PHYSICIANS PREVENTION OF STD/HTLV III INFECTION

该提案完成了一项战略的干预和评估阶段， 逐步教育计划，以提高初级保健医生的 预防性传播疾病和人类 免疫缺陷病毒（HIV）感染的成年患者，通过 提高医生的性行为史（SPH）技能，知识 关于性病和艾滋病毒感染和预防咨询意见。 的 目前资助的项目已通过一份 试点调查和所有教材的实地测试。 的 全面调查工作正在进行中。 到本项目结束时， 将完成对所有医生的干预前访谈， 干预开始了。 这项建议将使完成 干预和评估其影响。 一个准实验性的预- 将采用干预后设计。 医生将随机 分配接收邮寄的书面和音频材料（低 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 通过与医生的电话访谈收集。 1个月 干预后访谈将更有信心地归因于干预前 干预措施的变化，6个月后的测试将检测长期 性病/艾滋病毒知识、SPH和预防技能的变化。 在7个月时 干预后，模拟患者评价员访视，对10名 %的研究组，将直接观察，从而验证 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，华盛顿特区大都市区初级保健医生的 知识、态度和性病/艾滋病毒预防做法的3个方面， 时间;评估阶梯式教育的短期和长期影响 提高医生对SPH和预防知识的干预 成年患者中有关性传播疾病/艾滋病毒感染的咨询技能; 估计模拟的可行性，成本和可复制性 患者指导员作为一种基于办公室的CME方法， 验证数据;并进行分组分析，以确定如何 扩大基于办公室的继续医学教育“性病/艾滋病毒预防”干预， 评价概念

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.