Pathways Linking Poverty, Food Insecurity, and HIV in Rural Malawi

马拉维农村地区贫困、粮食不安全和艾滋病毒之间的联系途径

基本信息

批准号：
7494266
负责人：
Lance S Weinhardt
金额：
$ 53万
依托单位：
MEDICAL COLLEGE OF WISCONSIN
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-04-03 至 2013-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7494266
关键词：
AIDS prevention AIDS/HIV problem Address Affect Africa South of the Sahara Agriculture Area Attitude Autopsy Back Behavior Behavioral Birth Capital Cessation of life Collaborations Communities Community Surveys Control Groups Country Data Depth Development Diffusion Distal Economics Effectiveness of Interventions Elements Empirical Research Environment Environmental Risk Factor Evaluation Exposure to Family member Farming environment Food Funding Gender HIV HIV Infections Health Health Benefit Health Food High Prevalence Household Human immunodeficiency virus test Income Individual Interdisciplinary Study International Intervention Interview Knowledge Language Life Life Expectancy Link Longitudinal Studies Malawi Malnutrition Measurement Measures Mediator of activation protein Medical Modeling NIH Program Announcements Nature Nutritional status Outcome Outcome Assessment Participant Pathway interactions Patient Self-Report Perception Population Postdoctoral Fellow Poverty Practice Management Prevalence Prevention Prevention Research Process Production Program Evaluation Protocols documentation Public Health Quality of life Rate Recruitment Activity Reporting Research Research Design Risk Risk Behaviors Role Rural Savings Schools Security Sentinel Services Site Social Health Services Societies Source Surveys Sustainable Development Testing Textiles Training Translating Trust United States National Institutes of Health Violence Woman base cohesion design economic outcome farmer feeding follow-up food security improved intervention program member men nutrition programs response rural area service intervention skills social socioeconomics theories therapy development trend

项目摘要

DESCRIPTION (provided by applicant): This revised application is in response to PAR-06-114, "Research on Pathways Linking Environments, Behaviors and HIV/AIDS" and requests five years of support examine the relationship of HIV vulnerability to changes in economic environment and food security in rural Malawi. We have formed a multidisciplinary research team and partnered with CARE Malawi/USA to conduct three related studies: 1. We will conduct a quasi-experimental non-equivalent control group longitudinal study of the mechanisms, processes, and magnitude of impact of a large multi-level development and food security intervention (Improving Livelihoods through Increasing Food Security, or I-LIFE), as implemented by CARE Malawi, on HIV vulnerability (i.e., HIV risk behaviors, malnutrition, HIV infections, deaths due to HIV) and economic outcomes (i.e., food security, income, household assets). We will recruit participants from three types of areas of rural central Malawi: areas selected to receive the I-LIFE intervention from CARE, areas that will not receive I-LIFE but are participating in other CARE programming, and areas not receiving CARE programming during the life of the study. We will assess HIV-related, food security, and economic outcomes at both at the individual and community levels. In each of the CARE program areas, we will recruit 600 program participants and interview them at baseline and three yearly follow-ups to contrast I-LIFE participants directly with other CARE program recipients. We will examine broader changes at the community level, also hypothesized to result from the I-LIFE intervention, by conducting surveys with 1000 randomly-selected households in each of the 3 types of study areas at baseline and at a 36 month follow up. 2. We will conduct theory-based statistical analyses of longitudinal data collected in (1) to test pathways between socioeconomic changes, food security, HIV risk behavior, and HIV-related outcomes. 3. We will conduct a thorough qualitative end-of-program evaluation consisting of in-depth qualitative interviews with I-LIFE participants to understand the perceived impact of I-LIFE on their lives and the mechanisms of this impact. PUBLIC HEALTH RELEVANCE: The proposed research is directly relevant to public health by examining the effects of a multi-level intervention on HIV-related outcomes in Malawi, a country in sub-Saharan Africa with a high prevalence of HIV infection. In addition to examining the role of changes in economics and food security to HIV vulnerability, the proposed research will yield important information for determining the impact on HIV of multi-level environmental/structural interventions with the potential for sustainable long-term public health benefits, as well as for refining and improving the specific intervention under study for increased implementation.

描述（由申请人提供）：本修订后的申请是为了响应 PAR-06-114“环境、行为和艾滋病毒/艾滋病联系途径的研究”，并请求五年的支持来检查艾滋病毒脆弱性与经济环境变化的关系和马拉维农村地区的粮食安全。我们组建了一个多学科研究团队，并与CARE Malawi/USA合作开展了三项相关研究： 1. 我们将针对大型多学科的机制、过程和影响程度进行准实验性非等效对照组纵向研究。由 CARE Malawi 实施的针对艾滋病毒脆弱性（即艾滋病毒风险行为、营养不良、艾滋病毒感染、艾滋病毒死亡）和经济成果（即粮食安全、收入、家庭资产）。我们将从马拉维中部农村的三类地区招募参与者：选择接受 CARE 的 I-LIFE 干预的地区、不会接受 I-LIFE 但正在参加其他 CARE 计划的地区、以及在 CARE 期间未接受 CARE 计划的地区。学习生活。我们将评估个人和社区层面的艾滋病毒相关问题、粮食安全和经济成果。在每个 CARE 计划领域，我们将招募 600 名计划参与者，并对他们进行基线访谈和每年三年的随访，以直接将 I-LIFE 参与者与其他 CARE 计划接受者进行对比。我们将在基线和 36 个月的随访中对 3 种类型的研究区域中的每一种中随机选择的 1000 个家庭进行调查，以研究社区层面更广泛的变化（也假设是 I-LIFE 干预的结果）。 2. 我们将对（1）中收集的纵向数据进行基于理论的统计分析，以测试社会经济变化、粮食安全、艾滋病毒风险行为和艾滋病毒相关结果之间的路径。 3. 我们将进行彻底的定性项目结束评估，包括对 I-LIFE 参与者进行深入的定性访谈，以了解 I-LIFE 对他们生活的感知影响以及这种影响的机制。公共卫生相关性：拟议的研究与公共卫生直接相关，通过检查多层次干预措施对马拉维艾滋病毒相关结果的影响，马拉维是撒哈拉以南非洲国家，艾滋病毒感染率很高。除了研究经济和粮食安全变化对艾滋病毒脆弱性的影响外，拟议的研究还将产生重要信息，用于确定多层次环境/结构干预措施对艾滋病毒的影响，并具有可持续的长期公共卫生效益的潜力，以及完善和改进正在研究的具体干预措施以加强实施。