PHYSICIANS PREVENTION OF STD/HTLV III INFECTION

该提案完成了 阶段性教育计划，以改善初级保健医生的 性传播疾病(STDS)和人类 成人患者免疫缺陷病毒(HIV)感染 提高内科医生的性行为史(SPH)技能和知识 关于性传播疾病和艾滋病毒感染的预防咨询建议。这个 目前资助的项目已通过一项 调查的试点和所有教材的实地测试。这个 全面调查正在进行中。到当前项目结束时， 将完成对所有医生的干预前访谈，并 干预开始了。这项建议将允许完成 干预措施及其影响的评估。一种准实验的预实验 将采用干预后设计。医生将随机 负责接收邮寄的书面和音频材料(LOW 干预)，邮寄材料加上模拟患者和反馈 继续医学教育(CME)学分(高度干预)或无 材料(对照组)。基线，短期和长期数据将 通过与医生的电话采访收集的数据。A 1个月 干预后面谈将更自信地归因于岗位前 干预措施的变化，6个月的后测将检测到长期 性病/艾滋病知识、SPH和预防技能的变化。在7个月时 干预后，一次模拟的患者评估员访问， 研究小组的百分比，将直接观察并验证 医生自我报告的SPH评估和咨询技能。 本研究的总体目标是：记录和分析假设 关于华盛顿特区大都会地区的初级保健医生 知识、态度和性传播疾病/艾滋病毒预防实践3点： 时间；评估阶梯式教育的短期和长期影响 提高医师知识、自发性高血压和预防性疾病知识的干预 成人患者性传播疾病/艾滋病毒感染的咨询技巧； 评估模拟环境的可行性、成本和可复制性 患者指导作为一种基于办公室的继续医学教育方法和一种方法 验证数据；并进行分组分析，以确定 扩大以办公室为基地的继续医学教育“性传播疾病/艾滋病毒预防”干预和 评价理念。

This proposal completes the intervention and evaluation phases of a stepped educational program to improve primary care physicians' prevention of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) infection in adult patients through improving physicians' sexual-practices history (SPH) skills, knowledge about STDs and HIV infection and preventive counseling advice. The currently funded project has documented project feasibility through a pilot of the survey and a field test of all educational materials. The full scale survey is underway. By the end of the current project, the pre-intervention interview of all physicians will be completed and the intervention begun. This proposal will permit completion of the intervention and evaluation of its impact. A quasi-experimental pre- post-intervention design will be used. Physicians will be randomly assigned to receive mailed written and audio materials (low intervention), mailed material plus a simulated patient and feedback for continuing medical education (CME) credit (high intervention), or no material (control group). Baseline, and short- and long-term data will be collected through telephone interviews with physicians. A 1 month post-intervention interview will more confidently attribute pre-post changes to the intervention, a 6-month post test will detect long-term change in STD/HIV knowledge, SPH and prevention skills. At 7 months post-intervention, a simulated patient evaluator visit, made to ten percent of the study group, will directly observe and thus validate physicians' self-reported SPH assessment and counseling skills. The overall aims of this study are to : document and analyze hypotheses about Washington, D.C. metropolitan area primary care physicians' knowledge, attitudes, and STD/HIV prevention practices at 3 points i time; evaluate the short and long-term effects of a stepped educational intervention on improving physicians' knowledge, SPH and preventive counseling skills regarding STDs/HIV infection among adult patients; estimate the feasibility, costs, and replicability of a simulated patient instructor as an office-based CME method and as a method of validating data; and conduct subgroup analyses to identify ways to extend the office-base CME "STD/HIV prevention" intervention and evaluation concept.