Novel Dissemination of a Group Intervention for HIV+ Women Via Web Conferencing

通过网络会议传播艾滋病毒妇女群体干预的新颖方法

• 批准号: 8097475
• 负责人: Stephanie Lynn Marhefka
• 金额: $ 29.2万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-22 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8097475
• 关键词: AIDS/HIV problem; Address; Affect; Area; Behavior; Behavior Therapy; Behavioral; Centers for Disease Control and Prevention (U.S.); Child; Chronic; Clinical; Communities; Community Health Centers; Community Healthcare; Computers; Costs and Benefits; Decision Making; Disclosure; Effectiveness; Environment; Evidence based intervention; Face; Family; Feedback; Female; Florida; Friends; Funding; Gender; Genetic Crossing Over; Goals; HIV; HIV Seropositivity; Health; Health Services Research; Home environment; Incidence; Internet; Interpersonal Violence; Intervention; Knowledge; Lead; Learning; Life; Location; Low Prevalence; Manuals; Mediation; Mental disorders; Modality; National Institute of Mental Health; Online Systems; Outcome; Participant; Persons; Population Heterogeneity; Preparation; Preventive Intervention; Primary Prevention; Privacy; Process; Public Health; Randomized; Randomized Controlled Trials; Research; Research Personnel; Research Priority; Research Project Grants; Resources; Risk; Science; Secondary Prevention; Services; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Social support; Testing; Time; Translations; Unsafe Sex; Videoconferences; Videoconferencing; Waiting Lists; Woman; Work; base; chronic pain; community setting; cost effectiveness; design; disorder prevention; experience; follow-up; group intervention; improved; innovation; intervention program; male; meetings; new technology; novel; programs; public health relevance; safer sex; sex risk; skills; social skills; socioeconomics; tertiary prevention; transmission process; trial comparing

DESCRIPTION (provided by applicant): This proposal fits with the NIMH priority for research aimed at developing and testing "different modes for transferring efficacious interventions" into community settings--especially with regard to interventions serving HIV-positive persons (PA-08-166). In the U.S., HIV among women is increasing. Women living with HIV (WLH) face tremendous challenges, including: a) making decisions about disclosing their HIV status; and b) negotiating for and practicing safer sexual behavior. Although the Healthy Relationship (HR) intervention was developed to address these challenges, two substantial needs remain. First, there is a need for HR to better address the above described gender specific needs of WLH. Second, there is a need for more widespread dissemination to WLH. Although HR is disseminated in the US by CDC's Dissemination of Effective Behavioral Interventions (DEBI) project, dissemination is limited to geographical areas in which a critical mass of people with HIV can meet in a single location to participate, and where community agencies have the time and resources for these efforts. As such, the proposed R34 study is designed to pilot and feasibility test video group dissemination of an adapted, gender-specific version of Healthy Relationships (HR) for WLH. Our team is currently funded to work with a Community Advisory Board (CAB) to adapt HR into Healthy Relationships-Web (HR-W) to: a) address women's gender-specific needs; and b) enable more widespread delivery through web-based group videoconferencing accessed at community locations. This proposed study is the critical next step towards determining whether or not it is feasible and effective to disseminate HR-W to WLH. Building upon our current work, specific aims of the proposed study are as follows: 1) Conduct pilot testing of HR-W with WLH and make any necessary adaptations to finalize the manual; and 2) Conduct a small partial cross-over feasibility trial comparing HR-W with a wait-list control (WLC), in preparation for a large randomized controlled trial (RCT). For Aim 1, we will conduct a single-group pilot test and garner feedback from participants to improve the HR-W manual with assistance from our existing CAB. For Aim 2, WLH will be randomized into the HR-W (n=35) and WLC (n=35) conditions. HR-W participants will receive the intervention immediately after a baseline assessment. After both conditions complete a 6-month follow-up assessment, WLC participants will cross over to the HR-W condition, receive the intervention, and complete a follow-up 6 months later. In preparation for a large RCT (and R01 application), the overall goals of this project are to establish that it is feasible to provide HR-W through videoconferencing and gather evidence suggesting that HR-W may lead to significant reductions in sexual risk behavior. The long-term goal is to establish effectiveness of HR-W for WLH in urban as well as geographically dispersed, low-prevalence, and resource- poor environments. PUBLIC HEALTH RELEVANCE: The successful dissemination of Healthy Relationships-Web through group videoconferencing accessed at community-located intervention stations will have far-reaching methodological and public health impacts. First, this study will establish the feasibility of online dissemination of an adapted version of Healthy Relationships so that, despite socioeconomic and geographic barriers, many more women living with HIV can benefit from the intervention's social support and skills building components. Second, this study will advance behavioral translation science by contributing significantly to current understandings of disseminating group-based interventions online, thus establishing knowledge that can then be used to adapt and disseminate an array of primary, secondary, and tertiary prevention interventions for a range of public health issues.

描述（由申请人提供）：该提案符合NIMH优先级的研究，旨在开发和测试“将有效干预措施转移到社区环境中的不同模式” - 尤其是在为HIV阳性人士服务的干预措施方面（PA-08-166）。在美国，妇女中的艾滋病毒正在增加。患有艾滋病毒（WLH）的妇女面临巨大的挑战，包括：a）决定披露其艾滋病毒状况； b）谈判并实践更安全的性行为。尽管制定了健康的关系（HR）干预措施来应对这些挑战，但仍有两个实质性的需求。首先，人力资源需要更好地解决上述WLH的性别特定需求。其次，需要对WLH进行更多广泛的传播。尽管通过CDC传播有效的行为干预措施（DEBI）项目，人力资源在美国被传播，但传播仅限于地理领域，在该地区，批判性艾滋病毒的人可以在一个地点见面，并且社区机构有时间和资源有时间和资源来实现这些努力。因此，拟议的R34研究旨在试验和可行性测试视频组传播WLH的适应性，性别特定版本的健康关系（HR）。 目前，我们的团队有资金与社区顾问委员会（CAB）合作，以将人力资源适应健康的关系 - WEB（HR-W）：a）满足妇女特定性别的需求； b）通过在社区位置访问的基于Web的小组视频会议启用更多广泛的交付。这项拟议的研究是确定将HR-W传播到WLH是否可行且有效的下一步。在我们目前的工作的基础上，拟议的研究的具体目标如下：1）用WLH对HR-W进行试点测试，并进行必要的改编以最终确定手册； 2）进行了一项针对HR-W与候补名单对照（WLC）进行比较的小部分跨界可行性试验，以准备大型随机对照试验（RCT）。对于AIM 1，我们将在现有出租车的帮助下进行单组试点测试并获得参与者的反馈，以改善HR-W手册。对于AIM 2，WLH将随机分为HR-W（n = 35）和WLC（n = 35）条件。 HR-W参与者将在基线评估后立即接受干预。两种情况都完成了为期6个月的随访评估后，WLC参与者将越过HR-W条件，接受干预，并在6个月后完成随访。为了准备大型的RCT（和R01应用程序），该项目的总体目标是确定通过视频会议提供HR-W是可行的，并收集证据表明HR-W可能会导致性风险行为大幅减少。长期的目标是在城市以及地理上分散，低众和资源较差的环境中建立HR-W对WLH的有效性。 公共卫生相关性：通过在社区社区的干预站访问的小组视频会议上成功传播健康关系 - WEB将产生深远的方法论和公共卫生影响。首先，这项研究将确定在线传播健康关系版本的可行性，以便尽管社会经济和地理障碍，但越来越多的艾滋病毒妇女患有艾滋病毒的妇女可以从干预的社会支持和技能建设组成部分中受益。其次，这项研究将通过在线传播基于群体的干预措施的当前理解，从而提高行为翻译科学，从而建立知识，然后可以使用这些知识来适应和传播一系列主要，次要和第三级预防干预措施，以解决一系列公共卫生问题。