Partner Engagement Research Articles

Audit Partner Engagement in Charities and Client Financial Reporting Quality

SUMMARY This study uses large-sample archival data to examine the relation between audit partners’ charity engagement and their full-time job performance. Volunteering in a critical position at a charity may reflect innate personality traits that lead to better partner performance. However, charity engagement can decrease audit partners’ available working time and may, therefore, negatively impact their performance and clients’ financial reporting quality. Using accounting misstatements as our primary measure of financial reporting quality, we find a positive relation between volunteering and job performance: financial reporting quality is higher for the clients of audit partners who volunteer at a charity. The relation is more pronounced when the partner volunteers to serve as the charity’s board chair or donates to the charity. Although we study just one type of professional, our results speak to the broader question of the benefits and costs of volunteering. Data Availability: Data are available from the public sources cited in the text. JEL Classifications: M40; M42.

The effect of therapists’ enactment interventions in promoting vulnerability sharing in emotion focused couple therapy

Objective The primary purported change process in emotion-focused therapy for couples (EFT-C) involves partners accessing and revealing their underlying vulnerable emotions and responding empathically when their partners disclose their vulnerable emotions. One main intervention to facilitate vulnerability sharing is enactment – guiding partners to interact directly with each other. The objective of the current study was to identify interventions therapists can use to help partners share vulnerability in the context of enactment. The primary hypothesis of this study was that promoting these interventions would lead to more vulnerability expressions during enactments. Method One hundred and five vulnerability enactment events were identified from videod therapy sessions of 33 couples dealing with a significant emotional injury who received 12 sessions of EFT-C. Four therapists’ interventions were coded: setting a meaningful systemic context, promoting the revealing partner’s emotional engagement, preparing the revealing partner for enactment, and promoting the listening partner’s emotional engagement in the enactment. In addition, vulnerability expression was coded. Results Multilevel regression models showed that two interventions were significantly associated with greater levels of expressed vulnerability: setting a meaningful systemic context, and preparing the revealing partner for enactment. Conclusion These findings suggest that therapists can facilitated vulnerability sharing using specific preparatory interventions.

Mitigating inequity: ethically prioritizing patients for CAR T-cell therapy

AbstractManufacturing capacity and institutional infrastructure to deliver chimeric antigen receptor T-cell therapies (CAR-T) are pressured to keep pace with the growing number of approved products and expanding eligible patient population for this potentially life-saving therapy. Consequently, many cell therapy programs must make difficult decisions about which patient should get the next available treatment slot. This situation requires an ethical framework to ensure fair and equitable decision-making. In this perspective, we discuss the application of Accountability for Reasonableness (A4R), a priority-setting framework grounded in procedural justice, to the problem of limited CAR-T slots at our institution. We formed a multidisciplinary working group spanning several hematological malignancies. Through multiple rounds of partner engagement, we used A4R guiding principles to identify 4 main criteria to prioritize patients for CAR-T: medical benefit, safety/risk of complications, psychosocial factors, and medical urgency. Associated measures/tools and an implementation process were developed. We discuss further how ethical principles of fairness and equity demand a consistent approach within health systems that does not disadvantage medically underserved or underrepresented populations and supports overcoming barriers to care. In our commitment to transparency and collaboration, we make our tools available to others, ideally to be used to engage in their own A4R process, adapting the tools to their unique environments. Our hope is that our preliminary work will support the advancement of further study in this area globally, aiming for justice in resource allocation for all potential CAR-T candidates, wherever they may seek care.

Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses

BackgroundInvolving collaborators and partners in research may increase relevance and uptake, while reducing health and social inequities. Collaborators and partners include people and groups interested in health research: health care providers, patients and caregivers, payers of health research, payers of health services, publishers, policymakers, researchers, product makers, program managers, and the public. Evidence syntheses inform decisions about health care services, treatments, and practice, which ultimately affect health outcomes.Our objectives are to:A. Identify, map, and synthesize qualitative and quantitative findings related to engagement in evidence synthesesB. Explore how engagement in evidence synthesis promotes health equityC. Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement in evidence synthesesMethodsOur diverse, international team will develop guidance for engagement with collaborators and partners throughout multiple sequential steps using an integrated knowledge translation approach:1. Reviews. We will co-produce 1 scoping review, 3 systematic reviews and 1 evidence map focusing on (a) methods, (b) barriers and facilitators, (c) conflict of interest considerations, (d) impacts, and (e) equity considerations of engagement in evidence synthesis.2. Methods study, interviews, and survey. We will contextualise the findings of step 1 by assessing a sample of evidence syntheses reporting on engagement with collaborators and partners and through conducting interviews with collaborators and partners who have been involved in producing evidence syntheses. We will use these findings to develop draft guidance checklists and will assess agreement with each item through an international survey.3. Consensus. The guidance checklists will be co-produced and finalised at a consensus meeting with collaborators and partners.4. Dissemination. We will develop a dissemination plan with our collaborators and partners and work collaboratively to improve adoption of our guidance by key organizations.ConclusionOur international team will develop guidance for collaborator and partner engagement in health care evidence syntheses. Incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.

Hospital at Home: A New Model of Home Care in Brazil

Introduction: Home Care (HC) is directly responsible for reducing the demand for hospital beds in Brazil. Brazilian Home Hospitalization model in the private sector was built on continuous nursing care for the last 30-years without further review. Objectives: Find if Brazilian Home Hospitalization model aligns with the different HC models in effect around the world, evaluate its limitations and challenges and propose a new cost-effective model of domiciliary care in Brazil called Hospital at Home (HaH). Method: Review of articles published in databases, conference proceedings, clinical practice guidelines, and government regulations between 2006-2022. 920 patients receiving care in the Home Hospitalization modality by a private HC company in Brazil were analyzed in November 2022. Results: European and North American HC models are not built on continuous nursing care. 920 patients receiving care in the Home Hospitalization modality by a private HC company in Brazil had their eligibility assessed in November 2022 to be included in the new HaH model, proposed with 10 evidence-based pillars where a multidisciplinary team is aided by a care partner engagement approach and a clinical management strategy based on data analysis supported by digital health resources. Conclusions: We believe the HaH model will reshape home hospitalization in Brazil, set up the groundwork for value-based Home Care and contribute to the sustainability of Brazilian HC.

A reflection on the co-design approach to the development of the Medway Can campaign; a whole systems approach to obesity prevention using COM-B

Obesity is one of the highest metabolic risk factors associated with morbidity and mortality in the UK, with two-thirds of adults in the UK classed as overweight or obese. Whole systems approaches can be effective in tackling this public health challenge through stakeholder and key partner engagement. This article describes the co-design process for a social marketing obesity prevention campaign taking a whole systems approach based on the COM-B model of behaviour change. Development of social marketing campaigns through Agencies is often hampered by rapid turnaround and short timescales; we highlight how drawing on existing knowledge and co-design with beneficiaries can support the design, delivery and implementation of a social marketing behaviour change campaign.

Does green technology innovation contribute to logistics companies’ market value? The effects of stakeholder engagement and public attention

Although logistics companies are encouraged to carry out green technology innovation (GTI) to mitigate their carbon footprint and negative environmental impact, the performance effect of GTI still needs more conclusive evidence. Building on the resource-based view and stakeholder theory, we investigate the impact of logistics companies’ GTI on their market value and further explore the moderating effects of stakeholder engagement and public attention. We use panel data from 53 publicly listed Chinese logistics companies between 2011 and 2021 to test our hypothesized model. We find an inverted U-shaped relationship between GTI and market value. Interestingly, supply chain partner engagement steepens the inverted U-shaped GTI–market value linkage, whereas scientific institution engagement flattens this curvilinear linkage. In addition, public attention weakens this inverted U-shaped GTI–market value relationship. Our study extends the logistics literature by untangling the curvilinear GTI–market value relationship and the distinct moderating effects of stakeholder engagement and public attention on this relationship. It also provides managerial advice for managers in the Chinese logistics industry.

Community and partner engagement in dissemination and implementation research at the National Institutes of Health: an analysis of recently funded studies and opportunities to advance the field

BackgroundAs the focus has grown in recent years on both engaged research and dissemination and implementation (D&I) research, so too has federal funding to support these areas. The purpose of this analysis is to provide an overall perspective about the range of practices and approaches being used to engage partners in D&I research, with special attention to disparities-relevant research, and to identify gaps and opportunities in research funded by the US National Institutes of Health (NIH) in this space.MethodsThis analysis examined a portfolio of active D&I research grants funded in fiscal years 2020 and 2021 across the NIH. Grant applications were deductively coded and summary statistics were calculated. Cross-tabulations were used to identify trends by engagement and disparities foci.ResultsThere were 103 grants included in the portfolio, of which 87% contained some form of community or partner engagement, and 50% of engaged grants were relevant to health disparities. Engagement was planned across the research continuum with each study engaging on average 2.5 different partner types. Consultation was the most common level of engagement (56%) while partnership was the least common (3%). On average, each study used 2.2 engagement strategies. Only 16% of grants indicated formally measuring engagement. Compared to non-disparities studies, disparities-relevant studies were about twice as likely to engage partners at the higher levels of partnership or collaboration (19% vs. 11%) and were also more likely to be conducted in community settings (26% vs. 5%).ConclusionsBased on this portfolio analysis, D&I research appears to regularly integrate engagement approaches and strategies, though opportunities to deepen engagement and diversify who is engaged remain. This manuscript outlines several gaps in the portfolio and describes opportunities for increasing engagement to improve the quality of D&I research and application to advancing health equity. In addition, opportunities for leveraging the consistent and systematic application of engagement approaches and strategies to advance the science of engagement are discussed.

The ‘pregnant man’: a perceived role for husbands in maternal and child health risk reduction in rural Ghana

Background/Aims The concept of the ‘pregnant man’ was developed to encourage pregnant women's partners to be involved in pregnancy in a culture that does not encourage men's involvement in ‘womanly’ affairs. It is intended to encourage men to support their wives in seeking maternal care during pregnancy, to reduce risk and encourage a safe birth at a hospital facility. This study's aim was to explore the role of husbands during their wife's pregnancy. Methods This was a mixed-methods, community-based, cross-sectional study with couples who had a child <1 year old or who were pregnant. For quantitative data collection, 398 respondents (194 husbands and 194 wives) reported their opinions on male partner involvement and its barriers. A sample of 20 women participated in focus group discussions for qualitative data collection. These data were analysed using oral reflective analysis. Results Few men (15.5%) and even fewer women (9.3%) reported that husbands regularly participated in antenatal care visits. The reasons for this lack of involvement included being ‘too busy’ (18.1%), financial constraints (7.5%) and antenatal care opening hours restricting working husbands from accompanying their wives (13.8%). Conclusions Community-based education and husband-to-husband peer education should be prioritised by the Ghana health service to encourage men to be involved in their partner's antenatal care during pregnancy. More research is needed on partner engagement in maternal and child health services, particularly earlier in a woman's pregnancy.

Student perceptions on learning from participating in low-cost service-learning course assignments

ABSTRACT There exist many descriptions of how service-learning benefits higher learning. However, these usually involve large-scale and well-funded projects that are not easily exported. We conducted a secondary analysis of student reflection papers to better understand what was learned from participating in low-cost service-learning projects. Through collaborations with community-based organizations, student learning goals were to enhance aptitudes for research literacy, self-organizing, and teamwork. We also examined factors that encouraged and hindered student learning. Projects were embedded in bachelor of social work courses on community development. Student narratives described: growth and professional development, enhanced awareness of community issues, the importance of community partner engagement, and processes that encouraged teamwork and learning. Some students partnered with previous workplaces; this impacted group dynamics. Narratives highlight students’ conscientious effort to facilitate peer learning. Implications for teaching, educational policy, and the place of service-learning within professional programs, are contemplated.

Co‐designing a toolkit for evidence‐based decision making in conservation: Processes and lessons

Abstract Improving the effectiveness of conservation practice requires better use of evidence. Since 2004, researchers from the Conservation Evidence group (University of Cambridge) have engaged with over 1100 named practitioners, policymakers, funders and other academics from across the world to identify needs and develop a range of principles, tools and resources to embed evidence in decision making. The goal of this engagement (the Conservation Evidence Programme) was to deliver improved conservation practice leading to benefits for nature and society. Together, we developed a theory of change with five key strategies for delivering change, alongside a freely available Evidence Toolkit to support decision makers in achieving that change. The authors describe the toolkit, a collection of freely available tools and resources developed by the collaborative programme, and how co‐design, employing different levels of partner engagement, enabled its development. Reflecting on our experiences highlighted a number of insights and recommendations, including the need to identify where deep engagement is a necessary condition for success; the importance of collective agreement of the roles of different partners; the need to consider how to facilitate uptake of new tools or practices, particularly where that requires changes to organisational practices or culture; and the importance of establishing processes/channels for ongoing engagement with stakeholders, with a willingness to be flexible and open to incorporating new suggestions and perspectives as needed. The Conservation Evidence Programme has enabled practitioners, funders and policymakers to become part of a network of forward‐thinking organisations that is working collaboratively to help drive more effective conservation practice through improved evidence use.

Exploring the implications for occupational therapy in relation to assistive-technology access and use in urban and rural Canadian communities

ABSTRACT This study investigated the lived experience of older adults living in urban and rural geographies to identify and describe important contextual differences and clinical implications for occupational therapists. Community-dwelling older adults (N = 42) were recruited for this study which employed semi-structured interviews conducted over 19 months. A thematic analysis was undertaken to develop our qualitative findings. Two themes emerged, (1) Links to occupational therapy (2) Assistive technologies awareness and use. Occupational therapists utilizing a person-centered approach that considers personalities, infrastructure, care partner engagement, and geographical context, are more likely to achieve the best outcomes. Rural older adults are an underserved population, while urban older adults experience infrastructure barriers to engage with assistive technologies. Occupational therapists can serve as advocates along with their clients to improve equitable access to assistive technology for all.

Waterbird–habitat relationships in South Carolina: implications for protection, restoration, and management of coastal and inland wetlands

South Carolina coastal and inland wetlands are continentally important to resident, migrating, and wintering dabbling ducks (Anatini), diving and sea ducks (Aythini, Mergini, Oxyurini), pelagic waterbirds (Anhingidae, Laridae, Pelicanidae, and Phalcrocoracidae), and wading birds (Ardeidaie, Ciconiidae, Threskiornithidae). Our goal was to model wetland selection of these waterbird guilds in South Carolina during autumn–winter to determine habitat preferences and guide wetland conservation and restoration amid sea‐level rise and other coastal pressures. We conducted aerial surveys and recorded waterbird occurrence and relative abundance in winters 2017–2019. We modeled waterbird–habitat relationships relative to managed and unmanaged coastal and inland wetlands, legally protected conservation lands (e.g. federal, state, and private easements), and habitat diversity. Waterbirds selected a variety of wetlands emphasizing the importance of wetland diversity within habitat complexes. However, only managed tidal impoundments (MTIs) and protected conservation lands were selected across all waterbird guilds. Results suggest these are contemporary keystone habitats for promoting wintering waterbird abundance and diversity in South Carolina and other South Atlantic coastal regions. To compensate for future coastal wetland loss while facilitating the current and future needs of migrating and wintering waterbirds, we recommend: (1) identification and continued management of MTIs resilient to sea‐level rise; (2) strategic planning and partnerships for land acquisition and legal protections inland; and (3) land protection networks between extant coastal and inland sites designated for future construction and emigration of decommissioned MTIs. Stakeholder and partner engagement is paramount to prioritize resource allocation for the restoration, construction, and decommissioning of coastal and inland wetlands.

Using a health observance event to raise awareness: An assessment of World Birth Defects Day.

World Birth Defects Day (WorldBDDay), observed annually on March 3, was launched in 2015 to advocate for public health surveillance, research, and prevention of birth defects, along with improved care and treatment for affected individuals. Following its fifth observance in 2019, we assessed WorldBDDay by analyzing: (a) engagement and content of over 2000 WorldBDDay posts on Facebook, Twitter, and Instagram; (b) interview responses from 9 WorldBDDay charter (founding) organizations on their perceptions of strengths and areas for improvement for WorldBDDay; (c) survey responses from 61 WorldBDDay 2019 partner (participating) organizations on their WorldBDDay 2019 activities; and (d) post-2019 social media engagement. Most social media posts (60%) occurred from organizations using Twitter (80% vs. 14% for Instagram and 6% for Facebook), although posts from individuals had higher levels of engagement (e.g., likes and comments). The highest engagement occurred for posts focused on general awareness, prevention, or events. Charter organizations reported the need for existing and new partner engagement, including a designated WorldBDDay contact for regular communication and coordination of activities and prepared prevention-focused messaging. Partner organizations reported using the WorldBDDay toolkit, especially key messages and social media tips, and suggested expanding the toolkit with relevant resources. Post-2019 Twitter engagement was lower than 2019 WorldBDDay (peak event) but showed similar reach to WorldBDDay events prior to 2019. Our assessment identified WorldBDDay health observance events as an important tool to support knowledge dissemination and global community engagement around birth defects. Moving forward, engagement with more individuals and organizations may improve the reach of WorldBDDay.

Mosquito bed net use and associated factors among pregnant women in Rwanda: a nationwide survey

BackgroundIn malaria-endemic countries such as Rwanda, the appropriate use of mosquito bed nets is an effective intervention for malaria prevention. Despite being one of the demographics most impacted by malaria, there is a dearth of literature on the usage of mosquito bed nets by pregnant women in Rwanda. The study aimed to assess the prevalence and associated factors for mosquito bed net use among pregnant women in Rwanda.MethodsWe used weighted data from the 2020 Rwanda Demographic and Health Survey of 870 pregnant women, and multistage stratified sampling was used to select participants. Multivariable logistic regression was conducted to determine the factors associated with mosquito bed net use, using SPSS (version 26).ResultsOf the 870 pregnant women, 57.9% (95%CI: 54.6–61.1) used mosquito bed nets. However, 16.7% did not use bed nets among those owning bed nets. On one hand, older age (AOR = 1.59, 95%CI: 1.04–2.44), primary education (AOR = 1.18, 95%CI: 1.07–2.23), being married (AOR = 2.17, 95%CI: 1.43–3.20), being from Kigali region (AOR = 1.97, 95%CI: 1.19–3.91), partner’s education (AOR = 1.22, 95%CI: 1.13–3.41), having recently visited a health facility (AOR = 2.07, 95%CI: 1.35–3.18), and being in the third pregnancy trimester (AOR = 2.14, 95%CI: 1.44–3.18) were positively associated with mosquito bed net use. On the other hand, low wealth index (AOR = 0.13, 95%CI: 0.07–0.24), and being from Eastern region (AOR = 0.42, 95% CI: 0.26–0.66) had a negative association.ConclusionsAbout half of the pregnant women in Rwanda used mosquito bed nets and the usage was associated with various socio-demographics. There is a need for appropriate risk communication and continuous sensitisation to improve mosquito net use among pregnant women. Early antenatal care attendance and partner engagement in malaria prevention and mosquito net use, as well as consideration of household dynamics, are also crucial in improving not only mosquito net coverage but also utilization.

Partner engagement for planning and development of non-pharmacological care pathways in the AIM-Back trial.

Embedded pragmatic clinical trials are increasingly recommended for non-pharmacological pain care research due to their focus on examining intervention effectiveness within real-world settings. Engagement with patients, health care providers, and other partners is essential, yet there is limited guidance for how to use engagement to meaningfully inform the design of interventions to be tested in pain-related pragmatic clinical trials. This manuscript aims to describe the process and impacts of partner input on the design of two interventions (care pathways) for low back pain currently being tested in an embedded pragmatic trial in the Veterans Affairs health care system. Sequential cohort design for intervention development was followed. Engagement activities were conducted with 25 participants between November 2017 and June 2018. Participants included representatives from multiple groups: clinicians, administrative leadership, patients, and caregivers. Partner feedback led to several changes in each of the care pathways to improve patient experience and usability. Major changes to the sequenced care pathway included transitioning from telephone-based delivery to a flexible telehealth model, increased specificity about pain modulation activities, and reduction of physical therapy visits. Major changes to the pain navigator pathway included transitioning from a traditional stepped care model to one that offers care in a feedback loop, increased flexibility regarding pain navigator provider type, and increased specificity for patient discharge criteria. Centering patient experience emerged as a key consideration from all partner groups. Diverse input is important to consider before implementing new interventions in embedded pragmatic trials. Partner engagement can increase acceptability of new care pathways to patients and providers and enhance uptake of effective interventions by health systems. NCT#04411420. Registered on 2 June 2020.

(066) Development of Sex Education and Violence Prevention Curriculum for Adolescents

Abstract Introduction Controversy surrounding sex education for youth has led to increased clinical content in these curricula, emphasizing health implications of sexually transmitted infections and pregnancy prevention methods while failing to acknowledge nuanced areas such as pleasure or masturbation. The increasingly medicalized approach to sex education for high school students represents a missed opportunity to provide students with broader insight into topics that surround sexual health behaviors. Objective The purpose of our project was to develop an inclusive, comprehensive sex education and interpersonal violence prevention curriculum. Methods A curriculum was designed with the following learning objectives: 1) help students identify their sexual beliefs and their societal influences, 2) normalize sexual exploration and pleasure, and 3) address safe partner engagement. The first section of the curriculum focuses on the differentiation between gender and sexuality. Students are then encouraged to consider how these identities have been influenced by purity culture that deems sexuality permissible only within the context of a cis-gendered, heterosexual married couple. A second activity then validates individuals’ sexual preferences and normalizes the pursuit of personal pleasure through exploration and discussion of masturbation. The conversation is then expanded to tools for partnered pleasure including communication, consent, and sexually transmitted infection and pregnancy prevention methods. The final section of the curriculum addresses partner relationships outside of strictly sexual interactions and provides information about healthy relationships, behaviors concerning for intimate partner violence, and intervention techniques for both members of these relationships and bystanders. Results A pilot version of the curriculum was delivered to a group of high school students attending a summer program for aspiring healthcare professionals (n=13). A post-intervention survey was developed to assess students’ self-reported change in knowledge on a scale from one (no improvement) to five (improved a lot). Among the students who completed the evaluation (n=6), the average response was 3.67 for gender and sexuality topics, 3.83 for sexually transmitted infections and pregnancy prevention, and 4.50 for interpersonal violence recognition and intervention. Conclusions For future iterations of the curriculum, pre-assessment surveys will be distributed to measure students’ familiarity with gender, sexuality, contraception, and healthy relationships; thus, allowing the curriculum to be customized based on individual population needs. Additionally, methods for improving feedback survey adherence among students are being explored. Relationships with local high schools are currently being established to allow for wider distribution of the curriculum. Ultimately, this curriculum seeks to gain insight into the efficacy of normalizing desires and stressing personal pleasure to improve factual knowledge about sex and sexuality as well as bolster students’ confidence in assessing and addressing harmful relationship dynamics. Disclosure No

Innate Conformational Dynamics Drive Binding Specificity in Anti-Apoptotic Proteins Mcl-1 and Bcl-2.

The structurally conserved B-cell lymphoma 2 (Bcl-2) family of protein function to promote or inhibit apoptosis through an exceedingly complex web of specific, intrafamilial protein-protein interactions. The critical role of these proteins in lymphomas and other cancers has motivated a widespread interest in understanding the molecular mechanisms that drive specificity in Bcl-2 family interactions. However, the high degree of structural similarity among Bcl-2 homologues has made it difficult to rationalize the highly specific (and often divergent) binding behavior exhibited by these proteins using conventional structural arguments. In this work, we use time-resolved hydrogen deuterium exchange mass spectrometry to explore shifts in conformational dynamics associated with binding partner engagement in the Bcl-2 family proteins Bcl-2 and Mcl-1. Using this approach combined with homology modeling, we reveal that Mcl-1 binding is driven by a large-scale shift in conformational dynamics, while Bcl-2 complexation occurs primarily through a classical charge compensation mechanism. This work has implications for understanding the evolution of internally regulated biological systems composed of structurally similar proteins and for the development of drugs targeting Bcl-2 family proteins for promotion of apoptosis in cancer.

Exploratory validation of relationship functioning and non-pregnant partner behavior scales in pregnant people living with HIV in Mpumalanga Province, South Africa

ABSTRACT Partner engagement in antenatal care can improve care for pregnant people living with HIV. However, concerns about engaging unsupportive non-pregnant partners warrant further study to avoid engaging partners who pressure their pregnant partner to refuse testing or treatment and/or perpetuate intimate partner violence. We adapted established relationship functioning and partner behaviour questionnaires among pregnant people living with HIV initiating antenatal care in rural South Africa. We identified 13 previously validated psychometric scales with 255 items that assess relationship functioning and partner behaviour, but, to our knowledge, had not been used in Southern Africa. After item translation and cognitive interviewing with 30 pregnant people, we recruited an additional 208 pregnant people living with HIV receiving antenatal care. We conducted an exploratory factor analysis with maximum-likelihood extraction and oblique promax rotation with the 58 items and 10 scales that remained after translation and cognitive interviewing. We used parallel analysis, scree plots, and the Kaiser criterion to guide factor retention and assessed internal factor consistency via Cronbach’s alpha. Of the 208 participants recruited, 197 (95%) answered each question and were included in the analysis. Exploratory factor analysis revealed 7 factors that assessed partner social support, sexual relationship power, emotional intimacy, threatened or enacted violence, sexual intimacy, violence in relationships, and partner engagement in pregnancy care via 37 items. Factor absolute Spearman correlations ranged from 0.012 to 0.518 and Cronbach’s alpha ranged from 0.84 to 0.92. This preliminary analysis will guide further scale development. Future developments will also include relevant clinical outcomes to assess the predictive validity of the resulting measures. These steps will further refine these questions into a succinct screening tool to assess relationship functioning and partner behaviour. This screening tool may eventually guide the selection of partner-based interventions during pregnancy to improve outcomes for pregnant people and their partners.

"Ultimately, You Realize You're on Your Own": The Impact of Prostate Cancer on Gay and Bisexual Men Couples.

An estimated one in three gay and bisexual (GB) male couples receive a prostate cancer (PCa) diagnosis over their life course with limited understanding of the impacts on their relationships. Psychological distress related to PCa diagnosis and treatment-related side effects have been shown to disrupt established GB partnership dynamics. Communication barriers often develop within GB relationships affected by PCa, further exacerbating couple tensions, isolating partners, and lowering quality of life for both patients and partners. In order to elaborate on these phenomena following a PCa diagnosis, we conducted focus group discussions with GB men in relationships. Men were recruited nationally through PCa support groups, and after completing consent procedures, they were invited to one of two focus group discussions conducted through video conference. Topics discussed included the diagnosis and medical decision making pertaining to PCa; healthcare provider experiences; the emotional, physical, and sexual impact of PCa diagnosis and treatment; sources of support and appraisal of resources; and partner involvement and communication. There were twelve GB men who participated in focus group discussions that were audio-recorded and transcribed, and analyzed using a thematic approach. GB couple experiences with PCa during and after treatment choice and recovery identified common patient-provider communication barriers. In particular, GB men reported difficulties in disclosing their sexuality and relationship to their providers, limiting conversations about treatment choice and partner engagement in care. Both patients and partners experienced times of being alone after treatment, either by choice or to give space to their partner. However, partners often did not explicitly discuss their preferences for being alone or together, which resulted in partners' disengagement in their relationship and the prostate cancer healthcare process. This disengagement could blunt the notable PCa survival benefits of partnership for GB men.