Jillian Lucas Baker

The Development of a Culturally Relevant, Theoretically Driven HPV Prevention Intervention for Urban Adolescent Females and Their Parents/Guardians

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, accounting for the large majority of cervical cancer and anogenital warts cases. Two HPV vaccines are currently licensed and recommended for women and girls. However, vaccination rates have been suboptimal, with evidence of disparities influencing both uptake and series completion among African American and Hispanic adolescents. There has been a dearth of theory-based, behavioral interventions targeted to prevent HPV infection and increase HPV vaccine uptake among urban adolescents. This article describes the development of two skills-based intervention curricula aimed to increase HPV prevention and vaccination among low-income urban adolescent females 9 to 18 years old. Guided by the theory of planned behavior, elicitation research was conducted to elucidate the social psychological factors that underlie HPV vaccination intentions (N = 141). The findings were subsequently used to identify theoretical mediators of behavioral change to drive the intervention. Culturally relevant strategies to promote HPV vaccination were translated into the curricula content. Both curricula were designed to motivate and empower participants to reduce risk of being infected with HPV. Targeting theoretical mediators of behavioral change, derived from the voices of the community, may prove to be successful in increasing HPV vaccination and preventing HPV.

Barbershops as Venues to Assess and Intervene in HIV/STI Risk Among Young, Heterosexual African American Men

African Americans, particularly men, are disproportionately affected by the HIV epidemic. Inconsistent condom use and concurrent sexual partnerships are risk factors; there is limited investigation on how these factors influence HIV risk engagement in young, heterosexual, African American men. To identify contextual risk factors that place young men (18-24 years) at risk for HIV infection, one focus group was conducted with 13 men, and questionnaires were administered to 48 men. Participants were 18 to 24 years old and were recruited from local barbershops. The majority engaged in noncondom use (83%) and had multiple sexual partners (64%). Qualitative themes revealed noncondom use “when in the moment” and enhanced condom use with casual partners. This study provided an understanding of participants’ attitudes, intentions, and behaviors as they related to HIV risk and revealed the need for culturally relevant, theory-based HIV prevention programs to reduce HIV transmission among this population.

Lessons learned from field-testing a brief behavioral intervention package for African American women at risk for HIV/STDs.

This article describes how Sister to Sister, an evidence-based HIV/STD intervention for African American women in clinical settings, was prepared for national dissemination using the Centers for Disease Control and Prevention’s Replicating Effective Programs research translation process. To test the feasibility of the intervention in the “real world,” Sister to Sister’s original research team collaborated with community partners to field-test the intervention in three clinical settings. Experiences from field-testing and input from a community advisory board were used to translate research protocols into a package of user-friendly materials that could be easily adopted by frontline clinic staff throughout the nation. Process monitoring and evaluation data demonstrated that Sister to Sister could be implemented successfully by a variety of practitioners including nurses, health educators, and HIV test counselors. “Buy-in” from clinic administrators and providers was a prerequisite to the success of the intervention. Replicating Effective Programs provided a useful process that can be applied by others to successfully prepare evidence-based interventions such as Sister to Sister for national dissemination.

Development of a Barbershop-Based HIV/STI Risk Reduction Intervention for Young Heterosexual African American Men:

Young, heterosexual African American men ages 18 to 24 years continue to be at high risk for HIV and other sexually transmitted infections. However, few interventions have been designed to meet the needs of this “forgotten” population. The article describes the systematic development of a theory-based, culturally-tailored, gender-specific, barbershop-based HIV risk reduction intervention for heterosexual African American men ages 18 to 24. The process included developing a community advisory board, selecting a guiding theoretical framework, incorporating community-based participatory research principles, and conducting formative research with African American males, barbers, and barbershop owners. The result was Shape Up: Barbers Building Better Brothers, a 2-day, HIV risk reduction intervention focused on increasing HIV knowledge and condom use and reducing the number of sexual partners. Intervention sessions were facilitated by barbers who used iPads to deliver the content. As a high-risk population, this intervention has great public health significance for the health of African American men and their sexual partners.

“You Know What You Gotta Do”: African American Fathers and Sons Perspectives’ on Parent–Child Sexual Risk Communication and HIV Intervention Development Needs

Context: Although parents can be influential toward the sexual attitudes and behaviors of adolescents, fathers are significantly underrepresented in studies of parental influences on adolescent sexual practices and behaviors. Method: This mixed method study assessed the feasibility of implementing a HIV/STI (human immunodeficiency virus/sexually transmitted infection) risk reduction program for African American fathers and sons. Focus groups were conducted with 30 father–son pairs at a local barbershop. Adolescents ranged between 11 and 19 years old with a mean age of 14.71 years (SD = 2.14). Results: Fathers and sons were not in agreement about frequency of communication about sexual health issues. However, the majority of fathers and sons indicated they would attend a father–son HIV/STI risk reduction program together. Conclusion: This study supports the development of a HIV/STI risk reduction program for that can enhance sexual risk communication practices among African American fathers and sons.