Online Adaptation of HIV Risk-Reduction Interventions

描述(申请人提供)：本申请是根据PAR-03-078，从干预发展到服务：探索性研究资助(R34)提交的，旨在为一个为期3年的项目寻求资金，以调整和现场测试两种常用和有效的社区层面艾滋病毒预防干预措施，综合外展和大众意见领袖(POL)模式，用于在线环境，如“聊天室”。高危人群在网上结交性伴侣正变得越来越普遍。在对不同人群进行的多项研究中，研究人员证明，在网上寻求性伴侣的人表现出性风险行为增加的模式。互联网也有潜在的效用，可以接触到艾滋病毒高危人群。我们认为，社区一级的干预措施(综合外展，POL)在人口的日常互动中与其自然环境中的人口进行干预，显示出特别有希望适应网络使用。为了检验这一点，我们将进行三个阶段的研究：(1)对使用聊天室的人和进行在线干预的提供者进行初步访谈和焦点小组；(2)利用在形成阶段获得的信息，我们将根据我们对这些干预措施的初步构想，制定治疗方案和标准化干预手册，以适应互联网；(3)我们将进行试点研究和小规模概念测试，以检验干预措施改变社区规范、态度和艾滋病毒风险行为的潜在有效性。现场测试将使用随机设计，将4个聊天站点随机分配到以下3种情况之一：(A)综合外展、(B)POL和(C)仅限评估的对照。与PA一致，所使用的方法将提供关于在线社区一级干预的可行性、可接受性和实用性的初步数据。拟议的方法还将允许我们收集所需的数据，以提供更大规模试验所需的有效性的初步证据，包括对干预效果大小等结果参数的估计。

DESCRIPTION (provided by applicant): This application, submitted in response to PAR-03-078, From Intervention Development to Services: Exploratory Research Grants (R34), seeks funding for a 3 year project to adapt and field test two commonly-used and efficacious community-level HIV prevention interventions, Integrated Outreach and the Popular Opinion Leader (POL) Model, for use in online environments such as "chat rooms." It is becoming increasingly common for high-risk individuals to meet sexual partners online. In multiple studies with diverse populations, researchers have documented that persons who seek sexual partners online show a pattern of increased sexual risk behaviors. The Internet also has potential utility to reach populations at risk for HIV. We believe that community-level interventions (Integrated Outreach, POL) which intervene with populations in their natural environment during their day-to-day interactions show particular promise for adaptation for online use. To examine this, we will conduct 3 phases of research: (1) initial interviews and focus groups with persons using chat rooms and with providers who conduct online interventions (2) using information obtained during the formative stage, we will develop treatment protocols and standardized intervention manuals building upon our preliminary conceptualization of these interventions as adapted for the Internet, (3) we will conduct pilot studies and a small-scale test-of-concept field test to examine the potential efficacy of the interventions to alter community norms, attitudes, and HIV risk behavior. The field test will use a randomized design with 4 chat sites randomly assigned to 1 of 3 conditions: (a) Integrated Outreach, (b) POL, and (c) assessment-only control. Consistent with the PA, methods used will provide preliminary data concerning the feasibility, acceptability, and practicality of online community-level interventions. The proposed methods will also permit us to collect data needed to provide initial evidence of efficacy needed for a larger-scale trial, including estimates of outcome parameters such as intervention effect sizes.