Psychosocial Support to HIV/AIDS Affected Children in Zimbabwe

为津巴布韦受艾滋病毒/艾滋病影响的儿童提供心理社会支持

• 批准号: 7649565
• 负责人: Danuta Kasprzyk
• 金额: $ 57.15万
• 依托单位: BATTELLE CENTERS/PUB HLTH RES & EVALUATN
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7649565
• 关键词: 18 year old; AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescent; Adult; Affect; Africa; Africa South of the Sahara; Age; Anxiety; Attention; Behavior; Behavioral; Bereavement; Caring; Cessation of life; Child; Chronic; Clinical; Cognitive; Communities; Coping Skills; Data; Developed Countries; Developing Countries; Development; Discrimination; Early identification; Eating; Economics; Education; Effectiveness of Interventions; Emotional; Emotions; Ethnography; Evaluation; Family; Family Relationship; Feeling; Fostering; Future; Goals; Grief reaction; HIV; HIV Infections; HIV Seropositivity; Hour; Household; Human Resources; Income; Individual; Instruction; International; Intervention; Learning; Left; Life; Light; Link; Manuals; Mental Health; Modeling; Nurses; Orphan; Outcome; Parents; Performance; Population; Poverty; Preparation; Prevalence; Preventive Intervention; Problem behavior; Professional counselor; Protocols documentation; Psychosocial Assessment and Care; Research; Research Personnel; Risk; Rural; Rural Community; Self Perception; Siblings; Social Workers; Stigmata; Structure; Teenagers; Testing; Training; Training and Infrastructure; Translating; Translations; UNICEF; Universities; Wages; Withdrawal; Work; Zimbabwe; base; behavioral health; coping; depression; design; dysphoria; effective intervention; emotional distress; empowerment; experience; instrument; longitudinal analysis; meetings; mortality; nutrition; pandemic disease; psychosocial; social; social cognitive theory; social stigma; statistics

DESCRIPTION (provided by applicant): Current global estimates are that approximately 35 million adults (15-49 yrs) are infected with HIV, and sub Saharan Africa, with over 12.3 million children orphaned by AIDS, is one of the worst hit regions in the world. In Zimbabwe, the number of orphans could reportedly rise to 1.4 million in the next 5 years. Statistics on orphans, however, reflect only a small fraction of the total number of children affected by HIV/AIDS, and according to UNICEF (2001), it is the population of children living with HlV-affected parents which needs to be the focus of attention. Mounting evidence indicates that the emotional impact on such adolescent children is especially pronounced, in large part because these children are forced to confront the ever-changing demands of chronic parental illness with little access to psychosocial support. The proposed research, to be conducted in Zimbabwe, has 6 specific aims: 1) to conduct formative research and use the data, in conjunction with ethnographic data from current research, to adapt and implement a psychosocial support and coping skills intervention (Project TALC/TLC/CLEAR) with adolescent children (12-18) living with an HIV-positive parent; 2) to pilot test the intervention in 1 village and refine the intervention protocol based on these findings; 3) to conduct a full implementation of the modified intervention in 2 urban and 2 rural settings with families where at least 1 parent is HIV positive; 4) to assess the effectiveness of the intervention on psychosocial, behavioral, health, and clinical outcomes obtained at baseline, 6, 12, 24, and 36 months from randomly selected intervention and control families; 5) to ascertain psychosocial changes through longitudinal analysis; and 6) to modify the intervention protocol based on the findings, and make the intervention available for wider dissemination. Project TALC/TLC/CLEAR, which is based on social cognitive theory, has been implemented and evaluated with HlV-affected families in the U.S., and proven effective in reducing problem behaviors and emotional distress in both intervention children and parents. The intervention consists of 5 modules (i.e. staying healthy, family relationships, setting goals and reducing risk, mental health, and bereavement) designed to build coping skills and adolescent self-awareness of the link between negative emotions and dysfunctional behaviors. A team of trained nurses and social workers will deliver the intervention sessions for each module to small groups of parents and children, either alone or together, depending on the topic. The results from the proposed study will determine the extent to which the translation, implementation and evaluation of this intervention is effective in meeting the psychosocial needs of adolescent children in Zimbabwe whose parents are infected with HIV.

描述(申请人提供)：目前全球估计约有3500万成年人(15-49岁)感染艾滋病毒，撒哈拉以南非洲有超过1230万儿童因艾滋病成为孤儿，是世界上受影响最严重的地区之一。据报道，在津巴布韦，孤儿的数量可能在未来5年内上升到140万。然而，关于孤儿的统计数据只反映了受艾滋病毒/艾滋病影响的儿童总数的一小部分，根据儿童基金会(2001年)的数据，与感染艾滋病毒的父母一起生活的儿童人口需要受到关注。越来越多的证据表明，对这类青春期儿童的情感影响尤其明显，这在很大程度上是因为这些儿童被迫面对父母慢性疾病不断变化的要求，几乎没有机会获得心理社会支持。这项拟议的研究将在津巴布韦进行，有6个具体目标：1)进行形成性研究，并结合当前研究的人种学数据，对与艾滋病毒阳性父母一起生活的青春期儿童(12-18岁)调整和实施心理社会支持和应对技能干预(TALC/TLC/CLEAR项目)；2)在1个村庄试行干预措施，并根据这些结果改进干预方案；3)在2个城市和2个农村环境中全面实施修改后的干预措施，其中至少有1个父母为艾滋病毒阳性的家庭；4)评估干预对基线、6个月、12个月、24个月和36个月随机选择的干预和对照家庭的心理社会、行为、健康和临床结果的有效性；5)通过纵向分析确定心理社会变化；6)根据调查结果修改干预方案，使干预可用于更广泛的传播。基于社会认知理论的TALC/TLC/CLEAR项目已经在美国HLV感染家庭中得到实施和评估，并被证明在减少干预儿童和父母的问题行为和情绪困扰方面是有效的。干预包括5个模块(即保持健康、家庭关系、设定目标和降低风险、心理健康和丧亲)，旨在培养应对技能和青少年对负面情绪和功能失调行为之间联系的自我意识。一个由训练有素的护士和社会工作者组成的团队将根据主题单独或一起向父母和孩子的小组提供每个模块的干预课程。拟议研究的结果将决定这种干预措施的翻译、实施和评估在多大程度上有效地满足津巴布韦父母感染艾滋病毒的青少年的心理社会需要。