“We as Drug Addicts Need that Program”: Insight from Rural African American Cocaine Users on Designing a Sexual Risk Reduction Intervention for Their Community

Abstract

This focused ethnographic study examines data collected in 2007 from four gender- and age-specific focus groups (FGs) (N = 31) to inform the development of a sexual risk reduction intervention for African American cocaine users in rural Arkansas. A semi-structured protocol was used to guide audio-recorded FGs. Data were entered into Ethnograph and analyzed using constant comparison and content analysis. Four codes with accompanying factors emerged from the data and revealed recommendations for sexual risk reduction interventions with similar populations. Intervention design implications and challenges, study limitations, and future research are discussed. The study was supported by funds from the National Institute of Nursing Research (P20 NR009006-01) and the National Institute on Drug Abuse (1R01DA024575-01 and F31 DA026286-01).

RESUME

“Nous, comme toxicomanes, avons besoin de ce programme”: aperçu des toxicomanes afro-américaines ruraux de cocaïne sur le plan d'intervention de réduction de risques sexuels pour leur communauté

Cette étude ethnographique concentrée examine les données rassemblées en 2007 de quatre groupes de témoins spécifiques en termes de genre et d’âge (N = 31) pour informer le développement d'une intervention de réduction de risques sexuels pour les consommateurs afro-américaines ruraux de cocaïne dans l'Arkansas rural. Un protocole semi-structuré a été utilisé pour guider les analyses des groupes de témoins, enregistrés en audio. Les données ont été saisies et implémentées en Ethnograph et ont été analysées en utilisant les comparaisons des constantes et une analyse du contenu. Quatre codes avec des facteurs associés se sont dégagés des données et ont révélé des recommandations pour les interventions de réductions de risques sexuels avec des populations similaires. On discute les implications du plan de l'intervention et les défis, ainsi que les recherches dans l'avenir. Cette étude a été soutenue par des fonds de l'Institut National de Recherche de la Profession d'Infirmière (P20 NR009006-01) et l'Institut National sur l'Abus des Drogues (1R01DA024575-01 et F31 DA026286-01).

RESUMEN

“Nosotros, siendo drogadictos, necesitamos ese programa”: entendimiento de consumidores afroamericanos rurales de cocaína sobre la planificación de intervención de reducción de riesgos sexuales para su comunidad

Este estudio etnográfico enfocado examina los datos reunidos en 2007 de cuatro grupos focales específicos en términos de género y edad (N = 31) para informar el desarrollo de una intervención de reducción de riesgos sexuales para los consumidores afroamericanos de cocaína en el Arkansas rural. Un protocolo semi-estructurado fue usado para guiar los grupos focales, grabados en cinta de audio. Los dados fueron entrados en Ethnograph y fueron analizados usando una comparación de constantes y un análisis de contenido. Cuatro códigos con factores adjuntos salieron de los datos y dejaron ver recomendaciones para intervenciones de reducción de riesgos sexuales con poblaciones parecidas. Se discuten las implicaciones del plan de intervención y los retos, las limitaciones del estudio y las investigaciones del futuro. El estudio fue apoyado con fondos del Instituto Nacional de Investigaciones de Enfermería (P20 NR009006-01) y del Instituto Nacional de Abuso de Drogas (1R01DA024575-01 y F31 DA026286-01).

Keywords :

• focus group methodology
• formative research
• community engagement
• HIV prevention
• rural African Americans
• cocaine use

THE AUTHORS

Brooke E. E. Montgomery, MPH, Ph.D., was an undergraduate at Washington University in St. Louis and received her MPH and Ph.D. degrees from the UAMS. She currently serves as an Instructor in the Department of Health Behavior and Health Education at the UAMS Fay W. Boozman College of Public Health. Dr. Montgomery's research interests include developing behavioral interventions to reduce sexual risk, examining disparities in HIV and STIs among vulnerable populations, and investigating the role of social, cultural, and psychological factors on sexual risk and drug using behavior.

Katharine E. Stewart, MPH, Ph.D., was an undergraduate at UNC-Chapel Hill. She received her MPH and Ph.D. degrees from the University of Alabama at Birmingham. She currently serves as a Professor of Health Behavior and Health Education and as an Associate Dean of Academic Affairs in the Fay W. Boozman College of Public Health at the UAMS. She is also a licensed clinical psychologist. Dr. Stewart's research activities focus on developing behavioral interventions to prevent HIV and STIs, and to improving quality of life and health outcomes among persons living with HIV.

Patricia B. Wright, MPH, RN, is a doctoral candidate in Health Systems Research at the UAMS and also serves as a Project Director within the Fay W. Boozman College of Public Health at UAMS. Her areas of research interest are substance abuse, HIV prevention, and health services use in rural areas.

Jean McSweeney, Ph.D., RN, FAHA, FAAN, is theAssociate Dean for Research at the UAMS College of Nursing. She has conducted research on women and heart disease for over 20 years, with a variety of culturally diverse women. She used qualitative findings to develop an instrument to assess women's prodromal and acute myocardial symptoms. This instrument has been translated into several languages and is currently being used in a variety of funded grants. Dr. McSweeney has conducted qualitative research studies since 1990 and has served as a qualitative expert on mixed method grants since 1994. She is a recipient of the Katherine A. Lembright Award from the American Heart Association and the Distinguished Researcher Award from the Southern Nursing Research Society. She teaches in the Doctoral program in Little Rock, Arkansas. She is a Fellow in both the American Heart Association and the American Academy of Nursing.

Brenda M. Booth, Ph.D., has conducted health services research with drug and alcohol misuse for over 20 years. Her particular interests are in rural substance use and increasing drug and alcohol treatment participation.