Nicole Trabold

Oral pre-exposure prophylaxis (PrEP) for prevention of HIV in serodiscordant heterosexual couples in the United States: opportunities and challenges.

Oral HIV pre-exposure prophylaxis (PrEP) is a promising new biomedical prevention approach in which HIV-negative individuals are provided with daily oral antiretroviral medication for the primary prevention of HIV-1. Several clinical trials have demonstrated efficacy of oral PrEP for HIV prevention among groups at high risk for HIV, with adherence closely associated with level of risk reduction. In the United States (US), three groups have been prioritized for initial implementation of PrEP-injection drug users, men who have sex with men at substantial risk for HIV, and HIV-negative partners within serodiscordant heterosexual couples. Numerous demonstration projects involving PrEP implementation among MSM are underway, but relatively little research has been devoted to study PrEP implementation in HIV-serodiscordant heterosexual couples in the US. Such couples face a unique set of challenges to PrEP implementation at the individual, couple, and provider level with regard to PrEP uptake and maintenance, adherence, safety and toxicity, clinical monitoring, and sexual risk behavior. Oral PrEP also provides new opportunities for serodiscordant couples and healthcare providers for primary prevention and reproductive health. This article provides a review of the critical issues, challenges, and opportunities involved in the implementation of oral PrEP among HIV-serodiscordant heterosexual couples in the US.

Screening for intimate partner violence within a health care setting: A systematic review of the literature

Abstract The purpose of this review is to present literature regarding intervention research on Intimate Partner Violence (IPV) screening. Articles were obtained by searching six databases and review of reference pages. Of the articles selected for this review, all measured disclosure rates of IPV screening and five addressed safety practices, one study included both screening and safety practices. Two studies evaluated advocacys impact on safety and the level of violence. Five studies reported referral initiation to advocacy services. The results suggest that screening is effective in identifying IPV; however, a causal link between screening practices, increased safety practices, and decreased violence cannot be established. Practice and research implications for social work are discussed.

Experiences of Kratom Users: A Qualitative Analysis

Abstract Kratom (Mitragyna speciosa) is a psychoactive plant that has been used since at least 1836 in folk medicine in Southeast Asian countries. More recently, kratom has become widely available in the West and is used for both recreational and medicinal purposes. There has, however, been little scientific research into the short- and long-term effects of kratom in humans, and much of the information available is anecdotal. To supplement the increasing scientific understanding of kratom’s pharmacology and research into its effects in animals, we report the results of a qualitative analysis of first-hand descriptions of human kratom use that were submitted to, and published by, a psychoactive substance information website (Erowid.org). Themes that emerged from these experience reports indicate that kratom may be useful for analgesia, mood elevation, anxiety reduction, and may aid opioid withdrawal management. Negative response themes also emerged, indicating potential problems and unfavorable “side” effects, especially stomach upset and vomiting. Based on our analyses, we present preliminary hypotheses for future examination in controlled, quantitative studies of kratom.

An exploratory analysis of intimate partner violence and postpartum depression in an impoverished urban population

Research on the relationship between intimate partner violence (IPV) and postpartum depression (PPD) is limited. Numerous antecedents and consequences of both IPV and PPD are noted in the literature; however, understanding the mechanisms by which intimate partner violence impacts the postpartum mood are not clearly understood. This study utilized retrospective chart reviews from a pediatric/perinatal social work outreach program to explore urban minority women experiences with IPV and depression both during pregnancy and after. Findings do not suggest a direct relationship between IPV and PPD; however, there was a high co-occurrence of prenatal depression and PPD. The severity of IPV appears to influence the occurrence and acuity of prenatal depression suggesting an indirect relationship. Implications for health and social work practitioners are discussed.

Disordered eating behaviors in young adult Mexican American women: Prevalence and associations with health risks

Recent research has shown that disordered eating behaviors are as prevalent in heterogenous samples of Latinas living in the U.S. as in non-Hispanic white women, yet less is known about the prevalence in women of Mexican origin. The primary purpose of this study is to report the prevalence and associations among DE behaviors and health risk of alcohol, tobacco use and obesity in a sample of N = 472 young adult college enrolled Mexican American (MA) women living in the United States. This report focuses on baseline data from a 12-month repeated measures longitudinal study. Ecological momentary assessment (EMA) was used to capture the prevalence of disordered eating and health risk behaviors in the context of everyday activities. Disordered eating behaviors including purging, binge eating, fasting and exercise were reported by approximately 15% of the sample. Food/calorie restricting, was the most prevalent behavior reported by 48% of the sample and along with binge eating was a positive predictor of BMI. Fasting was the only disordered eating behavior associated with tobacco use. These findings suggest that subclinical levels of DE behaviors are prevalent in a community sample of women of Mexican origin and are associated with health risks of tobacco use and higher BMI. Early identification of DE behaviors and community-based interventions targeting MA women may help reduce disparities associated with overweight and obesity in this population.

Childhood Sexual Abuse and the Perpetration of Violence: The Moderating Role of Gender

This study sought to increase specificity in our knowledge of links among child sexual abuse (CSA), aggression, and physical intimate partner violence (IPV) perpetration by criminal offenders, with particular interest in gender. Participants were 202 men and 72 women (N = 274), who were recruited from an urban pretrial supervision program. Women reported higher rates of CSA than men. After controlling for relevant covariates, CSA was associated with general aggression and severe IPV. We found a gender by CSA interaction; CSA was associated with aggression and severe IPV for women, but not men. Findings provide preliminary evidence that CSA impacts aggression and IPV perpetration differently for female offenders compared to male offenders and gender-specific treatment might be warranted in pretrial settings.

A test of core psychopathic traits as a moderator of the efficacy of a brief motivational intervention for substance-using offenders.

OBJECTIVE In a randomized controlled trial we studied a brief motivational intervention (BMI) for substance use, examining core psychopathic traits as a moderator of treatment efficacy. METHOD Participants were 105 males and females who were 18 years of age and older and in a pretrial jail diversion program. The sample was approximately 52% Black and other minorities and 48% White. Outcome variables at a 6-month follow-up were frequency of substance use (assessed with the Timeline Follow-back Interview and objective toxicology screens), substance use consequences (Short Inventory of Problems-Alcohol and Drug version), and self-reported participation in nonstudy mental health and/or substance use treatment. Psychopathy was assessed using the Psychopathy Checklist-Revised (PCL-R). RESULTS BMI interacted with core psychopathic traits to account for 7% of the variance in substance use at follow-up. Treatment was associated with greater use among individuals with high levels of core psychopathic traits. Toxicology screening results were consistent with self-report data. The treatment and standard care groups did not differ on substance use consequences or nonstudy treatment participation at follow-up, and no moderation was found with these outcomes. An exploratory analysis indicated that low levels of affective traits of psychopathy were associated with benefit from the BMI in terms of decreased substance use. DISCUSSION Findings suggest that caution is warranted when applying BMIs among offenders; individuals with high levels of core psychopathic traits may not benefit and may be hindered in recovery. Conversely, they indicate that a low-psychopathy subgroup of offenders benefits from these brief and efficient treatments for substance use.

A Systematic Review of Intimate Partner Violence Interventions: State of the Field and Implications for Practitioners:

Intimate partner violence (IPV) victimization is a global public health issue and has serious consequences of women’s health. While scholars and researchers have made some progress in addressing IPV and its impact across different levels of care, there is a paucity of intervention research in this area. For example, we know little about which intervention models work best for particular groups of IPV survivors. Previous reviews have concluded there is insufficient evidence to recommend specific treatment options for victims, but they have also been limited in scope of target populations or have employed narrow eligibility criteria. This systematic review examined the efficacy and effectiveness of interventions for victims of IPV related to physical and mental health and revictimization. Three large databases were searched and articles were selected using specified criteria. Fifty-seven articles met inclusion criteria. Results indicate that both empowerment-based advocacy and cognitively focused clinical interventions demonstrate positive outcomes on the vast sequelae of violence in the context of an intimate relationship. The heterogeneity of intervention approaches and frameworks makes comparisons across studies challenging, but this review demonstrates that interventions focused on problem-solving/solution seeking, enhanced choice making and the alteration in distorted self-thinking and perception are promising in facilitating and maintaining positive physical and mental health changes for women who experience violence.

Development of an Ecological Momentary Assessment Mobile App for a Low-Literacy, Mexican American Population to Collect Disordered Eating Behaviors

Background Ecological momentary assessment (EMA) is a popular method for understanding population health in which participants report their experiences while in naturally occurring contexts in order to increase the reliability and ecological validity of the collected data (as compared to retrospective recall). EMA studies, however, have relied primarily on text-based questionnaires, effectively eliminating low-literacy populations from the samples. Objective To provide a case study of design of an EMA mobile app for a low-literacy population. In particular, we present the design process and final design of an EMA mobile app for low literate, Mexican American women to record unhealthy eating and weight control behaviors (UEWCBs). Methods An iterative, user-centered design process was employed to develop the mobile app. An existing EMA protocol to measure UEWCBs in college-enrolled Mexican American women was used as the starting point for the application. The app utilizes an icon interface, with optional audio prompts, that is culturally sensitive and usable by a low-literacy population. A total of 41 women participated over the course of 4 phases of the design process, which included 2 interview and task-based phases (n=8, n=11), focus groups (n=15), and a 5-day, in situ deployment (n=7). Results Participants’ mental models of UEWCBs differed substantially from prevailing definitions found in the literature, prompting a major reorganization of the app interface. Differences in health literacy and numeracy were better identified with the Newest Vital Sign tool, as compared with the Short Assessment of Health Literacy tool. Participants had difficulty imagining scenarios in the interviews to practice recording a specific UEWCB; instead, usability was best tested in situ. Participants were able to use the EMA mobile app over the course of 5 days to record UEWCBs. Conclusions Results suggest that the iterative, user-centered design process was essential for designing the app to be made usable by the target population. Simply taking the protocol designed for a higher-literacy population and replacing words with icons and/or audio would have been unsuccessful with this population.

Unhealthy weight control strategies: An outcome of body image and eating tensions in women of Mexican origin living in rural farming communities:

Unhealthy eating and weight control behaviors are important but modifiable factors that contribute to obesity in majority and minority populations. Studies suggest that these behaviors are common in Mexican American women, but most studies completed to date have focused on college enrolled Mexican American women. Little is known about body weight concerns, eating and weight control behaviors in low acculturated immigrant Mexican women. This qualitative descriptive study utilized two focus groups with 15 women to identify and describe body weight and shape perceptions, and thoughts and behaviors related to eating and weight control of low acculturated Mexican American living in disadvantaged economic situations. Conventional content analysis was used to analyze data and three main themes were identified: (1) body weight values and concerns, (2) eating and food, and (3) weight loss strategies and consequences. The first two themes shared five subthemes including emotion, health, age, family, and culture. Results suggest Mexican American women experience weight concerns that are in conflict with food/eating values and experiences. This conflict is influenced by cultural, family, and inter/intrapersonal factors and contributes to unhealthy eating and weight control behavior. The transition and assimilation to the United States is complex and dynamic. Thus understanding how the conflict regarding body weight and food influence Mexican American women’s health behaviors is important and provides valuable knowledge essential to guide further research and intervention development.