Ranelda Hastings
Johns Hopkins University
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American Journal of Psychiatry | 2015
Allison Barlow; Britta Mullany; Nicole Neault; Novalene Goklish; Trudy Billy; Ranelda Hastings; Sherilynn Lorenzo; Crystal Kee; Kristin Lake; Cleve Redmond; Alice Carter; John T. Walkup
OBJECTIVE The Affordable Care Act provides funding for home-visiting programs to reduce health care disparities, despite limited evidence that existing programs can overcome implementation and evaluation challenges with at-risk populations. The authors report 36-month outcomes of the paraprofessional-delivered Family Spirit home-visiting intervention for American Indian teen mothers and children. METHOD Expectant American Indian teens (N=322, mean age=18.1 years) from four southwestern reservation communities were randomly assigned to the Family Spirit intervention plus optimized standard care or optimized standard care alone. Maternal and child outcomes were evaluated at 28 and 36 weeks gestation and 2, 6, 12, 18, 24, 30, and 36 months postpartum. RESULTS At baseline the mothers had high rates of substance use (>84%), depressive symptoms (>32%), dropping out of school (>57%), and residential instability (51%). Study retention was ≥83%. From pregnancy to 36 months postpartum, mothers in the intervention group had significantly greater parenting knowledge (effect size=0.42) and parental locus of control (effect size=0.17), fewer depressive symptoms (effect size=0.16) and externalizing problems (effect size=0.14), and lower past month use of marijuana (odds ratio=0.65) and illegal drugs (odds ratio=0.67). Children in the intervention group had fewer externalizing (effect size=0.23), internalizing (effect size=0.23), and dysregulation (effect size=0.27) problems. CONCLUSIONS The paraprofessional home-visiting intervention promoted effective parenting, reduced maternal risks, and improved child developmental outcomes in the U.S. population subgroup with the fewest resources and highest behavioral health disparities. The methods and results can inform federal efforts to disseminate and sustain evidence-based home-visiting interventions in at-risk populations.
Aids Care-psychological and Socio-medical Aspects of Aids\/hiv | 2015
Lauren Tingey; Britta Mullany; Rachel Chambers; Ranelda Hastings; Angelita Lee; Anthony Parker; Allison Barlow; Anne Rompalo
Potential for widespread transmission of HIV/AIDS among American Indian (AI) adolescents exists, yet no evidence-based interventions (EBIs) have been adapted and evaluated with this population. Intensive psychoeducation may improve knowledge and decision-making which could potentially translate to reductions in HIV risk behaviors. A peer group randomized controlled comparison of an adapted EBI vs. control was delivered over an eight-day summer basketball camp in one reservation-based tribal community to adolescents ages 13–19. Outcome data were gathered immediately post-camp and at 6 and 12 months follow-up. Self-selected peer groups were randomized to intervention (n = 138) or control (n = 129) conditions for a total sample of 267 participants (56.2% female), mean age 15.1 years (SD = 1.7). Intervention participants had better condom use self-efficacy post-camp (Adjusted Mean Difference [AMD] = −0.75, p < 0.005) and at 6 (AMD = −0.44, p < 0.005) and 12 months (AMD = −0.23, p < 0.05) follow-up. Intervention participants also had higher HIV prevention and transmission knowledge (post-camp: AMD = 0.07, p < 0.01; 6 months: AMD = 0.06, p < 0.01) were more likely to believe condoms prevent sexually transmitted infections (post-camp: RR = 1.41, p < 0.005; 6 months: RR = 1.34, p < 0.05), to talk with an adult about HIV/AIDS (post-camp: RR=1.78, p < 0.005; 6 months: RR = 1.14, p < 0.005), had higher partner negotiation efficacy related to substance use during sex (post-camp: AMD = 0.37, p < 0.01), and were more likely to intend to use a condom (post-camp: RR = 1.39, p < 0.01). The adapted intervention had short- and medium-term impacts on AI adolescent risk for HIV/AIDS, but attenuated at 12 months. Intervention delivery through a community-based camp is feasible and acceptable with strong retention. Additional study is needed to evaluate the adapted interventions impact on sexual risk behaviors and if booster sessions and parent involvement translate to long-term impacts.
International Journal of Std & Aids | 2015
Lauren Tingey; Rachel Strom; Ranelda Hastings; Anthony Parker; Allison Barlow; Anne Rompalo; Charlotte A. Gaydos
American Indians suffer a disproportionate burden of sexually transmitted infection, particularly adolescents. Screening access barriers in rural and reservation-based communities necessitate alternatives to clinic-based options. Self-administered screening for three sexually transmitted infections was piloted among 32 American Indian adolescents aged 18 to 19. Participants self-collected in a private location; specimens were processed by trained, American Indian paraprofessionals and analysis was conducted by an outside laboratory. Participants testing positive were treated by a Public Health Nurse from the Indian Health Service. Results suggest high overall acceptability: 69% preferred a self-administered method over clinic-based screening, 75% would encourage their friends to use this method and 100% would use it again. A self-administered screening method has the ability to reach this and other high-risk populations that might not otherwise access screening, with added potential within the Indian Health Services system for uptake and dissemination in rural, reservation communities facing significant screening barriers.
Aids Care-psychological and Socio-medical Aspects of Aids\/hiv | 2015
Lauren Tingey; Britta Mullany; Rachel Chambers; Ranelda Hastings; Allison Barlow; Anne Rompalo
This paper describes the rationale, design, methods, and baseline results of a randomized controlled trial to evaluate the impact of an adapted evidence-based intervention (EBI), “Respecting the Circle of Life” (RCL) to reduce behavioral risks for HIV/AIDS among American Indian (AI) adolescents. A participatory approach shaped intervention adaptation and study design. A total of 267 participants (aged 13–19) were randomized by peer groups of the same sex to receive the RCL intervention or a control condition. Self-report assessments were administered at four intervals. The sample was predominately female (57%), had low HIV knowledge prevention scores, early sexual initiation (mean 14.6 years), and 56% reported intention to use a condom at next sex. Baseline characteristics were evenly distributed between groups with the exception of age and extrinsic reward scores. This is the first rigorous evaluation of an adapted EBI for HIV/AIDS prevention among AI adolescents, an at-risk and understudied population.
JAMA Pediatrics | 2006
Allison Barlow; Elena Varipatis-Baker; Kristen Speakman; Golda S. Ginsburg; Ingrid K. Friberg; Novalene Goklish; Brandii Cowboy; Pauline Fields; Ranelda Hastings; William Pan; Raymond Reid; Mathuram Santosham; John Walkup
American Journal of Psychiatry | 2013
Allison Barlow; Britta Mullany; Nicole Neault; Scott N. Compton; Alice Carter; Ranelda Hastings; Trudy Billy; Valerie Coho-Mescal; Sherilynn Lorenzo; John Walkup
Maternal and Child Health Journal | 2008
Golda S. Ginsburg; Elena Varipatis Baker; Britta Mullany; Allison Barlow; Novalene Goklish; Ranelda Hastings; Audrey E. Thurm; Kristen Speakman; Raymond Reid; John T. Walkup
American Indian and Alaska Native Mental Health Research | 2010
Allison Barlow; Britta Mullany; Nicole Neault; Yvonne Davis; Trudy Billy; Ranelda Hastings; Valerie Coho-Mescal; Kristin Lake; Julia Powers; Emily Clouse; Raymond Reid; John Walkup
Child Care Quarterly | 2012
Golda S. Ginsburg; Allison Barlow; Novalene Goklish; Ranelda Hastings; Elena Varipatis Baker; Britta Mullany; Jenn Yun Tein; John T. Walkup
American Indian and Alaska Native Mental Health Research | 2013
Britta Mullany; Allison Barlow; Nicole Neault; Trudy Billy; Ranelda Hastings; Valerie Coho-Mescal; Sherilyn Lorenzo; John T. Walkup