What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions.

Objectives: To identify and define potential positive and negative factors in patient experiences and patient-provider interactions that are associated with the pursuit and maintenance of treatment by those suffering from substance use disorders (SUD).

Methods: Two focus groups with patients in treatment for SUD were performed. The focus groups focused on questions aimed at mapping factors associated with initiating and maintaining treatment along the transtheoretical model of change.

Variation in Veteran Identity as a Factor in Veteran-Targeted Interventions.

The sociocultural identities that people self-assign or accept influence their interpersonal interactions and decision making. Identity-based interventions attempt to influence individuals by associating healthy behaviors with in-group membership. Outreach and educational efforts aimed at veterans may rely on "typical" veteran identity stereotypes.

Contextually appropriate measurement as the basis for culturally appropriate interventions: a case study in Managua, Nicaragua.

Despite recent advances in U.S. health care, racial and ethnic minorities experience significantly worse health and mental health outcomes.

Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self esteem, recovery orientation, empowerment, and perceived devaluation and discrimination.

Objective: The internalized stigma of mental illness impedes recovery and is associated with increased depression, reduced self-esteem, reduced recovery orientation, reduced empowerment, and increased perceived devaluation and discrimination. The Internalized Stigma of Mental Illness (ISMI) scale is a 29-item self-report questionnaire developed with consumer input that includes the following subscales: Alienation, Discrimination Experience, Social Withdrawal, Stereotype Endorsement, and Stigma Resistance. Here we present a 10-item version of the ISMI containing the two strongest items from each subscale.

A model of internalized stigma and its effects on people with mental illness.

Objectives: The investigators aimed to examine the prevalence of internalized stigma among individuals with serious mental illness and to construct and test a hypothesized model of the interrelationships among internalized stigma, self-concept, and psychiatric symptoms.

Methods: One hundred individuals, most of whom were African American and had a diagnosis of serious mental illness, were receiving mental health services from one of three community outpatient mental health programs or one Veterans Affairsmedical center. They completed an interview that included measures of internalized stigma, psychiatric symptoms, self-esteem, selfefficacy, and recovery orientation.

Social determinants of breast cancer screening in urban primary care practices: a community-engaged formative study.

Background: The recent decline in the breast cancer mortality rate can be attributed to intensive screening and early detection efforts. However, studies have documented a decline in self-reported recent mammography use and interventions to enhance mammography utilization have yielded modest improvements. To address the root causes of breast cancer disparities and improve mammography use, interventions need to address multiple layers of patient, provider, and health system factors.

Individual and community predictors of maternal smoking in the city of Baltimore: what can be learned from a predominantly minority case controlled study?

This case control study of 1,000 birth certificates examined what individual and community factors predicted maternal smoking in Baltimore, Maryland. Conditional multinomial logistic regression results indicated women who were White were more likely to start smoking at a young age, but as they got older, they were less likely to smoke. Minority women were more likely to start smoking at a later age.

Ending self-stigma: pilot evaluation of a new intervention to reduce internalized stigma among people with mental illnesses.

Objective: This study evaluated "Ending Self-Stigma" (ESS), a structured 9-session group intervention to help people with serious mental illnesses reduce internalized stigma.

Methods: Participants from two Veterans Administration mental health sites were assessed before and after the intervention regarding their levels of internalized stigma, empowerment, recovery orientation, perceived social support, and beliefs about societal stigma.

Results: Internalized stigma significantly decreased, and perceived social support and recovery orientation significantly increased.

Person-environment interactions contributing to nursing home resident falls.

Although approximately 50% of nursing home residents fall annually, the surrounding circumstances remain inadequately understood. This study explored nursing staff perspectives of person, environment, and interactive circumstances surrounding nursing home falls. Focus groups were conducted at two nursing homes in the mid-Atlantic region with the highest and lowest fall rates among corporate facilities.

Acceptance and expectations of information technology to support hypertension self-care in African Americans: a qualitative inquiry.

The aim of this study was to explore African American patients' experiences managing their hypertension and to investigate their perspective on how technology might be used to improve hypertension self-management. We conducted and analyzed four focus groups with 32 African American participants diagnosed with hypertension to develop a culturally tailored content for a home-based telecare program aimed at improving hypertension care in African Americans. The discussion about the use of technology was well accepted, demonstrated culturally and gender specific barriers in hypertension care, and generated a comprehensive list of concepts and features to be included to a home-based computerized hypertension telemanagement system.

Inner-city victims of violence and trauma care: the importance of trauma-center discharge and aftercare planning and violence prevention programs.

Inner-city trauma centers often provide care for disproportionately indigent populations who are victims of violence. Many of these victims of violence often return to the trauma center with more violent injuries. Research has shown that a majority of these individuals who return to the trauma center for care are expensive to treat, are uninsured and have significant social problems.

Predictors of participation in an HIV risk reduction intervention for socially deprived Latino women: a cross sectional cohort study.

Background: Little is known about predictors of participation and attrition in HIV prevention programs for socially deprived Latino women.

Objectives: The purpose of this study was to examine factors that predict program participation and attrition among Latino women in a community-based, culturally specific HIV risk reduction intervention.

Design: This was a cross-sectional comparison of baseline data drawn from a randomized HIV risk reduction trial.

A randomized clinical trial of an HIV-risk-reduction intervention among low-income Latina women.

Background: HIV infection has increased within the Latina community more than in any other ethnic or racial group within the United States. Latinas comprise only 13% of the U.S.