SEPA III: The Effectiveness Trial

SEPA III：有效性试验

• 批准号: 8655809
• 负责人: Nilda P Peragallo Montano
• 金额: $ 32.16万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8655809
• 关键词: AIDS prevention; ARHGEF5 gene; Accounting; Acculturation; Acquired Immunodeficiency Syndrome; Address; Age; Alcohol consumption; Behavior; Cause of Death; Centers for Disease Control and Prevention (U.S.); Centers of Research Excellence; Characteristics; Chlamydia trachomatis; Communication; Communities; Community Practice; Conflict (Psychology); County; Dependency; Diagnosis; Economics; Effectiveness; Evaluation; Evidence based practice; Family; Florida; Foundations; Frequencies; Gender; Goals; HIV; HIV Infections; HIV risk; Health; Health Personnel; Health education; High Risk Woman; Hispanics; Human Resources; Incidence; Inequality; Intervention; Knowledge; Life; Linear Models; Logistic Regressions; Low income; Mediating; Mediation; Men' s Role; Mexican; Minority; Neisseria gonorrhoeae; Not Hispanic or Latino; Nurses' Health Study; Partner Communications; Population; Prevention; Prevention strategy; Preventive Intervention; Problem Solving; Public Health; Puerto Rican; Randomized; Randomized Controlled Trials; Readiness; Recruitment Activity; Relative (related person); Religious Belief; Reporting; Research; Research Design; Risk; Risk Behaviors; Risk Reduction; Sampling; School Nursing; Self Care; Services; Sex Behavior; Sexually Transmitted Diseases; Site; Syphilis; Testing; Time; Translating; Universities; Waiting Lists; Woman; Women' s Health; Women' s Role; community setting; condoms; effectiveness trial; evidence base; health disparity; improved; intervention effect; intimate partner violence; minority health; motherhood; novel; peer; research study; response; sex; sexually active; skills training; therapy design; violence prevention

The proposed study's overarching goal is to reduce the ethnic disparities in HIV between Hispanic and non-Hispanic women. This goal will be accomplished by two aims: Aim 1 is to establish a novel and effective partnership to improve minority health by integrating SEPA (i.e., Salud, Educacion, Prevencion y Autocuidado; Health, Education, Prevention and Self-Care) an evidenced based, HIV preventive intervention into community setting while assessing agency and facilitator characteristics and readiness for practice improvement, implementation, fidelity, and sustainability; and Aim 2 is to evaluate the effectiveness of SEPA to increase HIV prevention behaviors and to reduce the incidence of STIs for Hispanic women when delivered in a real-world setting by community agency personnel. 300 Spanish-speaking Hispanic women between the ages of 18 and 50 who are sexually active will be recruited from one of four Miami-Dade County Public Health Department sites and randomized to either SEPA or a Wait-List Control condition. SEPA has been evaluated and found to be efficacious in two separate randomized controlled trials. In the first study (Peragallo et al., 2005), SEPA was shown to be efficacious relative to a Wait List Control condition in increasing the frequency of condom use, increasing partner communication regarding sex, and increasing HIV knowledge. In the second study (Peragallo et al., 2011), SEPA was efficacious (relative to Wait List Control) in reducing the incidence of STIs, in increasing the frequency of condom use, increasing partner communication, reducing intimate partner violence, and decreasing alcohol use. Partner communication regarding sex mediated the effects of the intervention on frequency of condom use. Hierarchical Linear Modeling (HLM) will be used to test (HI a): SEPA will be more effective relative to Wait List Control in reducing unprotected sexual behavior (defined as frequency of condom use in the past 90 days) over time. Logistic Regression will be used to test (H2a): SEPA will be more effective relative to Wait List Control in reducing STI incidence (specifically, the incidence of Neisseria gonorrhea. Chlamydia trachomatis, and Syphilis). Additionally, HLM and logistic regression, respectively, will be used to determine whether (H1b): The effect of SEPA on unprotected sexual behavior will be partially mediated by improvements in sexual communication with partner; and (H2b) The effect of SEPA on STI incidence will be partially mediated by improvements in sexual communication with partner and reductions in unprotected sexual behavior.

拟议的研究的总体目标是减少西班牙裔和非西班牙裔妇女之间艾滋病毒的种族差异。这个目标将通过两个目标来实现：目标1是建立一种新颖有效的伙伴关系，通过整合SEPA（即Salud，Educacion，Prevencion y Autocuidado；健康，教育，预防和自我保健），以改善少数民族健康。 ，艾滋病毒预防性干预社区环境，同时评估代理机构和促进者的特征以及准备实践，实施，忠诚和可持续性的准备；目标2是评估SEPA在社区机构人员在现实世界中交付的西班牙裔妇女的发病率并减少西班牙裔妇女的性传播疾病的发病率的有效性。 300名讲西班牙语的西班牙裔女性在18至50岁之间的性活动中，将从迈阿密戴德四个县公共卫生部门之一中招募，并随机分配到SEPA或等待名单的控制条件。 已经对SEPA进行了评估，并发现在两个独立的随机对照试验中有效。在第一项研究（Peragallo等，2005）中，SEPA被证明是有效的，相对于等待列表控制条件，在增加了使用安全套的频率，增加有关性别的伴侣沟通以及增加HIV知识的情况下是有效的。在第二项研究（Peragallo等，2011）中，SEPA在降低STI的发生率的情况下是有效的（相对于等待名单控制），在增加了使用安全套的频率，增加伴侣的交流，减少亲密的伴侣暴力并减少酒精使用。关于性别的伴侣沟通介导了干预对避孕套使用频率的影响。 分层线性建模（HLM）将用于测试（HI A）：SEPA将在减少未保护的性行为（在过去90天内定义为使用避孕套的频率）的等待列表控制更有效。逻辑回归将用于测试（H2A）：SEPA将在降低STI发病率的等待列表控制方面更有效（特别是淋病奈瑟氏菌的发生率，沙眼衣原体和梅毒）。此外，HLM和Logistic回归将分别用于确定（H1B）是否：SEPA对不受保护的性行为的影响将部分通过与伴侣的性交进行的改善来部分介导； （H2B）SEPA对STI发病率的影响将部分通过与伴侣的性交流和降低无保护的性行为的改善所介导的。