Publications by authors named "Katherine B Roland"

For Hispanic/Latino MSM (HLMSM) in the South, HIV burden remains high, and HIV elimination is a national priority. Between July and September 2016, using a strengths-based approach informed by resilience theory, we conducted qualitative interviews with HIV-negative HLMSM in five southern cities in the United States with elevated HIV prevalence. We analyzed data using a qualitative content analysis approach, assessing for interrater reliability.

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Data to Care (D2C) uses US public health surveillance data to identify persons with diagnosed HIV who are not receiving adequate medical care. These persons are linked to care and ancillary social services through personalized outreach. We conducted semistructured interviews with 36 adults with HIV in Louisiana who were engaged for the first time or reengaged back into HIV care through D2C efforts.

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Introduction: Among persons with HIV (PWH), homelessness is associated with poorer health. From 2009-2014, national HIV prevention goals included a reduction in homelessness among PWH. We sought to examine social ecological factors associated with homelessness among PWH at a sub-national level during that period.

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Data-to-Care (D2C) is a public health strategy designed to engage out-of-care (OOC) persons with HIV (PWH) in HIV care. OOC PWH are identified through review of state and local HIV data and engaged in care through individualized efforts that address barriers to HIV care. Perspectives of D2C program staff can contribute to D2C program development and sustainability.

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Introduction: People who inject drugs (PWID) are disproportionately affected by HIV in the United States, and HIV prevention and care services may be inaccessible to or underutilized by PWID. In 2018, the Massachusetts Department of Public Health (MDPH) and the Centers for Disease Control and Prevention (CDC) investigated an increase in HIV diagnoses primarily among unstably housed PWID in Lawrence and Lowell.

Methods: The response team interviewed 34 PWID in Lawrence and Lowell, with and without HIV, to inform effective response strategies.

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Patient navigation is a promising strategy for improving health among persons with multiple barriers to HIV care, yet little is known about navigation's core components. From 24 systematically identified navigation studies, we abstracted navigators' activities, grouped activities into 20 thematic activity categories, and ordered them by frequency. Subsequently, Principal Components Analysis of activity categories was used identify independent clusters.

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Patient navigation is increasingly used to link and (re)engage persons with human immunodeficiency virus (HIV) to care. A more holistic understanding of patient navigation can be achieved by exploring the experiences of navigators, the persons who comprise half of the navigation process. We conducted a meta-synthesis of navigator experiences with HIV patient navigation using a phenomenological approach.

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Patient navigation is increasingly utilized to link and (re)engage persons with HIV to care. Understanding client experiences with HIV patient navigation can facilitate intervention design and translation of evidence to practice. We conducted a qualitative meta-synthesis of client experiences with HIV patient navigation.

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Objective: To provide the first systematic review on the associations between HIV patient navigation and HIV care continuum outcomes (i.e. linkage to care, retention in care, antiretroviral therapy (ART) uptake, medication adherence, and viral suppression) in the United States.

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In the United States, disparities in cancer screening, morbidity, and mortality are well documented, and often are related to race/ethnicity and socioeconomic indicators including income, education, and healthcare access. Public health approaches that address social determinants of health have the greatest potential public health benefit, and can positively impact health disparities. As public health interventions, community health workers (CHWs), and patient navigators (PNs) work to address disparities and improve cancer outcomes through education, connecting patients to and navigating them through the healthcare system, supporting patient adherence to screening and diagnostic services, and providing social support and linkages to financial and community resources.

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Background: Current cervical cancer screening guidelines include the option of lengthening the screening interval to 5 years for average-risk women aged 30-65 years when screened with Pap and human papillomavirus (HPV) test (co-test). Because many providers are reluctant to extend screening intervals, we launched an educational intervention to promote recommended screening practices. The study objective was to assess changes in provider attitudes and beliefs to extending screening intervals among low-income women.

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Article Synopsis
  • Women in the study showed improved knowledge about HPV after an educational intervention, but their beliefs about co-testing and extended cervical cancer screening remained negative.
  • The study, conducted in Illinois clinics with 644 participants, used surveys to assess the impact of an HPV test and educational pamphlet on patients' understanding and attitudes.
  • Despite increased HPV knowledge, no significant positive changes in beliefs about longer screening intervals or co-testing were observed, suggesting the need for more effective communication from healthcare providers on these topics.
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Reasons for racial/ethnic disparities in HPV infection are unclear. This study assessed racial/ethnic differences in and risk factors for HPV positivity among low-income women. Data were collected from 984 low-income women visiting Federally Qualified Health Centers across Illinois (2009-2011).

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Objective: Little is known about the information providers share with patients when ordering a co-test, or combined human papillomavirus (HPV) and Papanicolaou (Pap) test, for cervical cancer screening. We assessed provider perceptions of such communication practices with female patients aged 30-60 years.

Methods: We analyzed data from 98 providers in 15 Federally Qualified Health Center clinics across Illinois (2009-2010).

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Background: Among providers who serve low-income and uninsured women, resistance to extending the cervical cancer screening interval following normal Pap and co-test results has been documented. Our objective was to examine provider characteristics and beliefs associated with guideline-consistent screening interval recommendations.

Method: We collected cross-sectional survey data between 2009 and 2010 from 82 primary care providers in six Federally Qualified Health Centers in Illinois, USA.

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Aims: To understand how US cancer control plans address alcohol use, an important but frequently overlooked cancer risk factor, and how many US adults are at risk.

Methods: We reviewed alcohol control efforts in 69 comprehensive cancer control plans in US states, tribes and jurisdictions. Using the 2011 Behavioral Risk Factor Surveillance System, we assessed the prevalence of current alcohol use among US adults and the proportion of these drinkers who exceeded guidelines for moderate drinking.

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Background: Since 2003, U.S. Preventive Services Task Force guidelines recommend against Pap testing for women without a cervix following a hysterectomy and those aged >65 years.

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Special events such as health fairs, cultural festivals and charity runs are commonly employed in the community to increase cancer screening; however, little is known about their effectiveness. The purpose of this study is to assess the activities, screening outcomes, barriers and recommendations of special events to increase breast, cervical and colorectal cancer screening. In-depth interviews were conducted nationally with 51 coordinators of events in June to September 2012.

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Article Synopsis
  • Federally Qualified Health Centers (FQHCs) provide crucial services like cervical cancer screening and HPV vaccinations to underserved women but sometimes do not follow guidelines regarding vaccine eligibility.
  • A survey of 98 primary care providers showed that while 93% recommended the HPV vaccine, many relied on inappropriate criteria like HPV test results and sexual history to determine eligibility.
  • Although most providers believe vaccination reduces the risk of abnormal Pap tests and future referrals, many still do not plan to change their screening practices for vaccinated women, particularly for younger females who are the target age for vaccination.
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Background: Cervical cancer is a leading cause of cancer mortality in nearly all U.S. Affiliated Pacific Island Jurisdictions (USAPIJ); however, most jurisdictions are financially and geographically limited in their capacity to deliver routine screening.

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Background: Special events are common community-based strategies for health promotion. This paper presents findings from a systematic literature review on the impact of special events to promote breast, cervical or colorectal cancer education and screening.

Methods: Articles in English that focused on special events involving breast, cervical, and/or colorectal cancer conducted in the U.

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Background: The recommended screening interval when using the Papanicolaou (Pap) and human papillomavirus (HPV) test (co-testing) is 5 years. However because providers are reluctant to extend the screening interval, we launched a study to identify barriers to appropriate use of the co-test and to implement an educational intervention to promote evidence-based screening practices. This article provides an overview of the study including the multi-component intervention and participant demographics.

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Importance: Since licensure of the human papillomavirus (HPV) vaccine in 2006, HPV vaccine coverage among US adolescents has increased but remains low compared with other recommended vaccines.

Objective: To systematically review the literature on barriers to HPV vaccination among US adolescents to inform future efforts to increase HPV vaccine coverage.

Evidence Review: We searched PubMed and previous review articles to identify original research articles describing barriers to HPV vaccine initiation and completion among US adolescents.

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Objective: Despite guidelines recommending cervical cancer screening intervals be extended beyond one year, clinical practice has been slow to change. Patient preferences are a potential barrier. In the Centers for Disease Control's Cervical Cancer (Cx3) Study at Federally Qualified Health Centers (FQHCs) across Illinois, we surveyed patients about screening practices, and assessed beliefs regarding lengthening screening intervals.

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