Novel Dissemination of a Group Intervention for HIV+ Women Via Web Conferencing

通过网络会议传播艾滋病毒妇女群体干预的新颖方法

• 批准号: 8097475
• 负责人: Stephanie Lynn Marhefka
• 金额: $ 29.2万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-22 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8097475
• 关键词: AIDS/HIV problem; Address; Affect; Area; Behavior; Behavior Therapy; Behavioral; Centers for Disease Control and Prevention (U.S.); Child; Chronic; Clinical; Communities; Community Health Centers; Community Healthcare; Computers; Costs and Benefits; Decision Making; Disclosure; Effectiveness; Environment; Evidence based intervention; Face; Family; Feedback; Female; Florida; Friends; Funding; Gender; Genetic Crossing Over; Goals; HIV; HIV Seropositivity; Health; Health Services Research; Home environment; Incidence; Internet; Interpersonal Violence; Intervention; Knowledge; Lead; Learning; Life; Location; Low Prevalence; Manuals; Mediation; Mental disorders; Modality; National Institute of Mental Health; Online Systems; Outcome; Participant; Persons; Population Heterogeneity; Preparation; Preventive Intervention; Primary Prevention; Privacy; Process; Public Health; Randomized; Randomized Controlled Trials; Research; Research Personnel; Research Priority; Research Project Grants; Resources; Risk; Science; Secondary Prevention; Services; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Social support; Testing; Time; Translations; Unsafe Sex; Videoconferences; Videoconferencing; Waiting Lists; Woman; Work; base; chronic pain; community setting; cost effectiveness; design; disorder prevention; experience; follow-up; group intervention; improved; innovation; intervention program; male; meetings; new technology; novel; programs; public health relevance; safer sex; sex risk; skills; social skills; socioeconomics; tertiary prevention; transmission process; trial comparing

DESCRIPTION (provided by applicant): This proposal fits with the NIMH priority for research aimed at developing and testing "different modes for transferring efficacious interventions" into community settings--especially with regard to interventions serving HIV-positive persons (PA-08-166). In the U.S., HIV among women is increasing. Women living with HIV (WLH) face tremendous challenges, including: a) making decisions about disclosing their HIV status; and b) negotiating for and practicing safer sexual behavior. Although the Healthy Relationship (HR) intervention was developed to address these challenges, two substantial needs remain. First, there is a need for HR to better address the above described gender specific needs of WLH. Second, there is a need for more widespread dissemination to WLH. Although HR is disseminated in the US by CDC's Dissemination of Effective Behavioral Interventions (DEBI) project, dissemination is limited to geographical areas in which a critical mass of people with HIV can meet in a single location to participate, and where community agencies have the time and resources for these efforts. As such, the proposed R34 study is designed to pilot and feasibility test video group dissemination of an adapted, gender-specific version of Healthy Relationships (HR) for WLH. Our team is currently funded to work with a Community Advisory Board (CAB) to adapt HR into Healthy Relationships-Web (HR-W) to: a) address women's gender-specific needs; and b) enable more widespread delivery through web-based group videoconferencing accessed at community locations. This proposed study is the critical next step towards determining whether or not it is feasible and effective to disseminate HR-W to WLH. Building upon our current work, specific aims of the proposed study are as follows: 1) Conduct pilot testing of HR-W with WLH and make any necessary adaptations to finalize the manual; and 2) Conduct a small partial cross-over feasibility trial comparing HR-W with a wait-list control (WLC), in preparation for a large randomized controlled trial (RCT). For Aim 1, we will conduct a single-group pilot test and garner feedback from participants to improve the HR-W manual with assistance from our existing CAB. For Aim 2, WLH will be randomized into the HR-W (n=35) and WLC (n=35) conditions. HR-W participants will receive the intervention immediately after a baseline assessment. After both conditions complete a 6-month follow-up assessment, WLC participants will cross over to the HR-W condition, receive the intervention, and complete a follow-up 6 months later. In preparation for a large RCT (and R01 application), the overall goals of this project are to establish that it is feasible to provide HR-W through videoconferencing and gather evidence suggesting that HR-W may lead to significant reductions in sexual risk behavior. The long-term goal is to establish effectiveness of HR-W for WLH in urban as well as geographically dispersed, low-prevalence, and resource- poor environments. PUBLIC HEALTH RELEVANCE: The successful dissemination of Healthy Relationships-Web through group videoconferencing accessed at community-located intervention stations will have far-reaching methodological and public health impacts. First, this study will establish the feasibility of online dissemination of an adapted version of Healthy Relationships so that, despite socioeconomic and geographic barriers, many more women living with HIV can benefit from the intervention's social support and skills building components. Second, this study will advance behavioral translation science by contributing significantly to current understandings of disseminating group-based interventions online, thus establishing knowledge that can then be used to adapt and disseminate an array of primary, secondary, and tertiary prevention interventions for a range of public health issues.

描述（由申请人提供）：该提案符合 NIMH 的研究优先事项，旨在开发和测试“将有效干预措施转移到社区环境的不同模式”，特别是针对艾滋病毒阳性者的干预措施（PA-08-166） ）。在美国，女性感染艾滋病毒的人数正在增加。感染艾滋病毒的女性 (WLH) 面临着巨大的挑战，包括： a) 做出有关披露其艾滋病毒状况的决定； b) 协商并实行更安全的性行为。尽管健康关系（HR）干预措施是为了应对这些挑战而制定的，但仍然存在两个实质性需求。首先，人力资源部门需要更好地满足 WLH 的上述性别特定需求。其次，需要更广泛地传播 WLH。尽管在美国，HR 是通过 CDC 的有效行为干预措施传播 (DEBI) 项目进行传播的，但传播仅限于足够数量的 HIV 感染者可以在一个地点聚集参与且社区机构有时间的地理区域。以及这些努力的资源。因此，拟议的 R34 研究旨在试点和可行性测试视频组传播适合 WLH 的健康关系 (HR) 的适合性别的版本。 我们的团队目前获得资助，与社区咨询委员会 (CAB) 合作，将人力资源纳入健康关系网络 (HR-W)，以： a) 满足女性的特定性别需求； b) 通过在社区地点访问的基于网络的群组视频会议实现更广泛的交付。这项拟议的研究是确定将 HR-W 传播到 WLH 是否可行且有效的关键下一步。基于我们当前的工作，拟议研究的具体目标如下： 1) 使用 WLH 进行 HR-W 试点测试，并进行必要的调整以最终确定手册； 2) 进行一项小型部分交叉可行性试验，将 HR-W 与等待名单对照 (WLC) 进行比较，为大型随机对照试验 (RCT) 做准备。对于目标 1，我们将进行单组试点测试并收集参与者的反馈，以在现有 CAB 的协助下改进 HR-W 手册。对于目标 2，WLH 将被随机分为 HR-W (n=35) 和 WLC (n=35) 条件。 HR-W 参与者将在基线评估后立即接受干预。在这两种情况完成 6 个月的随访评估后，WLC 参与者将过渡到 HR-W 情况，接受干预，并在 6 个月后完成随访。在准备大型随机对照试验（和 R01 申请）时，该项目的总体目标是确定通过视频会议提供 HR-W 是可行的，并收集表明 HR-W 可能导致性危险行为显着减少的证据。长期目标是在城市以及地理分散、患病率低和资源匮乏的环境中建立 HR-W 对于 WLH 的有效性。 公共卫生相关性：通过在社区干预站访问的小组视频会议成功传播健康关系网络将产生深远的方法和公共卫生影响。首先，这项研究将确定在线传播改编版《健康关系》的可行性，以便尽管存在社会经济和地理障碍，更多感染艾滋病毒的妇女可以从干预措施的社会支持和技能建设中受益。其次，这项研究将通过极大地促进当前对在线传播基于群体的干预措施的理解来推进行为翻译科学，从而建立可用于适应和传播一系列初级、二级和三级预防干预措施的知识。公共卫生问题。