Using concept mapping methods to evaluate overdose data to action program efforts in Allegheny County, Pennsylvania.

Background: The Pitt Public Health evaluation team used a mixed-methods, community-based participatory research method of concept mapping to evaluate factors affecting the Overdose Data to Action (OD2A) opioid overdose surveillance and prevention project outcomes for Allegheny County, Pennsylvania.

Methods: In June 2021 we developed the focal prompt: "What factors work to help or limit OD2A program outcomes at the individual, community, and or/system level?"Community partners participated in three phases: Brainstorming, Sorting and Rating, and Interpretation. Using concept mapping software, we applied multidimensional scaling to visualize a point map displaying factors and their relative relationships, and hierarchical cluster analysis to generate concept maps displaying clusters of factors.

A qualitative exploration of health care workers' approaches to relational harm reduction in HIV primary care settings.

Background: Structural harm reduction is an approach to care for people who use drugs (PWUD) that incorporates services and resources (e.g., naloxone, sterile syringes).

eHealth-Enhanced Peer Navigation for Substance Use Treatment and HIV Prevention Service Linkage for Young Adults Surveilled by the Criminal Legal System: Protocol for a Pilot Randomized Trial Study.

Background: In the United States, the proportion of criminal legal-involved (CLI) adults with a substance use disorder reaches 72%, and ~150,000 persons with HIV pass through a carceral setting annually, which represents 16% of the HIV-infected population nationally. Despite the high need for substance use treatment and HIV prevention services, few carceral settings successfully link CLI individuals to treatment upon release. Young adults represent 41.

Community-engaged Processes for Restarting Federally Funded Research in a Community-based Organization during the Coronavirus Disease 2019 Pandemic.

Background: Birmingham AIDS Outreach (BAO) is one of three study sites partnering with the University of Pittsburgh Graduate School of Public Health (Pitt Public Health) for a National Institutes of Health-funded randomized controlled trial on a financial management intervention for people with HIV who are experiencing homelessness or housing instability. After the onset of the coronavirus disease 2019 (COVID-19) pandemic in March 2020, the study team used a community-engaged approach to adapt research protocols at this site. We sought to describe a community-engaged approach to restarting National Institutes of Health-funded research during the COVID-19 pandemic.

Understanding Polarizing Community Perspectives on Harm Reduction Strategies: Challenges to Addressing the Opioid Crisis in Appalachian Pennsylvania.

Introduction: Rural communities face barriers to opioid treatment and overdose prevention including concerns about stigma and lack of harm reduction services.

Purpose: The aim of this study was to explore community perspectives and understanding of harm reduction approaches to opioid use and overdose in a high-risk Northern Appalachian case community in Pennsylvania.

Methods: A small town approximately 10 miles from Pittsburgh was identified as the community with the greatest predicted probabilities of epidemic outbreak using posteriors from spatial models of hospitalizations for opioid use disorders.

Characterizing Biomedical HIV Prevention Awareness and Use Among Black Transgender Women in the United States.

Black transgender women (BTW) in the United States experience disproportionate rates of HIV despite biomedical prevention interventions such as pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP). Using a sample of 490 BTW collected from 2014 to 2017, bivariate, multivariable, and multinomial analyses were conducted to determine factors associated with awareness and use of PrEP and nPEP. BTW living with HIV were more aware of PrEP than HIV-negative BTW.

More Than a Means to an End: Alignment of Social Service Organizations' Missions with Representative Payee Program Goals.

Although nearly 5 million Social Security Income and Social Security Disability Insurance beneficiaries receive entitlements through representative payee programs and approximately 5% of these receive representative payee services from social service agencies, few studies have assessed ways that these services align with their organizations' missions. We conducted nine qualitative interviews with 15 staff members of organizations in Pennsylvania that provide representative payee services in addition to other social or supportive services, with some interviews conducted with multiple representatives within an organization. The purpose of the interviews was to explore the goals of representative payee services for these organizations, whether these providers incorporated representative payee services into their organizational missions, and the extent to which organizations incorporate client-centered approaches in their representative payee services.

A Scoping Review of Patient Preferences for HIV Self-Testing Services in the United States: Implications for Harm Reduction.

Purpose: Despite marked progress in the ability to test for, treat, and prevent HIV, the epidemic remains a significant public health concern, especially among key populations including prisoners; sex workers; transgender individuals; gay, bisexual, and other men who have sex with men (MSM); and Black and Latinx MSM. This scoping review was conducted to provide an overview of the current research describing patient preferences for HIVST in the United States to understand what key populations value about HIVST and why they are willing to use it. A targeted search for published literature on patient preferences for HIVST was conducted using Ovid Medline, PsychINFO, and an HIVST research database.

"Support People the Way in Which They Want to Be Supported": Best Practices for Incorporating Client-Centeredness in Representative Payee Programs.

Nearly 1 million Social Security beneficiaries have representative payees to manage their funds. Although coercion and paternalism are historically associated with payee services, a recent study showed high satisfaction in a payee program incorporating client-centered practices. Separately we reported ways organizations align payee services with their missions to empower clients and improve outcomes.

Protocol of a randomized controlled trial to test the effects of client-centered Representative Payee Services on antiretroviral therapy adherence among marginalized people living with HIV.

Background: Client-Centered Representative Payee (CCRP) is an intervention modifying implementation of a current policy of the US Social Security Administration, which appoints organizations to serve as financial payees on behalf of vulnerable individuals receiving Social Security benefits. By ensuring beneficiaries' bills are paid while supporting their self-determination, this structural intervention may mitigate the effects of economic disadvantage to improve housing and financial stability, enabling self-efficacy for health outcomes and improved antiretroviral therapy adherence. This randomized controlled trial will test the impact of CCRP on marginalized people living with HIV (PLWH).

Drivers of opioid use in Appalachian Pennsylvania: Cross-cutting social and community-level factors.

Background: Four Appalachian states including Pennsylvania (PA) have the highest drug overdose rates in the country, calling for better understanding of the social and economic drivers of opioid use in the region. Using key informant interviews, we explored the social and community drivers of opioid use in a non-urban Appalachian Pennsylvania community.

Methods: In 2017, we conducted qualitative interviews with 20 key stakeholders from a case community selected using the results from quantitative spatial models of hospitalizations for opioid use disorders.

HIV Testing and ART Adherence Among Unstably Housed Black Men Who Have Sex with Men in the United States.

Black men who have sex with men (BMSM) have the highest HIV incidence rate among all MSM in the United States (US), and are also disproportionately affected by homelessness and housing instability. However, little is known about the effects of homelessness on the HIV testing and care continuum for BMSM. Between 2014 and 2017, the Promoting Our Worth, Equality, and Resilience (POWER) study collected data and offered HIV testing to 4184 BMSM at Black Pride events in six US cities.

Intimate Partner Violence and Depression among Black Transgender Women in the USA: The Potential Suppressive Effect of Perceived Social Support.

Depression among Black transgender women (BTW) in the USA is an often understudied mental health concern with far-reaching consequences for overall physical and mental health at both the individual and community levels. Intimate partner violence (IPV) among BTW is also a frequently understudied and important social determinant of health in need of further exploration. This study sought to address the gap in research on the relationship between IPV and depression among BTW using a time- and location-based community sample of BTW from six US cities.

A Systematic Review of Health Outcomes Associated With Provision of Representative Payee Services.

Objective: The Social Security Administration's Representative Payment Program appoints payees as financial managers for individuals determined incapable of managing their funds. The aim is to afford stability and increase clients' ability to meet health and behavioral priorities. This systematic review examined literature on the effect of representative payee services on identified outcomes.

Characterizing the HIV Care Continuum and Identifying Barriers and Facilitators to HIV Diagnosis and Viral Suppression Among Black Transgender Women in the United States.

Background: Although black transgender women (BTW) experience high prevalence of HIV in the United States, no characterization of the HIV care continuum exists for this population. This study addresses this gap by (1) characterizing the HIV care continuum, and (2) exploring correlates of HIV diagnosis and viral suppression among a community-based sample of BTW.

Methods: Data came from Promoting Our Worth, Equality, and Resilience (POWER).

Strategies for Introducing Outpatient Specialty Palliative Care in Gynecologic Oncology.

Purpose: Concern that patients will react negatively to the idea of palliative care is cited as a barrier to timely referral. Strategies to successfully introduce specialty palliative care to patients have not been well described. We sought to understand how gynecologic oncologists introduce outpatient specialty palliative care.

Gynecologic Oncologist Views Influencing Referral to Outpatient Specialty Palliative Care.

Objective: Early specialty palliative care is underused for patients with advanced gynecologic malignancies. We sought to understand how gynecologic oncologists' views influence outpatient specialty palliative care referral to help inform strategies for improvement.

Methods/materials: We conducted a qualitative interview study at 6 National Cancer Institute-designated cancer centers with well-established outpatient palliative care services.