Engaged Scholarship: A Promising Research Methodology to Address Health Inequalities Among Students Attending Historically Black Colleges/Universities

Background and Purpose- Data have shown that young adults from minority populations represent the majority of new HIV/HCV infections. Historically Black Colleges and Universities (HBCU’s) have a documented and consistent concentration of minority young adult between the ages of 18 and 24. This project examined behavioral health disparities among at-risk African American young adults (ages 18-24) on campus and in the surrounding community by encouraging the implementation of strategies to decrease the differences in access, service use, and outcomes among the racial and ethnic minority populations served. The objectives of this federally funded program support the four primary goals of the National HIV/AIDS Strategy which includes: 1) reducing new HIV infections, 2) increasing access to care and improving health outcomes for people living with HIV, 3) reducing HIV-related disparities and health inequities, and 4) achieving a coordinated response to the HIV epidemic.

Methodology- Evaluation data assessing direct and indirect prevention and intervention strategies were used to examine program outcomes and effectiveness. Direct (individual-level) activities included prevention education and risk reduction activities. Indirect (population-level) activities included environmental strategies, community processes, and information dissemination. To evaluate direct activities participant level data was collected using the federally approved youth and young adult questionnaire. The questionnaire was administered pre/post prevention education sessions and collected baseline characteristics of the served population and changes in participants’ knowledge, attitudes, behaviors. To evaluate indirect activities, local public health data, results from HIV testing events, meetings with campus (and community) stakeholders, and focus groups with certified campus-based peer educators was used. Indirect activities examined changes in the normative environment and in health disparities at the campus level, factors associated with changes at the campus level, and strategies and combinations of outreach and engagement strategies associated with participant-and campus/community-level changes.

Results- The three year program educated over 4,500 participants on SA, HIV/AIDS, and Hep C using evidence-based programming and culturally relevant edutainment events. The program tested 3,799 individuals (exceeding the 2000 project goal). Evaluation results indicate that the program Increased participant’s knowledge, attitudes, and perception of risk related to drugs, alcohol, and sexual behavior. The program also increased participant’s intention to reduce use of alcohol, drugs, and risky sexual behaviors. Capitalizing on other campus and community events and activities was key to building capacity. Talking about alcohol and drug use, HIV, and HCV helped to normalize sensitive and taboo topics and reduced stigma. The overall impact on the community was coordinated and strategic collaboration to help reduce alcohol and drug use, new HIV and HCV infections.

Implications- HBCU’s can be important partners for bridging access to HIV testing and public health education. Because of the long history of as educational and supportive systems in Black communities, HBCU’s are uniquely positioned to address disparities and promote health equity in young adult substance use and HIV/AIDS prevention. Programs that create federal, local health department, academic partnerships can strengthen the foundation for primary research and community engaged partnerships at HBCU’s.