PRIMARY CARE PROVIDERS' ROLE IN HIV/STD PREVENTION

初级保健提供者在艾滋病毒/性病预防中的作用

• 批准号: 2416076
• 负责人: DANIEL E MONTANO
• 金额: $ 71.62万
• 依托单位: BATTELLE CENTERS/PUB HLTH RES & EVALUATN
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-09-30 至 1999-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2416076
• 关键词: AIDS; AIDS education /prevention; behavior modification; behavioral /social science research tag; counseling; disease /disorder prevention /control; health education; human subject; nurses; patient care; patient care personnel relations; primary care physician; questionnaires; sexually transmitted diseases

The human immunodeficiency virus (HIV) is spread largely through sexual contact with an infected individual. Preventing the spread of HIV through designing interventions to help individuals choose safer sexual behavior is necessary. Primary Care Providers (PCPs) are in a unique position to intervene and have an impact on patients' health. Since the late 1980's, a number of organizations have recommended that PCPs act in their practices to help curb the spread of HlV and other sexually transmitted diseases (STDs). Studies conducted among primary are physicians show low rates (10%) of sexual and drug history assessment. None of the studies have used a comprehensive theoretical framework for understanding the relationships among providers' behavior and mutable variables which might have a direct effect on that behavior. In order to develop effective interventions to change clinicians' perceptions and increase the likelihood of sexual and drug history taking behavior and HlV/STD preventive counseling, we need a better understanding of how provider and patient beliefs, values, normative influences, perceived skill in counseling, practice characteristics and other factors affect these provider behaviors. An expanded version of the Theory of Reasoned Action (TRA) is used as the theoretical framework for this proposed research. Use of the TRA will allow the determination of actors directly affecting providers' behavior. Results from this research will lead to the design of intervention programs to increase PCPs sexual and drug history taking and HlV/STD preventive counseling behavior. The research will be conducted in Washington State with a sample of PCPs selected using multistage, luster, stratified probability sampling. PCPs will be surveyed to assess the determinants which impact individual provider's behaviors in regards to sexual and drug history assessment and HlV/STD prevention counseling behavior. In addition, for a subsample of providers (n = 200), patient's perceptions regarding their provider's behavior will be assessed. Patients will be surveyed in two groups. A randomly selected sample of patients from the subsample of PCPs will be surveyed with a mailed survey instrument. These patients will be used to corroborate provider's self reported sexual and drug risk assessment and HlV/STD prevention counseling behavior. In addition, selected patients and their providers will be surveyed after the patient's health maintenance visit with heir provider. Regression analyses will be conducted to identify the key beliefs, values, social normative influences, past experiences, perceived skill, critical events, and patients' beliefs and values that best predict rates of provider HlV/STD risk assessment and counseling behavior. Data from providers and patients will be linked. Analyses will be conducted looking at patterns within and across provider specialty and patient and provider gender groups. Further analyses will be conducted to compare groups on identified key variables and to determine which factors are amenable to intervention through educational methods.

人体免疫缺陷病毒（HIV）主要通过性传播。 与受感染的人接触。预防艾滋病毒的传播， 设计干预措施，帮助个人选择更安全的性行为 是必要的.初级保健提供者（PCP）处于独特的地位， 干预并影响患者的健康。自20世纪80年代末以来， 一些组织建议，PCP在其 帮助遏制艾滋病毒和其他性传播疾病传播的做法 性病（STDs）。在初级保健医生中进行的研究显示， 性和药物史评估率（10%）。没有一项研究 使用了一个全面的理论框架来理解 提供者的行为和可变变量之间的关系， 对这种行为有直接的影响。 为了开发有效的干预措施来改变临床医生的 增加性和吸毒史的可能性 行为和HIV/STD预防咨询，我们需要更好地了解 提供者和患者的信仰、价值观、规范性影响， 心理咨询技能感知、实践特征等因素 影响这些供应商的行为。理论的扩展版本 理性行动（TRA）被用作这一理论框架 提议的研究。使用TRA将允许确定演员 直接影响供应商的行为。这项研究的结果将 导致干预方案的设计，以增加PCP的性和 吸毒史和HIV/STD预防咨询行为。 研究将在华盛顿州进行，样本为PCP 采用多阶段、分层、分层概率抽样的方法进行选择。PCPs 将进行调查，以评估影响个人的决定因素 提供者在性和药物史评估方面的行为， HIV/STD预防咨询行为。此外，对于 提供者（n = 200），患者对其提供者的看法 行为将被评估。将对两组患者进行调查。一 将从PCP子样本中随机选择患者样本， 用邮寄的调查工具进行调查。这些患者将习惯于 证实提供者自我报告的性和药物风险评估， HIV/STD预防咨询行为。此外，选定的患者和 他们的提供者将在病人的健康维护后接受调查 拜访继承人提供者。 将进行回归分析，以确定关键的信念，价值观， 社会规范的影响，过去的经验，感知技能，关键 事件，以及患者的信念和价值观，最好地预测率 提供者HIV/STD风险评估和咨询行为。数据从 医生和病人将被联系在一起。将进行分析， 在提供者专业内部和跨提供者专业以及患者和提供者之间的模式 性别群体。将进行进一步分析，以比较 确定关键变量，并确定哪些因素适合 通过教育方法进行干预。