Mentor Mothers: A Sustainable Family Intervention in South African Townships

导师母亲：南非乡镇的可持续家庭干预

• 批准号: 7168117
• 负责人: Mary Jane Rotheram-Borus
• 金额: $ 71.8万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-19 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7168117
• 关键词: AIDS; AIDS education /prevention; Africa; HIV infections; awareness; behavior therapy; behavioral /social science research tag; child rearing; child welfare; clinical research; communicable disease transmission; experimental designs; health behavior; human subject; human therapy evaluation; longitudinal human study; mentoring /mentor; mother /infant health care; mother child interaction; outcomes research; rural area; social support network; therapy compliance; therapy design /development; urban area; women' s health

DESCRIPTION (provided by applicant): South Africa has 5 million persons living with HIV (2.7 million women of childbearing age), the country with the most persons living with HIV (UNAIDS, 2004a). Fortunately, HIV testing and access to antiretroviral drugs (ARV) to prevent mother-to-child transmission (MTCT) of HIV from HIV+ pregnant women and their babies is being scaled up . Yet, 40.7% of pregnant women are HIV seropositive (HIV+) in townships such as those in the KwaZulu-Natal (KZN) Province of South Africa (Department of Public Health, South Africa, 2004). This project is primarily aimed at enhancing the adjustment of children of MLH by improving the health and mental health of MLH which benefits their children, as well as the MLH. The Mothers' Programmes (TMP) is a community based non-government organization, operating in South Africa including the Western and Eastern Cape, KZN, Mpumalanga and Northern Cape Provinces and two other African countries, Ethiopia and Botswana. TMP provides wrap-around preventive social support and educational services for MLH at MTCT clinic sites. The proposed project aims to transform the existing TMP into a theoretically-based, sustainable behavioral prevention program (the Mothers-To-Mothers [M2M] intervention) that will improve the adjustment of MLH and their babies. Rather than design an intervention that then must adapt itself to a delivery vehicle, we will take a delivery vehicle (TMP) and enhance its efficacy by creating the M2M intervention. We propose a two phase project over five years. In Phase 1 over the first year, we will finalize all measures, procedures, recruitment of staff, training protocols, and intervention manuals and strategies. In Phase 2, a quasi-experimental design will be implemented with 1632 MLH at 8 clinics (204 mothers/ clinic). Study clinics will be selected that provide environmental access to these services from two strata (large, peri-urban clinics [4 clinics] & small, rural clinics [4 clinics]). All MLH in 8 clinics (n = 1632) will be randomly assigned by clinic within strata to either: 1) standard care (SC), the health care that is delivered by the province; or 2) an enhanced care intervention condition (Mothers-to- Mothers [M2M]). The M2M intervention will be focused on caring for one's own health, parenting one's baby, maintaining mental health, and reducing transmission. The intervention's impact will be assessed over 15 months in a design that is a blend of an efficacy and effectiveness trial.

描述（由申请人提供）：南非有 500 万艾滋病毒感染者（270 万育龄妇女），是艾滋病毒感染者最多的国家（联合国艾滋病规划署，2004a）。幸运的是，艾滋病毒检测和抗逆转录病毒药物（ARV）的获取正在扩大，以防止艾滋病毒阳性孕妇及其婴儿的艾滋病毒母婴传播（MTCT）。然而，在南非夸祖鲁-纳塔尔省 (KZN) 等乡镇，40.7% 的孕妇艾滋病毒血清呈阳性 (HIV+)（南非公共卫生部，2004 年）。该项目主要旨在通过改善 MLH 的健康和心理健康来增强 MLH 子女的适应能力，这对他们的孩子以及 MLH 都有好处。母亲计划 (TMP) 是一个以社区为基础的非政府组织，在南非开展业务，包括西开普省和东开普省、夸大省、普马兰加省和北开普省以及另外两个非洲国家埃塞俄比亚和博茨瓦纳。 TMP 在 MTCT 诊所为 MLH 提供全方位的预防性社会支持和教育服务。拟议项目旨在将现有的 TMP 转变为基于理论的可持续行为预防计划（母亲对母亲 [M2M] 干预），以改善 MLH 及其婴儿的适应能力。我们不会设计一种必须适应运载工具的干预措施，而是采用运载工具 (TMP) 并通过创建 M2M 干预措施来增强其功效。我们提出了一个为期五年的两阶段项目。在第一年的第一阶段，我们将最终确定所有措施、程序、员工招聘、培训方案以及干预手册和策略。在第二阶段，将在 8 个诊所（204 名母亲/诊所）的 1632 名 MLH 中实施准实验设计。将选择从两个层次（大型城郊诊所[4 个诊所]和小型农村诊所[4 个诊所]）提供获得这些服务的环境通道的研究诊所。 8 个诊所 (n = 1632) 的所有 MLH 将按阶层内的诊所随机分配到： 1) 标准护理 (SC)，即由省提供的医疗保健；或 2) 强化护理干预条件（母亲对母亲 [M2M]）。 M2M 干预措施将侧重于照顾自己的健康、养育婴儿、保持心理健康和减少传播。干预措施的影响将在 15 个月内通过功效和效果试验相结合的设计进行评估。