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

2/2-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：
8662797
负责人：
LISA P ARMISTEAD
金额：
$ 21.09万
依托单位：
GEORGIA STATE UNIVERSITY
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/8662797
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，本合作 R01 的目的是进行一项全面的干预试验，以帮助感染艾滋病毒的母亲 (MLH) 向她们的孩子披露她们的血清状况（年龄6-14岁），好孩子。干预措施的试点研究最近已完成（R01 MH077493）并实现了其主要目标。试点干预措施的开发基础是三名 R01（MH057207，目前为 14 年级）的工作，旨在纵向评估 MLH 及其子女。在这项工作中，进行了几项关于母亲披露的研究（例如，Murphy, Marelich, & Hoffman, 2002；Murphy, Roberts, & Hoffman, 2002；Murphy, Roberts, & Hoffman, 2003；Murphy, Roberts, & Hoffman, 2006；Murphy, Roberts, & Hoffman, 2006；Murphy, Roberts, & Hoffman, 2003）。 Murphy、Steers 和 Dello Stritto，2001），表明披露很困难，并且通过干预可以改善 MLH 和儿童的结果。这项试点研究在社区中被称为“教学、抚养和与孩子沟通”(TRACK)，它基于综合披露理论（Derlega 等人，2004 年）。试点试验的结果表明，干预组的人数是其六倍 9 个月的随访显示，与对照组相比，有 33% 的 MLH 更有可能向孩子透露自己的 HIV/艾滋病状况（OR 6.33），而对照组的这一比例仅为 7.3%。也许更重要的是，与对照组相比，干预组的情绪功能和满意度在干预后显着改善。同样，干预MLH儿童的心理健康指标在随访时也显着优于对照组儿童。在这项研究 TRACK II 中，我们建议在两个地点进行全面的干预试验：(1) 洛杉矶县（地点 1，进行试点试验的地方），其中将包括高比例的拉丁裔家庭以及较小比例的非裔美国人和白人家庭； (2) 佐治亚州亚特兰大（地点 2，试点试验的主要顾问在此进行研究），其中将包括很大比例的南部非洲裔美国家庭以及白人家庭。 MLH 及其子女（总共 N = 440 名；每个中心 110 名母亲和 110 名儿童，每个中心 n = 220 名）将在基线以及 3、9 和 15 个月的随访时进行评估。 MLH 将被随机分配至干预组或对照组。目标是： 1. 促进向儿童披露母亲的艾滋病毒状况，其中包括以下次要目标：提高母亲披露和回答儿童有关艾滋病毒问题的自我效能； b.减少母亲对信息披露和耻辱的恐惧； c.提高母亲对儿童发育的了解以及如何根据儿童年龄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. 随着时间的推移，改善儿童心理健康指标（即抑郁、焦虑、表现行为）； 4. 改善家庭功能指标（例如，母子之间的凝聚力、亲密感）。