University of South Carolina Scholar Commons Theses and Dissertations 12-14-2015 Nurses Utilizing the V.O.I.C.E.S. HIV Prevention Intervention in the Black Church Community Jason Richard University of South Carolina - Columbia Follow this and additional works at: https://scholarcommons.sc.edu/etd Part of the Nursing Commons Recommended Citation Richard, J.(2015). Nurses Utilizing the V.O.I.C.E.S. HIV Prevention Intervention in the Black Church Community. (Doctoral dissertation). Retrieved from https://scholarcommons.sc.edu/etd/3253 This Open Access Dissertation is brought to you by Scholar Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. Nurses Utilizing the V.O.I.C.E.S. HIV Prevention Intervention in the Black Church Community by Jason Richard Bachelor of Science San Francisco State University, 2004 Bachelor of Science University of South Carolina, 2009 Submitted in Partial Fulfillment of the Requirements For the Degree of Doctor of Nursing Practice in Nursing Practice College of Nursing University of South Carolina 2015 Accepted by: Laura Hein, Major Professor Stephanie Burgess, Committee Member Abbas Tavakoli, Committee Member Stacy Smallwood, Committee Member Lacy Ford, Senior Vice Provost and Dean of Graduate Studies © Copyright by Jason Richard, 2015 All Rights Reserved. ii DEDICATION I dedicate this dissertation to my family – Yvonne Maxey (my beloved grandmother), Darryl Richard, Melva Lee, and LaCreacia Mpu. Also, I dedicate this to my best friends for life – Dr. Lisa T. Williams, Dr. Ashley Sirianni, and Ms. Alia Mujadidi. Thanks for your unconditional love, unwavering support, and continuous encouragement! You all have helped me persevere through my darkest hours and pushed me to move forward at times when I felt hopeless, discouraged, and insecure. I do not know if I would have completed this dissertation without you all being my faithful cheerleaders to the very end. When I think of you all, I smile, and thank God. I am truly blessed to have each of you in my life – y’all really-really rock! iii ACKNOWLEDGEMENTS I would like to acknowledge and thank each and every one who help me complete this arduous dissertation. First, I give glory and honor to my personal Lord & Savior Jesus Christ who had made all things possible! Second, I thank my Black African Queen – my grandmother Ms. Yvonne L. Maxey, who raised me and has been my rock of support throughout everything. Third, I thank my fabulous parents Mr. Darryl Richard and Mrs. Melva Lee for their unwavering support, words of encouragement, many-many prayers, and being a source of motivation during my darkest hours. I give a special thanks to my dear sister Ms. LaCreacia Mpu whose divine wisdom and tremendous wealth of knowledge has blessed me throughout my academic journey, especially during this dissertation. And to all the “People in the Village” who helped me complete this journey, I thank God for you guys and I would like to take this special opportunity to acknowledge y’all. Thanks to my wonderful editor, Ms. Melissa Dugan, who has been a joy to work with and made the writing process fun. Thanks to my San Francisco State University colleagues who were “mini-mentors” that helped me think outside the box: Ms. Sherrita Cobbs, Dr. Karthic Ekambaram, Ms. Liza Maulino, Ms. Lala Motlhabi, Dr. Christine Natan, Mrs. Kinjal Nayar, and Mrs. Norma Traverso. Thanks to my USC colleague, Dr. Donna Becker, who was my biggest cheerleader keeping me motivated to cross the finish line. Thanks to my “Black Girls That Rock” who gave me tremendous in-sight during this doctoring process: Dr. Sonia Campbell, Dr. Denise Crawford, Dr. Sheryl Mitchell, and Dr. Lisa iv Williams. Thanks to my church family and friends who gave me unprecedented foresight when implementing this project: Mrs. Angela Burrell, Ms. Tomika Johnson, Mr. Elimuel & Mrs. Calotta Porterfield, and Mr. Jean-Marie & Mrs. Emilienne Watonsi. I also would like to thank Project F.A.I.T.H for allowing me to use their HIV Stigma Survey: Dr. Coleman, Dr. Gaddist, Dr. Lindley, and Dr. White. Last, but not least, I would like to thank the following community leaders for providing the V.O.I.C.E.S. intervention materials: Dr. AnnDenise Brown (The Balm in Gilead), Mr. Dean Edwards (Palmetto AIDS Life Support Services), Mr. Chestly Price (South Carolina HIV/AIDS Counsel), and Ms. Stephanie Upton (Center for Disease Control). v ABSTRACT The Human Immunodeficiency Virus (HIV) epidemic is a significant problem in the United States, especially in the “Bible Belt” Deep South where the epidemic is hitting this region the hardest. The HIV epidemic in the state of South Carolina is very real, significant, and quite alarming. In fact, the Center for Disease Control and Prevention (CDC) labels South Carolina as an HIV “hot spot.” All racial and ethnic groups are susceptible and impacted by HIV. However, evidence shows that African Americans – especially young adults 18-35, bear the brunt of the burden to the extent that the “new face” of the HIV epidemic is Black. Consistent with national trends, African Americans residing in the state of South Carolina are disproportionately impacted by the HIV epidemic versus all other racial/ethnic groups. The HIV healthcare crisis African Americans are facing in South Carolina is very problematic and evidence suggests that the Black Church can play a significant role to counteract the HIV epidemic within the African American community. In order to provide HIV prevention to young adult African Americans in the Black Church setting, evidence suggests it is imperative to target church leadership and gain their consent to do so. This evidence-based practice quality improvement project entails introducing Black Church leadership to the community-based CDC-approved HIV intervention titled Video Opportunity for Innovative Condom Education and Safer Sex (V.O.I.C.E.S.). A sample of 32 leadership participants from four South Carolinian Black Churches was introduced to the four core elements of the V.O.I.C.E.S. intervention. A leadership survey was administered to participants to obtain their input whether the vi V.O.I.C.E.S. intervention is appropriate to implement in the Black Church setting in its original form or whether it needs to be modified. An HIV-stigma survey was administered to participants to assess their level of HIV knowledge and HIV stigma and determine if there is a relationship in leadership’s opinion in the adoption of the intervention in the church setting. A mixed method research design was employed. Results show that South Carolinian Black Church leadership who are more knowledgeable about HIV were more likely to agree that the V.O.I.C.E.S. intervention is appropriate to implement in its original form in this setting. Also, leadership from different Black Church denominations appear to differ how HIV prevention should be presented to their young adult parishioners. Implications from this evidence-based practice quality improvement project suggests that nursing can collaborate/negotiate with Black Church leadership to tailor the V.O.I.C.E.S. intervention to suit the needs of their parishioners while adhering to church doctrine. vii TABLE OF CONTENTS DEDICATION ................................................................................................................... iii ACKNOWLEDGEMENTS ............................................................................................... iv ABSTRACT ....................................................................................................................... vi LIST OF TABLES ........................................................................................................... xiii LIST OF ABBREVIATIONS .......................................................................................... xiv DEFINITIONS ...................................................................................................................xv CHAPTER 1: INTRODUCTION ........................................................................................1 1.1 SIGNIFICANCE ................................................................................................1 1.2 HIV AMONG AFRICAN AMERICAN PEOPLE ............................................3 1.3 BARRIERS AND VULNERABILITY FOR HIV ............................................5 1.4 HIV IMPACT: MORBIDITY AND MORTALITY .........................................8 1.5 CURRENT PRACTICES ................................................................................10 1.6 PRACTICE INNOVATION BY UTILIZING THE BLACK CHURCH AS HIV PREVENTION PLATFORM ..................................................................15 1.7 PURPOSE ........................................................................................................19 1.8 THEORETICAL FRAMEWORK ...................................................................21 1.9 SPECIFIC AIM & PICO QUESTION ............................................................29 1.10 ASSUMPTIONS ............................................................................................31 CHAPTER 2: LITERATURE REVIEW ...........................................................................32 viii 2.1 HIV/AIDS SIGNIFICANCE AMONG AFRICAN AMERICANS ................33 2.2 HIV AMONG AFRICAN AMERICAN FEMALES ......................................37 2.3 HIV/AIDS RISK FACTORS IN AFRICAN AMERICAN FEMALES..........40 2.4 SOCIOECONOMIC