This pilot study assessed the HIV prevention needs of older Hispanic Women (OHW), identifying socio-cultural risk factors, age related factors, partner factors, acceptability of rapid HIV testing, and intervention preferences to facilitate the adaptation of the SEPA(Salud/Health, Educacion/Education, Prevencion/Prevention, Autocuidado/Self-care) intervention for this population.
The aim of this study is to better understand the predictors of outpatient or residential placement of youth who have psychiatric mental health disorder(s). Specifically, the project will examine the process in which youth that are involved in the Juvenile Addiction Receiving Facility (JARF), and diagnosed with a psychiatric mental health disorder, are referred to outpatient or residential treatment. Of particular interest, based on the youth’s psychiatric mental health diagnosis, is how decisions are made in terms of which residential treatment center the youth is referred to, and whether the treatment centers are positioned to, and can effectively provide the appropriate treatment for the youth. This study is funded through a University of Miami Provost Research Award.
This mixed methods pilot study, funded by El Centro in Year 2, enrolled 121 Hispanic men and women who were expecting a baby to assess attitudes and beliefs surrounding male circumcision.
This randomized clinical trial, funded by El Centro in Year 1, tests the efficacy of a culturally informed and flexible family-based therapy for adolescents in reducing/preventing substance abuse and risky sexual behaviors by modifying current mental disorders that place youngsters at risk. Two hundred Hispanic youth (11-14 years of age) and families were recruited into the study and were randomized into either the experimental CIFFTA treatment or an individually focused “Treatment As Usual”. Families are assessed at baseline, 4, 12 and 20 months to evaluate the impact of the intervention for reducing existing psychiatric, behavioral and family problems in youth, and prevention effects of the intervention on the emergence of HIV/STI.
This study, funded by NIMHD, focuses on working with Hispanic and African American youngsters ages 12-15 and their families to integrate CIFFTA interventions with technology for intervention delivery.
This randomized clinical trial , funded by NIDA, uses the CIFFTA intervention for adolescents 14-17 who have been diagnosed with a Substance Abuse Disorder. Hispanic youth and families are randomized into either the CIFFTA treatment or Traditional Family Therapy. Families are assessed at baseline, 4, 6 and 12 months to evaluate effects on reducing substance use, risky sexual behaviors, and related behavior problems.
The purpose of this study is to develop and validate a Spanish-language version of the College Alcohol Problems Scale (Maddock et al., 2001). This brief, 8-item scale assesses both personal and social problems related to drinking for college students. A Spanish version was translated and back-translated by a bilingual team of experts in youth and college student mental health. Hispanic college student participants are recruited anonymously via the Internet and in collaboration Florida International University. This study will compare the structure of the scale when administered in English and Spanish to Hispanic students.
There is limited research examining the coming out process among Hispanic youth. The coming out to one’s family may be more challenging for Hispanic sexual minority youth than for white youth because Hispanic cultural factors, (i.e., the importance of marriage and having children, traditional gender roles, conservative religious values), and widespread homophobia may result in homosexuality being regarded more negatively. This study incorporates interviews with Hispanic emerging adults who identify as gay, lesbian, or bisexual in order to: (1) describe the coming out experiences of Hispanic LGB youth, (2) identify perceived barriers experienced by Hispanic LGB youth to coming out, and (3) gather recommendations from Hispanic LGB youth regarding family-based interventions that can facilitate the coming out process. Information gathered from this study will be used to develop or tailor an intervention to help families navigate the coming our process.
Alcohol is linked to serious consequences (e.g., assault, arrests, dependence) in college. The standard screening question about binge drinking may over-identify students unlikely to have these consequences, and to need intensive intervention. Over-identification may lead to a smaller proportion of students with the highest risks being missed. The Alcohol Use Disorders Identification Test (AUDIT) is brief (10 items), and is expected to provide better information than the single binge drinking question. No studies have compared these tools’ ability to identify students with the highest risk of serious consequences related to drinking. The CASC study will assess undergraduates at the UM Wellness Center with two screening tools, a psychiatric interview, and other measures of alcohol consequences and is funded through a University of Miami Provost Research Award.
This is a student led study to assess the health education needs of victims of domestic violence through key informant interviews, participant observations and a survey. The study will lay the foundation for a health education program that will be implemented at the Coordinated Victim Assistance Center by University of Miami students.
This pilot study, aim developed an internet STI-HIV prevention intervention for young Chilean women between the ages of 18 and 24. Phase I of the study adapted and refined the SEPA prevention intervention for low-income Chilean women for use as an internet based intervention for young Chilean women. Phase II of the study will piloted the internet based STI-HIV prevention intervention.
This administrative supplement, funded by El Centro in years 7- 9, is aimed at investigating predictors of HIV and sexually transmitted infections (STIs) and HIV/STI testing within a racially and ethnically diverse sample of victims of intimate partner violence (IPV) and to identify culturally-informed strategies to increase HIV/STI testing in this population. The project will expand on existing partnerships between El Centro and the Violence Prevention and Intervention Services Division of the Miami Dade County Community Action and Human Services Department.
The Miami Dade Community Action and Human Services Department is one of 12 jurisdictions in the U.S. that has been awarded a cooperative agreement grant by the Office of Violence Against Women and the National Institute of Justice with the ultimate aim of preventing homicides among victims of domestic violence. Dr. Gonzalez-Guarda is leading the evaluation components of the community assessment of the cooperative agreement in Miami Dade County (Phase 1). Six of the 12 grantees will move onto implementing an evidenced based homicide prevention program for victims of domestic violence in the county (Phase II).
The aim of this randomized control trial was to evaluate the feasibility, effect on resistance self-efficacy, and appeal of using an avatar based virtual reality technology game (DRAMA-RAMA) as the skill building component for the Mighty Girls intervention. This intervention builds peer resistance skills so that middle school Latinas are empowered to resist pressure from friends to engage in activities that put them at risk for early initiation of sexual intercourse. Forty-four low-income early adolescent Latinas were randomly assigned to play either DRAMARAMA or an attention control game (Wii Dancing with the Stars) after completing the classroom session component of the intervention. Results supported feasibility; demonstrated a significant game effect at posttest for peer resistance self-efficacy (F = 4.21, p< .05), but not at follow-up (F = 0.01, p = .92); and verified game appeal.
The project addresses the lack of implementation of evidence-based alcohol screening interventions in primary care practice and the prevalence of risky drinking in college students. The intervention will be delivered to students using the existing electronic health record (EHR) system at the University of Miami Student Health Center. EASI has three components: universal alcohol screening, feedback, and three levels of intervention determined by reported alcohol use risk. EASI will be compared to standard care. This study will have a mixed-methods analysis approach. Qualitative data will be collected in individual interviews with providers immediately following the pilot intervention. Quantitative data will be collected with a brief alcohol measure before the health center visit, and other measures emailed to students at 3-, 6-, and 12-months after the visit.
HIV-infected men who have sex with men (MSM) are at greatest risk for developing anal cancer. Anal cancer is caused by the Human Papillomavirus (HPV), the virus which also causes non-cancerous genital warts. Persistent HPV infection can lead to the development of precancerous lesions which, left untreated, develop into anal cancer. HIV-infected MSM are not regularly screening for these precancerous lesions. This study explores HIV-infected MSM’s understanding, attitudes, and behaviors related to the prevention of anal cancer. Sixty in-depth interviews were conducted with HIV-infected English-speaking MSM to explore their ideas about the prevention and early detection of anal cancer. An additional 25 interviews with Spanish-speaking HIV-infected MSM are planned. This study is funded by the University of Miami’s NIH-funded Center for AIDS Research (CFAR).
The purpose of this research is to explore the processes and policies related to implementing anal cancer screening as a yearly routine procedure for HIV-infected patients. Focus groups will be conducted with health care providers from various HIV primary care clinics. The formative data obtained from this study will be used to apply for external funding to conduct a community-based pilot intervention aimed at increasing anal cancer screening among HIV-infected gay and bisexual men. This research is funded by a 2015 School of Nursing and Health Studies Dean’s Award.
In this phenomenological sub-study of Project JOVEN, teens’ experiences seeking services for teen dating violence are explored. Through interviews with teens that have gone through the process of seeking services, researchers will learn about barriers and supports each experienced, and thereby inform future practice.
This study, which was a companion to a randomized clinical trial, tested the effects of a family intervention, Structural Ecosystems Therapy (SET), on family members of HIV+ women in drug recovery. Women in the trial were randomly assigned to either SET or a psychoeducational health group. Women and their family members were assessed at baseline, 4, 8 and 12 months. The study examined the impact of SET on family functioning and on family-member outcomes.
This mixed methods pilot study, funded by the Aqua Foundation for Women and conducted in partnership with the South Beach AIDS Project, Inc., aims to explore the health risk behaviors of 50 transgender women living in South Florida. In Phase I, participants will complete measures of health risks. In Phase II, a qualitative interview will be administered to 30 of the participants to gain their perspectives on how to address health risk behaviors in the transgender community.
The purpose of this study was to conduct a maternal-child health needs assessment evaluation in the South of Haiti. The study was conducted in 5 communes: Les Cayes, Aquin, St. Louis due Sud, Cavailllon, Maniche, and Ile a Vache. Eighty (80) women and 39 health care workers participated in the study. To collect the data 8 focus groups and 40 interviews were conducted. Observational data was collected visiting 20 health centers in the area to assess their needs. Health issues faced by women during pregnancy, delivery and the postpartum phase include anemia, infection, hemorrhage and preeclampsia/eclampsia. Health issues that affect newborns include prematurity, low birth weight, infections, and tetanus. The main problem that the health care system confronts is the lack of trained professionals in maternal-child care specialty nurse-midwives.
This mixed methods pilot study, funded by El Centro in Year 2, enrolled 74 Hispanic HIV+ adults to assess the relationship of acculturation, health literacy and other psychosocial factors to adherence patterns and healthcare utilization.
This administrative supplement to El Centro in Year 4, aimed to expand mental health capacity in Cap Haitien, Haiti in collaboration with Hospital Universitaire Justinien and the Northern Health Department of Haiti, which serves a population of 1 million people. Approximately 100 local health providers were trained to identify, triage and provide supportive services for mental health disorders 25 trainees participated in a “train the trainers” program as a means of sustaining increased capacity.
Project JOVEN is funded by the Robert Wood Johnson Foundation. Phase I of the study aims to develop, refine and manualize this culturally-specific, school-based, and theoretically grounded teen dating violence prevention program for Hispanic 9th graders, including components for parents and school personnel. Phase II will pilot test the program to assess its feasibility and acceptability and evaluate it to determine the preliminary efficacy when compared to a no-intervention control group in preventing and reducing the occurrence of teen dating violence and affecting mediators that have been found to be risk or protective factors for teen dating violence.
The aim of this randomized group trial is to test the efficacy of a promising and innovative intervention (Mighty Girls) for reducing teen Latina sexual behavior and pregnancy that was developed in a successful R15 feasibility trial. Mighty Girls uses cutting-edge technology to create a novel, highly interactive, video game that provides a live, realistic simulation of peer pressure. Players talk directly with avatars as they would with peers in their everyday life. This intervention focuses on building communication skills for resistance that are derived from evidence-based programs that do not jeopardize friendships and incorporate Latino cultural values (Marianismo, Personalismo, Simpatía) – skills valued by middle school Latinas.
Under the mentorship of Daniel Santisteban, Dr. Karina Gattamorta will use data from the CIFFTA study to examine the relationship between mental health and substance abuse in Hispanic adolescents. She will also investigate the effect of gender on treatment outcomes.
The primary aim of this descriptive study was to determine the appeal of DRAMA-RAMA under free choice conditions. A secondary aim was to collect data that could be combined with feasibility trial data to evaluate whether engagement in game play was enhanced by an improved game appearance, story and interface. A tertiary aim was to use the two data sets to establish the reliability and validity of a measure of human interaction involvement adapted to assess human-avatar involvement. Results supported appeal under free choice conditions: DRAMA-RAMA was more likely to be played multiple times than the Wii (61% vs. 24%; p< .01) and those that played both games (n= 20) expressed stronger positive affect regarding DRAMA-RAMA than the Wii (p< .01). Improved game appearance, story and interface were associated with greater engagement (higher flow ratings, higher involvement scores, lower predictability ratings), and reliability and support for assessing involvement.
This community-based participatory research (CBPR) pilot study, funded by El Centro in Year 3, created a community partnership for the prevention of domestic violence, conducted focus groups with domestic violence service providers and community adults, secondary analysis and a community forum regarding the needs and preferences for domestic violence prevention programs targeting high-risk Hispanics in Miami-Dade County. This study led to funding from the Robert Wood Johnson Foundation for the JOVEN (Juntos Opuestos a la Violencia Entre Novios/Together Against Dating Violence) study.
This mixed methods pilot study, funded by El Centro in Year 1, examined the experiences of 164 community-dwelling Hispanic heterosexual men and men who have sex with men (MSM) with respect to substance abuse, violence, and intimate/sexual relationships.
SBIRT (Screening Brief Intervention and Referral to Treatment) is an evidence based intervention designed: 1) to identify problem drinking and the abuse of illicit or prescription medication and 2) to counsel the patient in a way that elicits motivation to change the unhealthy behavior. The 3 year training grant received from the Substance Abuse and Mental Health Service Administration (SAMHSA) funds SBIRT and Motivational Interviewing training to a diverse set of approximately 450 healthcare students and healthcare workers per year in the classroom and in practice settings. The SBIRT training program is designed to enhance the skills of nurses, nursing students, medical residents, social workers, and counselors to identify and treat unhealthy substance use behaviors that don’t yet meet criteria for addiction. Partners include the UM School of Education, the FIU School of Public Health and Social Work, the University of Miami Hospital, Connect Familias, and Saint John Bosco Clinic.
This study aims to examine screening policies for IPV in primary care, obstetrics/gynecology, emergency, pediatrics, and behavioral health settings in MDC. Specific aims include: 1) estimate the proportion of healthcare practices in MDC with policies in place for routine screening of IPV; 2) evaluate the procedural characteristics of existing IPV screening policies; 3) identify differences in policy implementation by facility characteristics and; 4) understand barriers/facilitators to the implementation of screening policies. Phase I utilizes an epidemiologic observational study design with 420 health care facilities randomly selected to participate in a brief phone survey regarding screening practices. In Phase II, a subset of facilities (n=20) will be selected to participate in in-depth qualitative interviews regarding barriers and facilitators to implementing IPV screening practices at their facility. This study is funded through a University of Miami Provost Research Award.
This randomized clinical trial , funded by El Centro in Year 1, tested the efficacy of the SEPA intervention vs. a delayed control to prevent HIV/AIDS and other STIs, and to reduce/prevent family and intimate partner violence among Hispanic women. The trial enrolled 548 women (age 18 – 50 years) who completed structured interviews at baseline and 3, 6, and 12 months post-baseline.
This translational randomized trial, funded by El Centro in Year 6, will recruit 300 Spanish-speaking women between the ages of 18 and 50 who are sexually active from Miami-Dade County Department of Heath sites and randomize to either the SEPA intervention or a Wait-List Control condition. The proposed study’s overarching goal is to reduce the ethnic disparities in HIV between Hispanic and non-Hispanic women.
This pilot study, funded by El Centro in Year 4, tested the acceptability and feasibility of SEPA-O, an adaptation of the SEPA intervention, for older Hispanic women in preparation for a randomized trial.
This translational randomized trial, funded by El Centro in Year 6, will enroll 172 mothers in outpatient substance abuse or mental health treatment and their children (ages 2-17). Mothers will be randomly assigned to treatment as usual (TAU) or TAU+ Healthy Home, a family-based nurse-home health intervention. Mothers/children will be assessed at baseline, 4, 8, and 12 months post-baseline. The main study outcomes are improved health and mental health in the mothers; and improved health and emotional well-being of the children. The SET-R/Healthy Home intervention manual is available upon request.
This quantitative pilot study, funded by the University of Texas at El Paso School of Nursing, will examine the relationships of these variables among a sample of 150 community-dwelling MSM. This study will provide a more in-depth investigation of the influence of mental health factors (stress, sleep, etc.) on sexual risk behaviors.
This qualitative research study, aims to explore the nature of sexual decision making among Hispanic Men and to investigate the need for and delivery methods preferred for interventions targeting sexual decision making among HIV seronegative Hispanic MSM.
This randomized clinical trial tested the impact of Mano a Mano-Mujer (MM-M), an adaptation of the SEPA intervention for Chilean women, on HIV prevention and depressive symptoms. A total of 400 women in Santiago Chile were enrolled in the study and were randomized into either experimental intervention or a control group. The intervention consisted of six sessions delivered in small groups. Face-to-face interviews were conducted at baseline and at 3-month follow-up.
This mixed methods study, funded by the University of Miami’s NIH-funded Center for AIDS Research (CFAR), examines the influence of Hispanic cultural factors on risk behaviors and mental health among Hispanic MSM. Participants complete self-report measures of sexual behaviors, acculturation, mental health, substance abuse and violence in Phase I of the study. In Phase II of the study, participants are interviewed to gain perspective on how to incorporate Hispanic culture into risk reduction programs for Hispanic MSM.
This qualitative study, aims to gain the perspectives of mothers in substance abuse treatment (or recently in treatment) in the areas of treatment motivation, stressors and motivators including family, preferences and barriers for involving family in aftercare, and perceptions of family therapy, with the goal informing the development of a family-based substance abuse treatment aftercare interventions for mothers and their children.
Victims of intimate partner violence (IPV) are at increased risk for acquiring HIV compared to the general population. Encouraging those with a history of IPV to participate in HIV counseling, testing and linkage to care is an important strategy for prevention and early treatment. Despite the importance of HIV testing, numerous barriers to testing exist, particularly for victims of IPV. The purpose of this study is to better understand the HIV testing process from the perspective of victims of IPV and those who work with victims. A qualitative descriptive approach will be used to guide this study. Interviews will be conducted with key informants, namely, women with a history of IPV, HIV service providers, and IPV service providers (e.g., advocates).
This study was conducted to assess the feasibility of a telenovela to reduce HIV risk behaviors among Hispanic women in South Florida. Three focus groups were conducted with 25 Hispanic women 18 years and older to: (a) investigate Hispanic women’s perceptions of telenovelas for HIV prevention, (b) collect recommendations about the content and features that should be included in the development of a telenovela for HIV prevention (e.g., topics for inclusion, setting, length), and (c) assess the types of technologies that women consider more appealing/feasible to deliver the intervention (e.g., tablet, internet using a laptop, iPod Touch). Also, complementary activities that could enhance the engagement of Hispanic women in the telenovela were discussed in the focus groups (e.g., text messages after each episode about the content of the episode, telephone line staffed by a Registered Nurse from the research team to clarify the content of the episode).
This qualitative study, aims to describe the experiences of 30 young, minority adults living with perinatal-acquired HIV infection related to their adolescence and transition to young adulthood.