HIV Prevention Groups for AOD Using SMI Women

描述（由申请人提供）： 拟议的研究是一个性别和文化特定的适应和随机试验的一组格式化的动机增强，简短的行为技能干预（BBSI-A），以减少320主要是西班牙裔和非洲裔美国妇女的艾滋病毒风险，代表的目标人口的AOD滥用，严重精神病（SMI）人口在社区治疗的艾滋病毒震中迈阿密。一个关键的焦点是群体如何处理（例如，群体联盟、参与、凝聚力和气候），这些在艾滋病毒预防研究中很少研究，可能会介导变化。调整和评估的干预措施来自信息-动机-行为（IMB）理论，以证据为基础，并通过科学共识存档以供传播。适应，BBSI-A，将进行比较，以时间匹配，基于视频的“治疗为基础”的教育（EDUC）条件。分层线性和结构方程模型将用于探索艾滋病毒风险结果以及干预效果如何通过群体过程（例如，团体参与、联盟、凝聚力和气候）、IMB变量、AOD使用和精神病学变量。这些分析技术还将用于探索艾滋病毒风险结果如何受到两个关键因素的调节：认知功能和创伤性虐待史。了解干预措施发挥其作用的因果机制，包括理论上重要的群体过程因素的中介影响，应有助于随后的努力，在其他临床环境中应用有效的干预措施。拟议的项目响应国家卫生研究院的优先级桥接临床研究和实践，其中的重点是适应有效的研究为基础的干预策略，为“真实的世界”所面临的条件，以社区为基础的供应商。如果成功的话，这项研究将提出一个艾滋病毒干预战略，可以实际实施的高风险的AOD滥用SMI妇女在他们的社区。

DESCRIPTION (provided by applicant): The proposed study is a gender-and-culturally specific adaptation and randomized trial of a group-formatted Motivational-Enhanced, Brief Behavioral Skills Intervention (BBSI-A) for reducing HIV risk among 320 predominantly Hispanic and African American women, representing a target population of the AOD abusing, seriously mentally ill (SMI) population in community treatment in the HIV epicenter of Miami. A key focus is how group processes (e.g., group alliance, engagement, cohesion, and climate), which have been rarely studied in HIV prevention research, may mediate change. The intervention to be adapted and evaluated is derived from Information-Motivation-Behavior (IMB) theory, and is evidence-based and archived by scientific consensus for dissemination. The adaptation, BBSI-A, will be compared to a time-matched, video-based "Treatment as Usual" Educational (EDUC) condition. Hierarchical Linear & Structural Equations Modeling will be used to explore HIV risk outcomes as well as how intervention effects are mediated by Group Processes (e.g., group engagement, alliance, cohesion and climate), IMB variables, AOD use and Psychiatric variables. These analytical techniques will also be used to explore how HIV risk outcomes are moderated by 2 key factors: cognitive functioning, and traumatic abuse history. Understanding causal mechanisms by which interventions exert their effects, including the mediating influences of theoretically important group process factors, should contribute to subsequent efforts to apply effective interventions in other clinical settings. The proposed project responds to the NIH priority on bridging clinical research and practice, in which the emphasis is on adapting effective research-based intervention strategies for the "real world" conditions faced by community based providers. If successful, this research will present an HIV intervention strategy that can be practically implemented for high-risk AOD abusing SMI women within their communities.