Doctoral Study Oral Defense Proposal Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Title: Stigma and HIV testing among African-American women in New Jersey Doctoral Study Oral Defense Proposal Mirriam Limage Pierre, BSMT, MPH Walden University Walden University Ph.D. Residency - Minneapolis, MN July 2008

Thank you Chair: Dr. Peter Anderson Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Thank you Chair: Dr. Peter Anderson 2nd Committee Member: Dr. Cheri Langley URR: Dr. Daniel Michael Nwabufo Okenu Program Director: Tammy Root Add your private notes here as a memory aid MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Background African-American women constitute 13% of the total population (Office on Women’s Health, 2014) African-American women account for two-thirds of all new diagnoses among women (Office on Women’s Health, 2014). Few studies have examined the role of stigma associated with HIV/AIDS in this population (Office of Women’s Health, 2014). Put your notes here as memory guides MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Problem In 2012, New Jersey had the highest estimated number of women living with AIDS among all 50 states in the country. Rate of HIV diagnosis among African-American women was 23 times higher than the rate for Non-Hispanic White women during 2006-2007. HIV stigma adversely affects people living with the disease. People Living with HIV (PLHIV) are victims of discrimination in healthcare and employment. HIV stigma affects the wider society. MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Purpose Statement The focus of this quantitative study is to determine if there is an association between HIV stigma and the uptake of HIV testing among African-American women in NJ. This study will address the gap in the literature regarding how HIV stigma impacts HIV testing among this population. HIV stigma may lead to delayed diagnosis of HIV Reduction on the level of stigma associated with having HIV can aid in the prevention of HIV/AIDS MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Research Question and Hypotheses Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Research Question and Hypotheses Research Question 1 Is there a significant correlation between the perceived benefits of HIV testing and the uptake of HIV testing among sexually active African-American women in New Jersey after controlling for the covariates of age, education level, and socioeconomic status? Hypothesis 1 Null hypothesis: There is no correlation between the perceived benefits of HIV testing and the uptake of HIV testing among sexually active African-American women in New Jersey. Alternative hypothesis: There is a correlation between the perceived benefits of HIV testing and the uptake of HIV testing among sexually active African-American women in New Jersey. Research Question 2 Is there a significant correlation between the perceived severity of HIV and the uptake of HIV testing among sexually active African-American women in New Jersey after controlling for the covariates of age, education level, and socioeconomic status? Hypothesis 2 Null hypothesis: There is no correlation between the perceived severity of HIV and the uptake of HIV testing among sexually active African-American women in New Jersey. Alternative hypothesis: There is a correlation between the perceived severity of HIV and the uptake of HIV testing among sexually active African-American women in New Jersey. MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Research Question and Hypotheses Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Research Question and Hypotheses Research Question 3 Is there a significant correlation between the perceived benefits of HIV testing and HIV stigma among sexually active African-American women in New Jersey after controlling for the covariates of age, education level, and socioeconomic status? Hypothesis 3 Null hypothesis: There is no correlation between the perceived benefits of HIV testing and HIV stigma among sexually active African-American women in New Jersey. Alternative hypothesis: There is a correlation between the perceived benefits of HIV testing and HIV stigma among sexually active African-American women in New Jersey. Research Question 4 Is there a significant correlation between the perceived severity of HIV and HIV stigma among sexually active African-American women in New Jersey after controlling for the covariates of age, education level, and Hypothesis 4 Null hypothesis: There is no correlation between the perceived severity of HIV and HIV stigma among sexually active African-American women in New Jersey. Alternative hypothesis: There is a correlation between the perceived severity of HIV and HIV stigma among sexually active African-American women in New Jersey. MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Research Question and Hypotheses Research Question 5 Does HIV stigma mediate the relationship between perceived benefits or perceived severity and the uptake of HIV testing among sexually active African-American women in New Jersey after controlling for the covariates of age, education level, and socioeconomic status? Hypothesis 5 Null hypothesis: HIV stigma does not mediate the relationship between perceived benefits or perceived severity and the uptake of HIV testing among sexually active African-American women in New Jersey. Alternative hypothesis: HIV stigma does mediate the relationship between perceived benefits or perceived severity and the uptake of HIV testing among sexually active African-American women in New Jersey. MLimagePierre – Proposal Oral Defense – March 2015

Theoretical framework Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Theoretical framework The conceptual framework of my dissertation is based on the Health Belief Model (HBM), a psychological model that explains and predicts health behaviors by individuals (Janz & Becker, 1984). Developed by Hochbaum, Rosenstock and Kegels MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Theoretical Framework HBM consists of six main constructs HBM has been used by public health workers in tuberculosis screening programs. HBM is ideal for use to predict behaviors relating to HIV testing. MLimagePierre – Proposal Oral Defense – March 2015

HBM Constructs The key constructs of the HBM used in this study: Perceived severity Perceived benefits MLimagePierre – Proposal Oral Defense – March 2015

Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Research Design The proposed research will be a quantitative research study. Provides quantitative data that is easy for analysis Higher level of objectivity than qualitative or ethnographic methodologies. MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Participants and sample size Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Participants and sample size Sample size: 107 African-American women from New Jersey The sample size was calculated using G*Power version 3.1.9.2 MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Recruitment and Data Collection Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Recruitment and Data Collection Participants will be Recruited via flyers posted at: Community centers Churches Beauty salons Other areas of gathering for African-American women. Survey Monkey will be used to administer the questionnaires. MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Four instruments will be used to gather data in this study. The sociodemographics questionnaire The Perceptions of Stigmatization by Others for Seeking Help (PSOSH) scale The HIV-related Health Belief Model (HIVHBM) Questionnaires for perceived benefits. The HIV-related Health Belief Model (HIVHBM) Questionnaire for perceived severity. MLimagePierre – Proposal Oral Defense – March 2015

Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Pilot Study I will conduct a pilot study to ensure the validity and reliability of the Perceptions of Stigmatization by Others for Seeking Help (PSOSH) scale that will be used in this study to measure HIV stigma. The pilot study will be conducted on a sample of 8-10 participants who are representative of the target population. MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Data Analysis Data will be downloaded from SurveyMonkey and analyzed with Software Statistical Package for the Social Sciences (SPSS). Descriptive statistics - sociodemographic factors and dependent variables. Multiple linear regression analysis - model the relationships between several independent variables and a dependent variable. Variables will be measured using a continuous Likert scale with a range of 1 to 5. Missing values on any of the questionnaires will be replaced using the participants mean score for that particular scale. MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008

Summary The literature has consistently shown that there is a correlation between stigma and HIV testing and other HIV-risk behaviors among homosexual males (Audet, McGowan, Wallston, Kipp, 2013; Logie et. al., 2013). The literature has also shown that this correlation occurs among African women and adolescents (Logie, James, Tharao, & Loutfy, 2013; Maughan-Brown & Nyblade, 2014; Schnall, Rojas & Travers, 2014). However, the literature has not adequately explored this relationship in African-American women to determine whether stigma mediates the relationship between perceived benefits or perceived severity and the uptake of HIV testing in this population. This study will address this gap in the literature. MLimagePierre – Proposal Oral Defense – March 2015

References Audet, C. M., McGowan, C. C., Wallston, K. A., & Kipp, A. M. (2013). Relationship between HIV Stigma and Self-Isolation among People Living with HIV in Tennessee. PloS one, 8(8), e69564. Janz, N. K. & Becker, M.H. The health belief model: A decade later. Health education Quarterly 1984 Vol 11(1): 1 – 47. Logie, C., James, L., Tharao, W., & Loutfy, M. (2013). Associations between HIV-related stigma, racial discrimination, gender discrimination, and depression among HIV-positive African, Caribbean, and Black women in Ontario, Canada. AIDS patient care and STDs, 27(2), 114-122. Maughan-Brown, B. & Nyblade, L. (2014). Different dimensions of HIV-related stigma may have opposite effects on HIV testing: Evidence among young men and women in South Africa. AIDS and Behavior, 18, (5), 958-965. Office of Women’s Health. (2014). Minority Women’s Health: HIV/AIDS. Retrieved from http://womenshealth.gov/minority-health/african-americans/hiv-aids.html Schnall, R., Rojas, M., & Travers, J. (2014). Understanding HIV Testing Behaviors of Minority Adolescents: A Health Behavior Model Analysis. Journal of the Association of Nurses in AIDS Care. MLimagePierre – Proposal Oral Defense – March 2015

Designing and Implementing a High Quality Research Project: Best Practices, Training and Practice Robert Kilmer, Ph.D. and Wade Smith, Ed.D. Closing Thank you Dr. Anderson and Dr. Langley for your time and attention. This concludes my proposal oral defense presentation. Now, I would like to invite your questions. MLimagePierre – Proposal Oral Defense – March 2015 Walden University Ph.D. Residency - Minneapolis, MN July 2008