Mobilizing Health Workers/Community HIV Prevention/Chile

动员卫生工作者/社区艾滋病毒预防/智利

• 批准号: 6922845
• 负责人: KATHLEEN F NORR
• 金额: $ 3.38万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-17 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6922845
• 关键词: AIDS education /prevention; South America; clinical research; community health services; health care model; health care personnel education; human subject; international cooperation; model design /development; peer group; rural area; rural health; safe sex /sex abstinence; training

DESCRIPTION (provided by applicant): The proposed AIDS-FIRCA research will adapt, implement, and test a peer group intervention to mobilize Chilean health workers as HIV/AIDS prevention leaders. The intervention was first developed in Botswana, then adapted for school teachers in Malawi, and now is being used to train health workers, community adults, and adolescents in Malawi. Health workers are key to success in the struggle to contain the HIV/AIDS pandemic. Chile has an incipient AIDS epidemic, but the epidemic is now spreading to the general population, beyond traditional high-risk groups. Very few efforts are now directed at containing the epidemic or preparing health workers for a role in HIV prevention. This model of peer group leader training for health worker mobilization is low cost and sustainable, and highly relevant for Chile and the Latin American region. The Chile research will be a partial replication of the Malawi study. In Phase I, a formative evaluation using focus groups and interviews with health administrators and workers will allow us to tailor the intervention and evaluation instruments for health workers in Chile. A quasi-experiment with pretest and post-test observations of health workers and clients in five intervention clinics and five comparable control clinics will evaluate the effects of the intervention. Process evaluation will document quality of the intervention. Health worker-client observations and interviews with health workers pre and post intervention in five intervention and five delayed-intervention control clinics will allow us to test hypotheses about changes in health services and health workers at three months post-intervention. Health services outcomes include: consistent practice of universal precautions, showing sensitivity toward HIV-related concerns, and incorporation of HIV prevention messages. Health worker outcomes include: increased HIV/AIDS knowledge, more positive attitudes toward persons living with HIV/AIDS and toward HIV prevention, and increased HIV prevention behaviors at work and in their personal lives. Power analysis indicates that the sample of 457 workers per clinic, with an 80% participation rate, will be adequate to test small to medium expected effects at a power of 0.80. Results will be disseminated to health workers and policy makers. Full participation by four Chilean coinvestigators and workshops by the US team will build research capacity at the host institution. The intervention is a low-cost sustainable model for national mobilization of health workers for HIV prevention.

描述（由申请人提供）：拟议的 AIDS-FIRCA 研究将调整、实施和测试同行小组干预措施，以动员智利卫生工作者成为艾滋病毒/艾滋病预防的领导者。该干预措施首先在博茨瓦纳开发，然后适用于马拉维的学校教师，现在正用于培训马拉维的卫生工作者、社区成年人和青少年。卫生工作者是遏制艾滋病毒/艾滋病流行斗争取得成功的关键。智利的艾滋病流行初期，但该流行病目前正在向普通人群蔓延，超出了传统的高危人群。目前，很少有人致力于遏制该流行病或让卫生工作者做好艾滋病毒预防工作的准备。这种针对卫生工作者动员的同行小组领导培训模式成本低且可持续，与智利和拉丁美洲地区高度相关。智利的研究将部分复制马拉维的研究。在第一阶段，通过焦点小组以及对卫生管理人员和工作人员的访谈进行形成性评估，这将使我们能够为智利的卫生工作者量身定制干预和评估工具。在五个干预诊所和五个可比较的对照诊所中对卫生工作者和客户进行测试前和测试后观察的准实验将评估干预措施的效果。过程评估将记录干预的质量。在五个干预诊所和五个延迟干预控制诊所中，在干预前后对卫生工作者-客户观察和对卫生工作者的访谈将使我们能够检验有关干预后三个月卫生服务和卫生工作者变化的假设。卫生服务成果包括：一致采取普遍预防措施、表现出对艾滋病毒相关问题的敏感性以及纳入艾滋病毒预防信息。卫生工作者的成果包括：增加艾滋病毒/艾滋病知识，对艾滋病毒/艾滋病感染者和艾滋病毒预防采取更积极的态度，以及在工作和个人生活中加强艾滋病毒预防行为。功效分析表明，每个诊所 457 名工作人员的样本（参与率为 80%）足以以 0.80 的功效检验中小预期效果。结果将分发给卫生工作者和政策制定者。四名智利联合研究人员的全面参与和美国团队的研讨会将增强主办机构的研究能力。该干预措施是动员全国卫生工作者预防艾滋病毒的低成本可持续模式。