A Parenting Intervention for HIV+ Moms: The IMAGE program

针对艾滋病毒妈妈的育儿干预：IMAGE 计划

• 批准号: 7808433
• 负责人: DEBRA A. MURPHY
• 金额: $ 35.99万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2013-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7808433
• 关键词: 14 year old; AIDS/HIV problem; Address; Age; Behavior Therapy; Behavioral; Child; Chronic; Data; Development; Disclosure; Educational Intervention; Effectiveness; Epidemic; Evaluation; Family; Female of child bearing age; Future; Goals; Growth; HIV; HIV Seropositivity; Health behavior change; Image; Incidence; Individual; Intervention; Intervention Trial; Interview; Lead; Learning; Life; Medical; Mental Health; Modeling; Modification; Mothers; Motivation; Observational Study; Outcome; Parent-Child Relations; Parenting behavior; Parents; Perception; Pilot Projects; Prevention; Problem behavior; Randomized; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Risk; Role; Self Care; Self Concept; Social support; Source; Stigmata; Stress; Testing; Time; Woman; Work; austin; base; coping; design; efficacy testing; experience; follow-up; improved; information processing; medication compliance; parent-child communication; parental monitoring; physical conditioning; pilot trial; programs; prospective; psychologic; public health relevance; secondary outcome; skills; skills training; social stigma; theories; therapy development; trend

DESCRIPTION (provided by applicant): The incidence of HIV is high among women of childbearing age in the U.S., and mothers living with HIV (MLH) report their greatest source of stress is combining the maternal role with the psychological and medical demands of coping with a chronic, life-threatening condition. The purpose of this R01 pilot study is to develop and then test the feasibility of implementing a parenting intervention for HIV-infected mothers with well children age 6 - 14 years old. The intervention is designed to improve parenting skills and maternal self-care skills in order to improve child and maternal outcomes. The basis for development of this intervention is work from two previous R01s (MH # 5R01MH057207, currently Yr. 12) designed to longitudinally assess HIV-positive mothers and their children. MLH (n = 60) and their children (total N = 120) will be recruited, randomized to a theory- based, skills training intervention or a control condition, and assessed at baseline and 3, 6, and 12-month follow-ups. The intervention ("Improving Mothers' parenting Abilities, Growth, & Effectiveness"-the IMAGE program) will consist of 5 sessions, and will be based on the Information - Motivation - Behavioral Skills (IMB) model of health behavior change, with specific skills selected based on our 10-year observational study of MLH and their children, which is on-going at UCLA. A random subset of 40% of the intervention mothers (n = 12) will be asked to participate in an in-depth qualitative interview after their last follow-up, to obtain detailed process information on their experiences in the intervention. The main aims of this randomized pilot trial are to: 1. develop the intervention and then evaluate the feasibility and acceptability of implementing the 5-week, theory based, individual behavior intervention to enhance positive parenting skills of MLH; and 2. conduct preliminary evaluation of the data for effect sizes and investigate trends in the data for: a. parenting practices outcomes (utilizing the parent practices scale), and secondary outcomes of parenting efficacy; b. parenting behaviors targeted (parent-child communication, parental monitoring, family routines, and appropriate parentification), and the self-care skills targeted (social support, disclosure, dealing with perceived stigma); c. maternal outcomes for mental health indicators and physical health indicators; d. child outcomes of mental health indicators, behavioral problems, and self-concept and coping; and e. family outcomes (family functioning, parent-child relationship). We are now in the third decade of the HIV epidemic, and few interventions, other than for prevention or medication adherence, are available for women living with HIV; this study will be the first step in the evaluation an intervention that will assist HIV-positive mothers in dealing with the stress of parenting while coping with HIV. The pilot data will lead to a future application for a full-scale trial of the intervention to test efficacy. PUBLIC HEALTH RELEVANCE: The purpose of this R01 is to conduct a pilot test of a parenting intervention for HIV-infected mothers with children age 6 - 14 years of age. We are now in the third decade of the HIV epidemic, and few interventions, other than for prevention or medication adherence, are available for women living with HIV; this study will pilot an intervention that will assist HIV-positive mothers in dealing with the stress of parenting while coping with HIV. The study will allow us to study mothers and children after the MLH obtain skills in the intervention to determine whether skill use increases over time and with practice, and provide information necessary for subsequent conduct of a full scale trial of the intervention.

描述（申请人提供）：美国育龄妇女艾滋病毒发病率很高，艾滋病毒感染者和母亲报告说，她们最大的压力来源是将母亲的角色与应对慢性、威胁生命的疾病的心理和医疗要求结合起来。这项R 01试点研究的目的是开发，然后测试的可行性，实施父母的干预艾滋病毒感染的母亲与健康的儿童年龄6 - 14岁。干预措施旨在提高为人父母的技能和产妇自我护理技能，以改善儿童和产妇的结果。开发该干预措施的基础是前两个R 01的工作（MH #5 R 01 MH 057207，目前为Yr. 12)旨在纵向评估艾滋病毒阳性母亲及其子女。将招募MLH（n = 60）及其子女（总计N = 120），随机分配至基于理论的技能培训干预或对照组，并在基线和3、6和12个月随访时进行评估。干预措施（“提高母亲的育儿能力、成长和有效性”-IMAGE方案）将包括5次会议，并将以健康行为改变的信息-动机-行为技能（IMB）模型为基础，根据我们对MLH及其子女的10年观察研究选择具体技能，该研究正在加州大学洛杉矶分校进行。40%的干预母亲（n = 12）的随机子集将被要求参加一个深入的定性访谈后，他们的最后一次随访，以获得详细的过程信息，他们的经验，在干预。这项随机试点试验的主要目的是：1。发展一套以理论为基础，为期五周的个别行为干预，以提升幼儿正面亲职技巧，并评估其可行性及可接受性。对效应量的数据进行初步评估，并调查数据的趋势：a.亲职实践结果（使用父母实践量表），以及亲职效能的次要结果; B.有针对性的养育行为（亲子沟通、父母监督、家庭常规和适当的养育）和有针对性的自我照顾技能（社会支持、披露、处理感知到的耻辱）; c.产妇心理健康指标和身体健康指标的结果; d.儿童心理健康指标、行为问题、自我概念和应对的结果;家庭结果（家庭功能、亲子关系）。 我们现在处于艾滋病毒流行的第三个十年，除了预防或坚持服药外，几乎没有什么干预措施可供感染艾滋病毒的妇女使用;这项研究将是评估一项干预措施的第一步，这项干预措施将帮助艾滋病毒抗体阳性的母亲在应对艾滋病毒的同时应对养育子女的压力。试点数据将导致未来申请进行全面的干预试验，以测试疗效。 公共卫生关系：本R 01的目的是对子女年龄在6 - 14岁之间的感染艾滋病毒的母亲进行育儿干预的试点测试。我们现在处于艾滋病毒流行的第三个十年，除了预防或坚持服药外，几乎没有什么干预措施可供感染艾滋病毒的妇女使用;这项研究将试行一项干预措施，帮助艾滋病毒抗体阳性的母亲在应对艾滋病毒的同时应对养育子女的压力。这项研究将使我们能够研究母亲和儿童在MLH获得干预技能后，以确定技能的使用是否随着时间的推移和实践而增加，并为随后进行的全面干预试验提供必要的信息。