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AHRQ Research Studies Date
Topics
- Behavioral Health (7)
- Burnout (1)
- Caregiving (1)
- Children/Adolescents (1)
- Communication (1)
- Depression (6)
- Diagnostic Safety and Quality (2)
- Education: Patient and Caregiver (1)
- Health Promotion (1)
- Health Services Research (HSR) (1)
- Human Immunodeficiency Virus (HIV) (11)
- Medication (4)
- Obesity (1)
- Obesity: Weight Management (1)
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- Patient Adherence/Compliance (4)
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- Pregnancy (1)
- Prevention (2)
- Racial and Ethnic Minorities (5)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- (-) Social Stigma (17)
- Substance Abuse (2)
- Surgery (1)
- Vulnerable Populations (3)
- Women (3)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedEarnshaw VA, Bogart LM, Menino D
Disclosure, stigma, and social support among young people receiving treatment for substance use disorders and their caregivers: a qualitative analysis.
The purpose of this study was to investigate relational processes experienced by youth with substance use disorders (SUDs) and their caregivers that may act as barriers to, or facilitators of, recovery. Single-session qualitative semi-structured interviews were conducted by clinicians from a SUDs program. There was variability in disclosure experiences. Addressing relational processes within treatment by encouraging patients and caregivers to share the disclosure decision-making process may support the recovery of youth with SUDs.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Bogart LM, Menino D .
Disclosure, stigma, and social support among young people receiving treatment for substance use disorders and their caregivers: a qualitative analysis.
Int J Ment Health Addict 2019 Dec;17(6):1535-49. doi: 10.1007/s11469-018-9930-8..
Keywords: Children/Adolescents, Caregiving, Substance Abuse, Social Stigma
Bi S, Gunter KE, Lopez FY
Improving shared decision making for Asian American Pacific Islander sexual and gender minorities.
This study examined the challenges Asian American Pacific Islander (AAPI) sexual and gender minorities (SGM) encounter with shared decision making (SDM) with their providers, especially concerning mental health. Focus groups were conducted in San Francisco and interviews were conducted in Chicago and San Francisco. The participants were surveyed about attitudes towards SGM disclosure and preferences about providers. Many participants felt that providers either ignored or overemphasized their identities. Some shared the stigma of SGM identities and effects on mental health in their own families.
AHRQ-funded; HS023050.
Citation: Bi S, Gunter KE, Lopez FY .
Improving shared decision making for Asian American Pacific Islander sexual and gender minorities.
Med Care 2019 Dec;57(12):937-44. doi: 10.1097/mlr.0000000000001212..
Keywords: Shared Decision Making, Racial and Ethnic Minorities, Vulnerable Populations, Patient and Family Engagement, Patient-Centered Healthcare, Behavioral Health, Social Stigma
Stringer KL, Marotta P, Baker E
Substance use stigma and antiretroviral therapy adherence among a drug-using population living with HIV.
Among people living with HIV (PLWH), HIV-related stigma predicts nonadherence to antiretroviral therapy (ART); however, the role of stigma associated with drug use is largely unknown. The this study the investigators examined the association between substance use (SU) stigma and optimal ART adherence in a sample of 172 self-reported HIV-infected drug users.
AHRQ-funded; HS013852.
Citation: Stringer KL, Marotta P, Baker E .
Substance use stigma and antiretroviral therapy adherence among a drug-using population living with HIV.
AIDS Patient Care STDS 2019 Jun;33(6):282-93. doi: 10.1089/apc.2018.0311..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Patient Adherence/Compliance, Medication, Substance Abuse
Lipira L, Williams EC, Huh D
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
Investigators recruited a sample of African-American women living with HIV to participate in a stigma-reduction intervention. The women lived in Chicago and Birmingham from 2013 to 2015. The relationship between HIV-related stigma and viral suppression was evaluated and the role of depression and nonadherence to antiretroviral therapy (ART) was assessed. Among 100 women who participated 95% reported some level of HIV-related stigma. Those who reported higher levels of stigma did have lower odds of being virally suppressed. The indirect effects of depression and ART nonadherence were not statistically significant.
AHRQ-funded; HS013853.
Citation: Lipira L, Williams EC, Huh D .
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
AIDS Behav 2019 Aug;23(8):2025-36. doi: 10.1007/s10461-018-2301-4..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Stigma, Women
Earnshaw VA, Mateo CM, Reisner SL
LGBT policy discourse and prevention of homophobic bullying.
This study analyzed the impact of public campaigns promoting lesbian, gay, bisexual, and transgender (LGBT) stigma. It references an article by Hatzenbuehler, et al. that addressed that gap in the literature. That study found that after the passing of Proposition 8 in California, the rates of homophobic bullying increased between 2000 and 2008 when the voting occurred. Homophobic bullying also occurred more where there were “bathroom bills” and other policies promoting transgender discrimination. It also found that schools with Gay-Straight Alliances have both lower rates and less dramatic increases in homophobic bullying. The authors call for action for pediatricians as researchers and as advocates for their patients.
AHRQ-funded; HS000063.
Citation: Earnshaw VA, Mateo CM, Reisner SL .
LGBT policy discourse and prevention of homophobic bullying.
Pediatrics 2019 Jun;143(6). doi: 10.1542/peds.2019-0903..
Keywords: Social Stigma, Vulnerable Populations
Crockett KB, Edmonds A, Johnson MO
Neighborhood racial diversity, socioeconomic status, and perceptions of HIV-related discrimination and internalized HIV stigma among women living with HIV in the United States.
This study sought to evaluate whether internalized HIV stigma and perceived HIV-related discrimination in health care settings differ based on individual- and neighborhood-level characteristics of women living with HIV (WLHIV). The authors also wanted to determine whether neighborhoods with more racial diversity was associated less internalized HIV stigma and discrimination regardless of individual race. A total of 1256 WLHIV enrolled in the Women’s Interagency HIV Study (WIHS) from 10 sites in US metropolitan areas were recruited. They completed surveys on internalized HIV stigma and HIV-related discrimination and also provided residential information so it could be geocoded and linked with census-tract level indicators. Greater neighborhood racial diversity was associated with less stigma and HIV-related discrimination. Neighborhood median income was positively associated with stigma and discrimination, while individual income was negatively associated with stigma and discrimination.
AHRQ-funded; HS013852.
Citation: Crockett KB, Edmonds A, Johnson MO .
Neighborhood racial diversity, socioeconomic status, and perceptions of HIV-related discrimination and internalized HIV stigma among women living with HIV in the United States.
AIDS Patient Care STDS 2019 Jun;33(6):270-81. doi: 10.1089/apc.2019.0004..
Keywords: Human Immunodeficiency Virus (HIV), Social Determinants of Health, Social Stigma
Lipira L, Williams EC, Nevin PE
Religiosity, social support, and ethnic identity: exploring "resilience resources" for African-American women experiencing HIV-related stigma.
The objective of this study was to evaluate whether religiosity, social support, and ethnic identity moderate the effects of HIV-related stigma on depression among African-American women living with HIV. Results showed that the protective effects of religiosity may be leveraged in interventions for African-American women living with HIV struggling with HIV-related stigma.
AHRQ-funded; HS013853.
Citation: Lipira L, Williams EC, Nevin PE .
Religiosity, social support, and ethnic identity: exploring "resilience resources" for African-American women experiencing HIV-related stigma.
J Acquir Immune Defic Syndr 2019 Jun;81(2):175-83. doi: 10.1097/qai.0000000000002006..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Social Stigma, Women, Depression, Behavioral Health
Dolan P, Afaneh C, Symer M
Assessment of public attitudes toward weight loss surgery in the United States.
The authors designed a national cross-sectional survey to assess attitudes toward weight loss surgery in the US general population. Their survey results suggested that a large percentage of the population has negative attitudes toward weight loss surgery, including men and non-Hispanic black respondents, who were more likely to think that people who chose weight loss surgery were taking the easy way out. The authors recommended further research with respect to normalizing weight loss surgery as a reasonable option for managing obesity.
AHRQ-funded; HS000066.
Citation: Dolan P, Afaneh C, Symer M .
Assessment of public attitudes toward weight loss surgery in the United States.
JAMA Surg 2019 Mar;154(3):264-66. doi: 10.1001/jamasurg.2018.4650..
Keywords: Obesity: Weight Management, Obesity, Surgery, Social Stigma
Turan B, Crockett KB, Buyukcan-Tetik A
Buffering internalization of HIV stigma: implications for treatment adherence and depression.
One mechanism through which social stigma of HIV affects health outcomes for people living with HIV (PLWH) is through internalization of stigma. However, this transformation of social stigma in the community into internalized stigma may not be of the same magnitude for all PLWH. In this study, the investigators examined the moderating effects of 3 personality traits-fear of negative social evaluation, attachment-related anxiety, and dispositional resilience-in transforming perceived stigma in the community into internalized stigma. They also investigated downstream effects of these moderated associations on depressive symptoms and antiretroviral treatment (ART) adherence.
AHRQ-funded; HS013852.
Citation: Turan B, Crockett KB, Buyukcan-Tetik A .
Buffering internalization of HIV stigma: implications for treatment adherence and depression.
J Acquir Immune Defic Syndr 2019 Mar;80(3):284-91. doi: 10.1097/qai.0000000000001915..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Social Stigma
Lipira L, Nevin PE, Frey S
The positive living program: development and pilot evaluation of a multimedia behavioral intervention to address HIV-related stigma and depression among African-immigrant people living with HIV in a large, Northwestern U.S. metropolitan area.
The purpose of thisstudy was to implement the first three steps (information gathering, preliminary design, preliminary testing) in the development of a culturally-adapted multimedia behavioral intervention to reduce HIV-related stigma among African-immigrant PLWH. The investigators concluded that input from key stakeholders and observed decreases in depressive symptoms post-intervention indicated that a multimedia behavioral intervention such as The Positive Living Program could be an effective way to address poor psychosocial outcomes associated with HIV-related stigma among African-immigrant PLWH.
AHRQ-funded; HS013853.
Citation: Lipira L, Nevin PE, Frey S .
The positive living program: development and pilot evaluation of a multimedia behavioral intervention to address HIV-related stigma and depression among African-immigrant people living with HIV in a large, Northwestern U.S. metropolitan area.
J Assoc Nurses AIDS Care 2019 Mar-Apr;30(2):224-31. doi: 10.1097/jnc.0000000000000037..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Depression, Behavioral Health, Racial and Ethnic Minorities
Dir AL, Saldana L, Chapman JE
Burnout and mental health stigma among juvenile probation officers: the moderating effect of participatory atmosphere.
This study examined the effects of job burnout on mental health stigma among juvenile probation offices (JPOs). Due to the high rate of mental health issues among juveniles in the justice system, there is a high burnout rate among JPOs.
AHRQ-funded; HS024296.
Citation: Dir AL, Saldana L, Chapman JE .
Burnout and mental health stigma among juvenile probation officers: the moderating effect of participatory atmosphere.
Adm Policy Ment Health 2019 Mar;46(2):167-74. doi: 10.1007/s10488-018-0902-x..
Keywords: Burnout, Behavioral Health, Social Stigma
Turan B, Rice WS, Crockett KB
Longitudinal association between internalized HIV stigma and antiretroviral therapy adherence for women living with HIV: the mediating role of depression.
This study investigated whether internalized HIV-related stigma predicts adherence to antiretroviral therapy (ART) longitudinally in women living with HIV in the United States; symptoms of depression as a mediator in the relationship between internalized stigma and suboptimal ART adherence was also examined. A new measure of internalized HIV-related stigma was added to the Women's Interagency HIV Study in 2013. Participants' first assessment of stigma and their assessments of other variables were used as baseline measures, and outcomes measured 2 years later. A measure of depression symptoms was assessed 18 months after the baseline. The results suggest that a higher internalized HIV-related stigma at the first assessment was a predictor of lower odds of optimal ART adherence at the two-year mark. Mediation analysis also indicated significant indirect effect on ART adherence through depression symptoms at the 18-month mark.
AHRQ-funded; HS013852.
Citation: Turan B, Rice WS, Crockett KB .
Longitudinal association between internalized HIV stigma and antiretroviral therapy adherence for women living with HIV: the mediating role of depression.
AIDS 2019 Mar;33(3):571-76. doi: 10.1097/qad.0000000000002071..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Social Stigma
Turan JM, Elafros MA, Logie CH
Challenges and opportunities in examining and addressing intersectional stigma and health.
The purpose of this article was to review and highlight existing intersectional stigma literature, as well as to identify gaps in methods for studying and addressing intersectional stigma. 'Intersectional stigma' is defined as a concept that characterizes the convergence of multiple stigmatized identities within a person or group and addresses effects on health and well-being. Examples illustrating promising analytical approaches are provided, and priorities for future health research elucidated. Evidence from existing literature, as well as the examples presented, suggest that people in diverse settings experience intersecting forms of stigma that influence their mental and physical health and their corresponding health behaviors. The authors conclude that intersectional stigma are a common reality, but remain poorly understood; it is vital that instruments and methods be developed to characterize the mechanisms and effects of intersectional stigma in relation to various health conditions.
AHRQ-funded; HS013852.
Citation: Turan JM, Elafros MA, Logie CH .
Challenges and opportunities in examining and addressing intersectional stigma and health.
BMC Med 2019 Feb 15;17(1):7. doi: 10.1186/s12916-018-1246-9..
Keywords: Health Services Research (HSR), Social Stigma
Sun CJ, Anderson KM, Toevs K
"Little tablets of gold": an examination of the psychological and social dimensions of PrEP among LGBTQ communities.
There are significant psychological, social, and cultural dimensions to the HIV epidemic in the United States, especially among lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. Biomedical HIV treatment has been shown to impact these dimensions. However, there is little understanding of the real-world psychosocial and sociocultural effects of the latest biomedical HIV prevention strategy, HIV pre-exposure prophylaxis (PrEP). This study explored the psychosocial and sociocultural dimensions of PrEP use among LGBTQ adults.
AHRQ-funded; HS022981.
Citation: Sun CJ, Anderson KM, Toevs K .
"Little tablets of gold": an examination of the psychological and social dimensions of PrEP among LGBTQ communities.
AIDS Educ Prev 2019 Feb;31(1):51-62. doi: 10.1521/aeap.2019.31.1.51..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Vulnerable Populations, Social Stigma
Payan DD, Derose KP, Fulcar MA
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. In this study, the investigators conducted in-depth interviews with 30 women living with HIV in the Dominican Republic to explore the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings.
AHRQ-funded; HS000046.
Citation: Payan DD, Derose KP, Fulcar MA .
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
J Int Assoc Provid AIDS Care 2019 Jan-Dec;18. doi: 10.1177/2325958219849042..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Women, Social Stigma, Depression, Behavioral Health
Payan DD, Florez KR, Bogart LM
Promoting health from the pulpit: a process evaluation of HIV sermons to reduce HIV stigma and promote testing in African American and Latino churches.
This study explored implementation of an HIV sermon as part of a multi-component intervention in three churches (Latino Catholic, Latino Pentecostal, and African American Baptist) in high HIV prevalence areas of Los Angeles County, California. The investigators found large variation in fidelity to communicating key HIV messages from the sermon guide. They concluded that structured training of clergy may be necessary to implement the more theoretically driven stigma reduction cues included in the sermon guide.
AHRQ-funded; HS000046.
Citation: Payan DD, Florez KR, Bogart LM .
Promoting health from the pulpit: a process evaluation of HIV sermons to reduce HIV stigma and promote testing in African American and Latino churches.
Health Commun 2019 Jan;34(1):11-20. doi: 10.1080/10410236.2017.1384352..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Racial and Ethnic Minorities, Diagnostic Safety and Quality, Health Promotion, Education: Patient and Caregiver, Communication, Prevention
Turan B, Stringer KL, Onono M
Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.
The investigators examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women. They found that, in this study group of women from rural Kenya, at 6 weeks postpartum, those who had not linked to HIV care after testing positive at their first antenatal visit had higher levels of depression and internalized stigma, compared to women who had linked to care. Internalized stigma mediated the effect of linkage to care on depression. Furthermore, participants who had both linked to HIV care and initiated antiretroviral therapy reported the lowest levels of depressive symptoms.
AHRQ-funded; HS013852.
Citation: Turan B, Stringer KL, Onono M .
Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.
BMC Pregnancy Childbirth 2014 Dec 3;14:400. doi: 10.1186/s12884-014-0400-4.
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Keywords: Depression, Human Immunodeficiency Virus (HIV), Pregnancy, Social Stigma