Search

BackgroundThe term “community health worker” (CHW) can apply to a wide range of individuals providing health services and support for diverse populations. Very little is known about the role of CHWs in Europe working in nonclinical settings who promote sexual health and prevent HIV and other sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (MSM). ObjectiveThis paper describes the development and piloting of the first European Community Health Worker Online Survey (ECHOES) as part of the broader European Union-funded ESTICOM (European Surveys and Trainings to Improve MSM Community Health) project. The questionnaire aimed to assess the knowledge, attitudes, and practices of CHWs providing sexual health services to gay, bisexual, and other MSM in European settings. MethodsECHOES comprises three superordinate domains divided into 10 subsections with 175 items (routed) based on a scoping exercise and literature review, online prepiloting, and Europe-wide consultation. Additional piloting and cognitive debriefing interviews with stakeholders were conducted to identify comprehension issues and improve the clarity, intelligibility, accessibility, and acceptability of the survey. Psychometric properties, including internal consistency of the standardized scales used as part of the survey were examined. The final survey was available to 33 countries in 16 languages. ResultsRecruitment closed on January 31, 2018. Data from 1035 CHWs were available for analysis after application of the exclusion criteria. The findings of the ECHOES survey and the wider ESTICOM project, are now available from the ESTICOM website and/or by contacting the first author. ConclusionsThe findings of this survey will help characterize, for the first time, the diverse role of CHWs who provide sexual health services to gay, bisexual, and other MSM in Europe. Importantly, the data will be used to inform the content and design of a dedicated training program for CHWs as part of the larger ESTICOM project and provide recommendations for MSM-specific strategies to improve sexual health in general and to reduce the incidence and prevalence of HIV, viral hepatitis, and other STIs in particular. International Registered Report Identifier (IRRID)RR1-10.2196/15012

Objective: We aimed to evaluate the usability and acceptability of a co‐designed mobile health (mHealth) application (PrEP‐EmERGE) within a digital health pathway to support HIV pre‐exposure prophylaxis (PrEP). Methods: This was a cross‐sectional study to evaluate the usability and acceptability of the PrEP‐EmERGE app. Data were collected via an online survey sent to all PrEP EmERGE users in September 2021. Usability was assessed with a validated usability tool, the System Usability Scale (SUS). Acceptability was assessed using modified patient‐reported experience measures (PREMs). Quantitative data were analysed using descriptive and/or inferential statistics and qualitative data (free text responses) using thematic analysis. Results: In total, 81/133 (61%) active PrEP EmERGE users completed the online survey, which was available directly from their PrEP EmERGE app: 78/81 (96%) identified as cis‐male, 74/81 (91%) reported their ethnicity as 'white', 69/81 (85%) reported daily PrEP use, 7/81 (9%) reported using an event‐based dosing schedule, and 5/81 (6%) were switching between dosing schedules. Overall, the median SUS score was 78/100 (interquartile range: 70–92). There were no differences in median SUS scores by PrEP dosing schedules (p = 0.78) or months of experience of using the app (p = 0.31). Overall, 73/81 (90%) would recommend the PrEP EmERGE app to a friend and 78/81 (96%) rated their satisfaction of the app as excellent, good or satisfactory. The free text responses generated three key themes: accessibility (for results and information); autonomy [taking responsibility for their (sexual) health] and functionality (including technical recommendations for app development and the digital health pathway). Conclusions: Innovative, co‐designed digital health pathways, such as PrEP EmERGE can help sexual health services to manage increasing numbers of people accessing PrEP – ensuring that they retain access for those who need to be seen face‐to‐face. We report high levels of acceptability and usability during the first 4 months of this novel pathway. [ABSTRACT FROM AUTHOR]

International student mobility amongst and between countries has become increasingly common and forms a central feature of the global higher education system. This paper examines the key learning experiences relating to the student mobility component of the Canadian-European Initiative for Health Promotion Advanced Learning (CEIHPAL) project. CEIHPAL was a unique and innovative project that fostered advanced intercontinental education and learning in health promotion from 2005-2008. With co-funding from the European Commission and the Canadian Government, the project facilitated institutional, student and faculty cooperation, by developing a high level of international communication. In particular, this paper focuses on the student mobility component and experiences of the CEIHPAL programme, a central part of the project activities. Feedback from both Canadian and European students themselves is used to document their participation in the programme, including the benefits derived from taking part as well as the problems and difficulties they encountered. (Contains 1 note and 2 tables.)

This study explores the experiences and support needs of lesbian, gay, bisexual, transgender and questioning (LGBTQ) young people living in Sussex (UK), and the training needs of practitioners working with LGBTQ young people. The aims were to explore the experiences of young people including bullying, "coming out," social service and educational needs, and to investigate how practitioners view the needs of LGBTQ young people. Twenty-nine interviews were conducted and analyzed thematically. Participants stressed the social and health impact of discrimination and bullying on young people as well as barriers faced in accessing services. Young people require support, yet practitioners lack the training to provide that support. Practitioners are open to this training and both groups of participants believe effective training should include youth in the development and delivery. There is an urgent need for the development of appropriate and dedicated LGBTQ youth training for all practitioners working with young people. (Contains 2 tables and 2 footnotes.)

It is now well acknowledged that parents can have a central role in supporting sensible alcohol use and reducing alcohol misuse amongst young people. However, little research has considered how communication and supervision in relation to alcohol actually takes place within the family. Drawing upon interviews with the parents of young people aged 13-17 years (n = 40), this article describes the strategies that many parents use in communicating, monitoring, and supervising alcohol use within the family. The findings revealed that many parents lack the guidance needed to convey "sensible drinking" messages to young people, and wish for greater information and support about young people and alcohol.

Sociological research investigating boys' masculinity performances has commonly recognised the importance of peer group cultures in identity construction. Whilst such work has undoubtedly offered important and useful frameworks for interpreting and understanding boys' behaviour in schools, the article argues that social psychological theories of intergroup relations also proffer important insights. Drawing upon interview and survey data, the article focuses on the existence of intergroup bias between peer groups in two secondary schools and demonstrates how a social identity framework can assist in providing a fuller and more complex understanding of boys' masculinities than sociological insights alone. Furthermore, it is suggested that gender work strategies designed to address and ultimately help some boys restructure their constructions of masculinity, which recognise the range of complex sociological "and" social psychological processes at work, are likely to more effective than those that offer partial insights. As such, strategies that draw upon work on masculinities and upon social psychological theories of intergroup relations may be particularly effective. (Contains 2 tables and 6 notes.)

Comparative European data using Second Generation Surveillance System (SGSS) are scarce among gay, bisexual and other men who have sex with men. This study evaluated the implementation of Sialon II, a bio-behavioural HIV research combined with targeted HIV prevention in 13 European cities conducted in collaboration with community partners. A mixed-methods process evaluation assessed the project's coverage, outputs, quality, challenges and opportunities for improvement. Data collected through structured questionnaire from 71 data collectors from community-based organisations and semi-structured interviews with 17 managers of participating gay venues were analysed. Overall implementation was successful, achieving 4901 valid behavioural questionnaires and obtaining 4716 biological samples. Challenges in conducting bio-behavioural research in gay venues related to strict research protocols and unfavourable characteristics of venues. Formative research, collaboration with community gay venues, and offering HIV prevention emerged as facilitators. Community researchers' training was crucial for fidelity to research protocols, increased trust amongst communities and enabled data collectors to effectively address practical problems in the field. Scientifically sound SGSS with community participation is feasible and allows for including 'hard-to-reach' populations. Prevention benefits include awareness raising, capacity building and sexual health promotion in gay venues. The findings are beneficial for epidemiological research among other HIV key populations. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, intersex, queer people and minority gender identities and sexualities (LGBTIQ+) are often stigmatized and experience discrimination in health care settings, leading to poorer mental health outcomes and unmet needs compared to heterosexual and cisgendered peers. It is thus imperative that mental health providers consider and address structural challenges in order to reduce mental health inequalities of this population. This narrative review assessed the barriers that may prevent access to care and the pathways for care in LGBTIQ + communities. PubMed, PsycInfo, Embase, and Scopus were searched for papers published between December 2021 and February 2022. A total of 107 papers were included with studies reflecting five themes: (1) Unmet mental health needs; (2) Young people; (3) Substance abuse and addiction; (4) Barriers and pathways to care; and (5) Interventions. Findings demonstrate that LGBTIQ + people experience stigmatization and higher rates of substance misuse and mental ill health, which may lead to barriers in accessing health care services, and fewer tailored interventions being provided. These findings have implications for policy, health care screening, and how specialist services are structured. Substantial gaps in the evidence-base exist, and future research should examine how mental health care providers can challenge social issues that maintain discriminatory and stigmatizing practices, and support LGBTIQ + individuals to sustain their resilience. [ABSTRACT FROM AUTHOR]