PRIMARY CARE PROVIDERS' ROLE IN HIV/STD PREVENTION

人类免疫缺陷病毒(HIV)主要通过性传播 与感染者接触。通过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 干预并对患者的健康产生影响。自上世纪80年代末以来，S 一些组织建议初级保健医生在他们的 有助于遏制HLV和其他性传播疾病传播的做法 疾病(性病)。在初级医生中进行的研究表明 性和吸毒史评估率(10%)。没有一项研究 使用了一个全面的理论框架来理解 供应商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，改变临床医生的 认知和增加性行为和吸毒史的可能性 行为与HLV/STD预防咨询，我们需要更好的理解 关于提供者和患者的信念、价值观、规范影响、 心理咨询知觉技能、实践特征等因素 影响这些提供程序行为。的理论的扩展版本 理性行动(TRA)被用作这方面的理论框架 拟开展的研究。TRA的使用将使行为者得以确定 直接影响提供商的行为。这项研究的结果将 导致设计干预计划，以增加PCP的性行为和 吸毒史与HLV/STD预防咨询行为。 这项研究将在华盛顿州进行，样本为五氯酚 选择采用多阶段、有光泽、分层概率抽样。PCP 将接受调查，以评估影响个人的决定因素 提供者在性和吸毒史评估方面的行为以及 HLV/STD预防咨询行为。此外，对于以下的子样本 提供者(n=200)，患者对提供者的看法 我们将对其行为进行评估。患者将被分成两组接受调查。一个 从初级保健医生的次级样本中随机选择的患者样本将是 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毒品风险评估和 HLV/STD预防咨询行为。此外，选定的患者和 他们的提供者将在患者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，以确定关键信念、价值观、 社会规范影响、过去经验、感知技能、批判性 事件，以及患者的信念和价值观，最能预测 提供艾滋病/性传播疾病风险评估和咨询行为。数据来自 提供者和患者将被联系在一起。将进行分析，以期 在提供商专科、患者和提供商内部和跨提供商的AT模式 性别群体。将进行进一步的分析，以比较以下几组 确定关键变量，并确定哪些因素适用于 通过教育方法进行干预。

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.