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）：许多人在进入惩教机构时首先被诊断出感染艾滋病毒或开始接受艾滋病毒医疗护理。此外，大多数在监狱接受抗逆转录病毒药物治疗的患者都被释放回社区。在社区研究中，监禁史与抗逆转录病毒药物依从性问题的更大风险有关。不遵守抗逆转录病毒治疗方案会很快导致耐药病毒株的产生，从而增加治疗反应不佳的可能性，并增加耐药艾滋病毒株传播给他人的可能性。因此，提高出狱后艾滋病病毒感染者的治疗依从性具有重要的健康和公共卫生益处。该申请要求三年的支持来进行发展研究，以设计和试点测试护士提供的电话干预措施，以提高被监禁的艾滋病毒携带者在从监狱到重返社区的过渡期间的抗逆转录病毒治疗依从性。我们提出一系列干预开发活动，其中包括：(1) 根据在监狱环境中进行的随机对照试验改编电话干预手册，以包含更有针对性的出狱后内容，(2) 制定和完善研究方案，用于跟踪和改进在研究参与者重新进入社区时留住他们，(3) 完善评估措施，(4) 在出狱前后的过渡期内对基于动机和认知行为技能的依从性干预进行随机试点测试，以及(5)评估可行性以及提供连接州监狱和社区环境的电话干预会议的可接受性。拟议的试点研究中制定的干预措施将建立在我们与监狱和社区环境中艾滋病毒阳性男性和女性的形成性工作的基础上。在动机访谈和行为改变的认知行为方法的指导下，拟议的社区过渡干预措施将提供电话支持，以促进出狱患者的药物依从性和社区艾滋病毒护理服务的使用。拟议的项目构成了下一阶段必要的研究，以解决在惩教机构接受艾滋病毒护理后重新进入社区的人维持治疗依从性这一重要的公共卫生问题。