Reducing HIV Risk in Adult Women with Intellectual Disabilities

描述（由申请人提供）：本申请的目的是扩展我们第一阶段的工作，并进一步为轻度智力残疾（智商约55至75）的成年妇女开发一个全交互式多媒体（IMM）计算机为基础的艾滋病毒/艾滋病预防课程。在第二阶段申请中，我们将扩大“降低智障妇女感染艾滋病毒风险”项目第一阶段完成的工作。第二阶段的开发将包括三个30分钟的IMM项目。这三个项目将侧重于：1)性与性教育项目，该项目基于第一阶段的专业访谈，涉及性与性、节育、怀孕、更年期和艾滋病毒/艾滋病；2)使用第一阶段开发的内容，我们将使用高清（HD）视频修改我们的原型，创建一个专注于艾滋病毒/艾滋病事实、知识、测试和避孕套使用的项目；3)我们将开发一个关于性行为的关系谈判的项目。关于性和性行为的第一个项目和关于关系谈判的第三个项目将包括为绝经前和绝经后妇女量身定制的信息，因为她们很少使用避孕套，因为她们没有怀孕的风险。三个二期项目的最终用户将是患有轻度智力残疾（ID）的成年女性（18岁以上）。这三个IMM项目使用基于掌握的学习（ML）、直接指导（DI）和通用学习设计（UDL）的元素，将在教育患有ID的成年女性方面非常有效。作为第二阶段课程系列的一部分，三个第二阶段课程中的每一个都将有一个配套的视频DVD和讲师指南。形成程序（即，顾问小组和电话访谈）将用于通知内容，剧本和框架方面的扩展程序。我们将使用随机治疗对照设计对80名轻度ID女性、30名服务提供者和30名家长进行评估，评估其可用性、吸引力、功能价值和购买可能性。这种评估方法将使我们能够确定，该项目适用于患有轻度艾滋病的妇女，能够有效地教会她们如何传播和避免艾滋病毒、进行艾滋病毒检测和使用避孕套，并且她们在基本消费者满意度因素上给予了很高的评价。此外，我们将确认服务提供者认为该计划适合他们的客户，它提供了重要的信息，他们会使用它并将其推荐给他们的同事，父母认为该计划和内容对他们的女儿有帮助和重要。该应用程序支持国家精神卫生研究所艾滋病和健康行为研究部，因为其目的是制定和传播行为干预措施，防止艾滋病毒传播，特别是在艾滋病毒感染高风险人群中传播。此外，它还支持开发课程和计算机软件，提供减少艾滋病毒风险的沟通技巧和培训，并开发减少或改变与艾滋病毒相关的风险行为的方法。

DESCRIPTION (provided by applicant): The purpose of this application is to expand upon our Phase I work and further develop a fully-interactive multimedia (IMM) computer-based HIV/AIDS prevention curricula for adult women with mild intellectual disabilities (ID) (I.Q. approximately 55 through 75). In this Phase II application, we will expand the work completed in Phase I of the "Reducing HIV Risk in Women with Intellectual Disabilities" program. Phase II development will result in a suite of three 30-minute IMM programs. The three programs will focus on 1) Sex and Sexuality education program based on input from Phase I professional interviews that addresses sex and sexuality, birth control, pregnancy, menopause, and HIV/AIDS, 2) using content developed in Phase I, we will revise our prototype using high-definition (HD) video and create a program focused on HIV/AIDS Facts, Knowledge, Testing and Condom Use, and 3) we will develop a program on Relationship Negotiations around sexual behavior. Program 1 on sex and sexuality, and program 3 on relationship negotiations will include messages tailored for women who are both pre- and postmenopausal as they seldom use condoms due to lack of pregnancy risk. End users of the three Phase II programs will be adult women with mild intellectual disabilities (ID) (age 18 +). Using elements of Mastery-based learning (ML), Direct Instruction (DI), and Universal Design for Learning (UDL), the three IMM programs will be highly effective at teaching adult women with ID. Each of the three Phase II programs will have a companion video DVD and instructor guide developed as part of the Phase II program series. Formative procedures (i.e., advisor groups and telephone interviews) will be used to inform the expanded programs in terms of content, scriptwriting, and framing. We will evaluate the program with 80 women with mild ID using a randomized treatment-control design, and with 30 service providers, and 30 parents for usability, appeal, functional value, and likelihood of purchase. This evaluative approach will allow us to establish that the program is useable by women with mild ID, effective at teaching them about the transmission and avoidance of HIV, HIV testing, and condom use, and that they rate it highly on essential consumer satisfaction factors. In addition, we will confirm that the program is seen by service providers as appropriate for their clients, that it provides vital information and that they would use it and recommend it to their colleagues, and that parents view the program and content as helpful and important for their daughters. This application supports the Division of AIDS and Health Behavior Research, National Institute of Mental Health, as its purpose is to develop and disseminate a behavioral intervention that prevents HIV transmission, especially among populations at high risk for HIV infection. Additionally it supports the development of curricula and computer software that provides communication skills and training for HIV risk reduction, and the development of methods to reduce or change HIV-associated risk behaviors. PUBLIC HEALTH RELEVANCE: While there continues to be little research on the prevalence of HIV/AIDS among people with intellectual disabilities (ID), there is reason to believe that the prevalence of HIV/AIDS in women with ID is similar to, if not greater than, that of the non-ID population. The CDC has identified unique challenges facing women in the fight against HIV/AIDS, and some of these challenges are amplified in women with mild ID, due to limited knowledge, limited communication skills, difficulty communicating with health care professionals, and the desire to be involved in intimate relationships while lacking some of the social judgment and decision-making skills that could help them identify and avoid high-risk fluids and high-risk sexual encounters.