Mechanisms of Behavior Change Resource Core for Alcohol-HIV Interventions

酒精-艾滋病毒干预措施的行为改变资源核心机制

• 批准号: 8719887
• 负责人: Christopher W. Kahler
• 金额: $ 67.74万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-20 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8719887
• 关键词: AIDS/HIV problem; Accident and Emergency department; Address; Adherence; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Audiotape; Behavior; Behavioral; Characteristics; Clinical Trials; Code; Cognitive; Collaborations; Comorbidity; Counseling; Data; Epidemic; Fostering; Future; Glean; HIV; HIV Infections; Heavy Drinking; Hepatic; Highly Active Antiretroviral Therapy; Human immunodeficiency virus test; Institution; Intervention; Language; Learning; Life; Literature; Mediation; Medical; Methods; Minority Groups; Modality; National Institute on Alcohol Abuse and Alcoholism; Nurses; Outcome; Outcomes Research; Patients; Persons; Pharmacotherapy; Physicians; Population; Professional counselor; Provider; Psychologist; Randomized Clinical Trials; Research; Research Personnel; Resources; Risk Factors; Safe Sex; Social Workers; Systems Analysis; Technology; Training; Universities; Unsafe Sex; Work; alcohol intervention; alcohol research; base; behavior change; brief intervention; design; drinking; evidence base; health care service utilization; high risk; high risk sexual behavior; insight; interest; medication compliance; men who have sex with men; motivational enhancement therapy; reduced alcohol use; sex risk; skills

DESCRIPTION (provided by applicant): Clinical trials to reduce heavy alcohol use in people living with HIV (PLWH) and those at high risk for HIV infection are currently being conducted through NIAAA-supported Consortia for HIV/AIDS and Alcohol-Related Outcomes Research Trials (CHAARTs). The overall objective of this proposal is to maximize the information gleaned from these trials to enable better design of evidence-based alcohol-HIV counseling interventions. While a good deal is known from the Motivational Interviewing literature about mechanisms of behavior change in counseling approaches for alcohol and other substance use, little is known about change mechanisms in interventions that focus on sexual risk behaviors or medication adherence, and there is a dearth of work on mechanisms of multiple behavior change. To address this gap, we will create a Mechanisms of Behavior Change Resource Core (MBCRC) within the Brown University Alcohol Research Center on HIV that will code provider-patient dialogues in five ongoing CHAART trials using two distinct coding systems. Specifically, we will adapt the Motivational Interviewing Skills Code to code both alcohol and HIV-relevant provider and patient language in alcohol-HIV interventions and apply the Generalized Medical Interaction Analysis System to examine factors that influence outcomes in alcohol-HIV interventions outside of motivationally-focused behavior change counseling. Overall, the MBCRC will transcribe and code provider-patient interactions across approximately 1,000 20-90, minute intervention sessions from four ongoing randomized clinical trials and one implementation study. Coding data will be used to predict future alcohol use, acceptance and use of alcohol pharmacotherapy, high-risk sex, HAART adherence, and HIV testing. Results will provide crucial insights about provider behaviors and skills that are most effective in fostering changes in drinking and HIV-relevant behaviors in identified high-risk populations, as well as key barriers to change. Results will have direct relevance (a) for training providers who work with HIV patients and those at high risk for HIV infection and (b) for the improvement and implementation of alcohol-HIV interventions in a range of contexts and populations.

描述（由申请人提供）：目前，正在通过NIAAA支持的HIV/AIDS和酒精相关结果研究试验（CHAARTS）进行临床试验，以减少艾滋病毒（PLWH）和艾滋病毒感染高风险的人的饮酒和高风险。该提案的总体目的是最大化这些试验中收集的信息，以更好地设计基于证据的酒精-HIV咨询干预措施。虽然关于咨询和其他物质使用的咨询方法中行为变化的机制的动机访谈文献已经知道了很多，但对重点是性风险行为或药物依从性的干预措施的变化机制知之甚少，并且缺乏对多种行为变化机制的工作。为了解决这一差距，我们将在Brown University hiv的艾滋病毒研究中心内创建行为变化资源核心（MBCRC）的机制，该机制将使用两个不同的编码系统进行五项正在进行的CHAART试验中的提供者对话。具体来说，我们将调整激励性访谈技能代码，以在酒精-HIV干预措施中对酒精和与艾滋病毒相关的提供者和患者语言进行编码，并应用广义的医学交互分析系统来检查影响以动机为中心行为行为改变咨询咨询的酒精-HIV干预措施的因素。总体而言，MBCRC将在四项正在进行的随机临床试验和一项实施研究的大约1,000个20-90的分钟干预课程中转录和代码提供者与患者的相互作用。编码数据将用于预测酒精药物疗法，高风险性别，HAART依从性和HIV测试的未来使用，接受和使用。结果将提供有关提供者行为和技能的关键见解，这些见解最有效地促进已确定的高风险人群中的饮酒变化和与HIV相关的行为，以及更改的关键障碍。结果将具有直接相关性（a）对于与艾滋病毒患者和艾滋病毒感染高风险的培训提供者以及（b）在一系列情况和人群中改善和实施酒精-HIV干预措施的培训提供者。