Lara Handler

Non-publication of large randomized clinical trials: cross sectional analysis

Objective To estimate the frequency with which results of large randomized clinical trials registered with ClinicalTrials.gov are not available to the public. Design Cross sectional analysis Setting Trials with at least 500 participants that were prospectively registered with ClinicalTrials.gov and completed prior to January 2009. Data sources PubMed, Google Scholar, and Embase were searched to identify published manuscripts containing trial results. The final literature search occurred in November 2012. Registry entries for unpublished trials were reviewed to determine whether results for these studies were available in the ClinicalTrials.gov results database. Main outcome measures The frequency of non-publication of trial results and, among unpublished studies, the frequency with which results are unavailable in the ClinicalTrials.gov database. Results Of 585 registered trials, 171 (29%) remained unpublished. These 171 unpublished trials had an estimated total enrollment of 299 763 study participants. The median time between study completion and the final literature search was 60 months for unpublished trials. Non-publication was more common among trials that received industry funding (150/468, 32%) than those that did not (21/117, 18%), P=0.003. Of the 171 unpublished trials, 133 (78%) had no results available in ClinicalTrials.gov. Conclusions Among this group of large clinical trials, non-publication of results was common and the availability of results in the ClinicalTrials.gov database was limited. A substantial number of study participants were exposed to the risks of trial participation without the societal benefits that accompany the dissemination of trial results.

Hidden Treasures: Librarian Office Hours for Three Health Sciences Schools

The changing needs of students and faculty have prompted UNC Chapel Hills Health Sciences Library to reconsider the delivery of library services. Several years of outreach and office hours have yielded an array of “hidden treasures,” or secondary outcomes, of both online and in-person office hours. The online office hours are tailored for the Schools of Medicine, Pharmacy, and Public Health. This article examines the benefits that go beyond simple consultation statistics and encompass more qualitative aspects of success resulting from increased outreach, goodwill, and stronger library-departmental partnerships.

Systematic review of mobile health behavioural interventions to improve uptake of HIV testing for vulnerable and key populations.

Introduction This systematic narrative review examined the empirical evidence on the effectiveness of mobile health (mHealth) behavioural interventions designed to increase the uptake of HIV testing among vulnerable and key populations. Methods MEDLINE/PubMed, Embase, Web of Science, and Global Health electronic databases were searched. Studies were eligible for inclusion if they were published between 2005 and 2015, evaluated an mHealth intervention, and reported an outcome relating to HIV testing. We also reviewed the bibliographies of retrieved studies for other relevant citations. The methodological rigor of selected articles was assessed, and narrative analyses were used to synthesize findings from mixed methodologies. Results A total of seven articles met the inclusion criteria. Most mHealth interventions employed a text-messaging feature and were conducted in middle- and high-income countries. The methodological rigor was moderate among studies. The current literature suggests that mHealth interventions can have significant positive effects on HIV testing initiation among vulnerable and key populations, as well as the general public. In some cases, null results were observed. Qualitative themes relating to the use of mobile technologies to increase HIV testing included the benefits of having low-cost, confidential, and motivational communication. Reported barriers included cellular network restrictions, poor linkages with physical testing services, and limited knowledge of appropriate text-messaging dose. Discussion MHealth interventions may prove beneficial in reducing the proportion of undiagnosed persons living with HIV, particularly among vulnerable and key populations. However, more rigorous and tailored interventions are needed to assess the effectiveness of widespread use.

A Scoping Review of Photovoice Research Among People With HIV

&NA; We describe how Photovoice–a participatory method in which people express and share ideas via images–has been used in research with people living with HIV (PLWH). Four databases, reference lists, and journal tables of content were searched to identify peer‐reviewed original research, in English, using Photovoice with a sample of PLWH, between 1994 and 2016. Of 1,898 citations identified, 22 studies were included. Studies included a mean of 18 (range 4‐38) participants. Studies were of strong quality but lacked consistent procedures. Goals varied and projects included different combinations of introductory, photo training, ethics, group, individual, and exhibit sessions. Descriptions of the researcher–participant relationship were uneven. Photovoice allowed PLWH to inform research and practice priorities through their own visual perspectives. Continued use of Photovoice with PLWH is recommended with greater emphasis on consistent methods and detailed reporting; more studies should be undertaken resulting in actions or advocacy.

HIV serostatus disclosure in the Democratic Republic of the Congo: a systematic review

ABSTRACT HIV status disclosure among people living with HIV/AIDS has been shown to have a number of both personal and public health benefits, but rates of HIV status disclosure remain low in many African countries, including the Democratic Republic of the Congo (DRC). This systematic review uses the Disclosure Process Model to examine the factors involved in serostatus disclosure and nondisclosure to various persons in the lives of people living with HIV/AIDS (PLWHA) in the DRC, as well as the specific outcomes of their disclosure or nondisclosure. MEDLINE/PubMed, Embase, Web of Science, Global Health, and PsycINFO were searched and research studies were included if: (i) the study discussed disclosure of HIV status; (ii) the study population included HIV-infected people in DRC; and (iii) the study was published in English. Fourteen articles met the inclusion criteria and were included in the study. Factors contributing to nondisclosure were generally associated with high stigma of HIV in adults and concern for emotional wellbeing when disclosing to HIV positive minors. Factors contributing to disclosure among adults were increased social support and religion. In disclosing to HIV positive minors, increasing age and health benefits were identified as approach goals that supported disclosure. The findings highlight the importance of understanding the avoidance and approach goals involved in HIV status disclosure among populations living in the DRC. Interventions and future research directed at increasing HIV disclosure among Congolese PLWHA should move beyond individual-level to consider multilevel factors including circumstantial social behaviors.

A Systematic Review and Narrative Synthesis of Interventions for Parental Human Immunodeficiency Virus Disclosure

Introduction Disclosure of parental human immunodeficiency virus (HIV) infection to their children remains a difficult process for parents living with HIV (PLWH). In order to identify the best strategies to facilitate parental HIV disclosure, it is necessary to examine the efficacy of existing interventions designed to help PLWH parents with the disclosure process to their children. Objectives To systematically review the efficacy of interventions designed to assist PLWH disclose their HIV status to their children. Methods We conducted a systematic review and narrative synthesis of interventions designed to assist PLWH disclose their HIV status to their children. MEDLINE/PubMed, PsycINFO, Embase, Global Health, and Web of Science were searched. Results Studies were eligible for inclusion if they evaluated an intervention for parental HIV disclosure. Five studies published between 2001 and 2015 met the inclusion criteria. The interventions were conducted in South Africa, China, and the United States. Three of the studies used two-arm randomized controlled trials, in which the intervention group was given enhanced care while the control group received standard care. Four of the five studies included a theoretically informed intervention and three were limited to mothers. Results showed that four of the interventions increased parental HIV disclosure. Conclusion The findings suggest that parental HIV disclosure interventions are successful in assisting parents with the disclosure process and can be adapted in different cultural context. Future parental HIV disclosure interventions should include fathers in order to assist men with parental HIV disclosure.

Listening to YOUR HEALTH: Librarians and Physicians Collaborating on the Radio and Online

The Chapel Hill campus of the University of North Carolina (UNC) is home to the University of North Carolina’s (UNC) NC Memorial Hospital, NC Children’s Hospital, NC Women’s Hospital, NC Neurosciences Hospital, and NC Cancer Hospital. UNC’s Health Affairs schools provide training for several health professions: Medicine, Dentistry, Nursing, Pharmacy, Public Health, and Allied Health Sciences. The Health Sciences Library (HSL), located at the center of the Health Affairs campus, has served all of these institutions as they grew in size and scope. As an academic library, the focus has primarily been on the information needs of the faculty, students, researchers, clinicians, and other health care practitioners. However, serving the health information needs of the public has been a stated part of the library’s mission for over a decade. HSL is open to the public, and many local residents use the library’s resources, especially the computers and Internet access. HSL had a small Consumer

Co-Streaming Classes: A Follow-Up Study in Improving the User Experience to Better Reach Users

Co-streaming classes have enabled library staff to extend open classes to distance education students and other users. Student evaluations showed that the model could be improved. Two areas required attention: audio problems experienced by online participants and staff teaching methods. Staff tested equipment and adjusted software configuration to improve user experience. Staff training increased familiarity with specialized teaching techniques and troubleshooting procedures. Technology testing and staff training were completed, and best practices were developed and applied. Class evaluations indicate improvements in classroom experience. Future plans include expanding co-streaming to more classes and on-going data collection, evaluation, and improvement of classes.