HIV Prevention Groups for AOD Using SMI Women

描述(由申请人提供)： 这项拟议的研究是一项针对性别和文化的适应和随机试验，是一项团体格式的动机增强的简短行为技能干预(BBSI-A)，旨在降低320名以西班牙裔和非裔美国人为主的妇女的艾滋病毒风险，这些妇女代表了在艾滋病毒中心迈阿密进行社区治疗的AOD滥用、严重精神病患者(SMI)人群的目标人群。一个关键的焦点是，在艾滋病毒预防研究中很少研究的群体过程(例如，群体联盟、参与度、凝聚力和气候)可能如何调节变化。需要调整和评估的干预措施源于信息-动机-行为(IMB)理论，以证据为基础，并由科学共识存档以供传播。改编的BBSI-A将与时间匹配的、基于视频的“照常治疗”教育(EDUC)条件进行比较。分层线性和结构方程模型将被用来探索HIV风险结果以及干预效果如何通过团体过程(例如，团体参与、联盟、凝聚力和气候)、IMB变量、AOD使用和精神病学变量来调节。这些分析技术还将被用来探索艾滋病毒风险结果如何受到两个关键因素的影响：认知功能和创伤性虐待史。了解干预措施发挥作用的因果机制，包括理论上重要的群体过程因素的中介影响，应有助于随后在其他临床环境中应用有效干预措施的努力。拟议的项目响应了NIH在临床研究和实践之间架起桥梁的优先事项，其中的重点是针对社区提供者所面临的“现实世界”条件，调整有效的基于研究的干预策略。如果成功，这项研究将提出一种艾滋病毒干预策略，可以在社区内对滥用SMI的高危AOD妇女实施。

DESCRIPTION (provided by applicant): The proposed study is a gender-and-culturally specific adaptation and randomized trial of a group-formatted Motivational-Enhanced, Brief Behavioral Skills Intervention (BBSI-A) for reducing HIV risk among 320 predominantly Hispanic and African American women, representing a target population of the AOD abusing, seriously mentally ill (SMI) population in community treatment in the HIV epicenter of Miami. A key focus is how group processes (e.g., group alliance, engagement, cohesion, and climate), which have been rarely studied in HIV prevention research, may mediate change. The intervention to be adapted and evaluated is derived from Information-Motivation-Behavior (IMB) theory, and is evidence-based and archived by scientific consensus for dissemination. The adaptation, BBSI-A, will be compared to a time-matched, video-based "Treatment as Usual" Educational (EDUC) condition. Hierarchical Linear & Structural Equations Modeling will be used to explore HIV risk outcomes as well as how intervention effects are mediated by Group Processes (e.g., group engagement, alliance, cohesion and climate), IMB variables, AOD use and Psychiatric variables. These analytical techniques will also be used to explore how HIV risk outcomes are moderated by 2 key factors: cognitive functioning, and traumatic abuse history. Understanding causal mechanisms by which interventions exert their effects, including the mediating influences of theoretically important group process factors, should contribute to subsequent efforts to apply effective interventions in other clinical settings. The proposed project responds to the NIH priority on bridging clinical research and practice, in which the emphasis is on adapting effective research-based intervention strategies for the "real world" conditions faced by community based providers. If successful, this research will present an HIV intervention strategy that can be practically implemented for high-risk AOD abusing SMI women within their communities.