Professional Affiliations:
Emma (E.J.) Brown, PhD, APRN-BC, FAAN
Associate Professor
University of Kentucky
College of Nursing
College of Nursing Building, Room 547
Lexington, KY 40536-0232
Phone: (859) 323-6621
Fax: (859) 323-1057
Email: ejbrow3@email.uky.edu
NARMH Positions and Projects:
Dr. Brown was elected to NARMH board in 2005
Rural Mental Health Involvement and Contributions:
Dr. E. J. Brown has been involved in conducting qualitative drug use research, quantitative and qualitative HIV/AIDS research, and implemented HIV prevention programs with various rural minority populations since 1999. The specific populations included ethnically diverse rural adolescents aged 13-19, mixed gender rural African Americans, and rural African-American women. Dr. Brown completed an NIDA funded ethnographic study with rural African-American women who use cocaine in December 2004. This study consisted of ethnographic mapping, participant observation, and in-depth interviewing of 30 participants for the purpose of understanding the culture of rural African-American women who use.
Dr. Brown’s current research funded by the Center of Disease Control and Prevention (2007-2011) is focused on HIV Testing Factors Among Rural/Small City Black Men. The study proposed in this application addresses the second new strategy for HIV prevention under CDC’s Advancing HIV Prevention (AHP) initiative; the implementation of new models for diagnosing HIV infections outside medical settings and one of the six research objectives of the RFA, Voluntary HIV testing and counseling of heterosexual Black and Hispanic males. The short-term study objective is to identify barriers and facilitators associated with HIV testing and disclosure of HIV+ test results-- black males18 - 64 who self-identify as heterosexual--determining whether these differ by relationship type (wife, regular outside female sexual partner, causal female sexual partner, male sexual partner) and to determine if providing HIV testing options will result in increase acceptability of HIV testing. The long-term objective is to develop an intervention to promote HIV testing and disclosure of HIV positive status to sexual partners that is cultural, gender, and region specific for rural/small city African American males who self-identify as heterosexual. The study design consists of four phases; Phase 1—Qualitative Descriptive focus groups (n=36) to inform the development of the survey items, Phase 2—Cross-sectional Instrument Developments and Testing (n=300) utilizing a mixed method approach of instruments administration and focus groups, Phase 3—Cross-sectional survey administration (n=3000) and randomized controlled trial at the individual level (n=300) comparing experimental condition with rapid HIV testing procedure (OraQuick Rapid HIV-1/2 Antibody or OraQuick Advance Rapid HIV-1/2 Antibody) via community outreach with the controlled condition/standard non-rapid OraSure or serological test, and Phase 4—Qualitative Descriptive process evaluation utilizing 12 focus groups (N=72, n=36 survey participants who did not participate in the randomized controlled trial and n=36 participants of the randomized controlled trial) to assess attitude toward HIV testing, perception of barriers to and facilitators of HIV testing, perception of assistance needed to improve HIV+ disclosure skills, and perception of strategies to improve HIV testing. The objective of this research has public health relevance to the Black community related to HIV. Three Healthy People 2010 objectives are addressed by this proposed research; 13-7 Increase the number of HIV positive persons who know their serostatus, 3-13 Increase the proportion of HIV-infected adolescents and adults who receive testing, treatment, and prophylaxis consistent with current Public Health Service treatment guidelines, and 5-8 Reduce HIV infections in adolescent and young adult females aged 13 to 24 years that are associated with heterosexual contact.
Dr. Brown other research interests include developing and evaluating the feasibility, and effectiveness of community-based substance abuse and HIV prevention interventions for rural minority populations of both genders. She is particularly interesting in evaluating the effectiveness of a modified prize-based contingency management drug treatment approach and in assessing the feasibility and cost effectiveness of incorporating individuals who are indigenous to the local drug culture (ex-drug users and non-users) as lay mental health advisors, who will provide services to clients using the intervention protocol. Another research interest of Dr. Brown’s is to assess the feasibility of recruiting individuals from a small cities and rural communities who use cocaine to participate in CM intervention over a 24-week period given the barriers and the possibility of their exposure to stigmatization.
In June 2000 Dr. Brown founded a 501(c)(3) not- for-profit community-based organization (CBO), the Coalition for the Health and Advocacy of Rural Minorities Incorporated, CHARM, Inc., out of a growing awareness of the need to provide health education focused on disease/social ill prevention and health promotion to under-served minorities in a ten-county service area of rural north Florida. CHARM’s mission is to promote healthy lifestyle choices aimed at addressing the leading causes of death (cancer, cardiovascular diseases, diabetes, HIV infection, homicides, unintentional injuries, pneumonia, and influenza) and social ills (drug use, teen pregnancy, and unemployment and/or underemployment) among rural minorities in North Florida. CHARM’s mission is achieved by: (1) developing and implementing educational prevention programs through community outreach, (2) establishing health care and social services referral data banks and, (3) advocating for the health care and social needs of rural minorities by raising awareness of these needs at local, state and national levels. All services are provided free of charge. Dr. Brown resigned as the Board President of CHARM in 2006, but continues to collaborate with through research studies and programs.
