Transition from Prison to Community: Pilot Intervention

从监狱到社区的过渡：试点干预

• 批准号: 7119769
• 负责人: SHERYL L CATZ
• 金额: $ 24.16万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7119769
• 关键词: AIDS education /prevention; AIDS therapy; HIV infections; antiviral agents; behavioral /social science research tag; clinical research; clinical trials; cognitive behavior therapy; community; correctional institutions; health care service evaluation; health services research tag; high risk behavior /lifestyle; human immunodeficiency virus 1; human subject; human therapy evaluation; interview; motivation; nurse patient relations; psychological adaptation; telemedicine; therapy compliance

DESCRIPTION (provided by applicant): Many people are first diagnosed with HIV or begin HIV medical care when they enter a correctional facility. Moreover, most patients treated with antiretroviral medications in prison are released back into the community. History of incarceration has been linked to greater risk of antiretroviral adherence problems in community studies. Lapses in adherence to antiretroviral regimens can quickly lead to the development of drug-resistant viral strains, thereby increasing the likelihood of a poor treatment response and raising the possibility of drug-resistant HIV strains being transmitted to others. Enhancing treatment adherence among HIV+ persons released from prison therefore carries important health and public health benefits. This application requests three years of support to conduct developmental research to design and pilot test a nurse-delivered telephone intervention to improve antiretroviral adherence among incarcerated HIV+ persons during the transitional period from prison to community re-entry. We are proposing a sequence of intervention development activities that will include: (1) adapting telephone intervention manuals from an ongoing RCT conducted in a prison setting to include more targeted post-prison release content, (2) developing and refining study protocols for tracking and retaining study participants as they re-enter the community, (3) refining assessment measures, (4) conducting a randomized pilot test of a motivational and cognitive-behavioral skills based adherence intervention during the transitional period prior to and after release from prison, and (5) evaluating the feasibility and acceptability of delivering telephone intervention sessions that bridge state prison and community settings. The intervention developed in the proposed pilot study will build on our formative work with HIV-positive men and women in prison and community settings. Guided by motivational interviewing and cognitive-behavioral approaches to behavior change, the proposed community transition intervention will provide telephone support to promote medication adherence and use of community HIV care services among patients leaving prison. The proposed project constitutes the next phase of study necessary to address the important public health issue of sustaining treatment adherence in persons who re-enter the community after receiving HIV care in correctional facilities.

描述（由申请人提供）：许多人首先被诊断出患有艾滋病毒，或者在进入惩教设施时开始艾滋病毒医疗服务。此外，大多数接受抗逆转录病毒药物治疗的患者被释放回社区。监禁史与社区研究中的抗逆转录病毒依从性问题的更大风险有关。遵守抗逆转录病毒方案的失误会迅速导致抗药性病毒菌株的发展，从而增加治疗反应不佳的可能性并增加了向其他人传播耐药的HIV菌株的可能性。从监狱释放的艾滋病毒+人之间的治疗依从性具有重要的健康和公共卫生益处。该申请要求进行三年的支持，以设计和试点测试护士分配的电话干预措施，以改善从监狱到社区重新进入社区重新进入的过渡时期，在被监禁的艾滋病毒+人之间的抗逆转录病毒依从性。我们提出了一系列干预开发活动，其中包括：（1）调整电话干预手册中正在进行的监狱中进行的RCT进行调整，以包括更有针对性的监狱发布内容，（2）制定和完善研究协议，用于跟踪研究和保留研究参与者，以重新进行社区重新进入社区，（3）基于进度的评估措施，（4）动机的动力， - （4）动机的动机，并进行了动力的手段，并进行了动力的手段，并进行了动力的手段，并进行了攻击。在从监狱释放前后的过渡期内的依从性干预，以及（5）评估交付电话干预会议的可行性和可接受性，这些课程弥合州监狱和社区环境。在拟议的试点研究中开发的干预措施将基于我们与艾滋病毒阳性男女在监狱和社区环境中的形成性工作。在拟议的社区过渡干预措施的指导下，拟议中的社区过渡干预将提供电话支持，以促进患者在离开监狱的患者中提供药物支持和使用社区艾滋病毒护理服务。拟议的项目构成了解决重要公共卫生问题的下一阶段研究，即在惩教设施中接受艾滋病毒护理后重新进入社区的人的维持治疗依从性。