Pre-post Survey Research Articles

Impact of a monitoring and evaluation training in 3 PEPFAR-supported countries

BackgroundThe second phase of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) transitioned from scaling up HIV prevention and treatment to promoting sustainability and capacity building for programs monitoring performance and evaluating key program indicators. We assessed the success of a monitoring and evaluation (M&E) curriculum designed to build capacity in three PEPFAR-supported countries. MethodsWe customized M&E trainings based on country-specific epidemic control priorities in Ethiopia, Guatemala, and Cameroon. The M&E curriculum included five modules and three evaluation activities to assess impact: (i) in-person pre-post confidence assessment surveys (CAS), (ii) in-person pre-post knowledge tests (PPKT), and (iii) electronic 6–12 months post-training translating knowledge into practice (TKP) surveys. Pre- and post-training results were compared within and across countries and triangulation with the qualitative data evaluated overall success. ResultsAmong 188 participants attending M&E trainings, 154 (82 %) responded to CAS and 165 (88 %) participants from Ethiopia and Cameroon completed PPKT. Overall CAS scores between pre- and post-test improved [Score mean difference:1.5–1.9]. PPKT indicated statistically significant knowledge gained. One out of five TKP respondents provided direct application examples from the M&E training. ConclusionWhile feedback was predominantly positive overall, revisions were recommended for three of the five modules. Developing a customizable and adaptable M&E curriculum may sustain countries’ ability to monitor their progress towards epidemic control.

Health Care for LGBTQ+ Youth: A Case-Based Workshop for Medical Students and Pediatric Residents.

Undergraduate medical education and graduate medical education lack formal curricula on providing care for lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) youth. The onset of the COVID-19 pandemic has led to further challenges in delivering engaging, patient-centered education on LGBTQ+ health. We developed a 90-minute case-based LGBTQ+ health curriculum delivered twice: to fourth-year medical students (in person only) and to pediatric residents (in-person and virtual options). Learners worked in small groups to engage in self-directed learning to review cases with associated questions, followed by a faculty-facilitated discussion and didactic component. Additionally, residents received a 45-minute patient-and-caregiver panel to explore lived experiences within the trans and nonbinary community. Retrospective pre-post surveys assessing knowledge, comfort, and perceived clinical impact were analyzed via paired t tests and descriptive statistics. Sixty-two learners completed our evaluation, including 19 residents and 43 medical students. After the curriculum, we noted significant improvement in learners' perceived knowledge and comfort in all surveyed competencies; >90% of learners noted the curriculum was well organized and engaging, with the patient-caregiver panel marked as a highlight. A multimodal curriculum using case-based, problem-based learning and a patient-caregiver panel can be a promising method of providing interactive and up-to-date education on LGBTQ+ health care. This model can also be used to provide education on other medical education topics that are constantly evolving and lack national standardization.

"Life with Diabetes": A Pilot Study on an Experiential Continuous Glucose Monitoring Curriculum for Resident Physicians.

The use of technology in diabetes mellitus (DM) management has been growing. The indications and coverage for continuous glucose monitoring (CGM) have increased. Primary care (PC) clinics, including resident continuity clinics, are the frontline for DM management; however, they struggle to adopt CGM. To implement a CGM curriculum to resident physicians to improve knowledge and confidence. An internal medicine (IM) resident PC clinic in an urban academic medical institution. Twenty-four IM residents. We designed a curriculum that included a lecture about CGM indications, interpretation, ordering, and insurance consideration; and a voluntary, experiential learning module in which the residents wore a CGM. We conducted a retrospective pre-post survey with a 4-point Likert scale. Average self-reported scores in knowledge increased for CGM (1) indications from 1.85 to 3.45, (2) ordering from 1.35 to 3.05, (3) functioning from 2.20 to 3.50, and (4) data interpretation from 1.85 to 3.25 (all p < 0.0001). Confidence for "describing CGM monitoring" and "fielding questions about CGM" increased from 2.25 to 3.65 (p < 0.0001) and 1.90 to 3.30 (p < 0.0001). Given the demand for DM management in the PC setting, this targeted CGM curriculum has promise to help residents adopt CGM into their practice.

Introducing comprehensive sexuality education in Italian schools: from the co-construction to the evaluation of a pilot intervention

IntroductionSchool-based comprehensive sexuality education (CSE) is a powerful tool that provides young people with information on all aspects of sexuality and is aimed at protecting their sexual and reproductive health and well-being throughout their lives. Currently, CSE is not integrated within the schools’ curriculum in Italy. This study describes the co-construction, implementation, and evaluation of a CSE project piloted among students attending lower secondary schools, in four regions of Italy. Evidence-based evaluation will be helpful in promote the inclusion of CSE programs in the Italian schools’ curriculum.MethodsThe pilot scheme was co-constructed by a multidisciplinary curriculum development group through a Delphi process, including educators who conducted the activities. The evaluation followed three directions: the program (based on a literature review of CSE principles and recommended characteristics), implementation (assessing the execution of the program through the analysis of the reflection tools used by the educators), and short-term outcomes (assessing critical thinking and conscious behavioural choices through pre-post and satisfaction surveys).ResultsThe main goal, learning modules and content were defined and structured in five interventions with the students, and two with families and teachers. A total of 638 students were involved in the activity, across 11 schools. Data analysis of pre/post surveys reported a significant increase in knowledge in 12 of the 15 items investigated (p < 0.05), and a high level of satisfaction with the topics addressed. Qualitative analysis added information on the pivotal role of educators in CSE.ConclusionsThe national piloting of this educational activity provided positive insights regarding the co-construction, implementation and short-outcome evaluation, suggesting potential for scalability and future inclusion of CSE in the curricula of Italian schools.

Parents’ learning in family literacy: a mixed-methods evaluation

In the USA, comprehensive family literacy programs integrate adult education and parent education, interactive parent-child literacy activities, and early childhood education or school for children. Although parents’ learning is central to family literacy, research overwhelmingly focuses on children’s outcomes or positions parents as conduits of children’s learning. Thus, we know little about changes in parents’ language and literacy capabilities, self-concepts, social support systems, or other benefits. This study reports findings from a multi-year, mixed-methods evaluation of five family literacy programs in Philadelphia, Pennsylvania. Participants were primarily immigrant mothers. Qualitative data, along with statistically significant quantitative data from a pre-post survey (n = 139), demonstrate learning in four domains: educational, personal, social, and parenting. Specifically, parents developed literacy and language skills; enjoyed reading more and spent more time reading alone and with children; were more involved in everyday literacy practices; increased their self-confidence and self-esteem; provided support for each other, developed friendships, and built a sense of community; and increased support for and involvement in their children’s development, literacy, and education. These results build on prior research on parental outcomes and illustrate the value of using multi-faceted, holistic measures to examine how parents benefit from family literacy.

A Randomized Trial of Virtual Reality Training to Improve Firearm Safety Counseling Skills

ObjectiveTo evaluate the efficacy of Resident Education And Counseling on Household (REACH) Firearm Safety, a novel virtual reality (VR) intervention. MethodsWe conducted a single-center, randomized controlled trial among pediatric residents in a Midwestern academic primary care center comparing REACH Firearm Safety with didactic training (intervention) to didactic training alone (control). In the intervention arm, participants practiced firearm safety counseling with virtual characters and received immediate feedback. All residents completed audio-recorded standardized patient (SP) encounters before and after the training as well as a retrospective pre-post survey. Two reviewers, blinded to the allocation arm, used a standardized assessment tool to generate performance scores. Outcomes of interest included the difference between groups in SP performance scores and self-reported confidence. ResultsFrom March to July 2023, 62% of eligible pediatric residents (n = 47/76) completed the allocated study tasks (intervention 19, control 28). In both groups, SP performance scores and self-reported confidence improved. Compared to the control group, the intervention group demonstrated improvement in sharing information on secure storage devices (P = 0.009) and increased confidence in providing information on secure storage (P = 0.002). ConclusionsCompared with didactic training alone, a VR intervention using deliberate practice improved residents’ skills and confidence related to firearm safety counseling.

Augmented reality for chemistry education to promote the use of chemical terminology in teacher training.

Chemistry as a whole is divided into three levels. The macroscopic level describes real, observable phenomena of the material world. The submicroscopic level focuses on particles. The representative level includes pictorial and symbolic representations to visualize substance in its nature. Students often have problems separating these levels and conceptually transfer each of the three levels to the other. Therefore, teachers need to use chemical terminology correctly when teaching the substance-particle concept. Augmented Reality (AR) connects real and virtual world. The observer physically moves in a real environment that integrates virtual elements. The AR technology has great potential for learning in the subject chemistry, especially when it comes to making the "invisible" visible and illustrating scientific phenomena at particle level. The simultaneous presentation should avoid split-attention and offers new possibilities to interactively deal with (M)ER. The question arises whether AR has a positive effect on the use of technical language and the associated understanding of the concept of dealing with (M)ER at the substance and particle levels. With an AR app on the tablet and the AR glasses, the chemical processes of a real experiment are represented by AR visualizations. Therefore, the AR app was piloted. This study captured the chemistry handling with (M)ER of chemistry teachers (N = 30) using a pre-post survey. The participating preservice teachers are described below. Each test includes five tasks elaborated by thinking aloud. The thinking-aloud protocols to acquire the use of the chemical terminology are evaluated in MAXQDA.

Empowering and educating the next generation of pharmacists through children’s books: A quality assurance initiative

ObjectiveThe objective of this quality assurance initiative was to internally measure children’s perceptions of the book, “All Aboard the Rx-Express!” and knowledge gained from its content. MethodsThis pharmacy-focused children’s book was read to elementary-age youth at a rural, Pennsylvania elementary school in the Spring of 2022. A brief, optional, anonymous prepost survey was administered to the youth before and after the reading to measure the book’s impact on third through fifth graders’ perceptions and knowledge of the pharmacy profession. Descriptive statistics, chi squared analysis, independent samples t-tests, and one sample proportions tests were used to analyze survey responses. ResultsOne hundred ninety-one students participated in the presurvey to assess baseline knowledge about the pharmacy profession before the book was read. One hundred eighty-five students answered the postsurvey. Prepost respondent demographics were collected in aggregate and were not significantly different between the pre- and postcohorts. Survey results demonstrated an increase in all questions that asked about students’ perceptions of pharmacists and the profession, and students reported favorable perceptions of the book itself. ConclusionEarly interventions such as this can increase elementary-age youth’s perceptions and knowledge of the roles of pharmacists. Future work in early intervention will be needed to increase interest in the profession and admissions to pharmacy schools.

Mammography Screening Preferences Among Screening-Eligible Women in Their 40s : A National U.S. Survey.

The U.S. Preventive Services Task Force (USPSTF) recently changed its recommendation for mammography screening from informed decision making to biennial screening for women aged 40 to 49 years. Although many women welcome this change, some may prefer not to be screened at age 40 years. To conduct a national probability-based U.S. survey to investigate breast cancer screening preferences among women aged 39 to 49 years. Pre-post survey with a breast cancer screening decision aid (DA) intervention. (ClinicalTrials.gov: NCT05376241). Online national U.S. survey. 495 women aged 39 to 49 years without a history of breast cancer or a known BRCA1/2 gene mutation. A mammography screening DA providing information about screening benefits and harms and a personalized breast cancer risk estimate. Screening preferences (assessed before and after the DA), 10-year Gail model risk estimate, and whether the information was surprising and different from past messages. Before viewing the DA, 27.0% of participants preferred to delay screening (vs. having mammography at their current age), compared with 38.5% after the DA. There was no increase in the number never wanting mammography (5.4% before the DA vs. 4.3% after the DA). Participants who preferred to delay screening had lower breast cancer risk than those who preferred not to delay. The information about overdiagnosis was surprising for 37.4% of participants versus 27.2% and 22.9% for information about false-positive results and screening benefits, respectively. Respondent preferences may have been influenced by the then-current USPSTF guideline. There are women in their 40s who would prefer to have mammography at an older age, especially after being informed of the benefits and harms of screening. Women who wanted to delay screening were at lower breast cancer risk than women who wanted screening at their current age. Many found information about the benefits and harms of mammography surprising. National Cancer Institute.

Applying the extension for community healthcare outcomes (ECHO) model to promote collaborative and effective school mental health services.

School staff increasingly seek to implement evidence-based school mental health services to promote student mental health. However, barriers to accessing programming and support mean that implementing these programs is difficult. Popular strategies to address these challenges, like one time professional development, often fail to be effective or sustainable. This study used mixed methods to evaluate how a set of training activities-sequential online learning modules combined with interprofessional telementoring, following the extension for community healthcare outcomes (ECHO) model-influenced provision of school mental health services. School counselors, nurses, psychologists, and social workers (n = 46) participated in training activities, which included nine, cohort-based ECHO sessions and 12 modules. We used a concurrent mixed methods design in which quantitative (implementation data and pre-post surveys) and qualitative (posttraining focus groups with a subset of participants, n = 11) data were used to evaluate training. Quantitative results indicated statistically significant pre-post improvements in participants' clinical self-efficacy (d = .83) and knowledge of evidence-based practices (d = .37). Qualitative data corroborated quantitative results. Post training, focus groups described positive reactions, learning, and behavior change, particularly with respect to equitable service provision and interprofessional teaming. ECHO appeared to facilitate the application of evidence-based strategies to real-life practice and improved participants' understanding of effective coordination of services. Taken together, findings suggest that group-based telementoring may be a high-impact strategy for supporting the implementation of effective, culturally specific, and collaborative school mental health services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Relationships Between Students’ Emotional Experiences and Cognitive and Physical Achievement During a Middle School Hybrid Sport Education Tactical Model Season

Purpose: Despite evidence regarding emotions’ impact on learners, there remains a paucity of research examining the relationships between student emotions and achievement within contemporary instructional models. Grounded in the Control-Value Theory of Achievement Emotions, changes in middle school students’ motivational beliefs, emotions, and learning outcomes across one hybrid Sport Education Tactical Model season were examined. Methods: Middle school students (N = 72) completed pre–post surveys regarding their control-value beliefs and emotions. They also completed physical and cognitive tests, and daily physical activity tracking. Repeated measures of multivariate covariance and regression were tested. Results: Students’ perceived control improved, while their extrinsic value reduced. Emotions did not significantly change, while cognitive exam scores and game performance increased. Conclusion: Emotions varied and influenced intentions for play as opposed to learning and achievement. The study provides preliminary insights into the complexity of how student emotions connect to their motivation and learning within the hybrid Sport Education Tactical Model.

An active-learning laboratory on urinary incontinence products for pharmacy students

Background and purposeTo describe an active-learning laboratory on urinary incontinence (UI) and its effect on students' confidence and comfort in addressing UI. Educational activity and settingSecond year pharmacy students (n = 98) participated in an active-learning laboratory focused on UI with four components: catheter lecture and demonstration, UI product overview, hands-on practice with UI absorbent products, and a debrief on the activity focused on difficult conversations. Students completed an optional retrospective pre-post survey at the end of the laboratory including five confidence questions, ranking of activities in the laboratory, and open-ended responses on how to change the activity as well as what was one takeaway from the debrief. Descriptive statistics assessed survey responses. Changes in student confidence were assessed using paired t-tests. Thematic analysis was used for the open-ended debrief question. FindingsOf the 101 students who participated in the laboratory, 98 students completed the pre/post-survey (response rate: 97%). Students demonstrated a significant increase in their confidence in all five areas assessed. The hands-on activity with the absorbent products was rated as the most useful activity. The themes from the debrief on difficult conversations included: self-awareness, expanding viewpoints, cultural sensitivity, and professional duty. Student feedback on the UI active-learning laboratory was largely positive, with most students suggesting no changes (n = 75) to the activity. SummaryAn active-learning laboratory on UI helped improve confidence and was well received by pharmacy students.

Professional Learning for ESL Teachers: A Randomized Controlled Trial to Examine the Impact on Instruction, Collaboration, and Cultural Wealth

Using a randomized controlled trial, we examined the impact of a teacher professional learning (PL) program on English as a Second Language (ESL) teachers’ use of evidence-based instructional strategies for multilingual learners, collaboration with classroom teachers, and incorporation of Latino multilingual learners’ cultural wealth into their classrooms. The analyses included 29 ESL teachers from 29 elementary schools in three school districts. The teachers completed pre–post surveys, and trained observers rated classroom instruction and cultural wealth for two cohorts of teachers in the yearlong program. The results showed that the PL program had a significant effect on the ESL teachers’ use of evidence-based instructional strategies. We also found a significant effect on the ESL teachers’ collaboration processes, including their use of an intentional framework for collaboration and their alignment with classroom teachers’ instruction. We did not find significant differences between the PL group and the control group on the ESL teachers’ incorporation of cultural wealth in their classroom environment or on the reported frequency of their collaboration.

Coding attitudes of fourth-grade latinx students during distance learning

ABSTRACT Background and Context Despite the growing initiatives in K-12 computer science (CS), there is a continued disparity in the participation of Latinx and multilingual students, a historically underrepresented group in computing. The inequitable participation may be understood by examining students’ early development of CS attitudes. Objective This study aims to explore shifts and elicitation in coding attitudes of fourth-grade, Latinx students (ages 9-10) who underwent a year-long remote coding curriculum, with consideration of gender and language designation. Method Using a mixed method approach, pre-post survey responses on coding attitudes were analyzed to understand shifts and portrayal of Interest, Confidence, Utility, Social Values, and Perception of Coders, with consideration of gender or designation as an English Language Learner. Findings Gender and language designation did not interact with overall attitude shifts. However, there is a significant difference in Social Values and Confidence over time. Student interviews revealed more nuance in social influences with siblings and cousins as key motivators for extended learning, underlying values of perseverance in confidence, mixed perception of what coders do, and the importance of creativity to develop interest. Implications The key role of social influence in driving higher identity among Latinx students points to the important role of extended family. Moreso, developing students’ confidence in domain-specific tasks should be a focus in curricula in order to have a longer-term impact on motivation. Finally, more research on the role that subjective task values pertaining to cultural values should be explored in early coding motivation in order to broaden participation. Keywords: Coding attitudes, elementary students, remote learning, expectancy-value theory, coding curriculum.

Learning disability awareness training for undergraduate midwifery students: Multi-method evaluation of a co-produced and co-delivered educational intervention in England

BackgroundMidwives lack the confidence and competence to identify and support people with learning disabilities, putting this population at risk of inequitable maternity care. ObjectivesTo co-produce, co-deliver and evaluate maternity focused learning disability awareness training for student midwives, in collaboration with experts-by-experience (people with learning disabilities). DesignMulti-methods study evaluating the impact and acceptability of learning disability awareness training. SettingsUniversity in south-east England, UK. Participants83 midwifery students and 7 experts-by-experience. MethodsMidwifery students completed pre-post training surveys and a follow-up survey 3 months post training to substantiate longer-term impact. Experts-by-experience took part in qualitative interviews post training. ResultsStudent-reported learning disability awareness was significantly higher across all domains post training and sustained at follow up. Students reported the most notable aspect of training was learning with and from people with learning disabilities. Three inter-related themes were constructed from interviews with experts-by-experience: reasonable adjustments to training and research processes; a positive social, emotional and learning experience; and perceptions of impact. ConclusionsFindings from this study suggest that co-producing and co-delivering resources and education to an undergraduate midwifery workforce with people with lived experience, can have a profound impact on students and is also a positive experience for people with learning disabilities. The co-produced resources used in this training are free and accessible [https://www.surrey.ac.uk/togetherproject]. Further evaluation will explore acceptability and perceived impact of training and resources on other healthcare professionals working with maternity services.

Empowering youth for sustainability in universities: service-learning and the willingness to act

PurposeService-learning (SL) shows potential to respond to the global policy agenda of education for sustainable development (ESD) by increasing pro-sustainability competences through direct involvement of students in projects that satisfy identified community needs. Nevertheless, there is a scarcity of studies that attempt to measure the impact of SL on students’ sustainability competences, especially the action competence. This study aims to address this gap by examining the experiences of higher education students.Design/methodology/approachA pre-post survey design based on the Self-Perceived Action Competence for Sustainability Questionnaire was conducted on an interdisciplinary group of 219 students of two courses (Sustainable Development and Ecology) in Medellin, Colombia, half of which (109) participated in SL projects.FindingsSufficient empirical evidence was found to suggest that SL boosts the impact of academic courses regarding action competences in students (specially their willingness to act).Research limitations/implicationsThe statistical analysis shows some contradictions that should be addressed in further research.Practical implicationsThese results can encourage more educators and universities to implement strategies such as SL to move forward with ESD and thus help overcome the current socioecological crisis.Originality/valueThis paper not only discusses the theoretical potential of SL but also contrasts theory with empirical observations of 13 SL projects assessed in terms of self-perceived action competence for sustainability.

A Novel Mental Health Curriculum Pilot for Pediatric Cardiology Fellows: Preparing the Subspecialist to Expand the Team.

Mental health (MH) is an important, yet understudied area of care for patients with congenital heart disease (CHD). Pediatric subspecialty fellows believe MH should be within their scope of practice, but few feel confident in their ability to appropriately screen, evaluate, manage, and make treatment referrals for youth with CHD and concurrent MH concerns. A 6-session, didactic-based curriculum was designed by an interprofessional team of experts. It was administered to pediatric cardiology fellows over 9months during two academic years. Topics included the following: Introduction to MH and CHD, MH Screening and Clinic-Based Interventions, Psychopharmacology, Delirium, Trauma-Informed Care, and Adult CHD and Transitional Care. An investigator-designed survey was developed to assess fellow comfort with MH knowledge, screening, and treatment recommendation domains. Twenty-three fellows participated with 14 completing the pre-post survey (58% participation, 11/17 in year 1, 3/6 in year 2). Most participants were in their first year of training (9/14, 57%). Overall, fellow comfort with MH topics increased significantly (mean score 2.89 ± 0.46 vs. 3.4 ± 0.4, p = 0.0005), with improved comfort in the MH knowledge (p = 0.003) and treatment recommendation domains (p = 0.001). A didactic-based MH curriculum improves the comfort of pediatric cardiology fellows to address the MH concerns of their patients. The topics in this curriculum will continue to be refined over time and could be generalized to training programs, both nationally and across pediatric specialties, to improve MH care for high-risk populations.

Improving age-friendly advance care planning in primary care: Outcomes from a Pacific Northwest learning collaborative.

Advance care planning (ACP) is the process of having conversations with patients to ensure preferences are known and support patient healthcare goals. ACP and the Age-Friendly Health Systems (AFHS) Initiative's, "What Matters," are synergistic approaches to patient-centered conversations. Implementation and measurement of ACP in primary care (PC) are variables in quality and consistency. We examined whether participation in an ACP learning collaborative (LC) would improve knowledge and ability to conduct ACP discussions and increase the frequency of documented ACP in participating practices. The WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) region Practice and Research Network (WPRN) and the Northwest Geriatrics Workforce Enhancement Center collaboratively organized a 9-month virtual LC. It consisted of 4 synchronous, 1.5-h sessions, technical support, and a panel of ACP experts. A Wilcoxon rank sum test assessed differences in knowledge from a pre-post survey. Documentation of ACP in the EHR was collected after at least one plan-do-study-act cycle. We enrolled 17 participants from 6 PC practices (3 hospital-affiliated; 3 Federally Qualified Health Centers) from the WPRN. Two practices did not complete all LC activities. There was a trend toward increased ACP knowledge and skills overall especially in having discussions patients and families (pre-mean 2.9 [SD = 0.7]/post-mean 4.0[SD = 1.1], p < 0.05). 4/6 practices observed an increase in EHR documentation post-collaborative (median 16.3%, IQR 1.3%-36.9%). The LC increased PC providers knowledge and skills of ACP and AFHS's What Matters, reported ACP EHR documentation, and contributed to practice change.

Reducing stigma and promoting HIV wellness/mental health of sexual and gender minorities: RCT results from a group-based programme in Nigeria.

High levels of HIV stigma as well as stigma directed towards sexual and/or gender minorities (SGMs) are well documented in the African setting. These intersecting stigmas impede psychosocial wellbeing and HIV prevention and care. Yet, there are few if any evidence-based interventions that focus on reducing internalized stigma and promoting mental health and HIV wellness for SGMs in Africa. We developed and evaluated a group-based intervention drawing on cognitive behavioural therapy (CBT) strategies for men who have sex with men (MSM) and transgender women (TGW) at risk for or living with HIV in Lagos, Nigeria. The intervention comprised four weekly in-person group sessions facilitated by community health workers. We conducted a delayed intervention group randomized controlled trial (April-September 2022), with pre-post surveys plus 3-month follow-up (immediate group only), as well as qualitative research with participants and programme staff. Outcomes included internalized stigma related to SGM and HIV status, depression, resiliency/coping and pre-exposure prophylaxis (PrEP)/HIV treatment use. Mean age of the 240 participants was 26 years (range 18-42). Seventy-seven percent self-identified as MSM and 23% TGW; 27% were people with HIV. Most (88%) participants attended all four sessions, and 98% expressed high intervention satisfaction. There was significant pre-post improvement in each psychosocial outcome, in both the immediate and delayed arms. There were further positive changes for the immediate intervention group by 3-month follow-up (e.g. in intersectional internalized stigma, depression). While baseline levels of ever-PrEP use were the same, 75% of immediate-group participants reported currently using PrEP at 3 months post-intervention versus 53% of delayed-group participants right after the intervention (p<0.01). Participants post-intervention described (in qualitative interviews) less self-blame, and enhanced social support and resilience when facing stigma, as well as motivation to use PrEP, and indicated that positive pre-intervention changes in psychosocial factors found in the delayed group mainly reflected perceived support from the study interviewers. This study demonstrated the feasibility and acceptability of a group-based CBT model for MSM and TGW in Nigeria. There were also some indications of positive shifts related to stigma, mental health and PrEP, despite issues with maintaining the randomized design in this challenging environment.

Enhancing care: evaluating the impact of True North Sexual Health and Rehabilitation eTraining for healthcare providers working with prostate cancer patients and partners.

Educational programs that enhance healthcare providers' competence in managing the care of patients with sexual dysfunction following prostate cancer treatments are needed to facilitate comprehensive sexual health treatments for patients and their partners. In this study we evaluated the impact of a real-world online sexual health educational intervention called the True North Sexual Health and Rehabilitation eTraining Program. This program is designed to increase healthcare providers' knowledge and self-efficacy in providing sexual healthcare to prostate cancer patients and their partners. Healthcare providers were invited to join a 12-week virtual training program. Participants completed precourse surveys (n = 89), retrospective prepost surveys (n = 58), and a 3-month follow-up survey (subset n = 18) to assess retention of relevant outcomes. Additionally, a course satisfaction survey was administered to participants (n = 57) at the end of the course. The main outcomes focused on participants' perceived knowledge and self-efficacy in conducting assessments and providing interventions for various relevant physical, functional, psychological, and relational domains of sexual dysfunction in prostate cancer patients and their partners. According to the retrospective analysis of post-then-pre-survey results, graduates perceived that their knowledge of and self-efficacy in providing sexual health counseling improved after completing the course. The 3-month follow-up survey indicated that the course graduate self-efficacy remained high 3 months after the course. Furthermore, the satisfaction survey indicated that a vast majority (98.2%) of participants were satisfied with the educational intervention. This real-world sexual health educational intervention can increase self-efficacy and knowledge in healthcare providers who are supporting prostate cancer patients dealing with sexual dysfunction. The use of a retrospective post-then-pre-survey helped to mitigate response shift bias while minimizing data gaps. However, it is important to note that this investigation was not a traditional research study and lacked a control group, thus limiting causal attributions. The True North Sexual Health and Rehabilitation eTraining program acts as an accessible and effective resource for healthcare providers seeking specialized training in providing sexual healthcare for prostate cancer patients and their partners.