Mobilizing Health Workers for HIV Prevention in Malawi

描述（由申请人提供）：卫生工作者是关键的潜在领导者 在遏制艾滋病毒/艾滋病流行的斗争中。这项创新研究将 一个有效预防艾滋病毒模式的广泛传播试验 马拉维是非洲最贫穷的国家之一， 有7名成年人艾滋病毒呈阳性。这种干预措施的基础是初级保健 护理和社会学习模式。将动员卫生工作者， 社区领导人将使社区参与同龄人小组干预， 预防艾滋病毒/艾滋病。干预措施分四个阶段实施， 培训-培训员模式。在第一阶段，地区医院的卫生工作者 将通过参加同龄人小组的活动， 干预在第二阶段，在一个选定的农村卫生诊所和 它所服务的村庄，训练有素的地区卫生工作者将培训诊所 卫生工作者和感兴趣的地方领导人担任社区同侪团体领导人。 第一和第二阶段的培训将使地区和农村诊所工作人员能够 改变自己的艾滋病毒预防行为，并修改卫生服务， 更支持艾滋病预防。在第三阶段， 社区成员作为同龄人小组的领导者， 教育和其他活动。在第四阶段， 该计划将扩大到提供父母需要保护的知识和技能， 从而加强青少年的安全性行为。的 干预措施将使社区成年人和青少年能够进行更安全的性行为 行为。关于卫生工作者、卫生服务 交付，社区成员的行为将通过比较 干预区与干预前类似的控制区， 在第一阶段后16个月和32个月，使用观察和健康记录 服务，与卫生工作者和客户的访谈，以及 社区成人和青少年。每个样本1100（550名成人，550名 青少年）在干预和控制社区将提供足够的 检验成人和青少年关键行为变化假设的能力 分开在第一阶段后的16个月，我们预计健康状况会发生重大变化。 工人和卫生服务，但干预可能没有扩散 这足以导致整个社区的差异。显著增加 在第一阶段结束后的32个月内，预期会出现更安全的性行为。该项目将 加强合作护理学院的研究能力， 地区和农村诊所卫生工作者。低成本和利用现有的 基础设施促进了高度可转移性。

DESCRIPTION (Provided by applicant): Health workers are key potential leaders in the struggle to contain the HIV/AIDS pandemic. This innovative research will test for wider dissemination a model of an effective HIV prevention intervention in Malawi, one of the poorest countries in Africa, where one in seven adults is HIV positive. This intervention is based on the primary health care and social learning models. Health workers will be mobilized as rural community leaders who will involve a community in a peer group intervention for HIV/AIDS prevention. The intervention is implemented in four phases using a train-the trainers model. In Phase 1, health workers at a district hospital will be trained as community leaders through participation in the peer group intervention. In Phase II, at a selected rural health clinic and the cluster of villages it serves, the trained district health workers will train clinic health workers and interested local leaders as community peer group leaders. Training in Phase I and II will enable the district and rural clinic workers to change their own HIV prevention behaviors and to modify health services to be more supportive of HIV prevention. In Phase III the clinic workers will train community members as peer group leaders who then will offer peer group education and other activities to the entire community. In Phase IV, the program will expand to provide the knowledge and skills parents need to protect their children, thus enhancing young people's safer sex behaviors. The intervention will enable community adults and adolescents to practice safer sex behaviors. Hypotheses regarding changes in health workers, health service delivery, and community members' behaviors will be evaluated by comparing the intervention district with a similar control district at pre-intervention and at 16 and 32 months after Phase I using observation and records of health services, interviews with health workers and clients, and sample surveys of community adults and adolescents. A sample of 1100 each (550 adults, 550 adolescents) in the intervention and control community will provide adequate power to test hypotheses about key behavior changes for adults and adolescents separately. At 16 months after Phase 1, we expect substantial changes in health workers and health services, but the intervention may not have diffused sufficiently to result in community-wide differences. Significant increases in safer sex behaviors are expected at 32 months after Phase 1. The project will strengthen research capacities of the collaborating college of nursing and the district and rural clinic health workers. Low cost and use of existing infrastructure facilitate high transferability.