Traslating Effective Health Behavior Strategies Into Practice for HIV+ Women

描述：这一受控“转化性”试验的多点应用程序建议测试一种以证据为基础的行为干预的传播策略，旨在接触到携带艾滋病毒的贫困有色人种妇女。在过去的十年里，这个多学科研究团队(纽约迈阿密大学和临床主任网络)对患有艾滋病毒/艾滋病的贫困女性(SMART/EST妇女计划)SWP进行了两项行为临床试验。这些试验表明，在抗逆转录病毒药物依从性、营养、自我效能、应对技能和生活质量方面有了显著改善，同时病毒载量、抑郁、焦虑、性风险和药物使用显著减少。申请者提议测试社区卫生中心工作人员是否可以接受培训，以便在纽约、新泽西州和佛罗里达州南部的社区卫生中心实施SMART/EST妇女计划，这三个地区是美国妇女艾滋病毒感染率最高的三个地区。从为期六个月的“试点阶段”开始，完善传播策略，这项研究将为社区卫生中心的卫生保健人员提供强化培训和后续支持，以便酌情用英语、西班牙语和克里奥尔语进行整个16期的人工干预。组织和临床变量将被评估，以确定这一战略的有效性，以通过参与的CHC采用、实施和维持这一计划。

DESCRIPTION: This multisite application for a controlled "translational" trial proposes to test a dissemination strategy for an evidence-based behavioral intervention designed to reach poor women of color living with HIV. Over the past ten years, this multidisciplinary research team (University of Miami and Clinical Directors Network, New York) has conducted two behavioral clinical trials with poor women of color living with HIV/AIDS (the SMART/EST Women's Program) SWP. These trials demonstrated significant improvements in antiretroviral medication adherence, nutrition, self-efficacy, coping skills, and quality of life, accompanied by significant reductions in viral load, depression, anxiety, sexual risk and substance use. The applicants propose to test whether Community Health Center staff can be trained to implement the SMART/EST Women's Program in CHCs in New York, New Jersey and south Florida, three locales with the highest HIV rates for women in the U.S. Beginning with a six month "pilot phase" to refine the dissemination strategy, the study will provide intensive training and follow-up support for CHC health care staff to deliver the entire 16 session manualized intervention in English, Spanish and Creole, as appropriate. Organizational and clinical variables will be assessed to determine the effectiveness of this strategy for the adoption, implementation and maintenance of this program by the participating CHCs.