Enhancing HIV Prevention Through a Multi-level Community Intervention To Promote

通过多层次的社区干预加强艾滋病毒预防

• 批准号: 7758720
• 负责人: MARGARET R. WEEKS
• 金额: $ 81.33万
• 依托单位: INSTITUTE FOR COMMUNITY RESEARCH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-15 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7758720
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adoption; Advocacy; Advocate; Agreement; Awareness; Barrier Contraception; Businesses; Cities; Clinic; Communities; Community Actions; Community Health; Complex; Couples; Cross-Sectional Studies; Development; Dimensions; Educational Curriculum; Effectiveness; Elements; Ensure; Environment; Epidemic; Ethics; Ethnography; Evaluation; Female Condoms; Gender Role; Goals; HIV; Health; Health Services; Health behavior outcomes; Heterosexuals; Incidence; Individual; Infection; Infection prevention; Intervention; Intervention Community Trial; Intervention Studies; Interview; Knowledge; Letters; Low income; Male Condoms; Mediating; Mediation; Methods; Modeling; Outcome; Pharmacy facility; Polyurethanes; Population; Populations at Risk; Poverty; Pregnancy; Prevention; Prevention Research; Process; Protocols documentation; Provider; Public Health; Randomized Controlled Trials; Reproductive Health; Research; Risk; Services; Sexually Transmitted Diseases; Social Environment; Social Health Services; Social Work; Study Section; Target Populations; Testing; Time; Training; Woman; Work; addiction; base; child bearing; community intervention; design; empowerment; ethnic minority population; follow-up; health organization; high risk; improved; interest; intervention effect; meetings; member; men; pandemic disease; peer; prevent; public health relevance; reproductive; sex; skills; social; theories; therapy design; therapy development; transmission process; vaginal microbicide; willingness

DESCRIPTION (provided by applicant): Heterosexual HIV transmission continues to be one of the most tenacious problems for reversing the epidemic, and incidence among women increases disproportionately in certain populations, particularly U.S. ethnic minorities, low-income and impoverished women. It is essential that women have available all effective prevention methods, including some they can initiate and control, in order to reduce heterosexual HIV risk. The goal of this 5-year study entitled, "Enhancing HIV Prevention Through Multi-level Community Intervention to Promote Women-Initiated Prevention Options," is to increase the community availability, accessibility, and support for use of the female condom (FC), as currently the most effective woman-initiated HIV/STI prevention option. Evidence increasingly supports the development of theoretically driven multi-level interventions, using a community-empowerment model to mobilize sectors of the community to move the issue forward in a sustained way. This study will use a community-based approach to develop and implement a multi-level community intervention by mobilizing and building the capacity of a body of key community agents, who will collectively develop and implement interventions at the community, organizational, and individual levels to achieve the project goals. A comprehensive dynamic trial (CDT) of this community intervention will be conducted first in Hartford, CT, and then repeated in New Britain, CT to identify core process and content needed for replication. The aims of the study are to: 1) create local Community Action and Advocacy Boards (CAABs) and build their capacity to develop, implement and evaluate a multi-level intervention designed to promote availability, accessibility, and support for FC in their community; 2) assist the CAABs to customize and tailor interventions promoting FC targeting multiple levels of the community with consistent messages/materials; 3) in two study communities sequentially, implement and test the ability of the multi-level intervention to increase availability, accessibility, and support for FC in organizations, and to increase awareness, knowledge, use and negotiation skills, ability to access, and willingness and efficacy to request, try, and use the FC among at-risk women and their partners in that community; 4) assess the sustainability of the CAABs and the CAAB- developed interventions; and 5) manualize the CAAB training protocol, and identify core elements of the community-based multi-level intervention needed for adaptation and implementation in other communities. The CDT will use intensive and iterative ethnographic process and outcome evaluation, repeated community assessments (observations and interviews) every 6 months in all local organizations and businesses that provide health, reproductive and sex information and products to document community and organizational level changes, and 3 cross-sectional surveys with at-risk target population members every 12 months to assess the impact and effects of the CAAB interventions on individuals in targeted high risk sectors of the community. PUBLIC HEALTH RELEVANCE: The proposed study will test a community participatory approach to developing and implementing a multi-level community intervention to increase availability, accessibility, and support for female condoms (FC), thereby increasing their use for the reduction of heterosexually transmitted HIV. Creation and capacity building of a local community coalition (the Community Action and Advocacy Board-CAAB) in each of two study towns is designed to increase local relevance and effectiveness of the CAAB-developed and implemented multi-level intervention(s) and to increase sustainability of intervention effects in their community.

描述（由申请人提供）：异性恋HIV传播仍然是逆转流行病的最顽强的问题之一，女性的发病率在某些人群中，尤其是美国少数族裔，低收入和贫困的妇女的发病率不成比例。妇女必须使用所有有效的预防方法，包括她们可以发起和控制的所有有效的预防方法，以降低异性恋HIV风险。这项为期5年的研究的目的为“通过多层次的社区干预来增强艾滋病毒预防，以促进妇女发起的预防选择”，是为了提高社区的可用性，可及性和支持女性避孕套（FC）的支持，这是目前是目前最有效的女性引起的艾滋病毒/STI预防选择。越来越多的证据支持理论上驱动的多层次干预措施的发展，使用社区授权模型来动员社区的部门以持续的方式将问题推向前进。这项研究将采用基于社区的方法来开发和实施多层次的社区干预，通过动员和建立关键社区代理机构的能力，他们将在社区，组织和个人层面上集体开发和实施干预措施以实现项目目标。该社区干预的全面动态试验（CDT）将首先在康涅狄格州的哈特福德进行，然后在康涅狄格州新英国重复，以识别复制所需的核心过程和内容。该研究的目的是：1）创建当地的社区行动和倡导委员会（CAABS），并建立其开发，实施和评估多层干预措施的能力，旨在促进社区中的FC的可用性，可及性和支持； 2）协助CAAB自定义和量身定制干预措施，以一致的消息/材料来促进针对社区多个层次的FC； 3）在两个研究社区中，依次实施和测试多级干预措施增加组织中FC的可用性，可访问性和支持的能力，并提高意识，知识，使用和谈判技巧，访问能力，访问能力以及在该社区中遇到风险的妇女及其合作伙伴中的要求，尝试，尝试和使用FC； 4）评估CAABS的可持续性和CAAB-开发的干预措施； 5）手动化CAAB培训协议，并确定在其他社区中适应和实施所需的基于社区的多层次干预的核心要素。 The CDT will use intensive and iterative ethnographic process and outcome evaluation, repeated community assessments (observations and interviews) every 6 months in all local organizations and businesses that provide health, reproductive and sex information and products to document community and organizational level changes, and 3 cross-sectional surveys with at-risk target population members every 12 months to assess the impact and effects of the CAAB interventions on individuals in targeted high risk sectors of the community. 公共卫生相关性：拟议的研究将测试一种社区参与式方法，用于开发和实施多层次的社区干预措施，以增加对女性避孕套（FC）的可用性，可及性和支持，从而增加了其用于减少异性传播HIV的使用。在两个研究城镇中的每个城镇中的每个城镇中的每个城镇中的每一个创建和能力建设（社区行动和倡导董事会）旨在提高CAAB开发和实施的多层干预的当地相关性和有效性，并提高社区中干预效果的可持续性。