The "Teach HADITHI" teacher training intervention to reduce classroom HIV- related stigma in Kenya

项目摘要：对于资源有限的感染艾滋病毒的儿童和青少年，艾滋病毒/艾滋病-- 相关污名(H/A污名)塑造了他们艾滋病毒管理的方方面面，从坚持用药到 关于艾滋病毒披露的决定。年轻人报告说，H/A在学校中的耻辱，表现在教师的态度上 和行动，以及课程中的限制，塑造了他们同龄人的信念和他们自己的感受 关于艾滋病毒的问题，并经常损害他们对艾滋病毒的管理。我们不知道最有效的策略来减少 H/A羞辱这些年轻人的经历。我们研究团队的长期目标是提供证据来改进 在资源有限的情况下对感染艾滋病毒的儿童和青少年进行慢性病管理。这个 这项建议的目的是评估创新的、以电影为基础的、多媒体的教师培训 课程干预将减少肯尼亚教师对艾滋病毒的负面态度和信念，并减少 在他们的教学和教室中的H/A耻辱。这项工作将通过一个长期的学术机构进行 肯尼亚和北美大学之间的合作伙伴关系称为学术模式，提供进入 医疗保健(AMPATH)，在那里我们还保持着长期的社区合作伙伴关系。具体目标是 本研究的目的是：目标1：编制以HIV和H/A为重点的多媒体教师培训课程包 耻辱，并适应最大的文化相关性，课程凝聚力和肯尼亚小学的影响 和中学教师。目标2：评估Teach Hadithi干预对肯尼亚人的影响 教师对艾滋病毒的态度、信念和知识，以及教师中与艾滋病毒相关的污名程度。 探索目标3：检查感染艾滋病毒的儿童和青少年是否在教室里与 接受教育Hadithi干预报告的人较少感知、实施或内化耻辱 与那些在教室里没有老师的学生相比。发展和完善教师培训 我们将利用定性的方法，包括焦点小组和对受试者的认知访谈 物质专家。为了评估疗效，我们将进行一项整群随机对照试验，按学校随机进行。 干预学校内的所有教师将接受教师培训干预，其中包括观看 当地制作的电影捕捉感染艾滋病毒的肯尼亚儿童的耻辱经历，并组织 与感染艾滋病毒的青少年内容专家和卫生保健专业人员的互动。对照学校 将不会有训练干预。我们将评估所有教师，包括干预和控制，对他们的 使用标准化问卷调查艾滋病毒携带者的相关知识、态度和信念 相隔几个月。我们还将对在AMPATH和AMPATH注册的艾滋病毒感染青年进行探索性评估 在参与的学校中，测量他们感知、经历或内化的H/A污名 在干预后的六个月内。这项研究将显著影响我们对 减少影响艾滋病毒感染儿童和青少年的H/A污名的社区战略。

PROJECT SUMMARY: For HIV-infected children and adolescents in resource-limited settings, HIV/AIDS- related stigma (H/A stigma) shapes every aspect of their HIV management, from medication adherence to decisions about HIV disclosure. Youth report that H/A stigma in schools, manifest through teacher attitudes and actions as well as limitations in the curriculum, shapes the beliefs of their peers and their own feelings about HIV, and often hurts their HIV management. We do not know the most effective strategies to reduce the H/A stigma these youth experience. The long-term goal of our research team is to provide evidence to improve chronic disease management among HIV-infected children and adolescents in resource-limited settings. The purpose of this proposal is to evaluate whether an innovative, film-based, multimedia teacher training curriculum intervention would decrease Kenyan teachers' negative attitudes and beliefs about HIV and reduce the H/A stigma in their teaching and classrooms. This work will take place through a long-standing academic partnership between Kenyan and North American universities called the Academic Model Providing Access to Healthcare (AMPATH), where we also maintain long-standing community partnerships. The specific aims for this study are to: Aim 1: Assemble a multimedia teacher training curriculum package, focused on HIV and H/A stigma and adapted for maximum cultural relevance, curricular cohesion, and impact among Kenyan primary and secondary school teachers. Aim 2: Assess the impact of the Teach HADITHI intervention on Kenyan teachers' attitudes, beliefs, and knowledge about HIV and the level of HIV-related stigma among teachers. Exploratory Aim 3: Examine whether HIV-infected children and adolescents in classrooms with teachers who have received the Teach HADITHI intervention report less perceived, enacted, or internalized stigma compared to those in classrooms with teachers who have not. To develop and modify the teacher training package, we will utilize qualitative approaches, including focus groups and cognitive interviews with subject matter experts. To assess efficacy, we will conduct a cluster randomized control trial, randomizing by school. All teachers within the intervention schools will go through a teacher training intervention that includes viewing locally created films capturing the stigma experiences of HIV-infected Kenyan children and structured interactions with an HIV-infected adolescent content expert and a health care professional. The control schools will have no training intervention. We will evaluate all teachers, both intervention and control, on their knowledge, attitudes and beliefs related to persons living with HIV using a standardized questionnaire given 6 months apart. We will also conduct an exploratory evaluation of HIV-infected youth enrolled in both AMPATH and in the participating schools, measuring the H/A stigma they have perceived, experienced, or internalized during the six months following the intervention. This research will significantly impact our understanding of community strategies to reduce H/A stigma impacting HIV-infected children and adolescents.