Browsing by Author "Carter, Gregory"

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    Enduring Uncertainty Through the Lens of Osteoporosis: A Mixed Methods Study
    (2024-06) Vlaeminck, Caitlin Mae; Miller, Wendy Trueblood; Carter, Gregory; Crowder, Sharron J.; Otte, Julie; Longtin, Krista
    Osteoporosis is a chronic illness that is underdiagnosed and often poorly managed. Uncertainty is a phenomenon experienced by individuals diagnosed with chronic illness. There are no published American studies describing whether women diagnosed with osteoporosis experience uncertainty. Experiencing uncertainty can lead to decreased quality of life (QOL), delays in decision-making, and negative impacts on relationships. A mixed methods approach was used using descriptive statistics and two scales, The Mishel Uncertainty in Illness Scale-Community Form (MUIS-C) and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health scale, and Interpretative Phenomenological Analysis (IPA). Significant negative correlations were found between levels of uncertainty and physical health status and between physical and mental health. The qualitative study focused on describing the experience individuals had with the diagnosis of osteoporosis. Data were collected through semi-structured interviews with fourteen Caucasian women who all had a diagnosis of osteopenia or osteoporosis. Thematic analysis revealed five themes that could be chronologically processed: The Sentinel Event, Adapting to Chronic Disease, Navigating Uncertainty, Being Less Than, and What the Future Holds. The findings of this study have implications for how healthcare providers share knowledge and education about the disease of osteoporosis with individuals. Future research should include women and men from diverse racial and ethnic backgrounds. This inclusive approach is crucial for ensuring that preventive measures and management strategies are tailored to the diverse needs of all individuals, fostering equity and efficacy in osteoporosis care.
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    HIV pre‐exposure prophylaxis uptake by advanced practice nurses: Interplay of agency, community and attitudinal factors
    (Wiley, 2019-11) Jayawardene, Wasantha; Carter, Gregory; Agley, Jon; Meyerson, Beth; Garcia, Justin R.; Miller, Wendy; School of Nursing
    Aims To identify associations among agency, community, personal and attitudinal factors that affect advanced practice nurses’ uptake of HIV pre‐exposure prophylaxis, an intervention consists of emtricitabine/tenofovir once‐daily pill, along with sexual risk reduction education. Design Cross‐sectional. Methods During March‐May 2017, randomly selected Indiana advanced practice nurses were invited to complete an online survey, consisted of several validated self‐rating measures (N = 1,358; response = 32.3%). Final sample (N = 369) was predominantly White, non‐Hispanic, female advanced practice nurses in urban practices (mean age = 46). Conceptual model for structural equation model included 29 original/composite variables and five latent factors. Results Final model consisted of 11 variables and four factors: agency, community, HIV prevention practices (including screening) and motivation to adopt evidence‐based practices overall. Community had direct effects on HIV prevention practices (estimate = 0.28) and agency (estimate = 0.29). Agency had direct effects on HIV prevention practices (estimate = 0.74) and motivation to adopt evidence‐based practices (estimate = 0.24). Community had indirect effects, through agency, on the two remaining factors. Conclusion Barriers exist against pre‐exposure prophylaxis implementation, although practice guidelines are available. HIV prevention practices must be integrated across organizational structures, especially in high‐risk communities, whereas practice change is more effective when focused on changing providers’ attitudes towards intervention. When planning a pre‐exposure prophylaxis intervention, advancing inputs from healthcare professionals, organizational leadership and community members, is crucial to success. Impact In settings where advanced practice nurses are primary contact points for health care, they may be best positioned to have an impact on implementation of HIV risk reduction strategies. Further research is needed to optimize their contributions to pre‐exposure prophylaxis implementation.
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    PrEP Familiarity, Interest, and Usage Among 364 Black and Hispanic Adults in Indiana
    (Frontiers Media, 2022-05-06) Campbell, Jessica T.; Adams, Olivia R.; Bennett-Brown, Margaret; Woodward, Brennan; Gesselman, Amanda N.; Carter, Gregory; School of Nursing
    Pre-exposure prophylaxis, or PrEP, is a once-daily preventative prescription pill against HIV for adults or adolescents who have sex or inject drugs. PrEP may be especially useful among Black and Hispanic Americans, who are particularly at risk for HIV in the United States. In spite of this vulnerability, rates of PrEP use in Black and Hispanic communities are low. Here, we examined familiarity with, prior usage of, and future interest in PrEP among 364 Black and Hispanic Indiana residents. Indiana is an important context for this work, due to severe HIV outbreaks in the area over the last 8 years. Around half of all participants had never heard of PrEP, with Hispanic participants being less familiar than Black participants. Prior PrEP use was low, at around 10%, and was lower for Hispanic than Black participants. Around 21% of all participants reported interest in PrEP after learning of it in our study. Further, participants identified strategies that would make discussions about PrEP with a medical provider more comfortable. Black and Hispanic participants reported feeling the most comfortable with addressing PrEP usage with providers if: (a) the provider was the one who brought up the subject of PrEP, (b) there was written information available to the patient (i.e., brochures), and (c) the patient already knew they qualified for the prescription in terms of personal eligibility and insurance coverage. Additional provider and patient education, as well as openness on the part of the provider, can help to lessen the disparities associated with PrEP need and actual PrEP usage.
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    PrEP Prescription Among MSM U.S. Military Service Members: Race and Sexual Identification Matter
    (Sage, 2022) Carter, Gregory; Staten, I.L.T. Colten; Woodward, Brennan; Mahnke, Brianna; Campbell, Jessica; School of Nursing
    An estimated 20.9% of U.S. service members report a high risk of HIV infection; however, only 2,000 service members had accessed HIV pre-exposure prophylaxis (PrEP) as of 2017. This study used a cross-sectional design to explore PrEP prescription predictors among service members who identify as a man who have sex with other men (MSM) (n = 354). Logistic regression was performed to assess the influence of four predictor variables: partner HIV status, race/ethnicity, primary partner gender, and sexual orientation on the odds participants' report being prescribed PrEP. A majority identified as gay (n = 246, 69.5%) and 23.4% (n = 83) identified as bisexual. Bisexual participants were 2.1 times (p = <.04) less likely to be prescribed PrEP. Accordingly, those who identify their primary sex partner as female were 5.1 times less likely to be prescribed PrEP (p < .001). MSM service members who had a partner disclose their HIV-positive status were 4.1 times more likely to have been prescribed PrEP (p = .013). Finally, participants who identify as Black were 3 times more likely (p = .001), and Latinx MSM were 3.6 times more likely (p = .003) to have been prescribed PrEP.
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    Sexual Communication Self-Efficacy and PrEP Literacy Helps to Meet HIV Prevention Outcomes Among Black and Latinx Individuals
    (Sage Journals, 2022) Carter, Gregory; Brown, Lucy; Mahnke, Brianna; Ohmit, Anita; Woodward, Brennan
    Background: Ending the HIV Epidemic is a campaign dedicated to reducing new HIV infections in the United States by 90% by 2030. Preexposure prophylaxis (PrEP) holds significant promise as a prevention tool. However, uptake has not improved much since then. As a result, this research looked at how PrEP literacy relates to sexual communication self-efficacy. Methods: Between August 4 and 21, 2020, we performed a community-informed cross-sectional study of Black and Latino residents in Indiana. We collected demographic information as well as PrEP literacy, sexual communication self-efficacy, and awareness of HIV status. Results: Being unaware of one's own HIV status and being unsure of one's sexual identity were both linked to reduced self-efficacy in the domain of sex communication. Those who had a greater level of PrEP literacy felt more confident in their ability to communicate with others about sexually related topics. People living in rural areas showed a significantly lower degree of sexual communication self-efficacy than participants in urban settings. Conclusion: Providing information about PrEP to those at risk of acquiring the virus may help them connect with treatment or prevention services. Healthcare professionals should take the time to understand their patients' levels of PrEP literacy and communication self-efficacy regarding sexual health.