Mobilizing Health Workers for HIV Prevention in Malawi

动员卫生工作者在马拉维预防艾滋病毒

基本信息

批准号：
6438134
负责人：
KATHLEEN F NORR
金额：
$ 42.09万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2001
资助国家：
美国
起止时间：
2001-09-30 至 2006-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6438134
关键词：
AIDS education /prevention Africa African behavioral /social science research tag clinical research community health services health care personnel health care service availability human subject patient care management sex behavior training

项目摘要

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.

描述（由申请人提供）：卫生工作者是关键的潜在领导者为了遏制艾滋病毒/艾滋病大流行。这项创新的研究将测试更广泛的传播一种有效的HIV预防模型干预马拉维，马拉维是非洲最贫穷的国家之一，其中一个七个成年人是艾滋病毒阳性。这种干预措施基于主要健康护理和社会学习模型。卫生工作者将被动员为农村社区领导者将涉及社区参加同伴小组干预艾滋病毒/艾滋病预防。干预措施使用A分为四个阶段火车 - 培训师模型。在第1阶段，地区医院的卫生工作者通过参加同伴小组，将接受社区领导者的培训干涉。在第二阶段，在选定的农村健康诊所和集群它服务的村庄，受过训练的地区卫生工作者将培训诊所卫生工作者和感兴趣的本地领导人是社区同伴团体领导者。第一阶段和第二阶段的培训将使地区和农村诊所工作者能够改变自己的艾滋病毒预防行为，并修改健康服务更支持预防艾滋病毒。在第三阶段，诊所工作人员将训练社区成员作为同伴小组领导者，然后将为同伴团体提供对整个社区的教育和其他活动。在第四阶段，计划将扩展以提供父母保护所需的知识和技能他们的孩子，从而增强了年轻人更安全的性行为。这干预将使社区成年人和青少年能够练习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和社区成员的行为将通过比较干预前干预区干预区，并第一阶段后16个和32个月，使用健康记录服务，与卫生工作者和客户的访谈以及对社区成人和青少年。一个1100个样本（550名成人，550个样本青少年）在干预和控制社区中将提供足够的测试成人和青少年关键行为变化的假设的能力分别地。在第1阶段之后的16个月，我们预计健康状况会发生很大变化工人和卫生服务，但干预可能没有扩散足够导致社区范围的差异。显着增加期望在第1阶段后32个月内更安全的性行为。加强了合作护理学院的研究能力和地区和农村诊所卫生工作者。低成本和现有的使用基础设施有助于高传递性。