Enhancing the Role of Commune Health Workers in HIV and Drug Control in Vietnam

描述（由申请人提供）：我们提议在越南实施一项为期5年的科学项目，旨在提高社区卫生工作者（CHWs）在艾滋病毒和吸毒预防和治疗中的作用。我们计划展示针对越南chw、IDUs及其家庭成员（FMs）的综合干预措施的开发、实施和评估过程。在第一阶段，将通过一系列焦点小组讨论制定干预主题、形式、交付程序和支持材料。在第二阶段，将进行实施试点和过程评估，通过在两个社区保健中心进行深入访谈，收集参与的保健员、注射吸毒者及其FMs的反馈。在第三阶段，我们将在60个社区卫生中心（每个社区中心有5个社区卫生中心，15个IDUs和10个FMs）进行干预试验（CHW CARE干预），共计300个社区卫生中心；900支idu和600支FMs。将在社区一级进行随机化（30个社区被分配到干预组；30个社区被分配到对照组）。在每个参与干预的社区，首先将干预措施提供给社区卫生工作者，并要求参与的社区卫生工作者与社区内的注射吸毒者和FMs进行个人和小组会议。通过比较干预组与对照组的chw、idu和FMs的结局指标，在基线、3、6、9和12个月的随访中评估干预的效果。此外，本研究亦将探讨健康护理人员、注射吸毒者及健康护理人员干预结果之间的关系。

DESCRIPTION (provided by applicant): We propose a 5-year implementation science project in Vietnam, aiming to enhance the role of commune health workers (CHWs) in HIV and drug use prevention and treatment. We plan to demonstrate the process of development, implementation, and evaluation of an integrated intervention for CHWs, IDUs, and their family members (FMs) in Vietnam. In Phase 1, intervention topics, format, delivery procedures, and supporting materials will be developed through a series of focus group discussions. In Phase 2, implementation pilot and process evaluation will be conducted to collect feedback from participating CHWs, IDUs and their FMs by in- depth interviews in two commune health centers. In Phase 3, we will conduct an intervention trial (CHW CARE intervention) in 60 commune health centers (5 CHWs, 15 IDUs and 10 FMs from each commune center), totaling 300 CHWs; 900 IDUs and 600 FMs. Randomization will occur at the commune level (30 communes assigned to the intervention group; 30 communes assigned to the control group). At each commune assigned to the intervention, the intervention will be delivered to CHWs first, and the participating CHWs will be required to conduct individual and group sessions with IDUs and FMs in their communes. The efficacy of the intervention will be assessed at baseline, 3, 6, 9, and 12-month follow-ups by comparing outcome measures of CHWs, IDUs and FMs in the intervention group to those in the control group. Relationships between the intervention outcomes of CHWs, IDUs and FMs will also be explored. PUBLIC HEALTH RELEVANCE: Globally, HIV burden is growing among drug using populations. To effectively deliver PEPFAR and other programs to prevent HIV/AIDS, there is an urgent need to translate and integrate behavioral interventions into routine healthcare practices. This proposed project responds to this urgent need by focusing on the important role of commune health workers in HIV and drug use prevention and treatment in Vietnam. This project can potentially demonstrate a successful model that can be implemented in primary care systems in other countries to address the HIV epidemic and drug use prevention, which remains a global public health priority.