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J E Mantell

Publications and source records attributed to J E Mantell.

10 recordsLinked to original sources
PubMed2006

Structural interventions: concepts, challenges and opportunities for research.

Structural interventions refer to public health interventions that promote health by altering the structural context within which health is produced and reproduced. They draw on concepts from multiple disciplines, including public health, psychiatry, and psychology, in which attention to interventions is common, and sociology and political economy, where structure is a familiar, if contested, concept. This has meant that even as discussions of structural interventions bring together researchers from various fields, they can get stalled in debates over definitions. In this paper, we seek to move these discussions forward by highlighting a number of critical issues raised by structural interventions, and the subsequent implications of these for research.

Acquired Immunodeficiency Syndrome↗
PubMed2006

The CASE adherence index: A novel method for measuring adherence to antiretroviral therapy.

The Center for Adherence Support Evaluation (CASE) Adherence Index, a simple composite measure of self-reported antiretroviral therapy (ART) adherence, was compared to a standard three-day self-reported adherence measure among participants in a longitudinal, prospective cross-site evaluation of 12 adherence programs throughout the United States. The CASE Adherence Index, consisting of three unique adherence questions developed for the cross-site study, along with a three-day adherence self-report were administered by interviews every three months over a one-year period. Data from the three cross-site adherence questions (individually and in combination) were compared to three -day self-report data and HIV RNA and CD4 outcomes in cross-sectional analyses. The CASE Adherence Index correlated strongly with the three-day self-reported adherence data (p < 0.001) and was more strongly associated with HIV outcomes, including a 1-log decline in HIV RNA level (maximum OR = 2.34; p < 0.05), HIV RNA < 400 copies/ml (maximum OR = 2.33; p < 0.05) and performed as well as the three-day self-report when predicting CD4 count status. Participants with a CASE Index score >10 achieved a 98 cell mean increase in CD4 count over 12 months, compared to a 41 cell increase for those with scores < or =10 (p < 0.05). The CASE Adherence Index is an easy to administer instrument that provides an alternative method for assessing ART adherence in clinical settings.

Adult↗
PubMed2001

The acceptability of the female condom: perspectives of family planning providers in New York City, South Africa, and Nigeria.

This article seeks to fill the gap in female condom acceptability research by examining family planning (FP) providers' attitudes and experiences regarding the female condom in three countries (South Africa, the US, and Nigeria) to highlight providers' potential integral role in the introduction of the female condom. The case studies used data drawn from three independent projects, each of which was designed to study or to change FP providers' attitudes and practices in relation to the female condom. The case study for New York City used data from semistructured interviews with providers in one FP consortium in which no special female condom training had been undertaken. The data from South Africa were drawn from transcripts and observations of a female condom training program and from interviews conducted in preparation for the training. The Nigerian study used observations of client visits before and after providers were trained concerning the female condom. In New York City, providers were skeptical about the contraceptive efficacy of the female condom, with only 8 of 22 providers (36%) reporting they would recommend it as a primary contraceptive. In South Africa, providers who had practiced insertion of the female condom as part of their training expressed concern about its physical appearance and effects on sexual pleasure. However, they also saw the female condom as a tool to empower clients to increase their capacity for self-protection. Structured observations of providers' counseling interactions with clients following training indicated that Nigerian providers discussed the female condom with clients in 80% of the visits observed. Despite the lack of a uniform methodology, the three case studies illuminate various dimensions of FP providers' perceptions of the acceptability of the female condom. FP providers must be viewed as a critical factor in female condom acceptability, uptake, and continued use. Designing training programs and other interventions that address sources of provider resistance and enhance providers' skills in teaching female condom negotiation strategies may help to increase clients' use of the female condom.

Attitude of Health Personnel↗
PubMed2000

Introducing the female condom through the public health sector: experiences from South Africa.

The successful implementation of new public health policy is influenced by provider preparedness and user acceptability of the new intervention. This paper describes the development and implementation of a participatory Training of Trainers (TOT) programme as a precursor to launch the South African government's female-initiated HIV prevention strategies in public health clinics. Three hundred peer-trainees from throughout South Africa were trained through a comprehensive, modular and interactive three-day workshop. The workshop content included: HIV/AIDS knowledge, beliefs and attitudes; values clarification regarding HIV infection and sexuality; sexual desensitization; 'hands-on' training in the use of and introduction of the female condom; and counselling, communication and programme planning skills. The TOT generated a cadre of knowledgeable health care workers for training others and provided a support structure at the service delivery level for ensuring potential users' access to the female condom within each province. Qualitative assessments of the training and trainer debriefing sessions suggest that the training was successful in increasing knowledge and promoting positive attitudes about female condoms. In addition, the expanded repertoire of problem-solving approaches left providers feeling confident about recommending this method to clients.

Attitude to Health↗
PubMed1989

Social workers respond to the AIDS epidemic in an acute care hospital.

Acquired immune deficiency syndrome (AIDS) has had dramatic effects on hospital staff, particularly social workers. However, little documentation exists of how hospitals and their social work departments have responded to the myriad needs of people with human immunodeficiency virus-related conditions. Patterns of social work service delivery to 152 persons with AIDS at St. Luke's-Roosevelt Hospital Center in New York City were reviewed. Gaps were identified; in particular, social workers provided services to only 40 percent of the identified persons with AIDS. The need for staff education and training, dedicated resources for services to persons with AIDS, and increased out-of-hospital services are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The AIDS crisis: a United States health care perspective.

The unanticipated onset of Acquired Immunodeficiency Syndrome in the United States, followed by its gradual progression into a full-blown, uncontrollable epidemic, has had severe economic and organizational consequences for the American health care system. AIDS has taken its toll on the health workforce as well in terms of stress, anxiety and workload demands. In the absence of adequate community-based treatment and care resources for persons with AIDS, hospitals had to assume the major burden for providing basic medical care and developing the needed range of services required. This expansion of responsibilities strained hospitals and other health care agencies beyond their capabilities. Some hospitals have faced economic and allocation dilemmas because of high occupancy rates by AIDS patients since there are no specialized reimbursement rates for the intensive resource utilization required for their care. These substantial burdens underscored the need for coordinated long-term planning for a continuum of in-patient, out-patient and community support services. A major response to the epidemic has been a restructuring of the health and social service delivery systems. Hospitals have had to maintain patients beyond their need for an acute level of care, develop infrastructures to manage the increasing numbers of patients, alter physical facilities, provide educational programs and support groups to increase staff's knowledge and decrease fears of AIDS, consider alternatives to in-patient medical management, and lobby with local, state and federal governments to obtain increased public monies for AIDS treatment and care. In the past year, there has been a discernible shift to widening the network of ambulatory medical services and community-based social and health care supports. A major focus of this paper is the social and organizational impact of this epidemic on the hospital and health care system and the systems' responses. Alternatives to an acute care treatment locus for persons with AIDS are explored. Recommendations for future directions for a comprehensive, coordinated health and social services delivery network are presented.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Hospice volunteer programs: a proposed agenda.

With the expansion of hospice services, volunteers are being increasingly used to provide emotional, spiritual, and tangible support to the terminally ill and their significant others. Unfortunately, little has been published about the experiences of hospice volunteers. In this paper, we (1) propose a timely agenda for the development and refinement of hospice volunteer programs; (2) outline basic program criteria about which there is emerging consensus; (3) delineate pertinent issues in the screening, training, and job performance of hospice volunteers; and (4) indicate how the implementation of formal program regulations and operations and program evaluation may benefit service recipients and institutional providers.

Hospices↗
PubMed1977

RX for social death: the cancer patient as counselor.

Cancer patients frequently encounter psychological problems distinct from those with other serious illnesses. Cancer's deadly nature and its drastic treatment often alienate patients from relatives and caregivers. The CanCervive program trained cancer patients to counsel other patients. They functioned as role models and provided opportunities for catharsis. Yet their own unresolved conflicts often led them to overidentify with patients. Volunteers lacked insight into their own feelings of stress at seeing dying patients and their own guilt over their relatively advantaged medical status. Despite this, they helped patients cope with their insecurities and dependency needs, and assisted with professional education.

California↗