An Intervention for Migrant Puerto Rican Drug Users

针对波多黎各移民吸毒者的干预措施

• 批准号: 7060339
• 负责人: SHERRY DEREN
• 金额: $ 65.4万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-09-01 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7060339
• 关键词: AIDS education /prevention; HIV infections; Puerto Rican; Puerto Rico; United States; adult human (21+); behavioral /social science research tag; clinical research; crack cocaine; culture; drug abuse therapy; health care personnel education; health education; high risk behavior /lifestyle; human subject; human therapy evaluation; intravenous drug abuse; medically underserved population; methadone; migrant; nonEnglish language; patient care personnel relations; patient oriented research; peer group; serology /serodiagnosis; sex behavior; smoking; substance abuse related behavior

DESCRIPTION (provided by applicant): This proposal is for a competing continuation of a study of determinants of HIV risk among Puerto Rican injection drug users (IDUs) and crack smokers in New York and in Puerto Rico. Based on data from the parent grant, this proposal was developed to test the efficacy of an intervention (The Bienvenidos Project) developed to reduce risk behaviors among Puerto Rican migrant drug users (defined as those who previously used heroin or cocaine in Puerto Rico and now use drugs in the NY area). Our research found that among Puerto Rican IDUs in NY, those who were migrants (39% of our IDU sample) were riskier (reported higher levels of shooting gallery use and sharing injection equipment). Our data also showed that these riskier practices were related to the higher levels of risk behaviors found in Puerto Rico. The Bienvenidos Project incorporates interventions at the social (Peer) level and the drug treatment program level. The study will use a group randomized trial design, and will be based in 4 pairs of MMTP clinics with substantial proportions of Puerto Rican clients. Within each pair, one clinic will be randomly assigned to an Intervention Condition, which will (a) provide joint training of staff and Peer Outreach Workers regarding the higher risk behaviors of Puerto Rican migrant drug users, and (b) train Peers in skills regarding outreach and risk reduction with migrants. In the Control Condition, Peers will receive a brief non-HIV related training and staff will receive delayed training. Assessments of the intervention's impact will be conducted at the clinic level, and with staff (n= 120), peers (n=120) and migrants (n=560). Qualitative data collection will provide contextual information to enhance understanding of the intervention's impact. Using hierarchical linear modeling as the primary statistical method, hypotheses to be tested include: (a) MMTP clinics in the Intervention Conditions will enhance their services to address needs of migrants; (b) MMTP staff in Intervention clinics will increase their knowledge about migrants' HIV risks and their communication with clients and staff regarding migrants;(c) Peers will reduce their drug and sex-related risk behaviors; and (d) Migrants recruited from the Intervention clinics' communities where Peers do outreach, will reduce their drug and sex-related risk behaviors. The results of this study will have implications for conducting interventions with migrant drug users, and will enhance our knowledge regarding multi-level interventions to reduce HIV risk.

描述（由申请人提供）：本提案旨在竞争性地继续一项关于纽约和波多黎各的波多黎各注射吸毒者 (IDU) 和吸毒者中艾滋病毒风险决定因素的研究。根据母基金的数据，制定该提案是为了测试一项干预措施（Bienvenidos 项目）的有效性，该干预措施旨在减少波多黎各移民吸毒者（定义为以前在波多黎各吸食海洛因或可卡因，现在在纽约地区吸毒的人）的风险行为。我们的研究发现，在纽约的波多黎各注射吸毒者中，移民（占注射吸毒者样本的 39%）风险更高（报告称使用射击场和共用注射设备的比例较高）。我们的数据还表明，这些风险较高的做法与波多黎各发现的较高风险行为有关。 Bienvenidos 项目纳入了社会（同伴）层面和戒毒治疗计划层面的干预措施。该研究将采用分组随机试验设计，并将以 4 对 MMTP 诊所为基础，其中波多黎各客户占很大比例。在每一对中，一个诊所将被随机分配到干预条件，该条件将（a）为工作人员和同伴外展工作人员提供有关波多黎各移民吸毒者高风险行为的联合培训，以及（b）培训同伴有关移民外展和降低风险的技能。在控制条件下，同事将接受简短的非艾滋病毒相关培训，工作人员将接受延迟培训。干预措施影响的评估将在诊所层面进行，参与者包括工作人员 (n=120)、同事 (n=120) 和移民 (n=560)。定性数据收集将提供背景信息，以增强对干预措施影响的理解。使用分层线性模型作为主要统计方法，需要检验的假设包括： (a) 干预条件下的 MMTP 诊所将加强其服务，以满足移民的需求； (b) 干预诊所的 MMTP 工作人员将增加对移民艾滋病毒风险的了解，并加强与客户和工作人员就移民问题进行的沟通； (c) 同伴将减少他们的吸毒和性相关风险行为； (d) 从同行开展外展活动的干预诊所社区招募的移民将减少他们的毒品和性相关危险行为。这项研究的结果将对移民吸毒者进行干预措施产生影响，并将增强我们对降低艾滋病毒风险的多层次干预措施的认识。