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: 7228958
• 负责人: SHERRY DEREN
• 金额: $ 63.73万
• 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/7228958
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Applications Grants; Area; Behavior; Client; Clinic; Cocaine; Communication; Communities; Condition; Crack Cocaine; Data; Data Collection; Drug usage; Drug user; Economics; Environment; Epidemic; Equipment; Frequencies; Funding; Group Purchasing; HIV; Health Services Accessibility; Health behavior; Heroin; Heroin Users; Incidence; Individual; Injecting drug user; Injection of therapeutic agent; Intervention; Intervention Studies; Joints; Knowledge; Language; Learning; Linear Models; Link; Literature; Maintenance; Methadone; Modeling; Needle-Exchange Programs; New Jersey; New York; Nomads; Pharmaceutical Preparations; Population; Population Study; Programming Languages; Provider; Puerto Rican; Puerto Rico; Randomized; Randomized Controlled Clinical Trials; Recruitment Activity; Reporting; Research; Research Design; Risk; Risk Behaviors; Risk Reduction; Sampling; Services; Smoker; Statistical Methods; Testing; Training; Treatment Efficacy; Unsafe Sex; Work; base; design; follow-up; high risk behavior; migration; nutrition; outreach; parent grant; peer; sex; skills; social; therapy development; tool; treatment program

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)：这项提案是对波多黎各注射吸毒者和纽约和波多黎各的吸烟者中艾滋病毒风险决定因素的竞争性继续研究。根据父母赠款的数据，制定这项建议是为了测试旨在减少波多黎各移民吸毒者(定义为以前在波多黎各使用海洛因或可卡因，现在在纽约地区使用毒品的人)中危险行为的干预措施(Bienvenidos项目)的有效性。我们的研究发现，在纽约的波多黎各注射吸毒者中，那些移民(占我们注射吸毒者样本的39%)风险更高(报告称使用射击场和共享注射设备的水平更高)。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水平的危险行为有关。Bienvenidos项目纳入了社会(同行)一级和药物治疗方案一级的干预措施。这项研究将采用分组随机试验设计，并将以4对波多黎各客户比例相当高的MMTP诊所为基础。在每一对中，将随机分配一家诊所接受干预条件，这将(A)就波多黎各移徙吸毒者的高风险行为对工作人员和同伴外展工作人员进行联合培训，以及(B)培训同伴有关与移徙者进行外联和减少风险的技能。在控制条件下，同行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。将在诊所一级对干预措施的影响进行评估，并与工作人员(n=120)、同行(n=120)和移民(n=560)进行评估。定性数据收集将提供背景信息，以加强对干预影响的了解。使用分层线性模型作为主要的统计方法，待检验的假设包括：(A)处于干预条件下的MMTP诊所将加强其服务，以满足移民的需求；(B)MMTP干预诊所的工作人员将增加他们对移民艾滋病毒风险的了解，以及他们与服务对象和工作人员关于移民的沟通；(C)同伴将减少他们的毒品和性相关危险行为；以及(D)从干预诊所社区招募的同伴开展外展，将减少他们的毒品和与性相关的危险行为。这项研究的结果将对对流动吸毒者进行干预产生影响，并将增强我们对降低艾滋病毒风险的多层次干预的知识。