Psychosocial Support to HIV/AIDS Affected Children in Zimbabwe

为津巴布韦受艾滋病毒/艾滋病影响的儿童提供心理社会支持

• 批准号: 7059261
• 负责人: Danuta Kasprzyk
• 金额: $ 55.56万
• 依托单位: BATTELLE CENTERS/PUB HLTH RES & EVALUATN
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7059261
• 关键词: Africa; HIV infections; adolescence (12-20); behavioral /social science research tag; child behavior; child psychology; clinical research; cognitive behavior therapy; coping; human subject; human therapy evaluation; interview; longitudinal human study; parent offspring interaction; psychological stressor; rural area; rural health; social psychology; therapy design /development; urban area

DESCRIPTION (provided by applicant): Current global estimates are that approximately 35 million adults (15-49 yrs) are infected with HIV, and sub Saharan Africa, with over 12.3 million children orphaned by AIDS, is one of the worst hit regions in the world. In Zimbabwe, the number of orphans could reportedly rise to 1.4 million in the next 5 years. Statistics on orphans, however, reflect only a small fraction of the total number of children affected by HIV/AIDS, and according to UNICEF (2001), it is the population of children living with HlV-affected parents which needs to be the focus of attention. Mounting evidence indicates that the emotional impact on such adolescent children is especially pronounced, in large part because these children are forced to confront the ever-changing demands of chronic parental illness with little access to psychosocial support. The proposed research, to be conducted in Zimbabwe, has 6 specific aims: 1) to conduct formative research and use the data, in conjunction with ethnographic data from current research, to adapt and implement a psychosocial support and coping skills intervention (Project TALC/TLC/CLEAR) with adolescent children (12-18) living with an HIV-positive parent; 2) to pilot test the intervention in 1 village and refine the intervention protocol based on these findings; 3) to conduct a full implementation of the modified intervention in 2 urban and 2 rural settings with families where at least 1 parent is HIV positive; 4) to assess the effectiveness of the intervention on psychosocial, behavioral, health, and clinical outcomes obtained at baseline, 6, 12, 24, and 36 months from randomly selected intervention and control families; 5) to ascertain psychosocial changes through longitudinal analysis; and 6) to modify the intervention protocol based on the findings, and make the intervention available for wider dissemination. Project TALC/TLC/CLEAR, which is based on social cognitive theory, has been implemented and evaluated with HlV-affected families in the U.S., and proven effective in reducing problem behaviors and emotional distress in both intervention children and parents. The intervention consists of 5 modules (i.e. staying healthy, family relationships, setting goals and reducing risk, mental health, and bereavement) designed to build coping skills and adolescent self-awareness of the link between negative emotions and dysfunctional behaviors. A team of trained nurses and social workers will deliver the intervention sessions for each module to small groups of parents and children, either alone or together, depending on the topic. The results from the proposed study will determine the extent to which the translation, implementation and evaluation of this intervention is effective in meeting the psychosocial needs of adolescent children in Zimbabwe whose parents are infected with HIV.

描述（由申请人提供）：目前全球估计约有3500万成年人（15-49岁）感染艾滋病毒，撒哈拉以南非洲有1230多万艾滋病孤儿，是世界上受影响最严重的地区之一。在津巴布韦，据报孤儿人数在今后5年内可能增加到140万。然而，关于孤儿的统计数字只反映了受艾滋病毒/艾滋病影响的儿童总数的一小部分，而且根据儿童基金会（2001年），与受艾滋病毒影响的父母生活在一起的儿童人口需要成为关注的重点。越来越多的证据表明，对这些青少年儿童的情感影响特别明显，这在很大程度上是因为这些儿童被迫面对父母慢性疾病不断变化的需求，几乎得不到心理社会支持。拟在津巴布韦进行的研究有6个具体目标：1）进行形成性研究，并利用这些数据，结合目前研究中的人种学数据，调整和实施心理社会支持和应对技能干预措施（TALC/TLC/CLEAR项目）与艾滋病毒阳性父母一起生活的青少年儿童（12-18岁）;（2）在一个村庄进行干预措施试点，并根据这些结果完善干预方案;（3）在父母中至少有一方为艾滋病毒阳性的家庭的两个城市和两个农村地区全面实施经修改的干预措施; 4）评估干预对基线、6、12、24和36个月时从随机选择的干预和对照家庭获得的心理社会、行为、健康和临床结果的有效性; 5）通过纵向分析确定心理社会变化;（6）根据调查结果修改干预方案，并使干预方案得到更广泛的传播。基于社会认知理论的TALC/TLC/CLEAR项目已经在美国的HIV感染家庭中实施和评估，并被证明在减少干预儿童和父母的问题行为和情绪困扰方面有效。干预措施包括5个模块（即保持健康、家庭关系、设定目标和减少风险、心理健康和丧亲之痛），旨在建立应对技能和青少年对负面情绪和功能失调行为之间联系的自我意识。一个由训练有素的护士和社会工作者组成的团队将根据主题，单独或一起向父母和儿童小组提供每个模块的干预课程。拟议研究的结果将确定这一干预措施的翻译、执行和评价在满足父母感染艾滋病毒的津巴布韦青少年儿童的心理社会需求方面的有效程度。