Mechanisms of Behavior Change Resource Core for Alcohol-HIV Interventions

酒精-艾滋病毒干预措施的行为改变资源核心机制

• 批准号: 8548212
• 负责人: Christopher W. Kahler
• 金额: $ 60.29万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-20 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8548212
• 关键词: AIDS/HIV problem; Accident and Emergency department; Address; Adherence; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Audiotape; Behavior; Behavioral; Characteristics; Clinical Trials; Code; Cognitive; Collaborations; Comorbidity; Counseling; Data; Epidemic; Fostering; Future; Glean; HIV; HIV Infections; Heavy Drinking; Hepatic; Highly Active Antiretroviral Therapy; Human immunodeficiency virus test; Institution; Intervention; Language; Learning; Life; Literature; Mediation; Medical; Methods; Minority Groups; Modality; National Institute on Alcohol Abuse and Alcoholism; Nurses; Outcome; Outcomes Research; Patients; Persons; Pharmacotherapy; Physicians; Population; Professional counselor; Provider; Psychologist; Randomized Clinical Trials; Research; Research Personnel; Resources; Risk Factors; Safe Sex; Social Workers; Systems Analysis; Technology; Training; Universities; Unsafe Sex; Work; alcohol intervention; alcohol research; base; behavior change; brief intervention; design; drinking; evidence base; health care service utilization; high risk; high risk sexual behavior; insight; interest; medication compliance; men who have sex with men; motivational enhancement therapy; reduced alcohol use; sex risk; skills

DESCRIPTION (provided by applicant): Clinical trials to reduce heavy alcohol use in people living with HIV (PLWH) and those at high risk for HIV infection are currently being conducted through NIAAA-supported Consortia for HIV/AIDS and Alcohol-Related Outcomes Research Trials (CHAARTs). The overall objective of this proposal is to maximize the information gleaned from these trials to enable better design of evidence-based alcohol-HIV counseling interventions. While a good deal is known from the Motivational Interviewing literature about mechanisms of behavior change in counseling approaches for alcohol and other substance use, little is known about change mechanisms in interventions that focus on sexual risk behaviors or medication adherence, and there is a dearth of work on mechanisms of multiple behavior change. To address this gap, we will create a Mechanisms of Behavior Change Resource Core (MBCRC) within the Brown University Alcohol Research Center on HIV that will code provider-patient dialogues in five ongoing CHAART trials using two distinct coding systems. Specifically, we will adapt the Motivational Interviewing Skills Code to code both alcohol and HIV-relevant provider and patient language in alcohol-HIV interventions and apply the Generalized Medical Interaction Analysis System to examine factors that influence outcomes in alcohol-HIV interventions outside of motivationally-focused behavior change counseling. Overall, the MBCRC will transcribe and code provider-patient interactions across approximately 1,000 20-90, minute intervention sessions from four ongoing randomized clinical trials and one implementation study. Coding data will be used to predict future alcohol use, acceptance and use of alcohol pharmacotherapy, high-risk sex, HAART adherence, and HIV testing. Results will provide crucial insights about provider behaviors and skills that are most effective in fostering changes in drinking and HIV-relevant behaviors in identified high-risk populations, as well as key barriers to change. Results will have direct relevance (a) for training providers who work with HIV patients and those at high risk for HIV infection and (b) for the improvement and implementation of alcohol-HIV interventions in a range of contexts and populations.

描述（由申请人提供）：目前正在通过 NIAAA 支持的艾滋病毒/艾滋病和酒精相关结果研究试验联盟进行减少艾滋病毒感染者 (PLWH) 和艾滋病毒感染高危人群大量饮酒的临床试验（图表）。该提案的总体目标是最大限度地利用这些试验收集的信息，以便更好地设计基于证据的酒精-艾滋病毒咨询干预措施。虽然从动机访谈文献中可以了解到很多关于酒精和其他物质使用咨询方法中行为改变机制的信息，但对于关注性危险行为或药物依从性的干预措施的改变机制知之甚少，而且缺乏研究多种行为改变的机制。为了弥补这一差距，我们将在布朗大学艾滋病毒酒精研究中心内创建行为改变资源核心机制 (MBCRC)，该机制将使用两种不同的编码系统对五项正在进行的 CHARART 试验中的提供者与患者的对话进行编码。具体来说，我们将采用动机访谈技能代码，对酒精-艾滋病毒干预措施中与酒精和艾滋病毒相关的提供者和患者语言进行编码，并应用通用医疗互动分析系统来检查在动机性之外影响酒精-艾滋病毒干预结果的因素。重点行为改变咨询。总体而言，MBCRC 将转录和编码来自四项正在进行的随机临床试验和一项实施研究的大约 1,000 个 20-90 分钟的干预会议。编码数据将用于预测未来的饮酒情况、酒精药物疗法的接受和使用、高危性行为、HAART 依从性和 HIV 检测。结果将提供有关提供者行为和技能的重要见解，这些行为和技能最有效地促进已确定的高危人群中饮酒和艾滋病毒相关行为的改变，以及改变的主要障碍。结果将直接影响 (a) 与艾滋病毒患者和艾滋病毒感染高危人群一起工作的培训提供者，以及 (b) 在一系列环境和人群中改进和实施酒精艾滋病毒干预措施。