HIV Prevention Through Multilevel Intervention to Promote Women-Initiated Options

通过多层次干预促进妇女发起的选择来预防艾滋病毒

• 批准号: 8207942
• 负责人: MARGARET R. WEEKS
• 金额: $ 75.47万
• 依托单位: INSTITUTE FOR COMMUNITY RESEARCH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-15 至 2013-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8207942
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adoption; Advocacy; Advocate; Agreement; Awareness; Barrier Contraception; Businesses; Cities; Clinic; Communities; Community Actions; Community Health; Complex; Couples; Cross-Sectional Studies; Development; Dimensions; Educational Curriculum; Effectiveness; Elements; Ensure; Environment; Epidemic; Ethics; Ethnography; Evaluation; Female Condoms; Gender Role; Goals; HIV; Health; Health Services; Health behavior outcomes; Heterosexuals; Incidence; Individual; Infection; Infection prevention; Intervention; Intervention Community Trial; Intervention Studies; Interview; Knowledge; Letters; Low income; Male Condoms; Mediating; Mediation; Methods; Modeling; Outcome; Pharmacy facility; Polyurethanes; Population; Populations at Risk; Pregnancy; Prevention; Prevention Research; Process; Protocols documentation; Provider; Public Health; Randomized Controlled Trials; Reproductive Health; Research; Risk; Role; Services; Sexually Transmitted Diseases; Social Environment; Social Health Services; Social Work; Study Section; Target Populations; Testing; Time; Training; Woman; Work; addiction; base; child bearing; community intervention; design; empowerment; ethnic minority population; follow-up; health organization; high risk; improved; interest; intervention effect; meetings; member; men; pandemic disease; peer; prevent; reproductive; sex; skills; social; theories; therapy design; therapy development; transmission process; vaginal microbicide; willingness

DESCRIPTION (provided by applicant): Heterosexual HIV transmission continues to be one of the most tenacious problems for reversing the epidemic, and incidence among women increases disproportionately in certain populations, particularly U.S. ethnic minorities, low-income and impoverished women. It is essential that women have available all effective prevention methods, including some they can initiate and control, in order to reduce heterosexual HIV risk. The goal of this 5-year study entitled, "Enhancing HIV Prevention Through Multi-level Community Intervention to Promote Women-Initiated Prevention Options," is to increase the community availability, accessibility, and support for use of the female condom (FC), as currently the most effective woman-initiated HIV/STI prevention option. Evidence increasingly supports the development of theoretically driven multi-level interventions, using a community-empowerment model to mobilize sectors of the community to move the issue forward in a sustained way. This study will use a community-based approach to develop and implement a multi-level community intervention by mobilizing and building the capacity of a body of key community agents, who will collectively develop and implement interventions at the community, organizational, and individual levels to achieve the project goals. A comprehensive dynamic trial (CDT) of this community intervention will be conducted first in Hartford, CT, and then repeated in New Britain, CT to identify core process and content needed for replication. The aims of the study are to: 1) create local Community Action and Advocacy Boards (CAABs) and build their capacity to develop, implement and evaluate a multi-level intervention designed to promote availability, accessibility, and support for FC in their community; 2) assist the CAABs to customize and tailor interventions promoting FC targeting multiple levels of the community with consistent messages/materials; 3) in two study communities sequentially, implement and test the ability of the multi-level intervention to increase availability, accessibility, and support for FC in organizations, and to increase awareness, knowledge, use and negotiation skills, ability to access, and willingness and efficacy to request, try, and use the FC among at-risk women and their partners in that community; 4) assess the sustainability of the CAABs and the CAAB- developed interventions; and 5) manualize the CAAB training protocol, and identify core elements of the community-based multi-level intervention needed for adaptation and implementation in other communities. The CDT will use intensive and iterative ethnographic process and outcome evaluation, repeated community assessments (observations and interviews) every 6 months in all local organizations and businesses that provide health, reproductive and sex information and products to document community and organizational level changes, and 3 cross-sectional surveys with at-risk target population members every 12 months to assess the impact and effects of the CAAB interventions on individuals in targeted high risk sectors of the community. PUBLIC HEALTH RELEVANCE: The proposed study will test a community participatory approach to developing and implementing a multi-level community intervention to increase availability, accessibility, and support for female condoms (FC), thereby increasing their use for the reduction of heterosexually transmitted HIV. Creation and capacity building of a local community coalition (the Community Action and Advocacy Board-CAAB) in each of two study towns is designed to increase local relevance and effectiveness of the CAAB-developed and implemented multi-level intervention(s) and to increase sustainability of intervention effects in their community.

描述（由申请人提供）：异性恋艾滋病毒传播仍然是扭转艾滋病毒流行最棘手的问题之一，在某些人群中，女性的发病率不成比例地增加，特别是美国少数民族、低收入和贫困妇女。至关重要的是，妇女拥有所有有效的预防方法，包括她们可以启动和控制的一些方法，以降低异性恋艾滋病毒风险。这项题为“通过多层次社区干预加强艾滋病毒预防，促进妇女发起的预防选择”的为期 5 年的研究的目标是增加社区对女用避孕套 (FC) 使用的可用性、可及性和支持，作为目前由妇女发起的最有效的艾滋病毒/性传播感染预防方案。越来越多的证据支持理论驱动的多层次干预措施的发展，利用社区赋权模式来动员社区各部门以持续的方式推动问题的发展。本研究将采用基于社区的方法，通过动员和建设关键社区代理人的能力来制定和实施多层次的社区干预措施，他们将在社区、组织和个人层面共同制定和实施干预措施，以实现项目目标。该社区干预的全面动态试验（CDT）将首先在康涅狄格州哈特福德进行，然后在康涅狄格州新不列颠重复进行，以确定复制所需的核心流程和内容。该研究的目的是：1) 创建当地社区行动和倡导委员会 (CAAB)，并培养其开发、实施和评估多层次干预措施的能力，旨在提高社区中 FC 的可用性、可及性和支持； 2) 协助 CAAB 针对社区的多个层面定制和定制促进 FC 的干预措施，并提供一致的信息/材料； 3) 依次在两个研究社区中实施和测试多层次干预的能力，以提高组织中 FC 的可用性、可及性和支持，并提高意识、知识、使用和谈判技巧、接触能力和意愿以及在该社区的高危妇女及其伴侣中请求、尝试和使用 FC 的有效性； 4) 评估 CAAB 和 CAAB 制定的干预措施的可持续性； 5) 将 CAAB 培训方案手册化，并确定其他社区适应和实施所需的基于社区的多层次干预的核心要素。 CDT 将使用密集和迭代的人种学过程和结果评估，每 6 个月对所有提供健康、生殖和性信息及产品的当地组织和企业进行重复的社区评估（观察和访谈），以记录社区和组织层面的变化，以及 3每 12 个月对高危目标人群进行一次横断面调查，以评估 CAAB 干预措施对社区目标高风险群体中个人的影响和效果。 公共卫生相关性：拟议的研究将测试社区参与方法，以制定和实施多层次社区干预措施，以提高女用避孕套 (FC) 的可用性、可及性和支持，从而增加其使用，减少异性传播艾滋病毒。在两个研究城镇中分别创建当地社区联盟（社区行动和倡导委员会 -CAAB）并进行能力建设，旨在提高 CAAB 制定和实施的多层次干预措施的当地相关性和有效性，并提高社区干预效果的可持续性。

项目成果

Structural issues affecting creation of a community action and advocacy board.

• DOI: 10.1093/her/cyt051
• 发表时间: 2013-06
• 期刊: Health education research
• 影响因子: 2.4
• 作者: Margaret R. Weeks;Maryann Abbott;Helena Hilario;K. Radda;Z. Medina;M. Prince;Jianghong Li;C. Kaplan