Communication Technology to Disseminate Evidence-Based HIV Interventions to NGOs

描述(由申请人提供)：我们关于有效的艾滋病毒预防干预措施的科学知识已经取得了很大的进步。然而，只有当循证艾滋病毒预防干预措施从研究领域转移到一线服务提供者手中并能够被他们成功使用时，这项研究才能帮助遏制在世界大多数地区仍处于失控状态的流行病。需要新的、可持续的方法，以快速、灵活和具有成本效益的方式向提供预防服务的提供者传播艾滋病毒预防科学方面的进展--无论它们何时发生。先进的互动通信技术可能被用来在全球范围内向服务提供商传播新的循证干预措施，但远程培训计划的效果还无法与更传统的提供商培训方法相比较。这项研究将从东欧国家的99个艾滋病非政府组织(NGO)中招募样本，东欧是世界上艾滋病毒发病率最高的地区之一。这项研究将传播一种社区一级的艾滋病毒预防干预措施--“民意领袖”(POL)模式--在研究文献中显示出有效，具有跨文化适应性，并应该地区非政府组织的广泛要求。对非政府组织主任和前线工作人员进行的深入基线电话访谈评估将衡量当前的预防服务，以及可能影响POL干预采用的组织因素和工作人员态度。非政府组织随后将被随机分为三种传播条件之一：(1)只分发干预印刷手册的控制条件；(2)提供手册的传统面对面讲习班培训条件；(2)提供手册、现场非政府组织工作人员培训讲习班和关于干预执行情况的后续电话咨询的传统讲习班培训条件；或(3)远程传播条件，提供与现场讲习班相当的非政府组织工作人员培训，但使用互动和基于互联网的远程培训方法，然后进行个性化远程后续咨询。在12个月和24个月的跟踪点，电话访谈评估非政府组织对传播干预措施的采用，确定新的非政府组织方案对传播模式核心要素的忠诚度，并确定调解或缓和采用的因素。我们假设，传统的面对面研讨会和远程培训方法都将导致供应商采用比控制组更多的供应商，并且远程方法将更具成本效益。由于远距离模式很适合非政府组织工作人员的重复和“进修”培训，第二个假设是，这种模式将比一次性讲习班产生更大的采用率。这项研究的总体目标是评估一个基于互联网的“虚拟”培训系统基础设施的原型，该基础设施可用于促进公共卫生干预措施在全球范围内从研究到实践的快速技术转让。

DESCRIPTION (provided by applicant): Great advances have been made in our scientific knowledge about effective HIV prevention interventions. However, this research can help to curtail an epidemic that remains out-of-control in most of the world only when evidence-based HIV prevention interventions are moved from the research arena into the hands of frontline service providers and can be successfully used by them. New, sustainable approaches are needed to quickly, flexibly, and cost-effectively disseminate advances in HIV prevention science-whenever they occur-to providers who deliver prevention services. Advanced interactive communication technologies can potentially be used to disseminate new evidence-based interventions to service providers on a global level, but the effects of distance training programs have not been compared to more traditional provider training methods. This study will enroll a sample of 99 AIDS nongovernmental organizations (NGOs) from countries in Eastern Europe, a region with HIV incidence among the highest in the world. The study will disseminate a community-level HIV prevention intervention-the "Popular Opinion Leader" (POL) model-shown efficacious in the research literature, adaptable cross-culturally, and widely requested by NGOs in the region. In-depth baseline telephone interview assessments with NGO directors and frontline staff will measure current prevention services, as well as organizational factors and staff attitudes that may influence POL intervention adoption. NGOs will then be randomized to one of three dissemination conditions: (1) a control condition in which only intervention print manuals are distributed; (2) a traditional face-to-face workshop training condition that provides manuals, an on-site NGO staff training workshop, and followup individualized telephone consultation on intervention implementation; or (3) a distance dissemination condition that provides NGO staff training comparable to the on-site workshop but that uses interactive and Internet-based distance training methods followed by individualized distance followup consultation. At 12- and 24-month followup points, telephone interviews assess NGO adoption of the disseminated intervention, determine the fidelity of new NGO programs to core elements of the disseminated model, and identify factors mediating or moderating adoption. We hypothesize that both the traditional face-to-face workshops and distance training methods will both result in greater provider adoption than that found in the control group and that the distance method will be more cost-effective. Because the distance modality lends itself well to repeated and "refresher"' training by NGO staff, a secondary hypothesis is that this modality will produce greater adoption than one-time workshops. The overarching goal of this research is to evaluate a prototype for an Internet-based "virtual" training system infrastructure that can be used to facilitate rapid research-to-practice technology transfer of public health interventions to providers on a global scale.