Mobilizing Health Workers for HIV Prevention in Malawi

职位描述(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/艾滋病大流行的斗争中。这项创新的研究将 更广泛传播的测试有效预防艾滋病毒的模式 在马拉维的干预，非洲最贫穷的国家之一，在那里 七名成年人艾滋病毒呈阳性。这项干预是基于初级健康 关爱和社会学习模式。卫生工作者将作为农村动员起来 社区领导人，他们将让社区参与同龄人小组的干预 预防艾滋病毒/艾滋病。该干预分四个阶段使用 Train-教练员模型。在第一阶段，一家地区医院的卫生工作者 将通过参加同龄人小组被培训为社区领袖 干预。在第二阶段，在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作为社区同龄人组长。 第一阶段和第二阶段的培训将使区和乡村诊所工作人员能够 改变自己的艾滋病预防行为，并将卫生服务改为 更支持艾滋病毒预防。在第三阶段，诊所工作人员将接受培训 社区成员作为同级小组领导人，然后他们将提供同级小组 对整个社区的教育和其他活动。在第四阶段， 计划将扩大，以提供父母需要保护的知识和技能 他们的孩子，从而加强年轻人的安全性行为。这个 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、卫生服务变化的假设 交付，社区成员的行为将通过比较 干预前和干预前设有类似控制区的干预区和 在第一阶段后16个月和32个月使用健康观察和记录 服务，对卫生工作者和客户的采访，以及对 社区成年人和青少年。每人1100人的样本(550名成年人，550名 青少年)在干预和控制社区将提供足够的 检验关于成人和青少年关键行为变化的假设的能力 分开的。在第一阶段结束后的16个月，我们预计健康状况将发生实质性变化 工人和医疗服务，但干预可能没有扩散 足以导致整个社区的差异。显著增加了 安全性行为预计在第一阶段后32个月。该项目将 加强合作护理学院的科研能力建设 区、乡卫生室卫生工作人员。低成本，充分利用现有资源 基础设施促进了高可转移性。

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.