Motivational interviewing by peer outreach workers: a pilot randomized clinical trial to retain adolescents and young adults in HIV care
Motivational interviewing by peer outreach workers: a pilot randomized clinical trial to retain adolescents and young adults in HIV care
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DOI：
10.1080/09540120802612824
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发表时间：
2009-07-01
影响因子：
1.7
通讯作者：
Parsons, Jeffrey T.
中科院分区：
文献类型：
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作者：
Naar-King, Sylvie;Outlaw, Angulique;Parsons, Jeffrey T.
青年艾滋病毒携带者(青年会)在艾滋病毒初级保健中留存不良的风险特别高。这项研究利用动机访谈(MI)来提高青少年在初级保健中的保留率，并比较了同伴外展工作者(POW)和大师级别工作人员(MLS)的忠诚度和结果。87名青年团成员被随机分成两组，接受战俘或MLS的两次MI治疗。青年一代的年龄在16-29岁之间，其中92%是非裔美国人。用动机访谈治疗诚信(MITI)编码系统对37个录音会话进行编码。通过回顾医疗记录来评估护理中的保留率。在两个MITI量表上，POW的保真度较高，而在其余三个量表上，POW与MLS没有区别。虽然两组都改善了初级保健预约的规律性，但战俘对护理保留率和干预剂量的影响幅度大于MLS。结果表明，在充分的培训和监督下，战俘可以提供与MLS相当的质量的MI。战俘为提高卫生保健服务的保留率而提供的MI可能会增加城市环境中循证实践的成本效益。
Youth living with HIV (YLH) are at particularly high risk for poor retention in HIV primary care. This study utilized Motivational Interviewing (MI) to improve youth retention in primary care and compared the fidelity and outcomes of peer outreach workers (POW) to masters level staff (MLS). Eighty-seven YLH were randomized to receive two M I sessions from POW or MLS. YLH were aged 16-29 and 92% were African American. Thirty-seven audiotaped sessions were coded with the Motivational Interviewing Treatment Integrity (MITI) coding system. Retention in care was assessed by review of medical records. POW had higher fidelity on two MITI scales, and did not differ from MLS on remaining three scales. While both groups improved the regularity of primary care appointments, the effect size for POW on retention in care and intervention dose was larger than that of MLS. The results suggest that POW can provide MI with quality comparable to MLS with adequate training and supervision. MI provided by POW to improve retention in health care services may increase the cost-effectiveness of evidence-based practices in urban settings.