title: An extended model of reasoned action to understand the influence of individual- and network-level factors on African Americans' participation in HIV vaccine research.
abstract: In the United States, the number and proportion of HIV/AIDS cases among black/African Americans continue to highlight the need for new biomedical prevention interventions, including an HIV vaccine, microbicide, or new antiretroviral (ARV) prevention strategies such as pre-exposure prophylaxis (PrEP) to complement existing condom usage, harm reduction methods, and behavioral change strategies to stem the HIV epidemic. Although black/African Americans are disproportionately impacted by HIV/AIDS, their participation in HIV clinical research continues to have unique challenges. We theorize that interaction among multilevel factors creates ideal alignment for minority participation in HIV clinical studies. Thus, we initially set out to test an extended model of reasoned action with 362 participants to understand the interplay of sociopsychological and network-level considerations influencing minority participation in HIV prevention research efforts. In this study, we linked the intrapersonal dimensions of attitudes, beliefs, and normative concerns to community-level components, appraisal of involvement with the clinical research organization, an entity which operates within a networked structure of community partner agencies, and identification with coalition advocacy aims. Various participatory outcomes were explored including involvement in future HIV vaccine community functions, participation in community promotion of HIV vaccine research, and community mobilization. Three-stage least squares estimates indicated similar findings across three models. Significant effects demonstrate the importance of positive attitudes toward HIV vaccine research, favorable health research beliefs, perceived social support for participation, HIV/AIDS issue engagement, and perceived relevance of the clinical research site's mission and values. Identification of these nuanced pathway effects provides implications for tailored community program development.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA. pfrew@emory.edu
authors.forename: Paula M
authors.initials: PM
authors.lastname: Frew
authors.forename: Matthew
authors.initials: M
authors.lastname: Archibald
authors.forename: Dazon Dixon
authors.initials: DD
authors.lastname: Diallo
authors.forename: Su-I
authors.initials: SI
authors.lastname: Hou
authors.forename: Takeia
authors.initials: T
authors.lastname: Horton
authors.forename: Kayshin
authors.initials: K
authors.lastname: Chan
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Mulligan
authors.forename: Carlos
authors.initials: C
authors.lastname: del Rio
mesh_terms: D016915:AIDS Vaccines; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D035843:Biomedical Research; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010358:Patient Participation; D014481:United States; D055815:Young Adult
chemical_list: D016915:AIDS Vaccines