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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

基本信息

批准号：
8264977
负责人：
Stephanie Lynn Marhefka
金额：
$ 10.91万
依托单位：
UNIVERSITY OF SOUTH FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-06-22 至 2014-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8264977
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

项目摘要

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的研究重点，旨在开发和测试“将有效干预措施转移到社区环境的不同模式”-特别是关于为艾滋病毒阳性者服务的干预措施（PA-08-166）。在美国，妇女感染艾滋病毒的人数正在增加。感染艾滋病毒的女性（WLH）面临着巨大的挑战，包括：a）做出披露其艾滋病毒状况的决定;以及B）谈判并采取更安全的性行为。虽然健康的关系（HR）的干预措施，以解决这些挑战，两个实质性的需求仍然存在。第一，人力资源部门需要更好地满足妇女和青年局上述性别方面的具体需求。第二，有必要向妇女和两性平等组织进行更广泛的宣传。虽然美国疾病控制和预防中心的传播有效的行为干预（DEBI）项目传播的人力资源，传播仅限于地理区域，其中一个临界质量的艾滋病毒感染者可以满足在一个单一的位置参加，并在社区机构有时间和资源，这些努力。因此，拟议的R34研究旨在试点和可行性测试视频组传播的适应，性别特定版本的健康关系（HR）的WLH。我们的团队目前得到资助，与社区咨询委员会（CA B）合作，将人力资源纳入健康网络（HR-W），以：a）满足妇女的性别特定需求;和B）通过在社区地点访问的基于网络的小组视频会议实现更广泛的交付。这项拟议的研究是决定向WLH传播HR-W是否可行和有效的关键下一步。基于我们目前的工作，拟议研究的具体目标如下：1）使用WLH进行HR-W的试点测试，并进行任何必要的调整以最终确定手册; 2）进行一项小型部分交叉可行性试验，比较HR-W与等待列表对照（WLC），为大型随机对照试验（RCT）做准备。对于目标1，我们将进行单组试点测试，并收集参与者的反馈，以在现有CAB的帮助下改进HR-W手册。对于目标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。在两种情况完成6个月的随访评估后，WLC参与者将交叉到HR-W条件，接受干预，并在6个月后完成随访。在准备大型RCT（和R 01应用）时，本项目的总体目标是确定通过视频会议提供HR-W是可行的，并收集表明HR-W可能导致性风险行为显著减少的证据。长期目标是在城市以及地理分散、发病率低和资源贫乏的环境中建立HR-W对WLH的有效性。公共卫生相关性：通过在社区干预站进行的小组视频会议成功传播健康网络，将对方法和公共卫生产生深远的影响。首先，这项研究将确定在线传播《健康关系》改编版的可行性，以便尽管存在社会经济和地理障碍，但更多的艾滋病毒感染妇女可以受益于干预措施的社会支持和技能建设部分。第二，这项研究将推动行为翻译科学，为当前在线传播基于群体的干预措施的理解做出重大贡献，从而建立可用于适应和传播一系列一级，二级和三级预防干预措施的知识，以解决一系列公共卫生问题。