This was a UCSD Center for AIDS Research-funded pilot study to develop and test a culturally-tailored and comprehensive self-care and HIV-prevention intervention designed for women who had been recently diagnosed with HIV. The Spanish-language intervention was delivered by a trained health educator and included messages to empower women to seek HIV care and reduce sexual and drug-use behavior. It was piloted with HIV-positive female sex workers in Tijuana
Results: From 2009-2010, a total of 16 female sex workers living with HIV in Tijuana participated in the study. Although the small sample size precludes more advanced analysis, we did observe a significant increase in overall level of being informed about HIV, which is generally supported by participant qualitative comments after the intervention. To our knowledge, there are currently no other interventions in Mexico like the one developed in this pilot study, designed specifically for recently-diagnosed women. This study resulted in the development of Spanish-language resources that may be used by other researchers working with similar populations in Tijuana. These include a protocol for emergencies, a guide on how to access HIV services in Tijuana, including providing cost, time, and transportation options for traveling to the primary state-funded comprehensive services clinic, CAPASITS.
Project Dates: 2009-2010
Total Funds Granted: $60,000
Director: Maria Luisa Zúñiga, Ph.D.
Not in Care Study:
Assessed reasons why some individuals who strongly suspect that they have HIV do not obtain an HIV test, and why others who know they have HIV do not access medical care. The project was a collaboration between the California Department of Health Services, Office of AIDS; the University of California, San Diego (UCSD); and select Early Intervention Program (EIP) sites implementing the Bridge Project.
Results: From September 2006 through January 2009, 215 HIV+ persons not currently receiving HIV care participated in the study. Among HIV+ persons not currently receiving care, both individual- and environmental-level factors are associated with never initiating HIV care. At the individual level, our study suggests high levels of isolation and denial among those never in care. It is clear that misperceptions about HIV treatment are also more common among those never in care. A minority reported knowing someone with HIV/AIDS or telling even one person about their HIV status, and a majority said they did not want to think about being HIV+. All three of these factors were independently associated with never being in care. This suggests that isolation and stigmatization serve as powerful barriers to care and must be addressed as part of interventions to facilitate timely treatment entry. At the environmental level, not having medical insurance and missed opportunities to facilitate treatment at the time of diagnosis were independently associated with never being in care. Both of these factors are amenable to intervention.
Total Funds Granted: $473,370
Director: Maria Luisa Zúñiga, Ph.D., firstname.lastname@example.org
Absenteeism-causing symptom level assessment network (ASLAN):
This project evaluated a technologically new system of having parents report absence-causing symptoms when reporting a child’s absence from school for illness. Automated collection and analysis of parents’ descriptions of their children’s illnesses classified symptoms into a set of syndromes that can detect spread of problems like seasonal flu, new viruses in the community, biohazards in school facilities, and other problems of importance to public health. This Division collaborated with Cal IT-2 and UCSD Cognitive Science, and was primarily responsible for interacting with schools and with public health authorities and for establishing medical protocols for collecting data. Data analysis is ongoing.
Project Dates: 2007-2010
Total Funds Granted: $45,000
Director: Howard Taras, M.D. email@example.com
Families in Transition Study (Project FIT)
This research project was an NIH-funded study designed to understand how the families of pregnant Latina teenagers adjust to the teen’s pregnancy and parenting, and why repeated teenage pregnancies occur within families and across siblings. The intended impact was to inform adolescent pregnancy prevention efforts aimed at the siblings of pregnant and parenting teens, as well as interventions that aim to help families prepare and adjust to the teenager’s childbearing.
Results: This study enrolled approximately 100 families at the time of the first teenager’s pregnancy, and followed these families at four different time points, or when: the teenager was in her last trimester of pregnancy, and when her baby was 2 months old, 6 months old, and 12 months old. Study results have been published in several journal articles and reveal how family functioning changes after a teenager’s baby is born, how mothers’ parenting is affected by a teenage daughter’s childbearing, and how younger siblings’ involvement in the caretaking of their teenage sister’s baby affects their psychological health and school adjustment.
Total Funds Granted: $1,612,424
Director: Patricia East, Ph.D
Healthy Start Pilot:
Analyzed feasibility of implementing & sustaining health curricula in Head Start Centers. Introduced primary disease prevention in low-income minority children and families, where health disparities are most prevalent.
Results: This was a feasibility study testing the fit of the Healthy Start curriculum in Head Start Centers. We found that teachers and administrators rated this health curriculum favorably and enjoyed using it. It continues to be used in many Head Start Centers and served as a pilot program for further research.
Years: 2002 – 2004 main study, 2005 follow-up
Total Funds Granted: about $75,000
Director/Contact: Shelia L. Broyles, Ph.D. firstname.lastname@example.org
Southern California Border HIV/AIDS Project:
Collaborative initiative with San Ysidro Health Center; Aim was to improve HIV/AIDS outreach, access to testing and primary care services, and cross border linkages (San Diego, Imperial County, border region). Intended impact was to Increase the number of high-risk Latino persons tested early for HIV and the number of HIV-positive persons who have access to primary care services, as well as improve providers’ capacity to deliver culturally-competent care.
Results: From July 2001 to September 2004, 300 HIV-positive patients were enrolled in the study at four community health centers in Southern California. First, half of the sample reported at least one current barrier to HIV care, with one-third reporting two or more barriers. Second, the population demonstrated high levels of bi-national health care utilization. Although study participants were accessing HIV care or social services in the US by virtue of recruitment locations, one third also reported receiving HIV care in Mexico, nearly one-half reported receiving non-HIV care in Mexico, and one-sixth obtained traditional medication or herbs in Mexico. Third, the study illuminated a number of factors that were independently associated with experiencing barriers to HIV care, which has important implications for health service delivery for HIV-positive persons in both Mexico and the US. We found that HIV-positive persons reporting at least one barrier to HIV care were significantly more likely to report the use of traditional medicines/herbs, but it was not known whether these therapies were being used in conjunction with, or in place of, HIV antiretroviral therapies (ARV). Since use of herbal therapies may potentially interact with some ARV regimens, characterizing the types of complementary and alternative medicines (CAM) being used among HIV-positive persons of Mexican origin is of broader significance to other HIV-positive populations.
Total Funds Granted: $534,000
Director: Maria Luisa Zúñiga, Ph.D.; email@example.com
Child and Adolescent Trial for Cardiovascular Health (CATCH):
An innovative school based program in physical and health education, and school nutrition, researched here and nationally and found to have a positive effect on physical activity, and healthy eating. CATCH has been named as the most cost-effective school based intervention available by the CDC and one of the first field tested interventions that focused on environmental changes.
Results: As published in the Journal of the American Medical Association, the CATCH Main Trial (1991-1994) demonstrated that CATCH:
- Reduced total fat and saturated fat content of school lunches;
- Increased moderate-to-vigorous physical activity during P.E. classes, and;
- Improved students' self-reported eating and physical activity behaviors.
Furthermore, the effects of the CATCH Main trial persisted over three years without continued intervention.
Total Funds Granted: Over $25,000,000 to multiple sites in 4 states
CATCH materials are available through FlagHouse, Inc