1/2-Maternal HIV: Multisite Trial to Assist Disclosure to Children

1/2-孕产妇艾滋病毒：多中心试验以协助向儿童披露

基本信息

批准号：
8664742
负责人：
DEBRA A. MURPHY
金额：
$ 38.07万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-11 至 2017-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8664742
关键词：
14 year old AIDS/HIV problem Acting Out African American Age Anxiety Area Behavior Characteristics Charge Child Child Development Child Mental Health Communities Control Groups Country County Demographic Factors Development Disclosure Educational Intervention Educational process of instructing Emotional Epidemic Ethnic Origin Family Fright Gender HIV HIV Seropositivity Individual Intervention Intervention Studies Intervention Trial Interview Interviewer Joints Knowledge Latina Life Los Angeles Mediating Mental Depression Mental Health Mothers NIH Program Announcements Online Systems Outcome Parents Pilot Projects Prevention Protocols documentation Quality of life Race Randomized Research Role Sample Size Sampling Secondary Prevention Self Efficacy Severity of illness Site Time Treatment Efficacy Woman Work base cohesion data management design efficacy testing follow-up group intervention improved longitudinal design medication compliance meetings pilot trial prevent quality assurance satisfaction social stigma theories therapy development

项目摘要

DESCRIPTION (provided by applicant): The purpose of this Collaborative R01, under Program Announcement PAR-09-153, is to conduct a full-scale trial of an intervention to assist mothers living with HIV (MLH) with disclosing their serostatus to their young (age 6 - 14 year old), well children. A pilot study of the intervention has recently been completed (R01 MH077493) and met its major aims. The basis for development of the pilot intervention was work from three R01s (MH057207, currently Yr. 14) designed to longitudinally assess MLH and their children. Within that work, several studies were conducted on maternal disclosure (e.g., Murphy, Marelich, & Hoffman, 2002; Murphy, Roberts, & Hoffman, 2002; Murphy, Roberts, & Hoffman, 2003; Murphy, Roberts, & Hoffman, 2006; Murphy, Steers, & Dello Stritto, 2001), suggesting disclosure is difficult, and outcomes for MLH and children could be improved by intervention. The pilot study, known in the community as Teaching, Raising, And Communicating with Kids (TRACK), was based on integrative disclosure theory (Derlega et al., 2004). Results of the pilot trial indicate that those in the intervention group were six times more likely to disclose their HIV/AIDS status to their child than those in the control group (O.R. 6.33) by the 9-month follow-up 33% of intervention MLH disclosed, compared to only 7.3% of the control group. Perhaps more importantly, the intervention group's emotional functioning and their satisfaction improved significantly following the intervention, compared to the control group Similarly, child mental health indicators among children of intervention MLH were significantly better than control group children at follow-ups. In this study, TRACK II, we propose to conduct a full-scale trial of the intervention in two sites: (1) Los Angeles county (Site 1, where the pilo trial was conducted), which will include a high proportion of Latina families and a smaller proportion of African-American and White families; and (2) Atlanta, Georgia (Site 2, where the primary consultant on the pilot trial conducts research), which will include a high proportion of Southern African-American families, as well as White families. MLH and their children (N = 440 total; 110 mothers and 110 children per site, n = 220 per site) will be assessed at baseline and at 3, 9, and 15-month follow-ups. MLH will be randomly assigned to the intervention or control. Aims are to: 1. facilitate disclosure of the mothers' HIV status to the children, which will includ secondary aims of: a. increasing mothers' self-efficacy to disclose and respond to child questions regarding HIV; b. reducing mothers' fears regarding disclosure and stigma; c. improving maternal knowledge of child development and how to provide appropriate levels of information given the age of the child; 2. improve MLH mental health indicators over time (i.e., depression, anxiety, quality of life); 3. improve child mental health indicators over time (i.e., depression, anxiety, acting out behaviors); and 4. improve family functioning indicators (e.g., cohesion, perceived closeness between mother and child).

描述（由申请人提供）：根据计划公告PAR-09-153，该协作R01的目的是对干预措施进行全面试验，以协助艾滋病毒（MLH）的母亲（MLH）向年轻（6-6-14岁）披露其血清，良好的孩子。该干预措施的试点研究最近已经完成（R01 MH077493），并达到了其主要目标。飞行员干预开发的基础是三个R01（MH057207，目前14年）的工作，旨在纵向评估MLH及其子女。在这项工作中，进行了几项研究（例如Murphy，Marelich，＆Hoffman，2002; Murphy，Roberts和Hoffman，＆Hoffman，＆Hoffman，2002; Murphy，Roberts和Hoffman，＆Hoffman，＆Hoffman，＆Hoffman，＆Hoffman，2003; Murphy，Roberts和Hoffman，＆Hoffman，＆Hoffman，＆Hoffman，＆Hoffman，2006; Murphy，Steers＆Dello for Is＆Dello＆Dello striTo＆uterto and and and and and and and and and and and and 2001，M。可以通过干预来改善儿童。该试点研究在社区中被称为教学，养育和与儿童沟通（轨道），是基于综合披露理论（Derlega等，2004）。试验试验的结果表明，干预组中的结果是六倍与对照组（O.R. 6.33）的9个月随访33％的干预MLH披露的MLH披露的33％相比，与对照组的艾滋病毒/艾滋病状况相比，其艾滋病毒/艾滋病状况可能比对照组的7.3％。也许更重要的是，与对照组相比，干预组的情绪功能及其满意度得到了显着提高，而MLH干预儿童的儿童心理健康指标明显优于随访中的对照组儿童。在这项研究中，我们建议在两个地点进行干预的全面试验：（1）洛杉矶县（洛杉矶县（Site 1）进行了PILO试验，其中包括大部分拉丁裔家庭和较小比例的非裔美国人和白人家庭；（2）佐治亚州亚特兰大（站点2，试点试验的主要顾问进行研究），其中包括很大比例的南部非裔美国人家庭以及白人家庭。 MLH及其子女（n = 440个；每个地点的110个母亲和110个孩子，n = 220个地点）将在基线和3、9和15个月的随访中进行评估。 MLH将随机分配给干预或控制。目的是：1。促进母亲对儿童的艾滋病毒状况，其中包括：提高母亲的自我效能感，以披露和回答有关艾滋病毒的儿童问题； b。减少母亲对披露和污名的恐惧； c。提高孕产妇对儿童发育的了解以及如何在孩子的年龄中提供适当水平的信息； 2。随着时间的推移改善MLH心理健康指标（即抑郁，焦虑，生活质量）； 3。随着时间的流逝，改善儿童心理健康指标（即抑郁，焦虑，表现行为）；和4。改善家庭功能指标（例如，凝聚力，母亲和儿童之间的亲密关系）。