with an attention-comparison person-centered condition and a community control condition. A sample of 209 HIV-seropositive, urban, low-income, African American women was randomized into 1 of the 3 conditions. Results of growth curve analyses over 5 time points revealed that SET was more efficacious than either of the control conditions in reducing psychological distress and family-related hassles. However, contrary to hypotheses, SET was not more efficacious in increasing family support. Latent growth mixture modeling analyses indicated that SET was most efficacious for women who, on average, were at or near the clinical threshold for psychological distress and for women with high levels of family hassles. Implications for further intervention development are discussed.
Recruitment is one of the most significant challenges in conducting research with ethnic minority populations. Establishing relationships with organizations that serve ethnic minority communities can facilitate recruitment. To create a successful recruitment process, a strategic plan of action is necessary prior to implementing community outreach efforts. For this study population of women who were HIV+ and recovering from substance abuse disorder, the authors found that establishing trust with community organizations that serve these women allows for a productive referral relationship. Although the majority of women in this study are African American, the authors were particularly challenged in recruiting Hispanic women. This article presents a recruitment process model that has facilitated our recruitment efforts and has helped the authors to organize, document, and evaluate their community outreach strategies. This model can be adopted and adapted by nurses and other health researchers to enhance engagement of minority populations. Keywords recruitment; minorities; community; engagement; outreach Despite recent efforts by the National Institutes of Health (NIH) to promote research that includes women and minorities (U.S. Department of Health and Human Services [USDHHS], 2003), there is a risk of continued underrepresentation of minority group members and women in health research because of barriers to research participation. Although special recruitment efforts are clearly needed to overcome these barriers (Atkinson & Flint, 2001;Brown, Fouad, Basen-Engquist, & Tortolero-Luna, 2000;Escobar-Chaves, Tortolero, Mâsse, Watson, & Fulton, 2002;Gilliss et al., 2001;Marquez, Muhs, Tosomeen, Riggs, & Melton, 2003), few reports have proposed working with community organizations and leaders explicitly for this purpose. Many of those who suggest working with such contacts have not described the process of establishing relationships between researchers and the community. We have used our experiences in attempting to recruit a culturally representative sample of women who were HIV+ for a behavioral study on HIV medication adherence and substance abuse recovery to NIH Public Access HIV/AIDS and Substance Abuse DisparitiesEthnic minority groups have been found to be at an increased risk for sexually transmitted diseases and substance abuse. Specifically, HIV/AIDS with co-occurring substance abuse disorders are devastating health problems that disproportionately affect minority populations (aCenters for Disease Control and Prevention [CDC], 2005a[CDC], , 2005cHessol et al., 2001 1997;Warren-Findlow, Prohaska, & Freedman, 2003). Difficulties in Engaging Minority WomenRecruiting ethnic minorities to participate in clinical research is more challenging and costly than recruiting participants from the ethnic majority (Escobar-Chaves et al., 2002;Levkoff & Sanchez, 2003;Marquez et al., 2003;Shavers-Hornaday & Lynch, 1997). African Americans are often distrustful of medical researchers for many reasons, including the his...
Hispanic women in the United States are disproportionately affected by HIV infection. Substance abuse and intimate partner violence (IPV) are conditions that have been associated with risk for HIV in the general population. However, few studies have explored the intersection of these three conditions within one integrated framework. The purpose of this exploratory study was to describe the relationships between HIV risks, substance abuse, and IPV among Hispanic community-dwelling women. A total of 82 structured interviews were conducted with Hispanic women between the ages of 18 and 60. Data regarding the participant's and her partner's histories of sexually transmitted infections, substance abuse, risky sexual behaviors, and IPV were collected. Relationships between the participant's history of sexually transmitted infections, her partner's substance abuse, risky sexual behaviors, and IPV were explored. Results from this study support the importance of targeting HIV, substance abuse, and IPV prevention among Hispanics within one integrated framework.
lthough strong research traditions have existed in both the family process and family therapy domain (Alexander, Holtzworth-Munroe, & Jameson, A 1994) and in the culture and ethnicity domain (Guarnaccia, Canino, Rubio-Stepic, & Bravo, 1993;Marin & Marin, 1991), the promise of integrating the two with the goal of rigorously investigating how ethnicity-related dimensions influence core family and clinical processes has remained largely unrealized. Core processes in the family functioning and family therapy domains have been effectively articulated and made the targets of rigorous research (Liddle, 1995; Patterson, Reid, & Dishion, 1992;Schmidt, Liddle, & Dakof, 1996) Likewise, there is a substantial literature showing ethnicity-related differences in how symptoms develop, are expressed, are explained, and how and to whom people communicate their distress (Guarnaccia et al., 1993;McGoldrick, 1996;Rivera-Arzola & Ramos-Grenier, 1997;Szapocznik, Scopetta, & King, 1978). One of the important challenges for family intervention science is to integrate these two streams of research and rigorously investigate the intricate interplay between ethnicity, family functioning, and family intervention. As McGoldrick has stated, "there is burgeoning evidence that ethnic values and identifications are retained for many generations after immigration and play a significant role in family life throughout the life cycle. Second-, third-, and even fourth-generation Americans differ from the dominant [White European] culture in values, behavior, and life cycle patterns" (McGoldrick, 1989, p. 70). Inclusion of these culture and ethnicity-related variables can help the family intervention scientist to understand unique processes in families of diverse ethnic backgrounds and in predicting patient responses to some of our commonly used interventions. The push toward this integration is timely, given that ethnic minority groups 33 1
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