SUPPORTING ALCOHOL REDUCTION IN HIV+ PATIENTS: A TRAINING FOR HIV CARE PROVIDERS

支持艾滋病毒患者减少饮酒：针对艾滋病毒护理人员的培训

• 批准号: 7230797
• 负责人: SHIELA M STRAUSS
• 金额: $ 14.1万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7230797
• 关键词: HIV infections; alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; clinical research; counseling; early /brief intervention /therapy; education evaluation /planning; focus groups; handbook; health care personnel education; human subject; interview; mental disorder diagnosis; motivation; patient care personnel attitude; self concept; training

DESCRIPTION (provided by applicant): This application aims to develop and evaluate a theory-driven training for HIV care providers to support their systematic use of the National institute on Alcohol Abuse and Alcoholism's effective brief intervention (NIAAA's Bl) for alcohol reduction. The high rate of at-risk alcohol use among individuals with HIV and HIV/HCV co-infection, and the serious harm that such alcohol use often causes in (a) accelerating disease progression, (b) limiting effectiveness and access to ARV therapy, and (c) sometimes increasing risky sexual behaviors that seriously jeopardize their health and that of their partners, provides the rationale and urgency for this research. Although providers are uniquely positioned to screen and counsel patients about alcohol reduction as part of a "prevention with positive" focus, they rarely do, often as a result of limited experience, skills, and self-efficacy. Thus, a provider training to implement NIAAA's Bl is critically needed, and, as our preliminary studies indicate, HIV care providers are interested in receiving such a training and indicate they would put the Bl skills they learn into practice. Thus, guided by Social Cognitive Theory and Simpson's Model of Organizational Change, the aims of the proposed developmental study are to (1) create a state-of-the-art provider training to encourage the implementation of NIAAA's Bl by teaching participants (a) how to screen patients for alcohol use, and (b) how to effectively counsel them to reduce this use using the principles of motivational interviewing; (2) to implement the training in 4 Designated AIDS Centers in New York City to obtain preliminary data regarding the impact of the training on providers immediately post-training, and 1- and 4- months post- training with regard to their knowledge, attitudes, self-efficacy, collective organizational efficacy, and actual use of NIAAA's Bl; and (3) to obtain preliminary data in order to examine the impact of the provider training on (a) patients' alcohol reduction; and on (b) the HIV provider organization, in terms of (i) the organizational climate towards dealing with alcohol and HIV and HIV/HCV co-infection; and (ii) the organization's actual expansion of existing alcohol reduction services and/or the implementation of new services to reduce alcohol consumption. If results demonstrate that the training is useful, feasible, acceptable, and effective in filling a critical service gap for HIV patients, we will seek funding to further examine its effectiveness in a variety of venues and to disseminate the training widely.

描述（由申请人提供）：本申请旨在为艾滋病毒护理提供者开发和评估理论驱动的培训，以支持他们系统地使用国家酒精滥用和酒精中毒研究所的有效简短干预（NIAAA的BI）来减少酒精。艾滋病毒和艾滋病毒/丙型肝炎病毒合并感染者中高风险酒精使用率，以及这种酒精使用经常导致的严重危害：（a）加速疾病进展，（B）限制抗逆转录病毒治疗的有效性和可及性，（c）有时增加严重危害其健康及其伴侣健康的危险性行为，为这项研究提供了理由和紧迫性。虽然提供者处于独特的地位，可以筛选和咨询患者减少酒精作为“积极预防”重点的一部分，但他们很少这样做，通常是由于经验，技能和自我效能有限。因此，迫切需要提供者培训以实施NIAAA的BI，并且如我们的初步研究所示，HIV护理提供者有兴趣接受这样的培训，并表示他们将把他们学到的BI技能付诸实践。因此，在社会认知理论和辛普森组织变革模型的指导下，本发展研究的目的是：（1）通过教授参与者（a）如何筛查患者是否饮酒，（B）如何使用动机访谈的原则有效地建议他们减少饮酒，创建一个最先进的提供者培训，以鼓励NIAAA的BI的实施;（2）在纽约市的4个指定艾滋病中心实施培训，以获取有关培训对提供者在培训后立即、培训后1个月和4个月的知识、态度、自我效能、集体组织效能和NIAAA BI实际使用情况的初步数据;以及（3）获得初步数据，以检查提供者培训对（a）患者饮酒减少的影响;以及对（B）艾滋病毒提供者组织的影响，包括（i）处理酒精和艾滋病毒以及艾滋病毒/丙型肝炎病毒合并感染的组织氛围;以及（ii）本组织实际扩大现有的减少酒精消费服务和/或实施新的减少酒精消费服务。如果结果显示培训有用、可行、可接受，并能有效填补艾滋病病毒感染者服务的一个关键缺口，我们会申请拨款，进一步研究培训在不同场所的成效，并广泛推广培训。